Ms. Jackson has been suffering from persistent vomiting for two days. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucous membranes and her capillary refill time takes more than 4 seconds. She is diagnosed with gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid base disorder is shown?

Metabolic Alkalosis, Partially Compensated

Respiratory Acidosis, Partially Compensated

Respiratory Alkalosis, Uncompensated

Metabolic Alkalosis, Uncompensated

Answer and Explanation

The Correct Answer is D

Choice A reason: This choice is incorrect. Partial compensation would typically involve a change in PaCO2 to counterbalance the elevated bicarbonate, which is not observed here.

Choice B reason: This choice is incorrect. Respiratory acidosis is characterized by a low pH and an elevated PaCO2, which is not consistent with the given values.

Choice C reason: This choice is incorrect. Respiratory alkalosis would present with a low PaCO2 due to hyperventilation, which is not the case here.

Choice D reason: This is the correct choice. The elevated pH and HCO3 with a normal PaCO2 indicate metabolic alkalosis without respiratory compensation. Persistent vomiting can lead to loss of stomach acid, which causes metabolic alkalosis.

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Correct Answer is D

Explanation

Choice A reason: A rosebud like stoma orifice is a normal appearance for a new colostomy, indicating that the stoma is healthy and not in distress.

Choice B reason: Red drainage from a stoma can be normal, especially in the early postoperative period, as the stoma may ooze a small amount of blood. However, if the drainage is excessive or persistent, it should be reported.

Choice C reason: A shiny, moist stoma is also a sign of a healthy stoma. The stoma should be moist and have a pink or red color, similar to the inside of the mouth.

Choice D reason: A purplish colored stoma indicates compromised blood flow and is a sign of ischemia. This is a serious complication that requires immediate medical attention to prevent tissue death.

A. "Drying time is prolonged with a synthetic cast." B. "A synthetic cast is lighter." C. "A plaster cast weighs less." D. "Application of a plaster cast requires specialized equipment."

Correct Answer is B

Explanation

Choice A reason: This statement is incorrect. Synthetic casts typically dry much faster than plaster casts. Plaster casts can take 24 to 48 hours to fully harden, while synthetic casts made from materials like fiberglass or plastic can harden within a few hours.

Choice B reason: This is the correct statement. Synthetic casts are indeed lighter than plaster casts. They are made from materials like fiberglass, which is lighter than the traditional plaster of Paris used in plaster casts.

Choice C reason: This statement is incorrect. Plaster casts are generally heavier than synthetic casts. The weight of a cast can be an important consideration, especially for children or for those who may have difficulty managing a heavier cast.

Choice D reason: This statement is incorrect. Both plaster and synthetic casts require specialized equipment for application, but it is not specific to plaster casts. The application involves similar steps for both types, including the use of a stockinette, padding, and then the casting material itself.

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Naxlex Comprehensive Predictor Exams

A nurse in a Post Anesthesia Care Unit (PACU) is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Correct Answer is D

Explanation

A nurse is teaching a newly licensed nurse about the differences between a plaster cast and a synthetic cast. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?

A nurse is talking with a client whose thyroid stimulating hormone (TSH) level will be measured. Which of the following statements by the nurse explains the purpose of this test?

A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care?

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

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 suspects a client with myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse take?

A nurse caring for a client who has hypertension is asked about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

A charge nurse is teaching a group of nurses about clients who report using garlic, ginger, and ginkgo biloba. The charge nurse should identify which of the following as an adverse effect of these supplements?