A nurse is reviewing the laboratory results of a client who is postoperative and has a respiratory rate of 7/min. The arterial blood gas (ABG) values include: pH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Oxygen saturation 80% Bicarbonate 28 mEq/L. Which of the following interpretations of the ABG values should the nurse make?
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
The Correct Answer is B
A. Metabolic acidosis
Metabolic acidosis is characterized by a low pH (< 7.35) and a decreased bicarbonate level (< 22 mEq/L). In this scenario, the pH is low (7.22), but the bicarbonate level is elevated (28 mEq/L), which does not support a diagnosis of metabolic acidosis.
B. Respiratory acidosis
Respiratory acidosis occurs when there is an accumulation of carbon dioxide (PaCO2 > 45 mm Hg), leading to a decrease in pH (< 7.35). In this case, the pH is low (7.22), and the PaCO2 is elevated (68 mm Hg), consistent with respiratory acidosis.
C. Metabolic alkalosis
Metabolic alkalosis is characterized by a high pH (> 7.45) and an elevated bicarbonate level (> 26 mEq/L). In this scenario, the pH is low (7.22), and the bicarbonate level is also elevated (28 mEq/L), which does not support a diagnosis of metabolic alkalosis.
D. Respiratory alkalosis
Respiratory alkalosis occurs when there is a decrease in carbon dioxide (PaCO2 < 35 mm Hg), leading to an increase in pH (> 7.45). In this case, the pH is low (7.22), and the PaCO2 is elevated (68 mm Hg), which is not consistent with respiratory alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Dyspnea: Dyspneais a hallmark symptom of emphysema. As lung function deteriorates, the client experiences difficulty breathing, especially during exertion, due to reduced gas exchange and air trapping in the lungs.
B. Barrel chest:A barrel chest is a common finding in emphysema due to hyperinflation of the lungs over time. This causes the chest to become rounded and expands the anterior-posterior diameter of the thorax.
C. Clubbing of the fingers: Clubbing of the fingers is not a typical finding in emphysema or COPD. It is more commonly associated with conditions like lung cancer, cystic fibrosis, or congenital heart disease, where chronic severe hypoxia is present.
D. Shallow respirations:Clients with emphysema often exhibit shallow respirations as their lung elasticity decreases, making it difficult to fully exhale. As a result, breathing may become more rapid and shallow to compensate for poor oxygen exchange.
E. Bradycardia: Bradycardiais not typically associated with emphysema. Instead, clients with chronic respiratory conditions like emphysema may experience tachycardiaas the body tries to compensate for low oxygen levels.

Correct Answer is C
Explanation
A. Muscle twitching
Muscle twitching is not a typical manifestation of oxygen toxicity. Instead, muscle twitching may be indicative of other conditions such as electrolyte imbalances (e.g., hypocalcemia or hypomagnesemia), neuromuscular disorders, or overstimulation of the nervous system.
B. Metallic taste in mouth
A metallic taste in the mouth is not commonly associated with oxygen toxicity. Instead, a metallic taste in the mouth may occur as a side effect of certain medications, dental issues, or as a symptom of other medical conditions such as acid reflux or oral infections.
C. Facial flushing
Facial flushing is a characteristic finding in oxygen toxicity. When exposed to high levels of oxygen over an extended period, individuals may experience facial flushing due to the vasodilatory effects of oxygen on blood vessels. This dilation of blood vessels leads to increased blood flow to the face, resulting in flushing or reddening of the skin.
D. Periorbital edema
Periorbital edema, or swelling around the eyes, is not a typical manifestation of oxygen toxicity. Instead, periorbital edema may occur as a result of various other conditions such as allergies, sinusitis, or fluid retention. It is not directly related to exposure to high levels of oxygen.

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