Anna's mother has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L.

What acid-base disorder is shown?

Respiratory Acidosis. Partially Compensated

Metabolic Alkalosis, Partially Compensated

Respiratory Alkalosis. Uncompensated

Metabolic Alkalosis, Uncompensated

Answer and Explanation

The Correct Answer is B

A.   Respiratory Acidosis, both compensated and uncompensated, is characterized by an elevated PaCO2, which is not present in this case.
B.   The elevated pH (7.5) and HCO3 (34 mmol/L) indicate metabolic alkalosis. The elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest the partially compensated state, which is the respiratory compensation attempting to correct the alkalosis.
C.   The fact that the PaCO2 is not low rules out respiratory alkalosis.
D.   The arterial blood gas values indicate a high pH (7.5), a normal PaCO2 (40 mm Hg), and an elevated HCO3 (34 mmol/L), which are indicative of metabolic alkalosis. However, the elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest a partially compensated state.

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Correct Answer is B

Explanation

A. Increasing sodium intake is generally not recommended in chronic kidney disease, as it can exacerbate hypertension and fluid retention.
B. Epoetin alfa is a medication used to treat anemia associated with chronic kidney disease, and iron supplementation is often necessary to support erythropoiesis.
C. Potassium intake may need to be restricted in chronic kidney disease, especially in later stages when kidney function declines.
D. Protein intake may need to be adjusted in chronic kidney disease, but it's not directly related to the prescription of epoetin alfa.

A. The client's voice is hoarse. B. The client reports tingling around the mouth C. Moderate serosanguinous drainage noted on neck dressing. D. The client has a slight tremor noted in both hands. E. The client's temperature has increased in 1 hr from 375° C (99.5° F) to 38.6°C (101.5 F) F. The client appears restless G. Oxygen saturation 95%

Correct Answer is ["A","B","C","D","E","F"]

Explanation

The nurse should report the hoarseness of the client's voice, which could indicate recurrent laryngeal nerve damage, which is a risk associated with thyroid surgery. Tingling around the mouth may suggest hypocalcemia, a common complication after thyroidectomy due to accidental removal or damage to the parathyroid glands. The moderate serosanguinous drainage on the neck dressing could signify bleeding or infection, which requires immediate attention. The noted tremor in both hands and the increase in temperature could be signs of a thyroid storm, a rare but life-threatening condition.

Furthermore, the client's restlessness could be a response to discomfort or could indicate a more serious issue, such as an impending thyrotoxic crisis. Oxygen saturation at 95% is within normal limits postoperatively; however, it should be monitored closely.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

Correct Answer is ["A","B","C","D","E","F"]

Explanation

A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?

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 laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function?

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?

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 assessing a client who is 2 weeks postoperative following a kidney transplant. Which of the following manifestations should the nurse identify as possible organ rejection?

A nurse is collecting the medical history from a client who has manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH?