George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L and Pa02 60 mm Hg.

How would you interpret this?

Metabolic Acidosis. Partially Compensated

Respiratory Acidosis, Uncompensated

Respiratory Acidosis, Partially Compensated

Metabolic Alkalosis Uncompensated

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is A

Explanation

A. Placing the client on seizure precautions is important as metabolic alkalosis can cause neurological symptoms, such as confusion and increased risk for seizures due to electrolyte imbalances (e.g., low calcium levels). Therefore, seizure precautions are warranted.
B. Breathing into a paper bag is used in respiratory alkalosis to increase CO2 levels, but it is not appropriate in metabolic alkalosis, where the issue is not primarily related to CO2 imbalance.
C. Encouraging the client to breathe slowly is generally more appropriate for respiratory alkalosis, not metabolic alkalosis. Slow breathing would not directly address the underlying issue of metabolic alkalosis.
D. Administering sodium bicarbonate would worsen metabolic alkalosis, as it would further increase the alkalotic state. Sodium bicarbonate is used in metabolic acidosis, not alkalosis.

A. Pathologic fractures B. Impaired skin integrity C. Fluid retention D. Dysphagia

Correct Answer is A

Explanation

A. Hyperparathyroidism can lead to bone resorption and weakening, putting the client at risk for fractures.
B. This is not directly associated with hyperparathyroidism.
C. Hyperparathyroidism typically leads to hypercalcemia, which can result in polyuria and dehydration rather than fluid retention.
D. This is not directly associated with hyperparathyroidism.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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?

Correct Answer is A

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 assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect?

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 caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

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 caring for a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?