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. Confusion is not a typical finding in polycystic kidney disease.
B. Flank pain is a common symptom of polycystic kidney disease due to the enlargement of the kidneys from cyst formation.
C. Urinary retention is not typically associated with polycystic kidney disease.
D. Hypotension is not a typical finding in polycystic kidney disease unless there are complications such as renal failure.

A. Hyponatremia B. Hyperkalemia C. Hypovolemia D. Hypervolemia

Correct Answer is D

Explanation

A. Hyponatremia is characterized by low sodium levels in the blood and is not typically associated with crackles in the lungs or elevated blood pressure.
B. While hyperkalemia is a concern in end-stage kidney disease, it is not typically associated with crackles in the lungs or elevated blood pressure.
C. Hypovolemia, or low blood volume, is not consistent with the client's reported symptoms of swelling in the lower extremities and crackles in the lungs.
D. Hypervolemia, or fluid overload, is common in end-stage kidney disease and can manifest with symptoms such as shortness of breath, lower extremity edema, crackles in the lungs (due to pulmonary congestion), and elevated blood pressure.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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 has respiratory alkalosis and is hyperventilating Which of the following actions should the nurse take?

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.)

A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?

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?