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 B

Explanation

A. Documenting the size and location is important for medical records, but it is secondary to providing immediate care for the wounds.

B. The first action is to inspect the cuts for any debris to ensure proper wound care. Cleaning the wounds and assessing their severity is necessary to prevent infection.

C. Administering a tetanus antitoxin is not the first step unless the cuts show signs of contamination or the patient is at risk of tetanus.

D. Implementing a behavioral modification plan is important for addressing self-harm behaviors, but the immediate priority is to assess and treat the cuts to prevent infection.

A. Avoid driving or operating heavy machinery until you know how alprazolam affects you. B. Relief of manifestations should be expected after a few weeks of therapy. C. Foods that are known to be high in dietary tyramine should be avoided. D. Increase the dose of medication as needed if relief of manifestations is not experienced.

Correct Answer is A

Explanation

A. Alprazolam is a benzodiazepine that can cause drowsiness, dizziness, and impair motor coordination. Therefore, the nurse should advise the client to avoid activities that require alertness until they understand how the medication affects them.

B. Alprazolam provides relatively quick relief of anxiety symptoms, often within hours, rather than requiring weeks of therapy like some other medications.

C. Foods high in tyramine are a concern for clients taking monoamine oxidase inhibitors (MAOIs), not alprazolam.

D. Increasing the dose without guidance from a healthcare provider is unsafe. The client should not adjust their medication dosage without consulting the provider.

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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 client who has bipolar disorder approaches the nurse and reveals fresh, self-inflicted, superficial cuts going up and down his right arm. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse is caring for a client who is prescribed alprazolam to manage severe manifestations of anxiety. Which of the following should the nurse prepare to discuss with the client?

Correct Answer is A

Explanation

A nurse is caring for a client who has bipolar disorder. Which of the following actions by the client should the nurse interpret as displaying manic behavior? (Select all that apply.)

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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?

A patient diagnosed with bipolar disorder is prescribed lithium carbonate. Which laboratory result should prompt the nurse to hold the medication and notify the healthcare provider?

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A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?

The nurse is preparing to transfer a client from the post-anesthesia care unit (PACU). Which assessment findings would delay the transfer of the client? (Select All that Apply.)

A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?