The nurse is caring for a client who underwent a colon resection yesterday due to having a bowel obstruction. ABGs show metabolic alkalosis. The nurse expects this finding is because of:
The client has a nasogastric tube connected to suction
The client is having a panic attack
The client has end-stage renal disease (ESRD)
The client has an epidural catheter for pain control
The Correct Answer is A
Choice A reason: Nasogastric suction removes gastric acid (HCl), reducing hydrogen ions, raising pH, and causing metabolic alkalosis, a common post-surgical complication here.
Choice B reason: Panic attacks cause respiratory alkalosis from hyperventilation, lowering CO2, not metabolic alkalosis, which involves base excess, unrelated to this ABG.
Choice C reason: ESRD typically causes metabolic acidosis from acid retention, not alkalosis, as kidneys fail to excrete hydrogen, opposing this patient’s ABG findings.
Choice D reason: Epidural catheters manage pain with analgesics, not affecting acid-base balance or causing metabolic alkalosis, irrelevant to the ABG shift observed.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Hydroxychloroquine treats autoimmune diseases like lupus by modulating immunity, not hyperthyroidism’s excess thyroid hormone production, irrelevant here.
Choice B reason: Levothyroxine supplements thyroid hormone in hypothyroidism, worsening this patient’s hyperthyroidism (high T3/T4), contraindicated for her symptoms.
Choice C reason: Potassium iodide inhibits thyroid hormone release, reducing T3 and T4 in hyperthyroidism (e.g., Graves’), addressing her goiter, exophthalmos, and weight loss effectively.
Choice D reason: Methotrexate suppresses immunity in cancer or autoimmunity, not targeting thyroid overactivity or hormone levels, unsuitable for hyperthyroidism management.
Correct Answer is B
Explanation
Choice A reason: Heparin prevents clotting during dialysis but doesn’t reduce hemoglobin or hematocrit directly. It’s not a primary cause of anemia in renal failure, unlike erythropoietin deficiency.
Choice B reason: Kidneys in chronic renal failure fail to produce erythropoietin, a hormone stimulating red blood cell production, leading to low hemoglobin and hematocrit, the key cause here.
Choice C reason: Minor blood loss occurs in dialysis, but it’s not the primary reason for chronic anemia. Erythropoietin deficiency from renal failure has a greater impact on counts.
Choice D reason: Poor protein intake affects overall health but isn’t the main driver of anemia in renal failure. Erythropoietin loss from kidney dysfunction is the dominant factor.
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