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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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Making a list of favorite beverages shows awareness but does not necessarily indicate an understanding of fluid restriction.
B. Putting beverages in large containers to deceive fluid intake is not a recommended or appropriate strategy for managing fluid restriction.
C. Not adding fluid-rich foods like ice cream to the total fluid intake demonstrates an understanding of fluid restriction and adherence to the prescribed limit.
D. Consuming most fluids during the evening is not an appropriate strategy for fluid restriction; fluid intake should be evenly distributed throughout the day.

A. Measure blood glucose levels every 4 hr. B. Check urine specific gravity. C. Administer a diuretic D. Initiate fluid restrictions

Correct Answer is B

Explanation

A. This intervention is not relevant to diabetes insipidus, which affects water balance rather than glucose levels.
B. Checking urine specific gravity helps assess the concentration of urine, which can be very dilute in diabetes insipidus.
C. Diabetes insipidus is already characterized by excessive urination (polyuria), so administering a diuretic would exacerbate fluid loss.
D. Fluid restrictions are not typically necessary in diabetes insipidus because the primary issue is water loss rather than retention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has acute kidney disease about fluid restrictions. Which of the following statements by the client should the nurse identify as understanding of the teaching?

Correct Answer is C

Explanation

A nurse is planning care for a client who has a new diagnosis of diabetes insipidus. Which of the following interventions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism?

A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take?

A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

A nurse is caring for a client who has the following arterial blood gas results: HCO3-, 18 mEq, PaCO, 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?