A patient has the following arterial blood gas results: PH: 7.50. PaC02: 31 mm Hg, HC03-: 25 mEq/L. The nurse determines that these results indicate:

Respiratory alkalosis

Respiratory acidosis

Metabolic alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is A

Based on the given arterial blood gas results, the patient's pH is elevated, indicating alkalosis. The PaCO2 level is decreased, which suggests respiratory compensation. The bicarbonate (HCO3-) level is within the normal range. Therefore, the interpretation of the arterial blood gas results is respiratory alkalosis.

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Correct Answer is B

Explanation

The statement "I had the stomach ﬂu earlier this week and couldn't take the hydrocortisone" indicates that the patient may not be adhering to their prescribed medication regimen, which can lead to an Addisonian crisis. Therefore, the nursing diagnosis of ineﬀective therapeutic regimen management related to lack of knowledge of management of the condition is appropriate.

Addison’s disease is a condition in which the adrenal glands do not produce enough cortisol and aldosterone. Hydrocortisone is a glucocorticoid medication that is often used to replace the cortisol that the adrenal glands are not producing. In the Addisonian crisis, the body is unable to produce the necessary levels of cortisol and aldosterone, which can lead to potentially life-threatening complications such as hypotension, dehydration, and electrolyte imbalances.

The other statements may indicate areas where patient education is needed, but they do not directly relate to the immediate risk of an Addisonian crisis.

A. "Oﬀer the client the commode or urinal every 2 hours." B. "Decrease the client's oral ﬂuid intake to 1 L/day." C. "Instruct the client to hold urine as long as possible to restore bladder tone." D. "Use a Foley catheter at night to prevent accidents."

Correct Answer is A

Explanation

The nurse will include the instruction "Oﬀer the client the commode or urinal every 2 hours" in the teaching plan for the client's family. This approach is known as timed voiding and can help the client re-establish a regular pattern of urination. Option "a" promotes frequent voiding, which helps

prevent accidents and promotes bladder health. Option "b" is not a recommended approach and can lead to dehydration, urinary tract infections, and other complications. Option "c" is also not recommended since holding urine for extended periods can lead to bladder distention and increase the risk of urinary tract infections. Option "d" is also not recommended since catheterization should only be considered in specific cases where other options have failed or are not feasible.

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A patient has the following arterial blood gas results: PH: 7.50. PaC02: 31 mm Hg, HC03-: 25 mEq/L. The nurse determines that these results indicate:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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