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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:While sharing needles can transmit hepatitis, it is more commonly associated with hepatitis B and C, not hepatitis A.
Choice B reason:Eating shellfish from contaminated water is a well-known route of transmission for hepatitis A, aligning with the client's symptoms.
Choice C reason:Blood transfusions were a risk for hepatitis transmission in the past, but since the 1990s, blood products are screened for hepatitis, making this an unlikely source.
Choice D reason:Unprotected sex can be a route of transmission for hepatitis, but hepatitis A is more commonly spread through ingestion of contaminated food or water, not sexual contact.
Correct Answer is C
Explanation
Choice A reason: Bradycardia, which is a slower than normal heart rate, is not a common finding associated with renal calculi. Renal calculi, or kidney stones, typically cause symptoms related to the urinary system rather than directly affecting the heart rate.
Choice B reason: Bradypnea, or abnormally slow breathing, is also not a typical symptom of renal calculi. Patients with kidney stones may experience changes in urination patterns, such as frequency or urgency, but not typically changes in respiratory rate.
Choice C reason: Severe pain is indeed the most common symptom associated with renal calculi. This pain, known as renal colic, is often sudden in onset, very severe, and may radiate from the back down to the lower abdomen or groin. The pain is caused by the stone moving into the ureter and causing a blockage, which leads to increased pressure and stretching of the kidney or ureter. Renal calculi can cause a range of symptoms, with severe pain being the most prominent and often the first symptom that leads individuals to seek medical care. The pain is typically very intense and can be accompanied by other symptoms such as nausea, vomiting, and hematuria (blood in the urine).
Choice D reason: Nocturia, or frequent urination at night, can be a symptom of renal calculi, especially if the stones affect the bladder or cause urinary tract infections. However, the most characteristic symptom of renal calculi is severe pain, not necessarily nocturia.
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