A nurse is caring for a client who is hyperventilating and has the following ABG results: pH 7.50 (7.35 to 7.45), PaCO₂ 29 mm Hg (35 to 45 mm Hg), and HCO₃ 25 mEq/L (21 to 28 mEq/L). The nurse should identify that the client has which of the following acid-base imbalances?

Choice A Reason:

The statement that “Your provider will use your digital rectal examination to perform the test” is incorrect. A fecal occult blood test (FOBT) typically involves collecting stool samples at home over several days, not during a digital rectal examination. The samples are then sent to a lab for analysis to detect hidden blood in the stool.

Choice B Reason:

The statement that “Your provider will prescribe a stimulant laxative prior to the procedure to evacuate the bowel” is also incorrect. There is no need for a stimulant laxative before an FOBT. The test requires normal bowel movements to detect any hidden blood in the stool.

Choice C Reason:

The recommendation to “begin annual fecal occult blood testing for colorectal cancer screening at 40 years old” is not accurate. Current guidelines generally recommend starting colorectal cancer screening at age 45 for individuals at average risk. However, those with higher risk factors may need to start earlier, based on their healthcare provider’s advice.

Choice D Reason:

The statement “You should avoid taking corticosteroids prior to testing” is correct. Certain medications, including corticosteroids, can cause gastrointestinal bleeding, which may lead to false-positive results in an FOBT. Therefore, it is important to avoid these medications before the test, as advised by a healthcare provider.

Choice A Reason:

Taking medicine with orange juice is not recommended for clients with GERD. Citrus juices, including orange juice, are highly acidic and can exacerbate GERD symptoms by increasing stomach acidity and causing reflux.

Choice B Reason:

A bedtime snack is likely to worsen heartburn rather than prevent it. Eating close to bedtime can increase the likelihood of acid reflux during the night, as lying down soon after eating can cause stomach contents to flow back into the esophagus.

Choice C Reason:

Lying down after meals is not advisable for clients with GERD. It is recommended to remain upright for at least 2-3 hours after eating to help prevent acid reflux. Lying down can increase the risk of stomach acid flowing back into the esophagus.

Choice D Reason:

Limiting activities that require bending at the waist is a good practice for managing GERD. Bending over can increase abdominal pressure and promote acid reflux. Instead, clients should try to bend at the knees or avoid such activities when possible.