BIOD 331 EXAM STUDY GUIDE QUESTIONS
AND ANSWERS 100% CORRECT
◍ Your client experiencing acidosis has all of the following
symptoms. Which one indicates to you that the acidosis is worsening?
a) The client is lethargic.
b) The client's deep tendon reflexes are 2+.
c) The patient has decreased urine output.
d) Trouseau's sign is positive.. Answer: a) The client is lethargic
*This would be congruent with hypocalcemia. Hypercalemia is
associated with acidosis.
◍ The nurse is caring for a group of clients on a medical surgical unit.
For which of these individuals does the nurse provide immediate
interventions to reduce the risk for pulmonary embolism (PE)?
a) A client receiving IV fluids through a peripheral line
b) A client returning from an open reduction and internal fixation of
the tibia
c) A client with diabetes and cellulitis of the leg
d) A client with fluid volume deficit and hypokalemia receiving
potassium supplements. Answer: b) A client returning from an open
reduction and internal fixation of the tibia
,*Surgery and perioperative immobility are very high risks for DVT
and PE. Orthopedic surgery compounds this risk.
*No evidence suggests that the client with DM is immobile, which is
a risk factor for PE.
*While severe fluid volume deficit and resulting hemoconcentration
may pose a risk for thrombosis, this is not as common as
thromboembolic complications after orthopedic surgery
◍ The nurse is caring for a group of clients on a Telemetry unit.
When providing client education, which client will the nurse
determine most needs information regarding preventing pulmonary
embolism (PE)?
a) A woman with a bleeding disorder
b) A man who works on a farm
c) A woman who frequently flies to Europe
d) A man admitted for a myocardial infarction. Answer: c) A woman
who frequently flies to Europe
*Individuals who engage in prolonged and frequent air travel are at
higher risk for PE due to the dependent position of the legs during
long air flights.
*farmer poses a low risk due to active lifestyle
*MI is caused by a thrombus or occlusion of the coronary arteries, not
of the leg veins. If the MI client is on prolonged bedrest, the client's
risk is increased.
,◍ The nurse is developing a plan of care for a client with PE. Which
client problem does the nurse establish as the priority?
a) Risk for infection related to leukocytosis
b) Inadequate nutrition related to food-drug interactions with
anticoagulant therapy
c) Hypoxemia related to ventilation-perfusion mismatch
d) Insufficient knowledge related to the cause of PE. Answer: c)
Hypoxemia related to ventilation-perfusion mismatch
*Restoring adequate oxygenation and tissue perfusion takes priority.
Obstruction of blood flow through the pulmonary artery or branches
impairs ability of the alveoli to deliver O2 to the L side of the heart;
the resulting hypoxemia may be profound. Initially the pt breathes
more rapidly and eliminates CO2 causing respiratory alkalosis.
*A large PE causes hypoventilation and prolonged hyperventilation
causes muscle fatigue and hypoventilation leading to respiratory
acidosis.
*Although nutrition must be addressed, priorities include airway,
breathing, and circulation.
◍ The nurse is reviewing the medical record of a client with PE.
What priority does the nurse set after reviewing the blood gas result
below? pH 7.46, PaCO2 30, HCO3 26, PaO2 62
a) Have the client breathe rapidly and deeply
b) Apply oxygen
c) Collaborate with the provider to increase the pH
d) Administer sodium bicarbonate. Answer: b) Apply oxygen
, *Hypoxemia is present, demonstrated by PaO2 below 80.
Supplemental O2 is needed to improve tissue perfusion.
Hyperventilation triggered by hypoxemia and pain 1st leads to
respiratory alkalosis, indicated by a low PaCO2 of 30 and a high pH
7.46. Breathing more rapidly and deeply will continue to "blow off"
CO2 and cause further alkalosis.
◍ When caring for a client with a pulmonary embolism, which
priority intervention will the nurse use to reduce anxiety?
a) Have the client breathe into a brown paper bag using pursed lips.
b) Remain with the client and provide oxygen in a calm manner.
c) Offer the client a mild sedative.
d) Allow a family member to remain in the room.. Answer: b) Remain
with the client and provide oxygen in a calm manner.
*Anxiety, agitation, tachycardia, and restlessness are early symptoms
of hypoxemia, which occurs with a PE. The priority nursing
intervention is to correct hypoxemia, the underlying cause of anxiety.
O2 will help to alleviate this problem.
*Rebreathing from a brown paper bag is an intervention that increases
PaCO2 during hyperventilation, as in a panic attack; it will not
provide needed O2 and tissue perfusion. Sedation and/or allowing a
family member to stay may calm the client, but will not improve
oxygenation and may delay appropriate treatment.
AND ANSWERS 100% CORRECT
◍ Your client experiencing acidosis has all of the following
symptoms. Which one indicates to you that the acidosis is worsening?
a) The client is lethargic.
b) The client's deep tendon reflexes are 2+.
c) The patient has decreased urine output.
d) Trouseau's sign is positive.. Answer: a) The client is lethargic
*This would be congruent with hypocalcemia. Hypercalemia is
associated with acidosis.
◍ The nurse is caring for a group of clients on a medical surgical unit.
For which of these individuals does the nurse provide immediate
interventions to reduce the risk for pulmonary embolism (PE)?
a) A client receiving IV fluids through a peripheral line
b) A client returning from an open reduction and internal fixation of
the tibia
c) A client with diabetes and cellulitis of the leg
d) A client with fluid volume deficit and hypokalemia receiving
potassium supplements. Answer: b) A client returning from an open
reduction and internal fixation of the tibia
,*Surgery and perioperative immobility are very high risks for DVT
and PE. Orthopedic surgery compounds this risk.
*No evidence suggests that the client with DM is immobile, which is
a risk factor for PE.
*While severe fluid volume deficit and resulting hemoconcentration
may pose a risk for thrombosis, this is not as common as
thromboembolic complications after orthopedic surgery
◍ The nurse is caring for a group of clients on a Telemetry unit.
When providing client education, which client will the nurse
determine most needs information regarding preventing pulmonary
embolism (PE)?
a) A woman with a bleeding disorder
b) A man who works on a farm
c) A woman who frequently flies to Europe
d) A man admitted for a myocardial infarction. Answer: c) A woman
who frequently flies to Europe
*Individuals who engage in prolonged and frequent air travel are at
higher risk for PE due to the dependent position of the legs during
long air flights.
*farmer poses a low risk due to active lifestyle
*MI is caused by a thrombus or occlusion of the coronary arteries, not
of the leg veins. If the MI client is on prolonged bedrest, the client's
risk is increased.
,◍ The nurse is developing a plan of care for a client with PE. Which
client problem does the nurse establish as the priority?
a) Risk for infection related to leukocytosis
b) Inadequate nutrition related to food-drug interactions with
anticoagulant therapy
c) Hypoxemia related to ventilation-perfusion mismatch
d) Insufficient knowledge related to the cause of PE. Answer: c)
Hypoxemia related to ventilation-perfusion mismatch
*Restoring adequate oxygenation and tissue perfusion takes priority.
Obstruction of blood flow through the pulmonary artery or branches
impairs ability of the alveoli to deliver O2 to the L side of the heart;
the resulting hypoxemia may be profound. Initially the pt breathes
more rapidly and eliminates CO2 causing respiratory alkalosis.
*A large PE causes hypoventilation and prolonged hyperventilation
causes muscle fatigue and hypoventilation leading to respiratory
acidosis.
*Although nutrition must be addressed, priorities include airway,
breathing, and circulation.
◍ The nurse is reviewing the medical record of a client with PE.
What priority does the nurse set after reviewing the blood gas result
below? pH 7.46, PaCO2 30, HCO3 26, PaO2 62
a) Have the client breathe rapidly and deeply
b) Apply oxygen
c) Collaborate with the provider to increase the pH
d) Administer sodium bicarbonate. Answer: b) Apply oxygen
, *Hypoxemia is present, demonstrated by PaO2 below 80.
Supplemental O2 is needed to improve tissue perfusion.
Hyperventilation triggered by hypoxemia and pain 1st leads to
respiratory alkalosis, indicated by a low PaCO2 of 30 and a high pH
7.46. Breathing more rapidly and deeply will continue to "blow off"
CO2 and cause further alkalosis.
◍ When caring for a client with a pulmonary embolism, which
priority intervention will the nurse use to reduce anxiety?
a) Have the client breathe into a brown paper bag using pursed lips.
b) Remain with the client and provide oxygen in a calm manner.
c) Offer the client a mild sedative.
d) Allow a family member to remain in the room.. Answer: b) Remain
with the client and provide oxygen in a calm manner.
*Anxiety, agitation, tachycardia, and restlessness are early symptoms
of hypoxemia, which occurs with a PE. The priority nursing
intervention is to correct hypoxemia, the underlying cause of anxiety.
O2 will help to alleviate this problem.
*Rebreathing from a brown paper bag is an intervention that increases
PaCO2 during hyperventilation, as in a panic attack; it will not
provide needed O2 and tissue perfusion. Sedation and/or allowing a
family member to stay may calm the client, but will not improve
oxygenation and may delay appropriate treatment.
