A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

Hematocrit 40%

Creatinine 0.9 mg/dL

WBC count 20,000/mm3

Potassium 3.8 mEq/L

Answer and Explanation

The Correct Answer is C

A.   A hematocrit of 40% is within the normal range for females, which is typically around 37-47%. This result is not concerning and does not typically require immediate notification to the surgeon.
B.   A creatinine level of 0.9 mg/dL is within the normal range for adults (normal range varies slightly among laboratories but is generally around 0.5-1.1 mg/dL). This result indicates normal kidney function and does not require immediate notification.
C.   A white blood cell (WBC) count of 20,000/mm3 is elevated above the normal range, which is typically between 4,500-11,000/mm3. An elevated WBC count could indicate infection or inflammation. Given the client is preoperative, an elevated WBC count may suggest an underlying infection that needs to be addressed before proceeding with surgery. The nurse should notify the surgeon promptly so appropriate evaluation and management can be initiated.
D.   A potassium level of 3.8 mEq/L is within the normal range (normal range is generally 3.5-5.0 mEq/L). This result is not concerning and does not require immediate notification to the surgeon.

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Correct Answer is D

Explanation

A. A pH of 7.45 indicates alkalosis, not acidosis. In respiratory acidosis, the pH would be lower than normal (below 7.35) due to the accumulation of carbon dioxide.
B. A bicarbonate (HCO3-) level of 30 mEq/L is within the normal range (typically 22-26 mEq/L). Bicarbonate levels may be normal or slightly elevated in respiratory acidosis as a compensatory mechanism to buffer the excess acid.
C. Potassium levels can vary in respiratory acidosis but are not typically specified by a specific value. The level of potassium is more directly related to metabolic acid-base disturbances rather than respiratory acidosis.
D. An elevated PaCO2 level above 45 mm Hg indicates respiratory acidosis. In this scenario, a PaCO2 of 50 mm Hg suggests that the client is retaining carbon dioxide, leading to an acidotic state (lower pH).

A. Metabolic alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Respiratory alkalosis

Correct Answer is B

Explanation

A. Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate (HCO3-). The ABG results show a pH of 7.32 (which is acidic), PaCO2 of 48 mm Hg (slightly elevated), and HCO3- of 23 mEq/L (within normal range). These findings do not indicate metabolic alkalosis.
B. Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mm Hg). The ABG results show a pH of 7.32 (acidic) and a PaCO2 of 48 mm Hg (slightly elevated). These findings are consistent with respiratory acidosis, where the elevated PaCO2 indicates inadequate ventilation leading to retention of carbon dioxide and subsequent acidosis.

C. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3-). The ABG results show a pH of 7.32 (acidic) and HCO3- of 23 mEq/L (normal). These findings are not indicative of metabolic acidosis.
D. Respiratory alkalosis is characterized by a high pH (>7.45) and a decreased PaCO2 (<35 mm Hg). The ABG results show a pH of 7.32 (acidic) and a PaCO2 of 48 mm Hg (elevated). These findings do not indicate respiratory alkalosis.

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A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 48 mm Hg and the HCO3 is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?

Correct Answer is B

Explanation

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