NR324/NR 324 Exam 1 V1 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient who has been diagnosed with metabolic acidosis. Which of
the following arterial blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 23 mEq/L
B. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
C. pH 7.30, PaCO2 50 mmHg, HCO3 28 mEq/L
D. pH 7.28, PaCO2 38 mmHg, HCO3 18 mEq/L
Correct Answer: D
Rationale: Metabolic acidosis is characterized by a low pH and a low bicarbonate level. A
pH of 7.28 indicates acidemia, while the HCO3 of 18 mEq/L is below the normal range of 22
to 26 mEq/L. The PaCO2 remains within the normal range, indicating no primary
respiratory cause for the imbalance.
2. When assessing a patient with hyperkalemia, which of the following clinical manifestations
should the nurse prioritize?
A. Polyuria and increased thirst
B. Muscle weakness and cardiac dysrhythmias
C. Hyperactive bowel sounds and diarrhea
,D. Circumoral tingling and positive Chvostek’s sign
Correct Answer: B
Rationale: Hyperkalemia can lead to life-threatening cardiac dysrhythmias and significant
muscle weakness or paralysis. Potassium is essential for the transmission of nerve
impulses and muscle contraction, particularly in the heart. Monitoring the ECG for tall,
peaked T waves is a priority nursing action in these patients.
3. A patient with COPD is receiving oxygen at 2L/min via nasal cannula. Which finding most
indicates that the oxygen therapy is effective?
A. The patient’s SpO2 is 91%.
B. The patient’s respiratory rate is 24 breaths/min.
C. The patient’s PaCO2 is 48 mmHg.
D. The patient’s skin is pink and warm.
Correct Answer: A
Rationale: For patients with COPD, the goal for oxygen saturation is typically between
88% and 92%. A saturation of 91% indicates that the patient is receiving sufficient oxygen
without suppressing the hypoxic drive. Higher levels of oxygen can lead to CO2 retention in
this specific patient population.
, 4. The nurse is providing education to a patient newly diagnosed with asthma. Which
statement by the patient indicates a correct understanding of the use of a spacer with a
metered-dose inhaler (MDI)?
A. ‘The spacer makes the medicine work faster once it hits my throat.’
B. ‘I should use the spacer only when I am having an acute attack.’
C. ‘The spacer will help me inhale more of the medication into my lungs.’
D. ‘I need to whistle while I breathe in to make sure it is working.’
Correct Answer: C
Rationale: A spacer device attached to an MDI helps coordinate the delivery of the
medication and ensures more of the drug reaches the lower airways. Without a spacer,
much of the medication may be deposited in the oropharynx rather than the lungs.
Whistling during inhalation actually indicates that the patient is breathing in too quickly.
5. A patient is 12 hours postoperative after an abdominal surgery. Which nursing intervention
is most effective in preventing atelectasis?
A. Administering humidified oxygen via face mask.
B. Maintaining the patient in a supine position.
C. Encouraging the use of an incentive spirometer every hour while awake.
D. Restricting fluid intake to prevent pulmonary edema.
Correct Answer: C
Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient who has been diagnosed with metabolic acidosis. Which of
the following arterial blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 23 mEq/L
B. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
C. pH 7.30, PaCO2 50 mmHg, HCO3 28 mEq/L
D. pH 7.28, PaCO2 38 mmHg, HCO3 18 mEq/L
Correct Answer: D
Rationale: Metabolic acidosis is characterized by a low pH and a low bicarbonate level. A
pH of 7.28 indicates acidemia, while the HCO3 of 18 mEq/L is below the normal range of 22
to 26 mEq/L. The PaCO2 remains within the normal range, indicating no primary
respiratory cause for the imbalance.
2. When assessing a patient with hyperkalemia, which of the following clinical manifestations
should the nurse prioritize?
A. Polyuria and increased thirst
B. Muscle weakness and cardiac dysrhythmias
C. Hyperactive bowel sounds and diarrhea
,D. Circumoral tingling and positive Chvostek’s sign
Correct Answer: B
Rationale: Hyperkalemia can lead to life-threatening cardiac dysrhythmias and significant
muscle weakness or paralysis. Potassium is essential for the transmission of nerve
impulses and muscle contraction, particularly in the heart. Monitoring the ECG for tall,
peaked T waves is a priority nursing action in these patients.
3. A patient with COPD is receiving oxygen at 2L/min via nasal cannula. Which finding most
indicates that the oxygen therapy is effective?
A. The patient’s SpO2 is 91%.
B. The patient’s respiratory rate is 24 breaths/min.
C. The patient’s PaCO2 is 48 mmHg.
D. The patient’s skin is pink and warm.
Correct Answer: A
Rationale: For patients with COPD, the goal for oxygen saturation is typically between
88% and 92%. A saturation of 91% indicates that the patient is receiving sufficient oxygen
without suppressing the hypoxic drive. Higher levels of oxygen can lead to CO2 retention in
this specific patient population.
, 4. The nurse is providing education to a patient newly diagnosed with asthma. Which
statement by the patient indicates a correct understanding of the use of a spacer with a
metered-dose inhaler (MDI)?
A. ‘The spacer makes the medicine work faster once it hits my throat.’
B. ‘I should use the spacer only when I am having an acute attack.’
C. ‘The spacer will help me inhale more of the medication into my lungs.’
D. ‘I need to whistle while I breathe in to make sure it is working.’
Correct Answer: C
Rationale: A spacer device attached to an MDI helps coordinate the delivery of the
medication and ensures more of the drug reaches the lower airways. Without a spacer,
much of the medication may be deposited in the oropharynx rather than the lungs.
Whistling during inhalation actually indicates that the patient is breathing in too quickly.
5. A patient is 12 hours postoperative after an abdominal surgery. Which nursing intervention
is most effective in preventing atelectasis?
A. Administering humidified oxygen via face mask.
B. Maintaining the patient in a supine position.
C. Encouraging the use of an incentive spirometer every hour while awake.
D. Restricting fluid intake to prevent pulmonary edema.
Correct Answer: C
