A client has been placed on a mechanical ventilator. The PCP has ordered the ventilator to be set at a respiratory rate of 28 breaths /min. The nurse questions the order, citing concerns about which acid-base problem?

Base deficit (HCO3): Acidosis

Acid excess (CO2): Acidosis

Base excess (HCO3): Alkalosis

Acid deficit (CO2): Alkalosis

Answer and Explanation

The Correct Answer is B

A. Base deficit (HCO3): Acidosis: A base deficit indicates metabolic acidosis, but respiratory acidosis is more likely with the high rate of ventilation.

B. Acid excess (CO2): Acidosis: This is the correct answer. A high respiratory rate can lead to hyperventilation, decreasing CO2 levels and causing respiratory alkalosis, which may be a concern with an elevated rate.

C. Base excess (HCO3): Alkalosis: This would indicate metabolic alkalosis, but it is not as related to ventilator settings.

D. Acid deficit (CO2): Alkalosis: If the CO2 level is too low due to hyperventilation, this can lead to alkalosis, which the nurse is questioning here.

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Correct Answer is C

Explanation

A. Heparin is an anticoagulant and does not typically cause bronchospasm or wheezing.

B. Morphine can cause respiratory depression but not bronchospasm.

C. Propranolol, a non-selective beta-blocker, can cause bronchospasm, particularly in clients with asthma.

D. Nitroglycerin primarily causes vasodilation and does not typically lead to bronchospasm or wheezing.

A. "In hot weather, I sweat so much that I drink six glasses of water each day." B. "I take sodium bicarbonate after every meal to prevent heartburn." C. "I don't drink milk because it gives me gas and diarrhea." D. "I have been taking digoxin every day for the last 15 years."

Correct Answer is B

Explanation

A. Drinking water in hot weather is important to prevent dehydration. This is not a risk factor for metabolic alkalosis unless the client is excessively losing electrolytes through sweating and not replacing them.

B. Sodium bicarbonate is an alkaline substance, and regular use, especially after meals, can contribute to metabolic alkalosis. The client should be instructed on the potential risks of using sodium bicarbonate too frequently.

C. Avoiding milk due to gastrointestinal symptoms does not directly contribute to metabolic alkalosis.

D. Digoxin does not directly affect acid-base balance, but it requires monitoring due to potential interactions with other medications or electrolyte imbalances.

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A client has been placed on a mechanical ventilator. The PCP has ordered the ventilator to be set at a respiratory rate of 28 breaths /min. The nurse questions the order, citing concerns about which acid-base problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

Correct Answer is B

Explanation

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