Study Guide for MDC4 Exam 2
Questions and Answers 2024
The patient is a 54-year-old male with history of COPD, who was rushed to the
emergency department with increasing shortness of breath, pyrexia, and a productive
cough with yellow-green sputum. Measurement of arterial blood gas shows pH 7.3,
PaCO2 68 mmHg, HCO3 28 mmol/L, and PaO2 60 mmHg. How would you interpret
this? - CORRECT ANSWER-Respiratory acidosis, partially compensated
Silver sulfadiazine (Silvadene, Thermazene) - CORRECT ANSWER-Watch for allergic
reaction causing a drop in white blood cell count.
Do not use if reaction to sulfonamide has occurred.
Use on deep partial-thickness or full-thickness wounds.
Monitor wounds for infection
A client with a 3-day history of nausea and vomiting presents to the emergency
department. The client is hypoventilating and has a respiratory rate of 10 breaths/min.
Arterial blood gases are drawn and the nurse reviews the results, expecting to note
which of the following? - CORRECT ANSWER-An increased pH with an increased
HCO3
A nurse is caring for a client with diabetic ketoacidosis and documents that the client is
experiencing Kussmaul's respirations. Based on this documentation, which of the
following did the nurse observe? - CORRECT ANSWER-Respirations that are labored
and increased in depth and rate
A nurse is caring for a client who has a tracheostomy and is receiving mechanical
ventilation. When the low-pressure alarm on the ventilator sounds, it indicates which of
the following to the nurse? - CORRECT ANSWER-Decreased lung compliance
A nurse on a medical-surgical unit is caring for a client who is postoperative following a
hip replacement surgery. The client reports feeling apprehensive and restless. Which of
the following findings should the nurse recognize as an indication of pulmonary
embolism? - CORRECT ANSWER-Sudden onset of dyspnea
A client comes to the emergency department in severe respiratory distress following
left-sided blunt chest trauma. The nurse notes absent breath sounds on the client's left
side and a tracheal shift to the right. For which of the following procedures should the
nurse prepare the client? - CORRECT ANSWER-Chest tube insertion
A nurse is caring for a client who is experiencing acute opioid toxicity. Which of the
following actions should the nurse identify as the priority? - CORRECT ANSWER-
Ensure an adequate airway
, A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD)
and is experiencing shortness of breath. Which of the following actions should the nurse
perform first? - CORRECT ANSWER-Place the client in an upright position
A nurse is assessing a client who has pharyngitis. Which of the following findings is the
nurse's priority to report to the provider? - CORRECT ANSWER-Inspiratory stridor
A nurse is caring for a client who has a 20-year history of COPD and is receiving
oxygen therapy at 2 L/min via nasal cannula. The client is dyspneic and has an oxygen
saturation via pulse oximetry of 85%. Which of the following actions should the nurse
take? - CORRECT ANSWER-Increase the oxygen flow and request an arterial blood
gas determination
A nurse is caring for a client who is scheduled to have his chest tube removed. Which of
the following actions should the nurse take? - CORRECT ANSWER-Instruct the client to
perform the Valsalva maneuver during removal
A nurse is caring for a client with pneumonia who is experiencing thick oral secretions.
Which of the following actions should the nurse take first? - CORRECT ANSWER-
Encourage deep breathing and coughing
Rib fracture cause - CORRECT ANSWER-blunt trauma to chest wall; CPR
Rib fracture pain - CORRECT ANSWER-defensive movements
reduced depth of breathing
reduced clearing of secretions
Flail Chest - CORRECT ANSWER-At least 2 neighboring ribs in 2 or more places
Paradoxical chest movement
Blunt trauma, CPR can Cause
Vasodilator (Nitroprusside) - CORRECT ANSWER-decreases pulmonary artery
pressure if impeding cardiac contractility
pulmonary embolism risk factors - CORRECT ANSWER-prolonged immobility
central venous catheter
surgery
obesity
advancing age
hx. of thromboembolism
smoking
pregnancy
estrogen therapy
HF
stroke
Questions and Answers 2024
The patient is a 54-year-old male with history of COPD, who was rushed to the
emergency department with increasing shortness of breath, pyrexia, and a productive
cough with yellow-green sputum. Measurement of arterial blood gas shows pH 7.3,
PaCO2 68 mmHg, HCO3 28 mmol/L, and PaO2 60 mmHg. How would you interpret
this? - CORRECT ANSWER-Respiratory acidosis, partially compensated
Silver sulfadiazine (Silvadene, Thermazene) - CORRECT ANSWER-Watch for allergic
reaction causing a drop in white blood cell count.
Do not use if reaction to sulfonamide has occurred.
Use on deep partial-thickness or full-thickness wounds.
Monitor wounds for infection
A client with a 3-day history of nausea and vomiting presents to the emergency
department. The client is hypoventilating and has a respiratory rate of 10 breaths/min.
Arterial blood gases are drawn and the nurse reviews the results, expecting to note
which of the following? - CORRECT ANSWER-An increased pH with an increased
HCO3
A nurse is caring for a client with diabetic ketoacidosis and documents that the client is
experiencing Kussmaul's respirations. Based on this documentation, which of the
following did the nurse observe? - CORRECT ANSWER-Respirations that are labored
and increased in depth and rate
A nurse is caring for a client who has a tracheostomy and is receiving mechanical
ventilation. When the low-pressure alarm on the ventilator sounds, it indicates which of
the following to the nurse? - CORRECT ANSWER-Decreased lung compliance
A nurse on a medical-surgical unit is caring for a client who is postoperative following a
hip replacement surgery. The client reports feeling apprehensive and restless. Which of
the following findings should the nurse recognize as an indication of pulmonary
embolism? - CORRECT ANSWER-Sudden onset of dyspnea
A client comes to the emergency department in severe respiratory distress following
left-sided blunt chest trauma. The nurse notes absent breath sounds on the client's left
side and a tracheal shift to the right. For which of the following procedures should the
nurse prepare the client? - CORRECT ANSWER-Chest tube insertion
A nurse is caring for a client who is experiencing acute opioid toxicity. Which of the
following actions should the nurse identify as the priority? - CORRECT ANSWER-
Ensure an adequate airway
, A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD)
and is experiencing shortness of breath. Which of the following actions should the nurse
perform first? - CORRECT ANSWER-Place the client in an upright position
A nurse is assessing a client who has pharyngitis. Which of the following findings is the
nurse's priority to report to the provider? - CORRECT ANSWER-Inspiratory stridor
A nurse is caring for a client who has a 20-year history of COPD and is receiving
oxygen therapy at 2 L/min via nasal cannula. The client is dyspneic and has an oxygen
saturation via pulse oximetry of 85%. Which of the following actions should the nurse
take? - CORRECT ANSWER-Increase the oxygen flow and request an arterial blood
gas determination
A nurse is caring for a client who is scheduled to have his chest tube removed. Which of
the following actions should the nurse take? - CORRECT ANSWER-Instruct the client to
perform the Valsalva maneuver during removal
A nurse is caring for a client with pneumonia who is experiencing thick oral secretions.
Which of the following actions should the nurse take first? - CORRECT ANSWER-
Encourage deep breathing and coughing
Rib fracture cause - CORRECT ANSWER-blunt trauma to chest wall; CPR
Rib fracture pain - CORRECT ANSWER-defensive movements
reduced depth of breathing
reduced clearing of secretions
Flail Chest - CORRECT ANSWER-At least 2 neighboring ribs in 2 or more places
Paradoxical chest movement
Blunt trauma, CPR can Cause
Vasodilator (Nitroprusside) - CORRECT ANSWER-decreases pulmonary artery
pressure if impeding cardiac contractility
pulmonary embolism risk factors - CORRECT ANSWER-prolonged immobility
central venous catheter
surgery
obesity
advancing age
hx. of thromboembolism
smoking
pregnancy
estrogen therapy
HF
stroke
