Ms. Jackson has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having 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

A.   Metabolic Alkalosis, Partially Compensated, is incorrect because there is no evidence of respiratory compensation (normal PaCO2).
B.   Respiratory Acidosis, Partially Compensated, is incorrect because the pH is high, not low as would be expected in acidosis, and the PaCO2 is normal, not high.
C.   Respiratory Alkalosis, Uncompensated, is incorrect because the primary problem is metabolic (high HCO3), not respiratory, and the PaCO2 is normal, not low as would be seen in respiratory alkalosis.
D.   Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. In this scenario, the pH is elevated (7.5) and the bicarbonate (HCO3) level is high (34 mmol/L), indicating alkalosis. Vomiting leads to loss of gastric acid (hydrochloric acid), causing metabolic alkalosis. The respiratory system has not yet compensated fully for the alkalosis, as indicated by the normal PaCO2 (40 mm Hg).

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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. Pacemaker B. Alcohol use disorder C. Breast cancer survivor for 8 years D. 65 years of age

Correct Answer is B

Explanation

A. Having a pacemaker is not a contraindication for kidney transplant unless there are significant underlying cardiac issues that would increase the risks associated with surgery.
B. Chronic alcohol abuse can lead to multiple organ damage and increased surgical risks, making it a contraindication for kidney transplant.
C. Being a breast cancer survivor is not a contraindication for kidney transplant unless there are active cancer or metastases that would affect surgical outcomes.
D. Age alone is not a contraindication for kidney transplant. The decision for transplant candidacy is based on overall health status and comorbidities rather than age alone.

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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

A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?

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?

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

A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications?

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).

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?

A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect?

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?