A nurse has been assigned to care for a client diagnosed with a small bowel obstruction. The client has a nasogastric tube attached to suction for 2 days. Which arterial blood gas result will the nurse expect to see for this client?

Metabolic alkalosis

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Answer and Explanation

The Correct Answer is A

A.   This condition occurs because the suctioning can lead to a significant loss of hydrochloric acid from the stomach. Since hydrochloric acid is one of the components that maintain the acid-base balance in the body, its loss can lead to an increase in blood pH, causing alkalosis
B.   Respiratory acidosis occurs due to retention of carbon dioxide (CO2), leading to an increase in PaCO2 and a decrease in pH. In the context of a small bowel obstruction with nasogastric tube suctioning, this is less likely unless there are concurrent respiratory issues.
C.   This condition occurs because the suctioning can lead to a significant loss of hydrochloric acid from the stomach. Since hydrochloric acid is one of the components that maintain the acid-base balance in the body, its loss can lead to an increase in blood pH, causing alkalosis. Acidosis is, therefore, unlikely.
D.   Respiratory alkalosis occurs due to hyperventilation, leading to a decrease in PaCO2 and an increase in pH. This is less likely in the context of nasogastric tube suctioning unless there are other contributing factors.

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Correct Answer is D

Explanation

A. Completing an incident report may be necessary if the refusal could potentially impact patient care or if there are policies or procedures in place that require documenting such incidents. It helps to document the details of the refusal and any subsequent actions taken.
B. If the AP refuses to take the specimen, the nurse may need to take responsibility for ensuring the specimen is delivered to the laboratory promptly. This ensures that patient care activities are not delayed and that necessary diagnostic tests are performed in a timely manner.
C. Reporting the refusal to the charge nurse or supervisor is appropriate, especially if there are concerns about the AP's behavior or if it is part of the facility's policy to escalate such incidents. The charge nurse can then address the situation and determine the appropriate course of action.

D. Communicating with the AP to understand their concerns is essential. It allows the nurse to clarify any misunderstandings, address any issues or barriers the AP may have, and potentially resolve the situation collaboratively. It's important to listen to the AP's perspective and provide clarification or reassurance if needed.

A. A client who has diarrhea B. A client who has salicylate intoxication C. A client who is vomiting D. A client who is taking a thiazide diuretic

Correct Answer is A

Explanation

A. Diarrhea can lead to loss of bicarbonate from the body, resulting in metabolic acidosis. The loss of bicarbonate through gastrointestinal fluids causes an imbalance between acids and bases in the body.
B. Salicylates (such as aspirin) can cause metabolic acidosis by several mechanisms, including direct stimulation of the respiratory center in the brainstem (leading to hyperventilation and respiratory alkalosis initially) and later causing metabolic acidosis due to increased production of acids like lactic acid and ketoacids.
C. Vomiting can lead to loss of gastric acid (hydrochloric acid), which could initially lead to metabolic alkalosis due to loss of acid.
D. Thiazide diuretics can cause metabolic alkalosis rather than metabolic acidosis. They promote the loss of potassium and hydrogen ions (acid), leading to increased blood pH (alkalosis).

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A nurse has been assigned to care for a client diagnosed with a small bowel obstruction. The client has a nasogastric tube attached to suction for 2 days. Which arterial blood gas result will the nurse expect to see for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is A

Explanation

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