CHA EXAM 2 CASE STUDIES EXAM QUESTIONS
AND ANSWERS 100% CORRECT!!
,What acid-base imbalance is occurring? Is there compensation occurring?
A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
A urinary catheter is put in place and over 5 hours there is a total output of 110 mL of
amber, clear urine. The patient says he has vomited one to two times in the last 2 days
and has had no bowel movement in the last 3 days; he normally has a bowel movement
daily. Auscultation of the abdomen reveals hypoactive bowel sounds. The skin is intact,
slightly moist, and pale, with no rash or wounds. The patient is alert and oriented to
person, place, and time. He can move all extremities and can follow simple commands.
A: Focused Assessment Findings:
Vital signs are: BP 80/47 mm Hg, HR 117 beats/min; RR 26 breaths/min, SpO2 92%
after being placed on 100% O2 via facemask.
Resp - ANSWER Uncompensated metabolic acidosis (possibly trying to compensate as
paco2 is close to moving outside of normal range).
What signs/symptoms of this patient relate to the acid base imbalance occurring?
A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
A urinary catheter is put in place and over 5 hours there is a total output of 110 mL of
amber, clear urine. The patient says he has vomited one to two times in the last 2 days
and has had no bowel movement in the last 3 days; he normally has a bowel movement
daily. Auscultation of the abdomen reveals hypoactive bowel sounds. The skin is intact,
slightly moist, and pale, with no rash or wounds. The patient is alert and oriented to
person, place, and time. He can move all extremities and can follow simple commands.
A: Focused Assessment Findings:
Vital signs are: BP 80/47 mm Hg, HR 117 beats/min; RR 26 breaths/min, SpO2 92%
after being placed on 100% O2 via facema - ANSWER There are not many
signs/symptoms specifically related to this, as his neuro status and musculoskeletal
system appear to be intact. He has slight dyspnea and we would anticipate an
, increased respiratory rate with compensation. Currently has low urine output which
could be a result of the metabolic problem.
What laboratory values indicate the medical condition of the patient?
A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
A urinary catheter is put in place and over 5 hours there is a total output of 110 mL of
amber, clear urine. The patient says he has vomited one to two times in the last 2 days
and has had no bowel movement in the last 3 days; he normally has a bowel movement
daily. Auscultation of the abdomen reveals hypoactive bowel sounds. The skin is intact,
slightly moist, and pale, with no rash or wounds. The patient is alert and oriented to
person, place, and time. He can move all extremities and can follow simple commands.
A: Focused Assessment Findings:
Vital signs are: BP 80/47 mm Hg, HR 117 beats/min; RR 26 breaths/min, SpO2 92%
after being placed on 100% O2 via facemask.
Respir - ANSWER Serum amylase and serum lipase are elevated in this patient,
indicating leukocytosis. These elevated levels indicate acute pancreatitis. Elevated
serum lipase levels are more specific for pancreatitis.
Decreased arterial oxygen is present in this case. The patient was appropriately placed
on oxygen. Respiratory failure is a complication with acute pancreatitis. The patient is in
primary metabolic acidosis.
What are the top four body systems important to focus on in this patient's assessment?
: A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
What are the underlying causes/pathophysiology of this concern?
S/B: Cindy, a 56-year-old female, is hospitalized after a MVA in which she sustained a
fractured femur. She is receiving Percocet 5/325 mg PO every 4-6 hours for pain,
levothyroxine 150 mcg PO daily, and lorazepam 0.5 mg Q HS.
A: This morning on your assessment, you find Cindy to be drowsy and slightly confused
until you reorient her.
AND ANSWERS 100% CORRECT!!
,What acid-base imbalance is occurring? Is there compensation occurring?
A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
A urinary catheter is put in place and over 5 hours there is a total output of 110 mL of
amber, clear urine. The patient says he has vomited one to two times in the last 2 days
and has had no bowel movement in the last 3 days; he normally has a bowel movement
daily. Auscultation of the abdomen reveals hypoactive bowel sounds. The skin is intact,
slightly moist, and pale, with no rash or wounds. The patient is alert and oriented to
person, place, and time. He can move all extremities and can follow simple commands.
A: Focused Assessment Findings:
Vital signs are: BP 80/47 mm Hg, HR 117 beats/min; RR 26 breaths/min, SpO2 92%
after being placed on 100% O2 via facemask.
Resp - ANSWER Uncompensated metabolic acidosis (possibly trying to compensate as
paco2 is close to moving outside of normal range).
What signs/symptoms of this patient relate to the acid base imbalance occurring?
A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
A urinary catheter is put in place and over 5 hours there is a total output of 110 mL of
amber, clear urine. The patient says he has vomited one to two times in the last 2 days
and has had no bowel movement in the last 3 days; he normally has a bowel movement
daily. Auscultation of the abdomen reveals hypoactive bowel sounds. The skin is intact,
slightly moist, and pale, with no rash or wounds. The patient is alert and oriented to
person, place, and time. He can move all extremities and can follow simple commands.
A: Focused Assessment Findings:
Vital signs are: BP 80/47 mm Hg, HR 117 beats/min; RR 26 breaths/min, SpO2 92%
after being placed on 100% O2 via facema - ANSWER There are not many
signs/symptoms specifically related to this, as his neuro status and musculoskeletal
system appear to be intact. He has slight dyspnea and we would anticipate an
, increased respiratory rate with compensation. Currently has low urine output which
could be a result of the metabolic problem.
What laboratory values indicate the medical condition of the patient?
A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
A urinary catheter is put in place and over 5 hours there is a total output of 110 mL of
amber, clear urine. The patient says he has vomited one to two times in the last 2 days
and has had no bowel movement in the last 3 days; he normally has a bowel movement
daily. Auscultation of the abdomen reveals hypoactive bowel sounds. The skin is intact,
slightly moist, and pale, with no rash or wounds. The patient is alert and oriented to
person, place, and time. He can move all extremities and can follow simple commands.
A: Focused Assessment Findings:
Vital signs are: BP 80/47 mm Hg, HR 117 beats/min; RR 26 breaths/min, SpO2 92%
after being placed on 100% O2 via facemask.
Respir - ANSWER Serum amylase and serum lipase are elevated in this patient,
indicating leukocytosis. These elevated levels indicate acute pancreatitis. Elevated
serum lipase levels are more specific for pancreatitis.
Decreased arterial oxygen is present in this case. The patient was appropriately placed
on oxygen. Respiratory failure is a complication with acute pancreatitis. The patient is in
primary metabolic acidosis.
What are the top four body systems important to focus on in this patient's assessment?
: A 40-year-old male is admitted to the hospital with a report of severe abdominal pain.
The patient has facial grimacing and moans occasionally during the nursing
assessment.
What are the underlying causes/pathophysiology of this concern?
S/B: Cindy, a 56-year-old female, is hospitalized after a MVA in which she sustained a
fractured femur. She is receiving Percocet 5/325 mg PO every 4-6 hours for pain,
levothyroxine 150 mcg PO daily, and lorazepam 0.5 mg Q HS.
A: This morning on your assessment, you find Cindy to be drowsy and slightly confused
until you reorient her.
