Maria, an elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He appears to be dehydrated-his eyes are sunken and mucous membranes are dry-and he has a two-week history of polydipsia, polyuria, and weight loss. Measurement of arterial blood gas shows pH 7.0, Pa02 90 mm Hg. PaCO2 23 mm Hg, and HCO3 12 mmol/L; other results are Na+ 126 mmol/L. K+ 5 mmol/L, and Cl-95 mmol/L.

What is your assessment?

Respiratory Acidosis, Partially Compensated

Metabolic Acidosis, Partially, Compensated

Metabolic Alkalosis. Uncompensated

Respiratory Acidosis, Uncompensated

Answer and Explanation

The Correct Answer is B

A.   This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B.   Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C.   This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D.   Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.

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Free Nursing Study Resources

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. Obesity B. Protein in the urine C. Iron deficiency D. Dehydration

Correct Answer is D

Explanation

A. While obesity can contribute to certain health conditions, it is not a direct risk factor for the formation of renal calculi.
B. Proteinuria may indicate kidney dysfunction, but it is not a direct risk factor for the formation of renal calculi.
C. Iron deficiency is not directly associated with an increased risk of renal calculi formation.
D. Dehydration can lead to concentrated urine, which increases the risk of crystal formation and subsequently the formation of renal calculi.

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Nursing Test Bank

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

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?

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 is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations?

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 Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?

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?

A nurse is caring for a client who has the following arterial blood gas results: HCO3-, 18 mEq, PaCO, 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?