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. Metabolic Acidosis
Metabolic acidosis is characterized by a low pH and low bicarbonate (HCO3) level. In this case, the pH is low (indicating acidosis), but the bicarbonate level is within the normal range, which is inconsistent with metabolic acidosis.

B. Respiratory Acidosis
This is correct. Respiratory acidosis is characterized by an elevated partial pressure of carbon dioxide (PaCO2), leading to a decrease in pH. The ABG values in this case indicate elevated PaCO2 and a low pH, consistent with respiratory acidosis.

C. Metabolic Alkalosis
Metabolic alkalosis is characterized by a high pH and high bicarbonate (HCO3) level. In this case, the pH is low (indicating acidosis), which is inconsistent with metabolic alkalosis.

D. Respiratory Alkalosis
Respiratory alkalosis is characterized by a low partial pressure of carbon dioxide (PaCO2) and a high pH. In this case, the PaCO2 is elevated, which is inconsistent with respiratory alkalosis.

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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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

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

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