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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "The parathyroid has no effect on calcium levels in the body; this will just help prevent osteoporosis":
Explanation: This statement is incorrect. The parathyroid gland plays a crucial role in calcium homeostasis. Hypoparathyroidism, characterized by decreased parathyroid hormone (PTH) production, leads to low blood calcium levels, not high levels.
B. "The reason you have hypoparathyroidism is that you were diagnosed with hypothyroidism, and when the thyroid doesn't work, neither does the parathyroid, so you need these supplements."
Explanation: This statement is incorrect. The parathyroid and thyroid are separate glands with distinct functions. Hypoparathyroidism is not a result of hypothyroidism.
C. "A decrease in parathyroid hormone causes low calcium levels, so your body to break down bones to maintain normal calcium levels, and this will prevent that from happening."
Explanation: This is the correct statement. Hypoparathyroidism leads to a decrease in PTH, resulting in low blood calcium levels. Without sufficient PTH, the body may resort to breaking down bones to maintain calcium levels.
D. "An increase in parathyroid hormone causes your body to move calcium into the cells to reduce blood calcium levels, so you have to replace the levels in the blood."
Explanation: This statement is incorrect. An increase in parathyroid hormone (PTH) typically leads to increased blood calcium levels by promoting the release of calcium from bones and reducing calcium excretion by the kidneys. This describes hyperparathyroidism, not hypoparathyroidism.
Correct Answer is A
Explanation
A. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature."
This statement suggests a duration of up to 21 days for room temperature storage after the vial is in use. However, most insulins can typically be stored at room temperature for up to 28 days after initial use. This recommendation might be more conservative than necessary for many types of insulin.
B. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature."
This choice suggests a timeframe of 14 days for room temperature storage after opening the vial. However, for many insulins, the recommended duration for room temperature storage after opening is up to 28 days.
C. "If you are going to use up the vial within 1 month, it can be kept at room temperature."
This option extends the timeframe to 1 month for room temperature storage after the vial is in use. However, the generally recommended duration for many insulins is up to 28 days after opening.
D. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."
This choice suggests a very short duration of 7 days for room temperature storage after opening the vial. Most insulins can typically be stored at room temperature for a longer duration after initial use.
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