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 D

Explanation

A. Constipation is not typically associated with hypocalcemia.
B. Shortened QT intervals are not characteristic of hypocalcemia; rather, prolongation of QT intervals is more common.
C. Hypoactive deep tendon reflexes, would suggest a decrease in neuromuscular excitability, which is contrary to the increased excitability seen in hypocalcemia. Therefore, hypoactive deep tendon reflexes is more commonly associated with hypercalcemia and not hypocalcemia.
D. Tingling of the extremities is a common symptom of hypocalcemia.

A. "It is caused by the lack of production of insulin by the pancreas.." B. "It is caused by the overproduction of growth hormone by the pituitary gland." C. "It is caused by the overproduction of parathormone by the parathyroid gland." D. "It is caused by the lack of production of aldosterone by the adrenal gland."

Correct Answer is D

Explanation

A. This statement describes the cause of diabetes mellitus, not Addison's disease.

B. This statement describes the cause of acromegaly, not Addison's disease.

C. This statement describes the cause of hyperparathyroidism, not Addison's disease.

D. This is the correct explanation of the cause of Addison's disease, which involves adrenal insufficiency.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

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?

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?

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

A nurse in a public clinic is researching health data on culturally diverse populations in the community. Which of the following population groups should the nurse anticipate having end- stage renal disease due to diabetes mellitus?

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 assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings 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 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?