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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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Free Nursing Study Resources

Correct Answer is D

Explanation

D. Sputum culture is the gold standard diagnostic test for confirming the diagnosis of tuberculosis. It involves culturing the bacteria from sputum samples to identify the presence of Mycobacterium tuberculosis, the causative organism of TB.

A. The Hemoccult test is used to detect occult (hidden) blood in stool samples, not sputum.

B. Chest x-ray or CT imaging is commonly used in the diagnosis of tuberculosis. However, imaging findings alone are not sufficient to confirm the diagnosis of TB.

C. The PPD skin test is a screening test for tuberculosis infection. A positive PPD test indicates exposure to TB bacteria but does not distinguish between latent TB infection and active TB disease.

A. Hyperventilation is eliminating carbon dioxide rapidly. B. Blood oxygen levels are stimulating the respiratory rate. C. Carbon dioxide is converted in the kidneys for elimination. D. High levels of carbon dioxide have accumulated in the blood.

Correct Answer is D

Explanation

D. Respiratory acidosis occurs when there is inadequate alveolar ventilation, leading to retention of carbon dioxide (hypercapnia) in the blood. The accumulation of carbon dioxide results in an increase in the partial pressure of carbon dioxide (PaCO2), leading to respiratory acidosis.

A. Hyperventilation refers to breathing at a rate and depth that exceeds the body's metabolic needs, leading to a decrease in the partial pressure of carbon dioxide (PaCO2) in the blood. Respiratory acidosis, however, is characterized by an increase in PaCO2 due to inadequate ventilation, not rapid elimination of carbon dioxide.

B. This choice refers to the hypoxic drive, which is a compensatory mechanism triggered by low oxygen levels in the blood. While hypoxemia (low oxygen levels) can stimulate the respiratory rate, it typically occurs in chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD) rather than acute respiratory acidosis.

C. While the kidneys play a role in regulating acid-base balance through the excretion of hydrogen ions and reabsorption of bicarbonate ions, they do not directly eliminate carbon dioxide from the body.

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Correct Answer is D

Explanation

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Correct Answer is D

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