A 25-year-old patient with generalized anxiety disorder presents to the ED with shortness of breath, dizziness, and tingling in the fingers. The nurse reviews the ABG results: pH: 7.50, PaCO2: 30 mmHg HCO3: 24 mEq/L. What is the most likely acid-base imbalance?

Respiratory acidosis

Metabolic alkalosis

Respiratory alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is C

A. Respiratory acidosis would present with a low pH (acidotic) and a high PaCO2, which is not the case here.

B. Metabolic alkalosis would be suggested by an elevated pH and elevated HCO3, but here, the bicarbonate level is normal (24 mEq/L).

C. Respiratory alkalosis is indicated by a pH of 7.50 (alkalosis) and a PaCO2 of 30 mmHg, which is lower than the normal range (35-45 mmHg). This low PaCO2 suggests that the patient is hyperventilating, likely due to anxiety, which causes the body to excrete too much CO2.

D. Metabolic acidosis would present with a low pH and a low bicarbonate level, neither of which are seen in this case.

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Correct Answer is C

Explanation

A. While support groups may be helpful, the immediate intervention for a client experiencing heightened anxiety and hypervigilance is to provide structure and safety.

B. Mindfulness meditation may be beneficial in the long term, but it is not the first intervention in an acute phase where anxiety and hypervigilance are prominent.

C. A structured environment with predictable routines and consistent staff can help clients with PTSD feel more secure and reduce feelings of anxiety, hypervigilance, and paranoia. Predictability and structure are key interventions for clients with PTSD.

D. Administering a PRN sedative medication should be a secondary intervention after providing a supportive and safe environment. Medications may be used as part of treatment, but they do not address the underlying anxiety and hypervigilance as effectively as a structured environment.

A. Agoraphobia B. Generalized anxiety disorder C. Separation anxiety disorder D. Panic disorder

Correct Answer is B

Explanation

A. Agoraphobia is marked by the fear of being in situations where escape may be difficult or help unavailable in case of panic-like symptoms. It is not characterized by generalized worry.

B. Generalized anxiety disorder (GAD) is characterized by excessive anxiety and worry that is difficult to control and is associated with a variety of circumstances. Individuals with GAD often experience chronic worry about multiple life domains, without a specific focus.

C. Separation anxiety disorder involves excessive fear of being separated from loved ones or familiar environments, which is different from generalized worry about multiple life events.

D. Panic disorder involves recurrent panic attacks that are not necessarily related to generalized anxiety or worry about various life situations.

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A 25-year-old patient with generalized anxiety disorder presents to the ED with shortness of breath, dizziness, and tingling in the fingers. The nurse reviews the ABG results: pH: 7.50, PaCO2: 30 mmHg HCO3: 24 mEq/L. What is the most likely acid-base imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with PTSD experiences exaggerated startle response. The client is paranoid and hypervigilant. Which nursing intervention is most appropriate?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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