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The following two questions are related to the same clinical scenario (patient). A 77-years-old patient with a significant history of COPD was admitted for a workup before an elective laparoscopic cholecystectomy. The nurse practitioner was asked for advice on perioperative management of chronic CO2 retention and severe lung disease.  On room air, the patient’s ABG was as follows: pH: 7.50; PCO2: 56; PO2: 63; HCO3: 48: BE: 22.7. Based on these results, the AGACNP calculated the age adjusted A-a Oxygen Gradient (A-a O2 G) to be:

The following two questions are related to the same clinical scenario (patient). A 56 year-old patient was admitted to the emergency department, confused and with respiratory distress.   The respiratory rate was 20 breaths per minute. The O2 saturation via pulse oximetry on oxygen at 2L/min via nasal cannula was 91%. An arterial blood gas was obtained and resulted as: 7.34/44/68/20/89%. The AGACNP calculates the expected A-a gradient to be 16.5, given the patient’s age.  The AGACNP then calculates the A-a gradient to be 79.7, based on the clinical data.  Considering the above, the AGACNP concludes that:

A 32-years-old patient was admitted to an urgent care facility with tachypnea, complaining of light-headedness. The patient disclosed a positive history of anxiety with panic attacks. Arterial blood gas was obtained with the following results: pH: 7.44 | PaCO2: 28 | HCO3: 20. The AGACNP interprets these results as:

A 67-years-old male patient presented to the ER with chest pain (right greater than left), dyspnea, and a non-productive cough. A positive history of COPD was recorded. On assessment, hyperresonance was auscultated on the right chest. Chest radiography showed a white visceral pleural line on the chest radiograph defining the interface between the lung and pleural with the absence of bronchovascular markings visible beyond the visceral pleural edge.  The AGACNP diagnostic impression is:

Which of the following would NOT be likely to result in the A-a gradient calculated for this patient? 

A 79-years-old patient was admitted to the ICU after presenting to the emergency department 12 hours before with shortness of breath, fever, tachycardia, and neglecting food intake for the past two days. Past significant history was positive for gastroesophageal reflux disease (GERD). In the ICU, the AGACNP assessed the patient and noted the patient to be confused, tachycardic, tachypneic, and with a productive cough. Chest radiography showed a localized right middle lobe diffuse infiltrate pattern. The AGACNP diagnostic impression is:

This quiz concerns Chapters 18 and 19 of your textbook.  It contains true/false and multiple choice questions. You will have 15 minutes to complete the quiz. Exceeding the time limit will result in a loss of points. A total of 32 points can be earned from this quiz.  This is a CLOSED BOOK/NOTEBOOK quiz. Good luck!

Linda agrees to buy Missy’s Greyhound race dog for $2,000. Linda is to deliver the money and take possession of the dog the next morning. That night, running his best race ever, the dog runs away from Missy, never to be seen again.

Costs to store a vehicle for a short period of time after an auto dealer fails to complete the contract to purchase the vehicle would be:

Nominal damages are awarded in contract cases when parties who have experienced an injury to their legal rights have no actual loss.