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A client has a nasogastric (NG) tube placed during abdominal surgery. During postoperative convalescence, the nurse identifies that the client is manifesting a hand tremor, muscle twitching, and confusion. Which arterial blood gases consistent with metabolic alkalosis should the nurse report to the healthcare provider?

Reference Range pH 17.35 to 7.45]

PaCO2 135 to 45 mm Hg]

HCO3 [21 to 28 mEq/L or 21 to 28 mmol/L]

PaO2 [80 to 100 mm Hg]

pH 7.30, PCO, 20 mm Hg, HCO, 22 mEq/L (22 mmol/L), PO, 85 mm Hg.

pH 7.46, PCO, 55 mm Hg, HCO, 36 mEq/L (36 mmol/L), PO, 95 mm Hg.

pH 7.49, PCO, 45 mm Hg, HCO, 32 mEq/L (32 mmol), PO, 90 mm Hg.

pH 7.29, PCO, 35 mm Hg, HCO, 25 mEq/L (25 mmol/L), PO, 99 mm Hg.

Answer and Explanation

The Correct Answer is B

B. pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L, PO2 95 mm Hg

The pH is high (alkalotic).

The HCO3 level is elevated, indicating metabolic alkalosis.

The PCO2 is high (respiratory acidotic picture due to secondary response). This option matches the criteria for metabolic alkalosis.

A. pH 7.30, PCO2 20 mm Hg, HCO3 22 mEq/L, PO2 85 mm Hg

The pH is low (acidic), not alkalotic.

The HCO3 level is within the normal range.

The PCO2 is low, which could indicate respiratory alkalosis. This option does not match the criteria for metabolic alkalosis.

C. pH 7.49, PCO2 45 mm Hg, HCO3 32 mEq/L, PO2 90 mm Hg The pH is high (alkalotic).

The HCO3 level is elevated, indicating metabolic alkalosis. The PCO2 is within the normal range.

This option does not meet the criteria for metabolic alkalosis D pH 7.29, PCO2 35 mm Hg, HCO3 25 mEq/L, PO2 99 mm Hg

The pH is low (acidic), not alkalotic. The HCO3 level is low, not elevated. The PCO2 is within the normal range.

This option does not match the criteria for metabolic alkalosis.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. A corneal abrasion is a condition that may be exacerbated by the use of ketorolac due to its potential to delay healing and increase bleeding risks. Therefore, it is essential to ensure that a patient does not have a corneal abrasion before administering ophthalmic ketorolac.

B. Radiation exposure is not directly relevant to the administration of ophthalmic ketorolac.

C. The presence of a foreign body is not directly related to ketorolac use

D. The presence of a chemical burn is not related with ketorolac use in a client.

A. Loperamide. B. Ipratropium. C. Famotidine. D. Aspirin.

Correct Answer is D

Explanation

D. Bismuth subsalicylate, a component of the regimen, has salicylate in its composition, which can lead to an increased risk of bleeding when taken with aspirin, a known blood thinner.

A. Loperamide is an antidiarrheal medication commonly used to treat diarrhea. It is not directly related to the treatment of Helicobacter pylori (H. pylori) infection.

B. Ipratropium is a bronchodilator medication used to treat conditions such as chronic obstructive pulmonary disease (COPD) and asthma. It is not directly related to the treatment of H. pylori infection.

C. Famotidine is a histamine-2 (H2) receptor antagonist commonly used to reduce stomach acid production. It is not directly related to the treatment of H. pylori infection.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for ophthalmic ketorolac, Prior to administering the medication, the nurse should review the medical record for which condition?

Correct Answer is A

Explanation

The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with a Helicobacter pylori (H. pylori) infection. Prior to administering the H. pylori treatment regimen, the nurse should review the electronic medical record for which medication?

Correct Answer is D

Explanation

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