Week 1

1. A patient with chronic obstructive pulmonary disease

(COPD) presents with dyspnea, wheezes, and cyanosis. The

nurse suspects that the patient has developed respiratory

acidosis. Which of the following laboratory values would

confirm this diagnosis?

a) pH 7.35, PaCO2 45 mmHg, HCO3 24 mEq/L

b) pH 7.25, PaCO2 50 mmHg, HCO3 26 mEq/L*

c) pH 7.45, PaCO2 35 mmHg, HCO3 22 mEq/L

d) pH 7.40, PaCO2 40 mmHg, HCO3 24 mEq/L

Rationale: Respiratory acidosis is a condition in which the

lungs cannot eliminate enough carbon dioxide, resulting in a

low pH and a high PaCO2. The kidneys try to compensate by

retaining bicarbonate (HCO3), which is a base. Option b

reflects these changes.

2. A patient with diabetes mellitus has a blood glucose level

of 450 mg/dL and is experiencing polyuria, polydipsia,

polyphagia, and ketonuria. The nurse recognizes that the

patient is in a state of diabetic ketoacidosis (DKA). What is

the primary cause of DKA?

a) Insufficient insulin production by the pancreas

b) Excessive carbohydrate intake and inadequate insulin

administration

c) Infection or stress that increases the demand for insulin*