Mrs. Jamerson, who had undergone surgery in the post-anesthesia care unit (PACU), is difficult to arouse two hours following surgery. Nurse Williams in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The client's respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and obtains ABGS STAT! Arterial blood gas measurement shows pH 7.10. PaCO2 70 mm Hg, and HCO3 24 mEq/L

What does this mean?

Metabolic Acidosis, Uncompensated

Respiratory Alkalosis. Partially Compensated

Respiratory Acidosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

Answer and Explanation

The Correct Answer is C

A.   Metabolic Acidosis, Uncompensated, is ruled out because the elevated PaCO2 and low pH indicate a respiratory problem rather than a metabolic one.
B.   Respiratory Alkalosis. Partially Compensated is ruled out because the pH and PaCO2 levels are both abnormal and indicate acidosis rather than alkalosis.
C.   The low pH (acidosis) along with the high PaCO2 indicate respiratory acidosis, and there is no evidence of compensation by the kidneys (normal HCO3).
D.   Metabolic Alkalosis. Partially Compensated, is ruled out because the pH is low (acidosis) rather than high (alkalosis), and the PaCO2 is elevated, suggesting a respiratory problem rather than a metabolic one.

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Correct Answer is A

Explanation

A. Salicylate intoxication can lead to metabolic acidosis due to the accumulation of salicylic acid, which increases metabolic rate and production of organic acids.
B. Thiazide diuretics can lead to metabolic alkalosis due to the loss of hydrogen and chloride ions.
C. Vomiting can lead to metabolic alkalosis due to the loss of gastric acid.
D. Diarrhea can lead to metabolic acidosis due to the loss of bicarbonate-rich fluids.

A. Administer aspirin as prescribed for any sign of hyperthermia. B. Provide a quiet low stimulus environment. C. Keep the client NPO. D. Observe the client carefully for signs of hypocalcemia

Correct Answer is B

Explanation

A. Aspirin administration is not typically indicated for hyperthermia associated with hyperthyroidism as it may displace thyroid hormone from binding proteins.
B. A calm environment can help prevent exacerbation of symptoms and reduce the risk of a thyroid crisis in hyperthyroid clients.
C. There is no indication to keep the client NPO solely based on hyperthyroidism.
D. Hypocalcemia is not a primary concern in hyperthyroidism. Monitoring for signs of hyperthyroid crisis is more pertinent.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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 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 reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO, 48 mm Hg and the HCO, is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?

A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?

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

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?