A client presents with a pH of 7.25, PC02 of 40 mmHg, HCO3- of 16 mEq/L. Which of the following best describes the client's acid-base imbalance?

Metabolic alkalosis

Metabolic acidosis, uncompensated

Respiratory acidosis

Respiratory alkalosis, partially compensated

Answer and Explanation

The Correct Answer is B

A. Metabolic alkalosis: This condition is characterized by an elevated pH above 7.45 and an increased bicarbonate level. In this case, the pH is low and the HCO₃⁻ is also decreased, ruling out metabolic alkalosis.
B. Metabolic acidosis, uncompensated: A pH of 7.25 indicates acidemia, and a bicarbonate level of 16 mEq/L confirms a metabolic origin. The PaCO₂ is normal at 40 mmHg, indicating that respiratory compensation has not yet occurred, making this an uncompensated metabolic acidosis.
C. Respiratory acidosis: Respiratory acidosis involves a low pH and elevated PaCO₂ due to hypoventilation. This client’s PaCO₂ is within normal range, so respiratory causes can be ruled out.
D. Respiratory alkalosis, partially compensated: This condition presents with a high pH and low PaCO₂, typically due to hyperventilation. The client has an acidic pH and a normal PaCO₂, which does not support respiratory alkalosis.

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Correct Answer is D

Explanation

A. Weight gain of 5 lb: While weight changes can reflect improved nutritional intake or fluid balance, a 5-pound weight gain is not a reliable indicator of improved beta-cell function. Weight gain may also increase insulin resistance, which could worsen glycemic control.
B. Fasting blood glucose of 140 mg/dL: A fasting glucose of 140 mg/dL is above the diagnostic threshold for diabetes and suggests poor glycemic control. This level does not support the idea of improved beta-cell function or recovery.
C. Client reports smoking cessation: Smoking cessation is a positive lifestyle change that benefits cardiovascular and overall health, but it is not a direct indicator of beta-cell recovery or improved glucose metabolism.
D. HbA1c = 5.6%: An HbA1c of 5.6% is within the normal, non-diabetic range, suggesting that the client’s average blood glucose levels have been well controlled over the past 2 to 3 months. This implies that the pancreas is producing insulin effectively, which may reflect restored beta-cell function.

A. Acetone breath B. Fever C. 68 years of age D. Serum glucose 800 mg/dl (74 to 105 mg/dL) E. Serum bicarbonate 15 mEq/L (21 to 28 mEq/L) Insidious onset

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

Explanation

A. Acetone breath: Acetone (fruity-smelling) breath is a hallmark of diabetic ketoacidosis (DKA), not HHS. It results from ketone production due to fat breakdown, which is typically absent in HHS.
B. Fever: Fever may indicate underlying infection, which is a common trigger for HHS in older adults. Infections raise stress hormone levels, worsening insulin resistance and contributing to severe hyperglycemia.
C. 68 years of age: HHS most commonly affects older adults, typically those with type 2 diabetes. Advanced age is a significant risk factor due to impaired thirst mechanisms and decreased kidney function.
D. Serum glucose 800 mg/dL (74 to 105 mg/dL): HHS is characterized by extremely high blood glucose levels, often exceeding 600 mg/dL. A level of 800 mg/dL is consistent with the severe hyperglycemia seen in HHS.
E. Serum bicarbonate 15 mEq/L (21 to 28 mEq/L) Insidious onset: While bicarbonate levels in HHS may be mildly decreased, they are usually higher than in DKA. An insidious (gradual) onset with progressive symptoms over days is typical of HHS and differentiates it from the rapid onset of DKA.

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A client presents with a pH of 7.25, PC02 of 40 mmHg, HCO3- of 16 mEq/L. Which of the following best describes the client's acid-base imbalance?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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