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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Instructing the client to maintain scheduled mealtimes is essential for a postpartum client with type 1 diabetes mellitus who is breastfeeding. Consistent and balanced meals help stabilize blood glucose levels, especially in diabetic clients who need to manage their insulin.
Choice B rationale:
Checking blood glucose levels every 8 hours is not appropriate for a postpartum client with type 1 diabetes mellitus. Diabetic clients typically need to monitor their blood glucose more frequently, especially after meals and during breastfeeding.
Choice C rationale:
Instructing the client to take more insulin with each meal than she did prior to pregnancy is not accurate advice. The insulin requirements may change during pregnancy, but it is essential to follow the healthcare provider's guidance on adjusting insulin doses after delivery.
Choice D rationale:
Limiting carbohydrate intake to 30 grams per day is not suitable for a breastfeeding postpartum client with type 1 diabetes mellitus. Carbohydrates are a crucial source of energy, and breastfeeding mothers usually require more carbohydrates to support lactation and energy needs. Restricting carbohydrates to such a low level could be harmful.
Correct Answer is B
Explanation
Choice A rationale:
The nurse should not measure the abdominal circumference at the level of the newborn's umbilicus every 12 hr because this action does not address the specific problem presented in the scenario, which is abdominal distention and bloody stools. Measuring abdominal circumference is typically done to assess for growth and may not provide valuable information in this situation.
Choice B rationale:
Inserting an orogastric decompression tube with low wall suction is the appropriate action for a newborn with abdominal distension and bloody stools. This intervention can help decompress the gastrointestinal tract, reducing abdominal distention, and possibly preventing further complications.
Choice C rationale:
Providing the newborn with an iron-rich formula containing vitamin B12 every 2 hr is not indicated based on the information provided in the scenario. The newborn's symptoms are suggestive of gastrointestinal issues, and this intervention may not address the underlying cause.
Choice D rationale:
Administering nitric oxide inhalation therapy to the newborn is not appropriate in this context. Nitric oxide inhalation therapy is typically used for conditions like persistent pulmonary hypertension in the newborn, and there is no indication for its use in this case.
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