A nurse is reviewing laboratory results for a client who has metabolic alkalosis. Which of the following blood gas values should the nurse expect?
pH 7.48 (7.35 to 7.45) PaCO 32 mm Hg (35 to 45 mm Hg). HC0 24 mg (22 to 25 mEq/L)
pH 7.36 (7:35 to 7.45) PaCO 38 mm Hg (35 to 45 mm Hg. HCO 25 mEq/L (22 to 26 mEq/L)
pH 7.46 (7.35 to 7.45) PaCO 36 mm Hg (35 to 45 mm Hg)HCO 29 mEq/L (22 to 25 mEq/L)
pH 7.26 (7.35 to 7.45). Paco; 35 mm Hg (35 to 45 min Hg HCD 18 mEq/L (22 to 26 mEq/L)
The Correct Answer is C
A. pH 7.48, PaCO₂ 32 mm Hg, HCO₃ 24 mEq/L: The elevated pH indicates alkalosis, but HCO₃ is within normal limits. This pattern suggests respiratory alkalosis with compensatory changes rather than metabolic alkalosis.
B. pH 7.36, PaCO₂ 38 mm Hg, HCO₃ 25 mEq/L: These values are within normal limits, indicating acid-base balance. They do not reflect metabolic alkalosis and would not explain clinical signs of alkalemia.
C. pH 7.46, PaCO₂ 36 mm Hg, HCO₃ 29 mEq/L: The elevated pH indicates alkalosis, and the increased HCO₃ identifies a metabolic origin. The PaCO₂ is near normal, suggesting minimal respiratory compensation, which is consistent with metabolic alkalosis.
D. pH 7.26, PaCO₂ 35 mm Hg, HCO₃ 18 mEq/L: The low pH and low HCO₃ indicate metabolic acidosis, not alkalosis. These values are inconsistent with the expected findings for metabolic alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Deliver 2 L of oxygen via partial nonrebreather mask: While supplemental oxygen may support oxygenation, it does not treat the underlying life-threatening allergic reaction. Oxygen alone is insufficient for anaphylaxis and should not delay definitive treatment.
B. Give epinephrine intramuscularly: Epinephrine is the first-line treatment for anaphylaxis and rapidly counteracts airway constriction, hypotension, and vascular permeability. Intramuscular administration in the mid-outer thigh provides rapid absorption and is essential to prevent respiratory compromise and shock.
C. Notify the radiology department: Notifying radiology is unrelated to the acute management of an allergic reaction. Immediate intervention to secure the airway and treat anaphylaxis takes priority over nonessential notifications.
D. Administer diazepam PO: Diazepam is an anxiolytic and has no role in managing anaphylaxis or airway obstruction. It does not reverse histamine-mediated effects and would delay critical emergency treatment.
Correct Answer is B
Explanation
A. Polio: The inactivated polio vaccine does not contain live virus and does not increase bleeding risk in clients with thrombocytopenia. It is generally considered safe to administer and does not worsen platelet destruction. Routine immunization schedules can usually be continued with this vaccine.
B. Measles, mumps, and rubella virus: The MMR vaccine is a live attenuated vaccine and is associated with the development or worsening of thrombocytopenia. In a client with idiopathic thrombocytopenic purpura, this vaccine should be withheld due to the risk of further platelet reduction and bleeding complications. Careful timing or deferral is recommended until platelet counts stabilize.
C. Diphtheria and tetanus toxoids and pertussis: This vaccine is inactivated and does not pose a risk of viral replication or immune-mediated platelet destruction. While injection technique may need to be adjusted to reduce bleeding risk, the vaccine itself is not contraindicated.
D. Hepatitis B: Hepatitis B vaccine is non-live and safe for clients with thrombocytopenia. Although intramuscular injections can increase the risk of localized bleeding, the vaccine itself does not exacerbate ITP. Applying firm pressure after injection helps minimize bruising or hematoma formation.
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