H ABG quiz GRADE A Q&A
The client presents to the emergency department with nausea, vomiting and anorexia
for the last few days. Based on the EKG obtained, what action should the nurse take
first?
ExhibitYou answered this question Incorrectly
1. Defibrillate at 200 joules x 2
2. Administer amiodarone IV 150 mg over 10 minutes
3. Infuse 500 mL NS with 40 mEq KCL (40 mmol/L) at 100 mL/hour
4. Begin 2 person cardiopulmonary resuscitation
Rationale
Strategies
Let's Talk - (correct answer)2. Correct: The one electrolyte we worry about with
arrhythmias is potassium. The first line medication is amiodarone.
1. Incorrect: Pulseless v-tach and v-fib require defibrillation.
3. Incorrect: KCL is needed but we need to treat the short run of v-tach first.
4. Incorrect: Not indicated. Treat short run of v-tach and increase potassium.
First, note the word FIRST in the question. So all option could be correct, but one takes
priority. Next, identify the clues in the question, such as "nausea", "vomiting", and
"anorexia". What electrolyte should the nurse worry about when these clues are seen?
Low potassium. The client has been vomiting, so the electrolytes losses are potassium,
hydrogen, and chloride. The anorexia further complicates the condition because we get
potassium from the foods we eat. Knowing this, you would be concerned that ventricular
tachycardia or ventricular fibrillation could occur. So, look at the strip. You should have a
basic knowledge of interpreting rhythm strips to identify the rhythm shown in the exhibit.
This EKG shows short runs of ventricular tachycardia. So what is the first thing the
nurse should do for v-tach. Give amiodarone, an antiarrhythmic medication. The
question does not say that the client is pulseless, so do not read into the question.
Pulseless v-tach would indicate the need for defibrillation. The client probably needs
potassium, but correcting the v-tach takes priority. CPR is initiated with pulseless v-tach.
,A client with a diagnosis of heart failure is observed in Fowler's position states, "I can't
get my breath". What is the priority intervention for this client?
You answered this questionIncorrectly
1. Dangle the client's legs over the side of the bed.
2. Auscultate anterior and posterior lung fields bilaterally.
3. Call respiratory therapy to the room stat to bring an oxygen mask.
4. Administer PRN morphine sulfate 2 mg IVP via existing venous access device. -
(correct answer)1. Correct: Since the client is already in a Fowler's position,the correct
option would be to "Dangle the client's legs over the side of the bed." The reason is that
by dangling the legs, blood is pooling in the periphery. This decreases the circulating
blood volume so that the heart does not have to work as hard and blood will then go in a
forward direction rather than going backward to the lungs.
2. Incorrect: This is assessment. The question is asking for an intervention.
3. Incorrect: This may take time. Do something to help the client immediately first.
4. Incorrect: The stem does not indicate that the client is experiencing any pain.
A nurse is caring for a client who had an abdominal hernia repair 16 hours ago. What
interpretation should the nurse make based on the results of the client's arterial blood
gases (ABGs)?
ExhibitYou answered this questionCorrectly
1. Metabolic acidosis
2. Respiratory acidosis
3. Metabolic alkalosis
4. Respiratory alkalosis
pH - 7.32
, PaO2 - 93%
PaCO2 - 48
HCO3 - 24 - (correct answer)2. Correct: The pH is 7.32 (normal 7.35-7.45) which means
acidosis. The paCO2 of 48 (normal 35-45) indicates a respiratory problem. The arterial
blood gas results indicate that the client is in respiratory acidosis.
1. Incorrect: This is a respiratory problem. The bicarb is within normal limits, eliminating
a metabolic problem.
3. Incorrect: The pH is low which indicates acidosis. The bicarb is within normal limits,
eliminating a metabolic problem.
4. Incorrect: The pH is low, which indicates acidosis.
A client with asthma has been admitted to the emergency room with sustained burns to
the upper torso, face, and neck as a result of a steam injury when a pressure cooker
exploded at home. Which intervention is the nurse's priority?
You answered this questionCorrectly
1. Initiate high flow oxygen.
2. Prepare for endotracheal intubation.
3. Administer 1000mL of lactate ringers (LR).
4. Assess for head and neck injuries. - (correct answer)2. Correct: Intubation must be
accomplished quickly while a tube can still be inserted. The burn clients neck and facial
area may become edematous due to capillary permeability. This can be done while
assuming the client may have a head and neck injury due to the explosion
.
1. Incorrect: The clients airway is the initial concern. The ventilation of the client is the
next step. Respiratory distress is an increase potenial due to pre existing diagnosis of
asthma.
3. Incorrect: Fluid resuscitation is needed, however, airway comes first. The client will
need IV fluids to replace the transfer of plasma to interstitual tissue.
The client presents to the emergency department with nausea, vomiting and anorexia
for the last few days. Based on the EKG obtained, what action should the nurse take
first?
ExhibitYou answered this question Incorrectly
1. Defibrillate at 200 joules x 2
2. Administer amiodarone IV 150 mg over 10 minutes
3. Infuse 500 mL NS with 40 mEq KCL (40 mmol/L) at 100 mL/hour
4. Begin 2 person cardiopulmonary resuscitation
Rationale
Strategies
Let's Talk - (correct answer)2. Correct: The one electrolyte we worry about with
arrhythmias is potassium. The first line medication is amiodarone.
1. Incorrect: Pulseless v-tach and v-fib require defibrillation.
3. Incorrect: KCL is needed but we need to treat the short run of v-tach first.
4. Incorrect: Not indicated. Treat short run of v-tach and increase potassium.
First, note the word FIRST in the question. So all option could be correct, but one takes
priority. Next, identify the clues in the question, such as "nausea", "vomiting", and
"anorexia". What electrolyte should the nurse worry about when these clues are seen?
Low potassium. The client has been vomiting, so the electrolytes losses are potassium,
hydrogen, and chloride. The anorexia further complicates the condition because we get
potassium from the foods we eat. Knowing this, you would be concerned that ventricular
tachycardia or ventricular fibrillation could occur. So, look at the strip. You should have a
basic knowledge of interpreting rhythm strips to identify the rhythm shown in the exhibit.
This EKG shows short runs of ventricular tachycardia. So what is the first thing the
nurse should do for v-tach. Give amiodarone, an antiarrhythmic medication. The
question does not say that the client is pulseless, so do not read into the question.
Pulseless v-tach would indicate the need for defibrillation. The client probably needs
potassium, but correcting the v-tach takes priority. CPR is initiated with pulseless v-tach.
,A client with a diagnosis of heart failure is observed in Fowler's position states, "I can't
get my breath". What is the priority intervention for this client?
You answered this questionIncorrectly
1. Dangle the client's legs over the side of the bed.
2. Auscultate anterior and posterior lung fields bilaterally.
3. Call respiratory therapy to the room stat to bring an oxygen mask.
4. Administer PRN morphine sulfate 2 mg IVP via existing venous access device. -
(correct answer)1. Correct: Since the client is already in a Fowler's position,the correct
option would be to "Dangle the client's legs over the side of the bed." The reason is that
by dangling the legs, blood is pooling in the periphery. This decreases the circulating
blood volume so that the heart does not have to work as hard and blood will then go in a
forward direction rather than going backward to the lungs.
2. Incorrect: This is assessment. The question is asking for an intervention.
3. Incorrect: This may take time. Do something to help the client immediately first.
4. Incorrect: The stem does not indicate that the client is experiencing any pain.
A nurse is caring for a client who had an abdominal hernia repair 16 hours ago. What
interpretation should the nurse make based on the results of the client's arterial blood
gases (ABGs)?
ExhibitYou answered this questionCorrectly
1. Metabolic acidosis
2. Respiratory acidosis
3. Metabolic alkalosis
4. Respiratory alkalosis
pH - 7.32
, PaO2 - 93%
PaCO2 - 48
HCO3 - 24 - (correct answer)2. Correct: The pH is 7.32 (normal 7.35-7.45) which means
acidosis. The paCO2 of 48 (normal 35-45) indicates a respiratory problem. The arterial
blood gas results indicate that the client is in respiratory acidosis.
1. Incorrect: This is a respiratory problem. The bicarb is within normal limits, eliminating
a metabolic problem.
3. Incorrect: The pH is low which indicates acidosis. The bicarb is within normal limits,
eliminating a metabolic problem.
4. Incorrect: The pH is low, which indicates acidosis.
A client with asthma has been admitted to the emergency room with sustained burns to
the upper torso, face, and neck as a result of a steam injury when a pressure cooker
exploded at home. Which intervention is the nurse's priority?
You answered this questionCorrectly
1. Initiate high flow oxygen.
2. Prepare for endotracheal intubation.
3. Administer 1000mL of lactate ringers (LR).
4. Assess for head and neck injuries. - (correct answer)2. Correct: Intubation must be
accomplished quickly while a tube can still be inserted. The burn clients neck and facial
area may become edematous due to capillary permeability. This can be done while
assuming the client may have a head and neck injury due to the explosion
.
1. Incorrect: The clients airway is the initial concern. The ventilation of the client is the
next step. Respiratory distress is an increase potenial due to pre existing diagnosis of
asthma.
3. Incorrect: Fluid resuscitation is needed, however, airway comes first. The client will
need IV fluids to replace the transfer of plasma to interstitual tissue.
