A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations?

Metabolic acidosis

Metabolic alkalosis

Respiratory alkalosis

Respiratory acidosis

Answer and Explanation

The Correct Answer is B

A.   Severe vomiting can lead to a loss of gastric acid, resulting in metabolic alkalosis and not acidosis.
B.   A client who is experiencing severe nausea and vomiting may lose gastric acid through vomitus and develop metabolic alkalosis, which is a condition characterized by a high pH (greater than 7.45) and a high bicarbonate (greater than 26 mEq/L). Metabolic alkalosis can cause confusion, tremors, tetany, and hypokalemia.
C. Respiratory alkalosis is not typically associated with vomiting; it is more often seen in conditions with hyperventilation.
D.   Respiratory acidosis is not the primary acid-base imbalance associated with vomiting; it is more commonly associated with conditions affecting lung function.

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Correct Answer is B

Explanation

A. The base excess, PaO2, saturation, and bicarbonate values are within normal ranges and do not indicate metabolic acidosis.
B. A client who has a respiratory rate of 7/min may have hypoventilation, which is a decreased rate or depth of breathing that causes carbon dioxide retention and decreased oxygenation. Hypoventilation can result in respiratory acidosis, which is a condition characterized by a low pH (less than 7.35) and a high PaCO2 (greater than 45 mm Hg).
C. The base excess, PaO2, saturation, and bicarbonate values are within normal ranges and do not indicate metabolic alkalosis.
D. The base excess, PaO2, saturation, and bicarbonate values are within normal ranges and do not indicate respiratory alkalosis.

A. Bilateral flank pain. B. Blood pressure 184/92 mm Hg. C. Generalized urticaria. D. Distended jugular veins.

Correct Answer is C

Explanation

A. Bilateral flank pain is more indicative of a possible renal issue, not an allergic transfusion reaction.
B. Elevated blood pressure is not a typical sign of an allergic transfusion reaction.
C. Generalized urticaria (hives) is a classic manifestation of an allergic transfusion reaction.
D. Distended jugular veins are not typically associated with an allergic transfusion reaction.

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A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGS? pH 7.22 PaCO2 68 mm Hg Base excess-2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Correct Answer is B

Explanation

A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction?

Correct Answer is C

Explanation

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