A nurse in an emergency department is admitting a client who has overdosed on antacids and is in a state of metabolic alkalosis. For which of the following manifestations should the nurse monitor?
Diarrhea
Bradycardia
Tinnitus
Tetany
The Correct Answer is D
A) Diarrhea: Metabolic alkalosis is more likely to be associated with constipation rather than diarrhea. Diarrhea is typically a cause of metabolic acidosis due to the loss of bicarbonate in stool, rather than a result of metabolic alkalosis.
B) Bradycardia: Bradycardia is not a typical manifestation of metabolic alkalosis. Alkalosis can lead to arrhythmias, but it generally does not cause a slow heart rate. Instead, tachycardia might occur as the body compensates for the altered acid-base balance.
C) Tinnitus: Tinnitus is not a common symptom of metabolic alkalosis. It is more often associated with aspirin toxicity or other conditions affecting the auditory system, rather than changes in acid-base balance.
D) Tetany: Tetany is a common manifestation of metabolic alkalosis. The alkalosis causes a decrease in ionized calcium levels, which increases neuromuscular excitability and can lead to muscle cramps, spasms, and tetany. This is a key sign for nurses to monitor as it indicates significant electrolyte disturbances associated with the alkalotic state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Bicarbonate 26 mEq/L: A bicarbonate level of 26 mEq/L is within the normal range (22-28 mEq/L) and does not indicate metabolic acidosis, which is characteristic of diabetic ketoacidosis (DKA). In DKA, bicarbonate levels are usually decreased due to buffering of the excess acids.
B) Serum pH 7.32: A serum pH of 7.32 is indicative of acidemia, which is consistent with metabolic acidosis seen in DKA. The pH is typically lower than the normal range (7.35-7.45) in DKA due to the accumulation of ketoacids.
C) Creatinine 1.2 mg/dL: A creatinine level of 1.2 mg/dL is slightly elevated but does not specifically indicate metabolic acidosis. Elevated creatinine may suggest renal impairment but is not directly linked to the acid-base disturbance seen in DKA.
D) BUN 20 mg/dL: A blood urea nitrogen (BUN) level of 20 mg/dL is elevated and may indicate dehydration or kidney dysfunction but does not specifically diagnose the acid-base imbalance associated with DKA. In DKA, bicarbonate and pH levels are more directly affected.
Correct Answer is C
Explanation
A) Sensorineural deafness
This is a possible complication of mumps but not a symptom indicating the illness stage. It can occur after the infection and does not reflect the active phase of the disease.
B) Maculopapular rash
This type of rash is not typically associated with mumps. It may indicate other viral infections, such as measles or rubella, rather than mumps.
C) Swelling of the parotid glands
Swelling of the parotid glands is a hallmark symptom of the illness stage of mumps. This swelling typically appears a few days after the onset of other symptoms like fever and malaise and signifies the active phase of the infection.
D) Nuchal rigidity
Nuchal rigidity can occur if there is mumps-related meningitis, but it is not a typical sign of the initial illness stage. It indicates potential complications involving the central nervous system.
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