A nurse is caring for a client who has the following arterial blood gas results: HCO3 18 mEq/L, PaCO2 28 mm Hg, and pH 7.30. The nurse recognizes the client is experiencing which of the following acid-base imbalances?

Metabolic alkalosis

Respiratory alkalosis

Respiratory acidosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Metabolic alkalosis is characterized by an elevated pH (greater than 7.45) and an increased bicarbonate (HCO3) level. In this case, the pH is 7.30, indicating acidosis, and the HCO3 level is 18 mEq/L, which is below the normal range (22-26 mEq/L). Therefore, metabolic alkalosis is not the correct diagnosis.

Choice B Reason:

Respiratory alkalosis is indicated by a high pH (greater than 7.45) and a low PaCO2 (less than 35 mm Hg). Although the PaCO2 is low at 28 mm Hg, the pH is 7.30, indicating acidosis rather than alkalosis. Therefore, respiratory alkalosis is not the correct diagnosis.

Choice C Reason:

Respiratory acidosis is characterized by a low pH (less than 7.35) and an elevated PaCO2 (greater than 45 mm Hg). In this case, the pH is low, indicating acidosis, but the PaCO2 is also low at 28 mm Hg, which does not fit the criteria for respiratory acidosis. Therefore, respiratory acidosis is not the correct diagnosis.

Choice D Reason:

Metabolic acidosis is indicated by a low pH (less than 7.35) and a low bicarbonate (HCO3) level (less than 22 mEq/L). In this case, the pH is 7.30, indicating acidosis, and the HCO3 level is 18 mEq/L, which is below the normal range. The low PaCO2 of 28 mm Hg suggests a compensatory respiratory response to the metabolic acidosis. Therefore, metabolic acidosis is the correct diagnosis.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A: Metformin

Reason: Metformin is known to interact with contrast material, particularly iodinated contrast media, and can increase the risk of acute kidney injury (AKI). This interaction can lead to a condition known as contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI). Metformin is primarily excreted by the kidneys, and impaired renal function can lead to its accumulation, increasing the risk of lactic acidosis, a rare but serious complication. Therefore, it is generally recommended to withhold metformin before and after the administration of contrast media until renal function is confirmed to be normal.

Choice B: Carvedilol

Reason: Carvedilol is a beta-blocker used to treat high blood pressure and heart failure. It does not have a known interaction with contrast media that would increase the risk of acute kidney injury. Carvedilol primarily affects the cardiovascular system and does not significantly impact renal function or interact with contrast agents.

Choice C: Nitroglycerin

Reason: Nitroglycerin is used to treat angina and other heart conditions by dilating blood vessels. It does not interact with contrast media in a way that would increase the risk of acute kidney injury. Nitroglycerin’s primary effects are on the cardiovascular system, and it does not have nephrotoxic properties.

Choice D: Atorvastatin

Reason: Atorvastatin is a statin used to lower cholesterol levels. While it can have effects on liver enzymes and muscle tissue, it does not interact with contrast media to increase the risk of acute kidney injury. Atorvastatin is metabolized by the liver and does not significantly impact renal function.

A. Ammonia B. Muscle rigidity C. Seizures D. Drooling at times E. Mask-like facial expression F. Shuffled gait

Correct Answer is A

Explanation

Choice A: Ammonia

Lactulose is administered to patients with hepatic encephalopathy to reduce the levels of ammonia in the blood. Hepatic encephalopathy occurs due to the liver’s inability to detoxify ammonia, a byproduct of protein metabolism. Lactulose works by converting ammonia into ammonium, which is then excreted in the stool. This helps to lower blood ammonia levels and alleviate the symptoms of hepatic encephalopathy.

Choice B: Dysarthria

Dysarthria, or difficulty in articulating words, is a common symptom of Parkinson’s disease. It results from the muscle rigidity and bradykinesia (slowness of movement) that affect the muscles involved in speech. Patients with Parkinson’s often have a soft, monotone voice and may struggle with the clarity of their speech.

Choice C: Muscle Rigidity

Muscle rigidity is one of the hallmark symptoms of Parkinson’s disease. It refers to the stiffness and inflexibility of the muscles, which can affect any part of the body. This rigidity can lead to discomfort and pain, and it contributes to the characteristic stooped posture and shuffling gait seen in Parkinson’s patients.

Choice D: Seizures

Seizures are not typically associated with Parkinson’s disease. While Parkinson’s affects the central nervous system, it primarily impacts motor function rather than causing seizure activity. Therefore, this is not a common finding in Parkinson’s patients.

Choice E: Drooling at Times

Drooling, or sialorrhea, is a common symptom in Parkinson’s disease. It occurs due to the decreased ability to swallow saliva, which can result from muscle rigidity and bradykinesia affecting the muscles involved in swallowing. This can be particularly bothersome for patients and may require management strategies.

Choice F: Mask-like Facial Expression

A mask-like facial expression, also known as hypomimia, is a common feature of Parkinson’s disease. It results from the rigidity and bradykinesia affecting the facial muscles, leading to reduced facial expressions and a fixed, staring appearance.

Choice G: Shuffled Gait

A shuffled gait is a characteristic feature of Parkinson’s disease. Patients often take small, shuffling steps and may have difficulty initiating movement. This gait pattern is due to the combination of muscle rigidity, bradykinesia, and postural instability.

Choice H: Stooped Posture

Stooped posture is another common symptom of Parkinson’s disease. It results from the muscle rigidity and postural instability that affect the patient’s ability to maintain an upright position. This can lead to a forward-leaning posture and balance issues.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who has the following arterial blood gas results: HCO3 18 mEq/L, PaCO2 28 mm Hg, and pH 7.30. The nurse recognizes the client is experiencing which of the following acid-base imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

Correct Answer is A

Explanation

The nurse is taking care of a client diagnosed with advanced liver disease with hepatic encephalopathy. Lactulose (Cephulac) is administered to the patient to reduce which of the following?

Correct Answer is A

Explanation

For the patient with diabetes mellitus, which microvascular complication of the blood vessel structure may occur? Select all that apply. One, some, or all responses may be correct.

The nurse is caring for a client with a heart rate of 143 beats/min with atrial fibrillation. Which assessment data will the nurse anticipate? Select all that apply:

An adult client who has been experiencing a seizure for approximately 15 minutes is brought to the emergency department by private vehicle. Which intervention should the nurse implement first?

A client experiences impaired swallowing after a stroke and has worked with speech-language pathology on eating. What nursing assessment best indicates that the expected outcome for this problem has been met?

The nurse is caring for a client diagnosed with chronic hepatitis who is receiving the medication lactulose. Which of these laboratory results would indicate the medication is achieving the desired therapeutic effect?

A new nurse is having a difficult time identifying which client should be seen first because they all seem important. The nurse preceptor helps and explains that the client with which of the following should be seen first?

A client with type II diabetes is scheduled to have a computed tomography (CT) scan with IV contrast of the brain to rule out a brain tumor. What health teaching would the nurse include?Your provider will obtain a signed consent from you prior to the completion of the CT scan.