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: A heart murmur is not a common finding in right-sided heart failure unless there is an associated valvular heart disease.
Choice B reason: Dependent edema is a classic sign of right-sided heart failure due to the accumulation of fluid in the tissues, particularly in the lower extremities.
Choice C reason: Chest pain is more commonly associated with left-sided heart failure or other cardiac conditions such as angina.
Choice D reason: Crackles in the lungs are typically found in left-sided heart failure due to pulmonary congestion, not right-sided heart failure.
Correct Answer is B
Explanation
Choice A: Instruct the client to lean forward This action is not related to the assessment of asterixis. Leaning forward can be part of the physical examination for other conditions, such as assessing for spinal issues or abdominal pain, but it does not provoke the characteristic flapping motion of the hands seen in asterixis.
Choice B: Ask the client to extend the arms This is the correct method to assess for asterixis. The patient is asked to extend their arms and dorsiflex their wrists. The nurse then observes for any involuntary flapping movements of the hands, which would indicate the presence of asterixis. This sign is indicative of a disturbance in the central nervous system’s regulation of muscle tone, often due to metabolic liver dysfunction. To assess for asterixis, the nurse should ask the client to extend their arms, which is the standard method for eliciting this sign. The presence of asterixis can help in the diagnosis of hepatic encephalopathy and other metabolic conditions affecting the brain’s control of muscle tone.
Choice C: Dorsiflex the client’s foot Dorsiflexion of the foot is not a method used to assess for asterixis. While changes in muscle tone can be assessed in the lower limbs, asterixis is specifically a hand tremor and is best observed in the upper extremities.
Choice D: Measure the abdominal girth Measuring abdominal girth is relevant in the assessment of ascites, which can occur in cirrhosis, but it is not a method for assessing asterixis. Ascites refers to the accumulation of fluid in the peritoneal cavity, leading to increased abdominal size, which is a common complication of cirrhosis.
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