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 ["B","C","E"]

Explanation

A. Buffalo hump:
Explanation: A buffalo hump is associated with excess cortisol, which is not a typical manifestation of Addison's disease. Instead, patients with Addison's disease may experience weight loss and muscle wasting.

B. Hyponatremia:
Explanation: Correct. Hyponatremia (low sodium levels) can occur in Addison's disease due to the loss of aldosterone, which plays a role in sodium and water balance.

C. Decreased glucose level:
Explanation: Correct. Addison's disease can lead to hypoglycemia (low blood glucose levels) because cortisol, which is important for maintaining blood glucose, is deficient.

D. Weight gain:
Explanation: Weight gain is not a typical manifestation of Addison's disease. Instead, weight loss and muscle wasting may occur.

E. Craving for salt:
Explanation: Correct. Addison's disease can lead to salt craving, as aldosterone deficiency results in increased sodium loss and potassium retention.

A. Persistently cold feet B. Acute pain, unrelieved by rest C. The presence of a tingling sensation D. Pain that does not respond to analgesia

Correct Answer is C

Explanation

A. Persistently cold feet:
This may be a sign of poor circulation, which is more associated with peripheral vascular disease than neuropathy.

B. Acute pain, unrelieved by rest:
Acute pain is not typically associated with peripheral neuropathy. Neuropathic pain is often chronic and may include sensations like tingling or burning.

C. The presence of a tingling sensation:
This is correct. Tingling sensations, along with numbness and pain, are common symptoms of peripheral neuropathy in diabetes.

D. Pain that does not respond to analgesia:
While neuropathic pain can be challenging to manage, the primary focus is on the characteristic nature of the pain (tingling, burning) rather than its response to analgesics.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient with Addison's Disease. Which of the following clinical manifestations should the nurse expect to observe? (SELECT ALL THAT APPLY)

Correct Answer is ["B","C","E"]

Explanation

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?

Correct Answer is C

Explanation

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 type 1 diabetes mellitus and peripheral neuropathy is seeing the nurse to review foot care. What would be a priority instruction for the nurse to give the client?

The nurse is preparing to administer Insulin Lispro (Humalog) to a client with Type 2 Diabetes Mellitus for carbohydrate coverage. The nurse understands the injection should be administered:

The nurse is caring for a female client with type 2 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

The nurse is caring for a patient with Addison's disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?

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

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?

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)