A nurse is reviewing laboratory results of a client. The client's ABG results are as follows: pH 7.2, HCO, 26 mEq/L, PaCO2 52 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
Respiratory acidosis
The Correct Answer is D
A) Metabolic acidosis: In metabolic acidosis, you would expect a low pH (acidosis) with a low bicarbonate (HCO3-) level. However, the given bicarbonate level is within the normal range (22-26 mEq/L), which indicates the acidosis is not metabolic in origin.
B) Metabolic alkalosis: Metabolic alkalosis would present with a high pH (alkalosis) and an elevated bicarbonate (HCO3-) level. The pH in this case is low, indicating acidosis, and the bicarbonate level is normal, ruling out metabolic alkalosis.
C) Respiratory alkalosis: In respiratory alkalosis, you would see a high pH (alkalosis) and a low PaCO2 due to hyperventilation. The given pH is low, indicating acidosis, and the PaCO2 is elevated, which is inconsistent with respiratory alkalosis.
D) Respiratory acidosis: Respiratory acidosis is characterized by a low pH (acidosis) and an elevated PaCO2 due to hypoventilation or impaired gas exchange. The client's ABG results show a low pH (7.2), a normal bicarbonate level (26 mEq/L), and an elevated PaCO2 (52 mm Hg), indicating the client is experiencing respiratory acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Drink cold beverages to increase peristalsis: While hydration is important for overall health, drinking cold beverages specifically is not a well-supported method for increasing peristalsis. The key to avoiding constipation is adequate fluid intake, but it doesn't need to be cold.
B) Increase daily water intake: Increasing daily water intake is a fundamental and effective strategy to prevent constipation. Adequate hydration helps soften the stool, making it easier to pass and promoting regular bowel movements.
C) Take a daily laxative to soften stools: Relying on a daily laxative is not recommended for long-term management of constipation as it can lead to dependence and disrupt normal bowel function. Dietary and lifestyle changes are preferred for preventing constipation.
D) Eat a low-residue diet: A low-residue diet, which is low in fiber and roughage, is typically used for specific medical conditions and may contribute to constipation rather than prevent it. To avoid constipation, a high-fiber diet is usually recommended to promote healthy bowel movements.
Correct Answer is D
Explanation
A) Aspirin can be given to decrease the fever caused by varicella: Aspirin should not be used in children with varicella (chickenpox) due to the risk of Reye’s syndrome, a rare but serious condition that can cause liver and brain damage. Instead, acetaminophen or ibuprofen is recommended for fever management in these cases.
B) Maintaining a warm environment decreases the eruption of lesions: Maintaining a warm environment does not affect the eruption of varicella lesions and could potentially exacerbate discomfort. A cool environment and loose, comfortable clothing are preferred to help alleviate itching and discomfort.
C) Varicella has an incubation period of 1 to 3 days: The incubation period for varicella is typically 10 to 21 days after exposure. The shorter period of 1 to 3 days is not accurate for varicella and does not reflect the standard incubation period of this disease.
D) An antihistamine can be administered to decrease pruritus: Antihistamines are effective in managing itching (pruritus) associated with varicella lesions. They can help provide relief from the discomfort caused by the rash, making this an appropriate intervention.
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