ESTUDYR
NCLEX-RN Case Study: COPD &
Respiratory Failure
Client Scenario: A 72-year-old male with a history of COPD and tobacco use (50 pack-
years) presents with increased shortness of breath and a productive cough with "greenish"
sputum.
Initial Assessment:
Resp: Labored breathing, using accessory muscles, tripod positioning. Coarse
wheezing throughout.
Vitals: SpO2 83% on Room Air, RR 28, HR 112, Temp 101.4°F.
Item 1: Recognizing Cues (Highlighting)
Question: Highlight the findings that indicate the client is in respiratory distress.
Findings: 72-year-old male; Using accessory muscles; Tripod positioning; Coarse
wheezing; SpO2 83%; RR 28.
Item 2: Analyzing Cues (ABG Interpretation)
Question: The nurse reviews the ABG: pH 7.28, PaCO2 62, HCO3 30, PaO2 54. Which
interpretation is correct?
1. Metabolic Acidosis
2. ✅Partially compensated Respiratory Acidosis
3. Fully compensated Respiratory Alkalosis
4. Uncompensated Metabolic Alkalosis
Rationale: The low pH indicates acidosis. The high PaCO2 indicates the cause is respiratory.
The high HCO3 shows the kidneys are trying to help (partial compensation).
NCLEX-RN Case Study: COPD &
Respiratory Failure
Client Scenario: A 72-year-old male with a history of COPD and tobacco use (50 pack-
years) presents with increased shortness of breath and a productive cough with "greenish"
sputum.
Initial Assessment:
Resp: Labored breathing, using accessory muscles, tripod positioning. Coarse
wheezing throughout.
Vitals: SpO2 83% on Room Air, RR 28, HR 112, Temp 101.4°F.
Item 1: Recognizing Cues (Highlighting)
Question: Highlight the findings that indicate the client is in respiratory distress.
Findings: 72-year-old male; Using accessory muscles; Tripod positioning; Coarse
wheezing; SpO2 83%; RR 28.
Item 2: Analyzing Cues (ABG Interpretation)
Question: The nurse reviews the ABG: pH 7.28, PaCO2 62, HCO3 30, PaO2 54. Which
interpretation is correct?
1. Metabolic Acidosis
2. ✅Partially compensated Respiratory Acidosis
3. Fully compensated Respiratory Alkalosis
4. Uncompensated Metabolic Alkalosis
Rationale: The low pH indicates acidosis. The high PaCO2 indicates the cause is respiratory.
The high HCO3 shows the kidneys are trying to help (partial compensation).
