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 ["B","D","E"]

Explanation

A. Bicarbonate excess is not a clinical manifestation but rather the underlying cause of metabolic alkalosis.
B. Metabolic alkalosis can lead to potassium depletion, which may cause muscle weakness.
C. Kussmaul's respirations, characterized by deep and labored breathing, are more commonly associated with metabolic acidosis, not alkalosis, as the body tries to compensate for acidemia by expelling more carbon dioxide through deep breaths.
D. Alkalosis can cause peripheral vasodilation and decreased calcium ionization, leading to circumoral and digital paresthesia.
E. Alkalosis can cause cerebral vasoconstriction and decreased cerebral perfusion, leading to dizziness.

A. Bone pain B. Slurred speech C. Hypotension D. Pruritus E. Bradypnea.

Correct Answer is ["A","B","D"]

Explanation

A. Bone pain can occur in ESRD due to mineral and bone disorders associated with chronic kidney disease.
B. Slurred speech can be seen in ESRD patients with uremic encephalopathy.
C. Hypotension is less common in ESRD; hypertension is more typical due to fluid overload and retention.
D. Pruritus is a common symptom of ESRD, often due to accumulation of uremic toxins.
E. Bradypnea is not typically associated with ESRD.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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.)

Correct Answer is ["B","D","E"]

Explanation

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).

Correct Answer is ["A","B","D"]

Explanation

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 assessing a client who has chronic kidney disease. Which of the following findings is a manifestation of hyperkalemia?

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?

A nurse is assessing a preschooler who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect?

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?