A nurse is reviewing the arterial blood gas (ABG) values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg

pH 7.50, HCO3- 20 mEq/L, PaCO2 32 mm Hg

pH 7.55, HCO3- 30 mEq/L, PaCO2 31 mm Hg

pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg

Answer and Explanation

The Correct Answer is A

Choice A reason:

This set of values indicates metabolic acidosis, which is common in chronic kidney disease due to the accumulation of acids in the body as the kidneys fail to eliminate them effectively³.

Choice B reason:

A pH of 7.50 is considered alkalotic, and while HCO3- and PaCO2 are within normal ranges, this set of values does not typically represent chronic kidney disease.

Choice C reason:

A pH of 7.55 is also alkalotic, and an HCO3- of 30 mEq/L indicates metabolic alkalosis, which is not characteristic of chronic kidney disease.

Choice D reason:

While a pH of 7.30 is on the lower end of the normal range, an HCO3- of 26 mEq/L is within the normal range, and a PaCO2 of 50 mm Hg indicates respiratory acidosis, not typically seen in chronic kidney disease without concurrent respiratory issues.

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Correct Answer is B

Explanation

Choice A reason:Lower extremity edema is more commonly associated with right-sided heart failure, as it indicates systemic fluid congestion.

Choice B reason:Crackles in lung bases are expected in left-sided heart failure due to pulmonary congestion from fluid backing up into the lungs².

Choice C reason:Jugular vein distention is typically a sign of right-sided heart failure, reflecting increased central venous pressure.

Choice D reason:Ascites, the accumulation of fluid in the peritoneal cavity, is generally associated with right-sided heart failure or liver disease, not specifically left-sided heart failure.

A. Frequent nosebleeds and bruising B. Urinary retention C. No bowel movement in three days D. Increased blood glucose

Correct Answer is A

Explanation

Choice A reason: Frequent nosebleeds and bruising are indicative of coagulopathy, a common complication in advanced cirrhosis due to the liver's impaired ability to synthesize clotting factors. This can lead to an increased tendency to bleed.

Choice B reason: Urinary retention is not typically associated with cirrhosis. Instead, cirrhosis can lead to renal dysfunction known as hepatorenal syndrome, characterized by the failure of the kidneys to filter waste from the blood².

Choice C reason: While constipation can occur in cirrhosis, no bowel movement in three days is not a direct complication of cirrhosis. However, it could be related to the overall health status of the patient or medications used.

Choice D reason: Increased blood glucose is not a direct complication of cirrhosis. Cirrhosis primarily affects the metabolism of proteins and fats and does not directly cause hyperglycemia unless there is concurrent diabetes or metabolic syndrome.

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A nurse is reviewing the arterial blood gas (ABG) values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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