A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

A client who is taking a thiazide diuretic.

A client who is vomiting.

A client who has salicylate intoxication.

A client who has hypoventilation.

Answer and Explanation

The Correct Answer is C

The correct answer is **Choice C: A client who has salicylate intoxication.**

Choice A rationale:

A client taking a thiazide diuretic is at risk for metabolic alkalosis, not metabolic acidosis. Thiazide diuretics can cause a loss of potassium and chloride, leading to a relative increase in bicarbonate and a higher pH, resulting in metabolic alkalosis.

Choice B rationale:

A client who is vomiting is at risk for metabolic alkalosis, not metabolic acidosis. Vomiting leads to a loss of gastric acid (hydrochloric acid), resulting in a relative increase in bicarbonate and a higher pH, leading to metabolic alkalosis.

Choice C rationale:

A client with salicylate intoxication is at risk for metabolic acidosis. Salicylates, the active ingredient in aspirin, can cause an increased production of organic acids, leading to a decrease in pH and the development of metabolic acidosis.

Choice D rationale:

A client with hypoventilation is at risk for respiratory acidosis, not metabolic acidosis. Hypoventilation leads to a buildup of carbon dioxide, which dissolves in the blood to form carbonic acid, resulting in a decrease in pH and respiratory acidosis.

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Correct Answer is B

Explanation

Choice A rationale:

Hct (hematocrit) of 34% is a normal finding during pregnancy. Normal ranges vary during pregnancy, but generally, a hematocrit between 33% to 45% is considered normal during the second trimester.

Choice B rationale:

BUN (blood urea nitrogen) of 25 mg/dL should be reported to the provider. BUN measures kidney function, and during pregnancy, values above 20 mg/dL may indicate possible impaired kidney function, which requires further evaluation.

Choice C rationale:

Platelets of 170,000/mm³ are within the normal range during pregnancy. The normal platelet count during pregnancy is typically between 150,000 to 400,000/mm³.

Choice D rationale:

HbA1c (glycated hemoglobin) of 6% is a good indicator of blood sugar control and is within the target range for a pregnant woman with diabetes. The target HbA1c level for pregnant women with diabetes is usually around 6% or lower.

A. Cataracts B. Hearing loss. C. Macrosomia D. Urinary tract infection (UTI)

Correct Answer is B

Explanation

The correct answer is choice **b. Hearing loss**.

Choice A rationale:

Cataracts are not a common finding in newborns with congenital CMV infection. Cataracts are more commonly associated with other congenital infections like rubella, toxoplasmosis, and herpes simplex virus (HSV).

Choice B rationale:

Hearing loss is one of the most common manifestations of congenital CMV infection. Up to 40-58% of infants with symptomatic congenital CMV infection develop sensorineural hearing loss, which can be unilateral or bilateral, and progressive over time.

Choice C rationale:

Macrosomia, or large birth size, is not a typical finding in congenital CMV infection. In fact, infants with symptomatic congenital CMV infection are more likely to be small for gestational age or have intrauterine growth restriction.

Choice D rationale:

Urinary tract infection (UTI) is not a common presentation of congenital CMV infection. CMV can cause inclusion bodies in the urine, but overt UTI is not a typical finding. More common manifestations include petechiae, hepatosplenomegaly, jaundice, and central nervous system involvement.

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A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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