Two days after admission for an exacerbation of chronic obstructive pulmonary disease (COPD), an older client's arterial blood gas (ABC) indicate an acid base imbalance. The client's laboratory results reveal a low hemoglobin level, an elevated creatinine clearance, and decreased urine specific gravity. Which is the most likely cause for the acid base imbalance?
Myocardial infarction one year ago.
Occasional use of antacids.
Chronic renal insufficiency.
Shortness of breath with exertion.
The Correct Answer is C
A. Myocardial infarction one year ago:
A myocardial infarction (MI) that occurred one year ago is not directly related to the current acid-base imbalance described in the scenario. While a history of MI may have implications for the client's overall cardiovascular health and management, it is not the most likely cause of the acid-base imbalance indicated by the laboratory results.
B. Occasional use of antacids:
Occasional use of antacids is unlikely to cause the acid-base imbalance described in the scenario. Antacids primarily work by neutralizing gastric acid and are not typically associated with significant alterations in acid-base status, especially when used intermittently.
C. Chronic renal insufficiency:
Chronic renal insufficiency is the most likely cause of the acid-base imbalance indicated by the laboratory results. A low hemoglobin level suggests anemia, which can occur in chronic kidney disease due to decreased erythropoietin production. An elevated creatinine clearance indicates impaired kidney function, as the kidneys are clearing creatinine at a faster rate than normal. Decreased urine specific gravity suggests the kidneys' inability to concentrate urine properly, which is a common finding in renal insufficiency. Renal insufficiency can lead to metabolic acidosis due to the kidneys' decreased ability to excrete acid and regulate bicarbonate levels.
D. Shortness of breath with exertion:
Shortness of breath with exertion, a symptom commonly seen in COPD exacerbations, is unlikely to directly cause the acid-base imbalance described in the scenario. While respiratory distress can lead to respiratory acidosis, which is characterized by elevated carbon dioxide levels and decreased pH, the laboratory results indicate metabolic rather than respiratory acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, specifically involving the stapes bone. This abnormal bone growth interferes with the transmission of sound vibrations from the middle ear to the inner ear, resulting in conductive hearing loss. Here's a breakdown of each option:
A) Presbycusis:
Presbycusis refers to age-related hearing loss, typically involving sensorineural components such as the degeneration of hair cells in the inner ear or changes in the auditory nerve. While presbycusis is a common cause of hearing loss in older adults, it is not directly related to otosclerosis or previous ear surgeries.
B) Conductive:
Correct. Otosclerosis primarily affects the middle ear by causing abnormal bone growth around the stapes bone, which can immobilize it and interfere with sound transmission to the inner ear. As a result, individuals with otosclerosis often experience conductive hearing loss, where sound is not effectively conducted from the outer or middle ear to the inner ear.
C) Endolymphatic:
Endolymphatic hydrops, also known as Ménière's disease, involves abnormal fluid accumulation in the inner ear, leading to symptoms such as vertigo, tinnitus, and fluctuating sensorineural hearing loss. While inner ear disorders like endolymphatic hydrops can cause sensorineural hearing loss, otosclerosis primarily affects the conductive components of hearing.
D) Sensorineural:
Sensorineural hearing loss occurs due to dysfunction or damage to the inner ear (cochlea) or auditory nerve pathways leading to the brain. This type of hearing loss is typically permanent and can result from various factors, including age-related changes, noise exposure, and certain medical conditions. While sensorineural hearing loss can coexist with conductive hearing loss in some cases, otosclerosis primarily causes conductive hearing loss rather than sensorineural hearing loss.
Correct Answer is C
Explanation
Hypothyroidism is characterized by deficient production of thyroid hormones by the thyroid gland, leading to a decrease in circulating levels of triiodothyronine (T3) and thyroxine (T4). As a compensatory mechanism, the pituitary gland releases increased amounts of thyroid stimulating hormone (TSH) in an attempt to stimulate thyroid hormone production.
A) Increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid stimulating hormone (TSH):
This pattern of laboratory findings is not consistent with hypothyroidism. Hypothyroidism is characterized by decreased levels of T3 and T4 due to impaired thyroid function, leading to increased TSH levels as a compensatory response. Therefore, this option is incorrect.
B) Increased triiodothyronine (T3) and thyroid stimulating hormone (TSH):
While TSH levels are typically increased in hypothyroidism, T3 levels are usually decreased. Therefore, the combination of increased T3 and TSH is not indicative of hypothyroidism. This option is incorrect.
C) Decreased triiodothyronine (T3) and thyroxine (T4) and increased thyroid stimulating hormone (TSH):
Correct. In hypothyroidism, there is a decrease in both T3 and T4 levels due to impaired thyroid function. As a compensatory mechanism, the pituitary gland releases increased amounts of TSH to stimulate the thyroid gland. Therefore, this pattern of laboratory findings is consistent with hypothyroidism.
D) Decreased thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4):
Decreased levels of TSH, T3, and T4 are not indicative of hypothyroidism. Hypothyroidism is characterized by elevated TSH levels and decreased T3 and T4 levels. Therefore, this option is incorrect.
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
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.