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. Respiratory acidosis would typically involve an elevated PaCO2, which is not seen in this case.
B. Metabolic alkalosis is characterized by an elevated bicarbonate level, which is not present in this scenario.
C. Respiratory alkalosis would present with a low PaCO2 and an elevated pH, which is not the case here.
D. The low bicarbonate level (HCO3) 18mEq/L (normal range of 22-26 mEq/L), and low pH 7.30 (normal range of 7.35-7.45), indicate metabolic acidosis. suggesting acidemia. The PaCO2 is also low at 28 mm Hg, indicating a respiratory compensation for the metabolic acidosis.

A. A client who has muscle hypertrophy. B. Moon face C. A client who has a butterfly rash on his face. D. A client who has a positive Chvostek's sign.

Correct Answer is B

Explanation

A. Muscle hypertrophy is not a typical manifestation of hypercortisolism; rather, muscle weakness and wasting may occur.
B. Moon face, or rounded facial appearance with prominent cheeks, is a characteristic manifestation of hypercortisolism (Cushing's syndrome).
C. A butterfly rash on the face is not specific to hypercortisolism; it may suggest other conditions such as systemic lupus erythematosus.
D. Chvostek's sign is associated with hypocalcemia, not hypercortisolism.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

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?

Correct Answer is B

Explanation

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 reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO, 48 mm Hg and the HCO, is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?

A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect?

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?

A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client?

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?