A nurse is admitting a client who has status asthmaticus. The client's ABG results are Ph:7.31, Pa02:74mm Hg, PaC02: 56 mmHg and HCO-3: 26mEq/L The nurse should interpret these laboratory values as which of the following imbalances?

Metabolic alkalosis

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Answer and Explanation

The Correct Answer is B

The pH value is less than the normal range of 7.35-7.45, indicating acidosis. The PaCO2 value is elevated above the normal range of 35-45 mmHg, indicating respiratory acidosis. The PaO2 value is lower than normal, but not significantly low enough to indicate hypoxemia. The HCO3- level is within the normal range, but not significantly high enough to indicate metabolic compensation for respiratory acidosis.

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Correct Answer is B

Explanation

Abdominal discomfort an hour after a meal is a common symptom of a gastric ulcer because the stomach is where food is initially processed, and stomach acid is most concentrated. In contrast, duodenal ulcers typically cause pain 2-3 hours after meals, as food moves out of the stomach and into the duodenum, where it encounters duodenal acid.

A positive stool occult blood test is a non-specific finding that can be caused by many gastrointestinal conditions, including peptic ulcers. It does not indicate the location of the ulcer.

The number of ulcers the client has had in the past does not indicate the location of the current ulcer.

Normal hemoglobin and hematocrit levels do not provide information about the location of the ulcer.

A. Excess ﬂuid volume related to intake greater than output. B. Risk for impaired skin integrity related to generalized edema. C. Activity intolerance related to muscle cramps and weakness. D. Insomnia related to waking at night to void.

Correct Answer is A

Explanation

Excess ﬂuid volume related to intake greater than output would be the most appropriate nursing diagnosis for a patient with symptoms of DI (diabetes insipidus). This condition results in excessive urine output and, as a consequence, can lead to dehydration and electrolyte imbalances. Therefore, monitoring and managing ﬂuid volume is a priority for patients with DI.

Risk for impaired skin integrity related to generalized edema is more commonly associated with conditions that cause ﬂuid retention such as heart failure, liver failure, or kidney disease, rather than DI.

Activity intolerance related to muscle cramps and weakness is a possible nursing diagnosis for patients with conditions that aﬀect muscle function, such as muscular dystrophy or multiple sclerosis, but not specifically for DI.

Insomnia related to waking at night to void is more commonly associated with urinary frequency or nocturia due to conditions such as urinary tract infections or benign prostatic hyperplasia, but not specifically for DI.

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A nurse is admitting a client who has status asthmaticus. The client's ABG results are Ph:7.31, Pa02:74mm Hg, PaC02: 56 mmHg and HCO-3: 26mEq/L The nurse should interpret these laboratory values as which of the following imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with diagnosis of peptic ulcer disease. Which assessment finding indicates to the nurse that the client most likely has an ulcer in the stomach rather than the duodenum?

Correct Answer is B

Explanation

The nurse is creating the care plan for a patient with symptoms of DI who was admited to the hospital for evaluation and treatment of the condition. An appropriate nursing diagnosis for the patient is:

Correct Answer is A

Explanation

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