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 ["A","C","D","E"]

Explanation

A. Lithium is a first-line treatment for managing both the manic and depressive episodes of bipolar disorder.

B. Donepezil is a cholinesterase inhibitor used in the treatment of Alzheimer's disease, not for bipolar disorder.

C. Olanzapine is an atypical antipsychotic often used in the treatment of acute mania in bipolar disorder.

D. Carbamazepine is an anticonvulsant and mood stabilizer that is also used to treat acute mania.

E. Valproic acid is an anticonvulsant and mood stabilizer used for managing mania in bipolar disorder.

A. Provide a structured activity schedule for the dent B. Instruct the client on relaxation techniques for use when anxiety increases. C. Identify precipitating factors for ritualistic behaviors. D. Discuss alternative coping strategies with the client

Correct Answer is C

Explanation

A. Providing a structured activity schedule can be beneficial but comes after understanding the triggers of the behaviors.

B. Relaxation techniques are helpful but would be more effective after understanding the client's specific rituals and triggers.

C. The first step in managing obsessive-compulsive disorder (OCD) is understanding the triggers or precipitating factors for the client's ritualistic behaviors. This helps the nurse identify patterns and understand the client's anxiety, which is essential for planning further interventions.

D. Discussing alternative coping strategies is important but should follow an assessment of the factors that drive the compulsive behaviors.

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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 nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder? (Select all that apply)

Correct Answer is ["A","C","D","E"]

Explanation

A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?

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A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client?

A nurse is caring for a client who is prescribed alprazolam to manage severe manifestations of anxiety. Which of the following should the nurse prepare to discuss with the client?

A 35-year-old client with OCD spends several hours each day arranging and rearranging household items in a specific order. The client becomes extremely distressed if the items are not arranged correctly. Which nursing intervention is most appropriate?

The nurse is preparing to transfer a client from the post-anesthesia care unit (PACU). Which assessment findings would delay the transfer of the client? (Select All that Apply.)

A nurse is caring for a client who experiences severe anxiety when going to work. The nurse should identify that which of the following areas of the autonomic nervous system is stimulated when the client goes to work?

Inability to leave one's home because of avoidance of severe anxiety suggests the existence of which anxiety disorder?