A woman was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6, PaO2 120 mm Hg. PaCO2 31 mm Hg, and HCO3 25 mmol/L.

What does this mean?

Respiratory Acidosis, Partially Compensated

Respiratory Alkalosis, Uncompensated

Metabolic Alkalosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

Answer and Explanation

The Correct Answer is B

A.   This is incorrect because the pH is indicative of alkalosis, not acidosis, and the body has not compensated.
B.   The arterial blood gas (ABG) values provided indicate a pH of 7.6, which is above the normal range (7.35-7.45), suggesting alkalosis. The PaCO2 is low at 31 mm Hg, indicating hyperventilation, which is a respiratory process. Since the HCO3 is normal at 25 mmol/L, it suggests that the metabolic system is not the cause of the alkalosis. The body has not had time to compensate for the high pH with renal adjustments to the bicarbonate level, which would be seen in a partially compensated state.
C.   This is incorrect because the bicarbonate level is normal, suggesting the metabolic system is not the cause.
D.   This is incorrect because the bicarbonate level is normal, suggesting the metabolic system is not the cause.

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Correct Answer is D

Explanation

A. Infusing hypotonic fluids such as 0.45% sodium chloride can exacerbate hyponatremia in a client with SIADH by further diluting serum sodium levels.
B. Desmopressin acetate is a synthetic form of ADH and would exacerbate the symptoms of SIADH by increasing water reabsorption and further diluting serum sodium levels.
C. Increasing dietary sodium intake would not be appropriate for a client with SIADH, as it would contribute to further fluid retention and exacerbate hyponatremia.
D. Fluid restriction is a key component of managing SIADH to prevent further water retention and dilutional hyponatremia. Restricting fluid intake helps to normalize serum sodium levels by allowing excess water to be excreted.

A. Decreased calcium level B. Decreased potassium level C. Elevated sodium level D. Elevated magnesium level

Correct Answer is B

Explanation

A. Postoperative ileus and NG tube drainage are not typically associated with decreased calcium levels.
B. The nurse should monitor for electrolyte imbalances, particularly a decreased potassium level. This is because the gastrointestinal tract, especially the stomach, contains a high concentration of potassium, and substantial losses can occur with ongoing gastric suctioning.
C. NG tube drainage does not typically result in elevated sodium levels.
D. NG tube drainage does not typically result in elevated magnesium levels.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

Correct Answer is D

Explanation

A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for?

Correct Answer is B

Explanation

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

A nurse is assessing a preschooler who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect?

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?

A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?