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

Explanation

A. Walking with the nurse in the courtyard provides a simple, safe, and structured activity that promotes physical exercise and reduces excess energy in a way that is appropriate for someone in a manic state. This also gives the nurse an opportunity to observe the client's behavior and provide supervision.

B. Watching a video with a group might not engage the client sufficiently and could be too passive for someone experiencing mania who might need a more stimulating activity.

C. Participating in a basketball game could be too physically demanding and might escalate the client's manic behavior, especially if they have high energy or impulsivity.

D. Joining a group discussion about a local election may not be stimulating enough for the client in a manic state, as it requires focus and attention that might be difficult for the client to maintain during acute mania.

A. Avoid driving or operating heavy machinery until you know how alprazolam affects you. B. Relief of manifestations should be expected after a few weeks of therapy. C. Foods that are known to be high in dietary tyramine should be avoided. D. Increase the dose of medication as needed if relief of manifestations is not experienced.

Correct Answer is A

Explanation

A. Alprazolam is a benzodiazepine that can cause drowsiness, dizziness, and impair motor coordination. Therefore, the nurse should advise the client to avoid activities that require alertness until they understand how the medication affects them.

B. Alprazolam provides relatively quick relief of anxiety symptoms, often within hours, rather than requiring weeks of therapy like some other medications.

C. Foods high in tyramine are a concern for clients taking monoamine oxidase inhibitors (MAOIs), not alprazolam.

D. Increasing the dose without guidance from a healthcare provider is unsafe. The client should not adjust their medication dosage without consulting the provider.

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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 caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored. Which of the following activities is appropriate for the nurse to suggest to this client?

Correct Answer is A

Explanation

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?

Correct Answer is A

Explanation

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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?

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