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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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.

A. Frequent mood changes B. Weight gain of 11 lbs in 3 weeks C. Sensitivity to cold D. Constipation

Correct Answer is A

Explanation

A. Frequent mood changes:
This is correct. Hyperthyroidism is associated with increased levels of thyroid hormones, which can affect the nervous system and lead to mood changes, including irritability and anxiety.

B. Weight gain of 11 lbs in 3 weeks:
Weight loss is more characteristic of hyperthyroidism due to increased metabolism. Rapid weight gain is not typical.

C. Sensitivity to cold:
Sensitivity to cold is more characteristic of hypothyroidism, where there is a deficiency of thyroid hormones.

D. Constipation:
Constipation is more commonly associated with hypothyroidism, where there is a slowing of the digestive system.

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Naxlex Comprehensive Predictor Exams

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

A nurse is caring for a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report?

Correct Answer is A

Explanation

A nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?

An occupational health nurse is screen a group of workers for diabetes. What statement should the nurse interpret as being suggestive of diabetes?

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?

The nurse is caring for a patient diagnosed with hypothyroidism. When assessing this patient, what sign or symptom would the nurse expect?

A nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?

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 assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy?

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)