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 D
Explanation
A. Respiratory Acidosis:
Explanation: Respiratory acidosis occurs when there is inadequate elimination of carbon dioxide, leading to an increase in PaCO2 and a decrease in blood pH. This is typically associated with conditions that impair ventilation.
B. Metabolic Alkalosis:
Explanation: Metabolic alkalosis is characterized by an elevated blood pH and bicarbonate (HCO3-) concentration. It is not directly caused by hyperventilation but is often associated with conditions such as excessive vomiting or excessive bicarbonate intake.
C. Metabolic Acidosis:
Explanation: Metabolic acidosis is characterized by a decrease in blood pH and bicarbonate concentration. It is not directly caused by hyperventilation but may result from conditions such as diabetic ketoacidosis or lactic acidosis.
D. Respiratory Alkalosis:
Explanation: Hyperventilation is the most common cause of respiratory alkalosis. During hyperventilation, there is an excessive loss of carbon dioxide (CO2) through rapid breathing, leading to a decrease in the partial pressure of carbon dioxide (PaCO2) in the blood. This results in an increase in blood pH, causing an alkalotic state.

Correct Answer is B
Explanation
A. 30 minute onset; 2-hour duration: This does not accurately represent the onset and peak action time of Insulin Lispro.
B. 15 minute onset; 30-60 minutes peak: This is correct. Insulin Lispro has a rapid onset (starts working within 15 minutes) and a peak action time of 30-60 minutes after administration.
C. 2-hour onset; 12-hour duration: This is not accurate for rapid-acting insulin. Rapid-acting insulin has a much quicker onset and shorter duration compared to this option.
D. 15 minute onset; no peak (continuous): While the onset time is correct, stating "no peak" is not entirely accurate. Rapid-acting insulin does have a peak, but it's relatively short, occurring within the first hour after administration.
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