A 25-year-old patient with generalized anxiety disorder presents to the ED with shortness of breath, dizziness, and tingling in the fingers. The nurse reviews the ABG results: pH: 7.50, PaCO2: 30 mmHg HCO3: 24 mEq/L. What is the most likely acid-base imbalance?

Respiratory acidosis

Metabolic alkalosis

Respiratory alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is C

A. Respiratory acidosis would present with a low pH (acidotic) and a high PaCO2, which is not the case here.

B. Metabolic alkalosis would be suggested by an elevated pH and elevated HCO3, but here, the bicarbonate level is normal (24 mEq/L).

C. Respiratory alkalosis is indicated by a pH of 7.50 (alkalosis) and a PaCO2 of 30 mmHg, which is lower than the normal range (35-45 mmHg). This low PaCO2 suggests that the patient is hyperventilating, likely due to anxiety, which causes the body to excrete too much CO2.

D. Metabolic acidosis would present with a low pH and a low bicarbonate level, neither of which are seen in this case.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. A lithium level of 1.0 mEq/L is within the therapeutic range (0.6 to 1.2 mEq/L). The nurse should administer the morning dose of lithium as prescribed.

B. While it is important to monitor for medication adherence, there is no indication from the current lithium level that this client is refusing the medication.

C. Gastric lavage is unnecessary, as the lithium level is not elevated enough to warrant this extreme intervention.

D. Early signs of lithium toxicity typically occur with levels above 1.5 mEq/L. Since the level is 1.0 mEq/L, the nurse should proceed with administering the medication.

A. "I will join a book club in my neighborhood." B. 1 plan to sit on a park bench for a few minutes each day." C. 1 can try participating in group therapy every week" D. "I should avoid entering elevators and other closed spaces."

Correct Answer is B

Explanation

A. Joining a book club may be too ambitious at the start of treatment for someone with agoraphobia.

B. Gradual exposure to feared situations is a common treatment for agoraphobia. This plan represents a reasonable and incremental goal, showing understanding of the treatment approach.

C. Participating in group therapy might be too overwhelming and may not directly address the client's fear of being outside.

D. Avoidance of elevators and closed spaces goes against the goal of treatment, which is to face fears gradually and safely.

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A 25-year-old patient with generalized anxiety disorder presents to the ED with shortness of breath, dizziness, and tingling in the fingers. The nurse reviews the ABG results: pH: 7.50, PaCO2: 30 mmHg HCO3: 24 mEq/L. What is the most likely acid-base imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse in a hospital is caring for a client who has agoraphobia. Which of the following statements by the client indicates understanding of the goals of treatment?

Correct Answer is B

Explanation

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