1. A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with

acute respiratory distress. The nurse assesses the patient's arterial blood gas (ABG) results and

finds a pH of 7.30, PaCO2 of 60 mmHg, PaO2 of 50 mmHg, and HCO3 of 28 mEq/L. What is the

most likely interpretation of these results?

A) Respiratory acidosis with partial compensation

B) Respiratory alkalosis with partial compensation

C) Metabolic acidosis with partial compensation

D) Metabolic alkalosis with partial compensation

Answer: A) Respiratory acidosis with partial compensation

Rationale: The patient has a low pH (acidosis), a high PaCO2 (respiratory component), and a

slightly elevated HCO3 (metabolic component). This indicates that the primary disorder is

respiratory acidosis due to impaired gas exchange and ventilation. The elevated HCO3 shows that

the kidneys are trying to compensate by retaining bicarbonate, but the compensation is incomplete

as the pH is still below the normal range (7.35-7.45).

2. A patient with type 1 diabetes mellitus is scheduled for a fasting blood glucose test in the

morning. The night before, the patient experiences nausea, vomiting, and abdominal pain. The

patient checks the blood glucose level and finds it to be 350 mg/dL. The patient decides to skip the

insulin dose to avoid hypoglycemia during the fasting period. The next morning, the patient is found

unconscious and is rushed to the emergency department. The nurse suspects that the patient has

developed which of the following complications?

A) Diabetic ketoacidosis (DKA)

B) Hyperosmolar hyperglycemic state (HHS)

C) Hypoglycemic coma

D) Diabetic nephropathy

Answer: A) Diabetic ketoacidosis (DKA)

Rationale: The patient has signs and symptoms of DKA, which is a life-threatening condition

caused by a lack of insulin and an excess of counterregulatory hormones (glucagon, cortisol,

epinephrine, growth hormone). These hormones stimulate lipolysis, resulting in the production of

ketone bodies that lower the pH of the blood and cause metabolic acidosis. The patient also has

dehydration, electrolyte imbalance, and hyperglycemia due to osmotic diuresis. Skipping the insulin

dose was a dangerous decision that worsened the condition.

3. A patient with hypertension is prescribed a beta-blocker medication to lower the blood pressure.

The nurse explains to the patient that this medication works by blocking the effects of which of the

following neurotransmitters on the heart and blood vessels