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A client has a nasogastric (NG) tube placed during abdominal surgery. During postoperative convalescence, the nurse identifies that the client is manifesting a hand tremor, muscle twitching, and confusion. Which arterial blood gases consistent with metabolic alkalosis should the nurse report to the healthcare provider?

Reference Range pH 17.35 to 7.45]

PaCO2 135 to 45 mm Hg]

HCO3 [21 to 28 mEq/L or 21 to 28 mmol/L]

PaO2 [80 to 100 mm Hg]

pH 7.30, PCO, 20 mm Hg, HCO, 22 mEq/L (22 mmol/L), PO, 85 mm Hg.

pH 7.46, PCO, 55 mm Hg, HCO, 36 mEq/L (36 mmol/L), PO, 95 mm Hg.

pH 7.49, PCO, 45 mm Hg, HCO, 32 mEq/L (32 mmol), PO, 90 mm Hg.

pH 7.29, PCO, 35 mm Hg, HCO, 25 mEq/L (25 mmol/L), PO, 99 mm Hg.

Answer and Explanation

The Correct Answer is B

B. pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L, PO2 95 mm Hg

The pH is high (alkalotic).

The HCO3 level is elevated, indicating metabolic alkalosis.

The PCO2 is high (respiratory acidotic picture due to secondary response). This option matches the criteria for metabolic alkalosis.

A. pH 7.30, PCO2 20 mm Hg, HCO3 22 mEq/L, PO2 85 mm Hg

The pH is low (acidic), not alkalotic.

The HCO3 level is within the normal range.

The PCO2 is low, which could indicate respiratory alkalosis. This option does not match the criteria for metabolic alkalosis.

C. pH 7.49, PCO2 45 mm Hg, HCO3 32 mEq/L, PO2 90 mm Hg The pH is high (alkalotic).

The HCO3 level is elevated, indicating metabolic alkalosis. The PCO2 is within the normal range.

This option does not meet the criteria for metabolic alkalosis D pH 7.29, PCO2 35 mm Hg, HCO3 25 mEq/L, PO2 99 mm Hg

The pH is low (acidic), not alkalotic. The HCO3 level is low, not elevated. The PCO2 is within the normal range.

This option does not match the criteria for metabolic alkalosis.

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Correct Answer is A

Explanation

A. Pulse oximetry measures the oxygen saturation of arterial blood, which is a crucial parameter to assess in clients with respiratory distress. Obtaining a pulse oximetry reading will provide information about the client's oxygenation status and help guide further interventions.

B. Huff coughing may be helpful for airway clearance but it may not be the most immediate intervention needed to address the client's respiratory distress.

C. Humidification may be beneficial for airway clearance in the long term but it may not be the most immediate intervention needed to address the client's acute respiratory distress.

D. Nebulizer breathing treatments, such as bronchodilators or corticosteroids, are commonly used to relieve bronchospasm and improve airflow in clients with COPD. However, in this scenario, the client's primary symptoms are dyspnea and tachypnea, indicating acute respiratory distress.

Correct Answer is ["100"]

Explanation

Vancomycin dosage: 500 mg

Concentration of vancomycin solution: 500 mg per 100 mL

Total volume of solution for each dose: 100 mL (since the concentration is 500 mg per 100 mL) To administer 500 mg of vancomycin, we need 100 mL of the solution.

To administer the medication over 1 hour, we need to deliver the entire 100 mL over 1 hour. Therefore, the infusion rate (in mL/hr) would be 100 mL/hr.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with chronic obstructive pulmonary disease who develops an onset of dyspnea, tachypnea with coughing. After positioning the client upright, which action should the nurse take next?

Correct Answer is A

Explanation

A client receives a prescription for vancomycin 500 mg IV every 8 hours. The medication is provided in "500 mg per 100 mL of dextrose 5% in water." To administer the medication over an hour, the nurse should set the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

Correct Answer is ["100"]

Explanation

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