A client in the emergency department reports that he has been vomiting excessively for the last 2 days. His arterial blood gas (ABG) analysis shows a pH of 7.50, the partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?

Metabolic Alkalosis

Respiratory Alkalosis

Respiratory Acidosis

Metabolic Acidosis

Answer and Explanation

The Correct Answer is A

A. Metabolic Alkalosis:
pH: Elevated (alkalotic).
PaCO2: Normal or slightly decreased (compensation may or may not be present).
HCO3: Elevated.
Explanation: Metabolic alkalosis is characterized by an excess of bicarbonate (HCO3) in the blood, leading to an elevated pH. In this case, the elevated pH and HCO3 levels suggest that the primary imbalance is metabolic alkalosis.

B. Respiratory Alkalosis:
pH: Elevated (alkalotic).
PaCO2: Decreased (due to hyperventilation, which blows off CO2).
HCO3: Normal or slightly decreased (compensation).
Explanation: Respiratory alkalosis is characterized by low levels of carbon dioxide (PaCO2) due to hyperventilation. However, in the provided ABG, the PaCO2 is not significantly decreased, suggesting that respiratory alkalosis is not the primary issue.

C. Respiratory Acidosis:
pH: Decreased (acidotic).
PaCO2: Increased (due to inadequate ventilation).
HCO3: Normal or slightly elevated (compensation).
Explanation: Respiratory acidosis is characterized by an increase in carbon dioxide (PaCO2) levels. In this case, the PaCO2 is within the normal range, indicating that respiratory acidosis is not the primary problem.

D. Metabolic Acidosis:
pH: Decreased (acidotic).
PaCO2: Normal or slightly decreased (compensation).
HCO3: Decreased.
Explanation: Metabolic acidosis is characterized by a decrease in bicarbonate (HCO3) levels. In this ABG, the HCO3 is elevated, ruling out metabolic acidosis as the primary issue.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Vitamin A Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Vitamin A deficiency is not typically associated with an enlarged tongue. It is more commonly linked to night blindness and skin issues.

B. Folic Acid Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Folic acid deficiency can lead to megaloblastic anemia and glossitis (inflammation of the tongue), which may present as an enlarged, smooth, and red tongue.

C. Vitamin B12 Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Vitamin B12 deficiency can cause pernicious anemia and glossitis, resulting in an enlarged, smooth, and red tongue.

D. Vitamin C Deficiency:
Symptoms: Not typically associated with an enlarged tongue.
Relevance: Vitamin C deficiency is more commonly associated with symptoms like scurvy, which includes bleeding gums, joint pain, and skin issues, but not specifically an enlarged tongue.

A. to prevent post-prandial hypoglycemia B. to treat the carbohydrates the client ate C. to treat the client's blood glucose level D. as a basal dose to prevent hyperglycemia for up to 24 hours

Correct Answer is B

Explanation

A. To prevent post-prandial hypoglycemia:
This statement is not accurate. Insulin Lispro is a rapid-acting insulin used for mealtime coverage to manage post-prandial glucose levels, but it is not given to prevent hypoglycemia.

B. To treat the carbohydrates the client ate:
This statement is more accurate. Insulin Lispro is used to cover the rise in blood sugar that occurs after meals. It helps regulate glucose levels by managing the effect of ingested carbohydrates.

C. To treat the client's blood glucose level:
This statement is generally correct. Insulin Lispro is administered to manage and lower elevated blood glucose levels, especially in response to meals.

D. As a basal dose to prevent hyperglycemia for up to 24 hours:
This statement is incorrect. Insulin Lispro is a rapid-acting insulin and is not used for basal (long-acting) coverage. Basal insulin is usually provided by long-acting insulin formulations.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is preparing to administer Insulin Lispro (Humalog) to a client with Type 1 Diabetes Mellitus for sliding scale coverage. The nurse understands the injection is given:

Correct Answer is B

Explanation

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?

A diabetes educator is teaching a patient about type 2 diabetes. The educator recognizes that the patient understands the primary treatment for type 2 diabetes when the patient states what?

A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon an assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the MOST common cause of which acid-base imbalance?

The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue?

The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.32; PaCO2, 48 mm Hg; PaO2, 70 mm Hg; and HCO3, 24 mEq/L. What do these values indicate?

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?