Lena Mason, who has diabetes, is admitted in a stuporous condition. Her blood gases show a pH of 7.33, PaCO2 of 40 mm Hg, and HCO3- of 20 mEq/L. What type of acid-base imbalance does this patient have?

Choice A reason: This is incorrect because filtration is a passive transport mechanism that does not require cellular energy. Filtration is the movement of fluid and solutes across a membrane due to hydrostatic pressure.

Choice B reason: This is correct because active transport is a transport mechanism that requires cellular energy in the form of ATP. Active transport is the movement of molecules across a membrane against their concentration gradient, using carrier proteins.

Choice C reason: This is incorrect because diffusion is a passive transport mechanism that does not require cellular energy. Diffusion is the movement of molecules from an area of higher concentration to an area of lower concentration, until equilibrium is reached.

Choice D reason: This is incorrect because osmosis is a passive transport mechanism that does not require cellular energy. Osmosis is the movement of water across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration.

Choice A reason: This is incorrect because bradypnea is a term for slow breathing, usually less than 12 breaths per minute. The client is breathing rapidly, not slowly.

Choice B reason: This is correct because Kussmaul's respirations are a type of breathing pattern that is deep, regular, and rapid, usually more than 20 breaths per minute. Kussmaul's respirations are a sign of metabolic acidosis, which occurs in diabetic ketoacidosis due to the accumulation of ketones in the blood. The client is trying to exhale the excess carbon dioxide and lower the acidity of the blood.

Choice C reason: This is incorrect because Cheyne-Stokes respirations are a type of breathing pattern that is irregular, with periods of apnea (no breathing) alternating with periods of rapid breathing. Cheyne-Stokes respirations are a sign of cerebral dysfunction, such as stroke, brain injury, or coma.

Choice D reason: This is incorrect because Biot's respirations are a type of breathing pattern that is irregular, with periods of apnea (no breathing) interspersed with periods of normal breathing. Biot's respirations are a sign of brainstem damage, such as meningitis, encephalitis, or head trauma.