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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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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is B

Explanation

B. Topical corticosteroids are commonly used in the treatment of psoriasis to reduce inflammation, itching, and scaling. They can help alleviate the symptoms described by the client, such as burning and bleeding of the affected areas.

A. While topical analgesics can provide pain relief, they do not directly address the underlying cause of psoriasis or reduce inflammation and scaling.

C. Topical antifungal agents are used to treat fungal infections of the skin, such as ringworm or athlete's foot. Psoriasis is not caused by a fungal infection.

D. Colloidal oatmeal-based lotions can help soothe and moisturize dry, irritated skin. While they may provide some relief of symptoms associated with psoriasis, such as itching and burning, they do not directly address inflammation or scaling.

A. Destruction of helper T-cells and CD4 cells. B. Increase in B-lymphocytes and IgM. C. Deficiency of cytotoxic T-cells. D. Proliferation of suppressor T-cells.

Correct Answer is A

Explanation

A. As HIV replicates within helper T-cells, it damages and destroys them, leading to a progressive decline in the number of CD4 cells in the body. This loss of helper T-cells weakens the immune system's ability to mount an effective response against infections

B. HIV infection does not typically lead to an increase in B-lymphocytes (B cells) or IgM antibodies.

C. While HIV infection can eventually lead to a deficiency in cytotoxic T-cells (CD8-positive T cells), particularly in advanced stages of the disease, the primary target of HIV is helper T-cells (CD4-positive T cells).

D. HIV infection does not result in the proliferation of suppressor T-cells (regulatory T cells).

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Naxlex Comprehensive Predictor Exams

A client with psoriasis returns to the clinic reporting the persistence of several silvery, scaly areas on the elbows and palms that frequently burn and sometimes bleed. Which prescription should the nurse teach the client to use for the skin condition?

Correct Answer is B

Explanation

The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS. The nurse should explain that HIV acts in which way to suppress the immune system?

Correct Answer is A

Explanation

The nurse notes that a client has been receiving hydromorphone every six hours for four days. Which assessment is most important for the nurse to complete?

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