A patient with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas (ABG) results: a blood pH of 7.29, a partial pressure of carbon dioxide (PaCO2) level of 49 mm Hg, and a bicarbonate ion (HCO3) level of 25 mEq/L. Which condition would the nurse have in mind when developing the patient's plan of care?

Metabolic acidosis.

Metabolic alkalosis.

Respiratory acidosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. In this case, the patient has a high bicarbonate ion level (25 mEq/L), indicating a compensatory response to respiratory acidosis. Metabolic alkalosis, on the other hand, would present with high pH and high bicarbonate ion levels.

Choice B rationale:

Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's bicarbonate ion level (25 mEq/L) is within the normal range, and the low pH and high PaCO2 (49 mm Hg) indicate respiratory acidosis, not metabolic alkalosis.

Choice C rationale:

Respiratory acidosis is characterized by low blood pH and high partial pressure of carbon dioxide (PaCO2) levels. In this case, the patient has a low pH (7.29) and elevated PaCO2 (49 mm Hg), indicating respiratory acidosis. The elevated bicarbonate ion level (25 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.

Choice D rationale:

Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (49 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.29) further supports the diagnosis of respiratory acidosis.

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Correct Answer is D

Explanation

Choice A rationale:

A lumbar puncture is not typically performed to rule out bone marrow involvement in non-Hodgkin lymphoma. Imaging studies and bone marrow biopsies are more appropriate for evaluating bone marrow involvement.

Choice B rationale:

Determining the level of cell differentiation is not the primary purpose of a lumbar puncture in non-Hodgkin lymphoma. This information is usually obtained from a biopsy of the affected lymph nodes or organs.

Choice C rationale:

Identifying the specific lymph cell type involved is not the main objective of a lumbar puncture in non-Hodgkin lymphoma. This information is usually determined through lymph node biopsy and other imaging studies.

Choice D rationale:

The purpose of a lumbar puncture in non-Hodgkin lymphoma is to find any central nervous system involvement. Lymphoma cells can spread to the central nervous system, and a lumbar puncture allows for the examination of cerebrospinal fluid to detect any cancerous cells, which can guide treatment decisions.

A. The electrolyte is the most abundant intracellular cation present in the body. B. The electrolyte may cause extracellular fluid overload. C. Magnesium may affect neuromuscular excitability and contractility. D. The patient is at risk for hypotension when the levels of magnesium decrease.

Correct Answer is C

Explanation

Choice A rationale:

While magnesium is indeed the most abundant intracellular cation in the body, this fact alone does not explain why the nurse would assess the patient's magnesium level.

Choice B rationale:

Magnesium imbalance can cause issues in the extracellular fluid compartment, but this choice does not explain why the nurse would specifically assess the patient's magnesium level.

Choice D rationale:

While hypotension can be a symptom of severe magnesium deficiency, this choice does not provide a rationale for assessing the patient's magnesium level. In this case, choice C is correct because magnesium plays a crucial role in neuromuscular excitability and contractility. Abnormal magnesium levels can lead to neuromuscular symptoms such as muscle weakness, tremors, and spasms. Additionally, magnesium is involved in cardiac muscle function, and low magnesium levels can lead to arrhythmias and other cardiac issues. Therefore, assessing the patient's magnesium level is essential in understanding their neuromuscular and cardiac health.

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Naxlex Comprehensive Predictor Exams

Which explanation will the nurse give a patient with non-Hodgkin lymphoma about the purpose of a planned lumbar puncture?

Correct Answer is D

Explanation

Which rationale supports the nurse's assessment of a patient's magnesium level?

Correct Answer is C

Explanation

The nurse provides education to a patient about the symptoms of uncontrolled hypertension.Which symptom would the nurse include? Select all that apply.One, some, or all responses may be correct.

Which phrase describes the function of a buffer?

A healthy 70-year-old patient has low hemoglobin levels and no signs of gastrointestinal bleeding.The nurse recognizes which item is an effect of aging that could be the reason for the low hemoglobin level?

Which information would the nurse include when discussing pain due to chronic stable angina with the patient?

The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?

The nurse provides discharge teaching to a patient with venous leg ulcers.Which statement made by the patient indicates the need for further education?

The nurse receives information about the assigned patients during shift report.Which patient would the nurse assess first?

The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?