A nurse reviewing the medical record of a patient who has metabolic acidosis should realize that which of the following findings contributes to the development of metabolic acidosis?
Diarrhea
Salicylate intoxication
Vomiting
Hyperventilation
The Correct Answer is A
Choice A reason: Diarrhea can lead to metabolic acidosis due to the loss of bicarbonate, which is a base, leading to a relative increase in acidity.
Choice B reason: Salicylate intoxication can initially cause respiratory alkalosis due to hyperventilation, but may later lead to metabolic acidosis as the body compensates.
Choice C reason: Vomiting typically leads to a loss of gastric acid, which would cause metabolic alkalosis, not acidosis.
Choice D reason: Hyperventilation is more commonly associated with respiratory alkalosis due to the excessive loss of CO2, which is an acid, not metabolic acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. Raise the head of the bed.
Choice A rationale:
Increasing the patient’s oral fluid intake is important for hydration and thinning secretions, but it is not the immediate priority when oxygen saturation is critically low.
Choice B rationale:
Raising the head of the bed helps improve lung expansion and facilitates easier breathing, which can quickly improve oxygen saturation levels. This is a critical first step in managing low oxygen saturation.
Choice C rationale:
Initiating humidified oxygen therapy is essential for improving oxygenation, but it should follow the immediate action of raising the head of the bed to optimize breathing.
Choice D rationale:
Encouraging the patient to cough and deep breathe is beneficial for clearing secretions and improving lung function, but it is not the first action to take when oxygen saturation is critically low.
Correct Answer is A
Explanation
Choice A reason: Swelling and tenderness around a wound are common signs of infection. The body's inflammatory response to the invading bacteria causes these symptoms.
Choice B reason: Serosanguineous drainage, which is composed of both blood and a clear yellow liquid called serum, is typically a normal part of the healing process and not necessarily a sign of infection.
Choice C reason: Bromocriptine is a medication and not a sign of wound infection. This choice seems to be a distractor and does not relate to the clinical signs of a wound infection.
Choice D reason: Urticaria, also known as hives, is a reaction that can be caused by an allergy, stress, or other factors, and is not a direct sign of wound infection.
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