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 C

Explanation

A. Metabolic acidosis would involve a low pH and low bicarbonate level, which is not evident in the given arterial blood gas results.
B. The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The increased HCO3 (normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
C. George Kent's arterial blood gas values indicate a lower pH and an elevated PaCO2, which are consistent with respiratory acidosis. The increased HCO3 ((normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
D. Metabolic alkalosis is not supported by the given arterial blood gas results.

A. Constipation B. Shortened QT intervals C. Hypoactive deep tendon reflexes D. Tingling of the extremities

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.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

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 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 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 in the oliguric phase of acute kidney injury. Which of the following findings 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 teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications?

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 discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?

A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO status. Which of the following solutions should the nurse prepare to infuse for this client?