The nurse identifies which client to be at risk for developing metabolic alkalosis? The client who:
has been vomiting for three days.
has had diarrhea for the past 24 hours.
has overdosed on heroin.
is admitted with an asthma exacerbation.
The Correct Answer is A
A. Vomiting results in loss of hydrochloric acid (HCl) from the stomach, leading to a loss of chloride ions (Cl-) and hydrogen ions (H+) from the body. This loss of hydrogen ions can result in an accumulation of bicarbonate ions (HCO3-) relative to hydrogen ions, leading to metabolic alkalosis. Therefore, this client is at risk for developing metabolic alkalosis due to prolonged vomiting.
B. Client who has had diarrhea for the past 24 hours: Diarrhea leads to loss of bicarbonate ions (HCO3-) from the body along with fluid and electrolytes. However, metabolic alkalosis is less likely to occur with diarrhea alone because the loss of bicarbonate ions is usually balanced by the loss of chloride ions (Cl-) and hydrogen ions (H+). Therefore, while diarrhea can lead to metabolic acidosis in some cases, it is less likely to cause metabolic alkalosis.
C. Client who has overdosed on heroin: Heroin overdose is not directly associated with metabolic alkalosis. In the context of heroin overdose, respiratory depression leading to respiratory acidosis is a more immediate concern. Therefore, this client is not at risk for developing metabolic alkalosis due to heroin overdose.
D. Client who is admitted with an asthma exacerbation: Asthma exacerbation can lead to respiratory alkalosis due to hyperventilation and excessive elimination of carbon dioxide (CO2) from the body. However, metabolic alkalosis is not a typical consequence of asthma exacerbation alone. Therefore, while this client may experience respiratory alkalosis, they are not at risk for developing metabolic alkalosis solely due to asthma exacerbation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. The sigmoid colon is the last part of the large intestine before the rectum. It functions to store fecal material and absorb water and electrolytes. Fecal material passing through the sigmoid colon tends to become more solid as water is absorbed, resulting in a more formed stool compared to other parts of the colon.
A. The transverse colon is located in the upper abdomen and is responsible for further absorption of water and electrolytes from the stool. Fecal material passing through the transverse colon tends to become more solid as water is absorbed, but it may not be as solid as stool from the descending colon or sigmoid colon.
B. The ascending colon is where stool is in a more liquid form as it moves up from the cecum. It undergoes further absorption of water and electrolytes as it travels through the colon, but it typically does not produce solid fecal output.
C. The ileum is the final portion of the small intestine and connects to the large intestine (colon). Stool passing through the ileum is still in a relatively liquid state as it contains undigested food particles, bile salts, and digestive enzymes. The primary function of the ileum is absorption of nutrients rather than water reabsorption, so fecal output from an ileostomy is usually more liquid.

Correct Answer is A
Explanation
A. This approach involves providing medication education to the client as each medication is administered. While this ensures that the client receives information about each medication in a timely manner, it may not allow for comprehensive education or adequate time for the client to ask questions or clarify information. Additionally, the client may feel overwhelmed by receiving information about multiple medications at once.
B. Incorporating medication education into another activity, such as assisting the client with his bath, can be an efficient use of time. However, it may not provide an optimal environment for focused learning and discussion. The client may be distracted or uncomfortable during the bath, limiting their ability to absorb and retain information effectively.
C. This approach involves providing medication education to the client after discharge via a follow-up phone call. While this allows for more time and flexibility in providing education, it may not address the client's immediate needs or questions prior to discharge. Additionally, the client may have already started taking the medications by the time of the follow-up call, potentially leading to missed opportunities for clarification or adjustment of the medication regimen.
D. Providing written instructions for the client to read at home is an efficient way to ensure that the client has access to information about their medications. This allows the client to review the information at their own pace and refer back to it as needed. However, written instructions alone may not be sufficient for addressing all aspects of medication education, such as potential side effects, drug interactions, or administration techniques.
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