A client in the emergency department reports that he has been vomiting excessively for the last 2 days. His arterial blood gas (ABG) analysis shows a pH of 7.50, the partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?

Metabolic Alkalosis

Respiratory Alkalosis

Respiratory Acidosis

Metabolic Acidosis

Answer and Explanation

The Correct Answer is A

A. Metabolic Alkalosis:
pH: Elevated (alkalotic).
PaCO2: Normal or slightly decreased (compensation may or may not be present).
HCO3: Elevated.
Explanation: Metabolic alkalosis is characterized by an excess of bicarbonate (HCO3) in the blood, leading to an elevated pH. In this case, the elevated pH and HCO3 levels suggest that the primary imbalance is metabolic alkalosis.

B. Respiratory Alkalosis:
pH: Elevated (alkalotic).
PaCO2: Decreased (due to hyperventilation, which blows off CO2).
HCO3: Normal or slightly decreased (compensation).
Explanation: Respiratory alkalosis is characterized by low levels of carbon dioxide (PaCO2) due to hyperventilation. However, in the provided ABG, the PaCO2 is not significantly decreased, suggesting that respiratory alkalosis is not the primary issue.

C. Respiratory Acidosis:
pH: Decreased (acidotic).
PaCO2: Increased (due to inadequate ventilation).
HCO3: Normal or slightly elevated (compensation).
Explanation: Respiratory acidosis is characterized by an increase in carbon dioxide (PaCO2) levels. In this case, the PaCO2 is within the normal range, indicating that respiratory acidosis is not the primary problem.

D. Metabolic Acidosis:
pH: Decreased (acidotic).
PaCO2: Normal or slightly decreased (compensation).
HCO3: Decreased.
Explanation: Metabolic acidosis is characterized by a decrease in bicarbonate (HCO3) levels. In this ABG, the HCO3 is elevated, ruling out metabolic acidosis as the primary issue.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "I have difficulty breathing when walking 30 feet":
Explanation: Difficulty breathing on exertion (dyspnea) is a common symptom of iron-deficiency anemia. This is because iron is a crucial component of hemoglobin, which carries oxygen to body tissues. In the absence of sufficient iron, the oxygen-carrying capacity of the blood is reduced, leading to symptoms such as shortness of breath.

B. "I feel hot all of the time":
Explanation: Feeling hot all the time is not a typical symptom of iron-deficiency anemia. Anemia is more likely to cause symptoms related to poor oxygen delivery, such as fatigue and shortness of breath.

C. "I have a difficult time falling asleep at night":
Explanation: Difficulty falling asleep is not a classic symptom of iron-deficiency anemia. Symptoms are more likely to be related to fatigue and weakness.

D. "I have an increase in my appetite":
Explanation: An increase in appetite is not a typical symptom of iron-deficiency anemia. In fact, individuals with anemia may experience a decrease in appetite.

A. The need to monitor urine for the presence of albumin B. The relationship between kidney function and blood glucose levels C. The need for frequent eye examinations for clients with diabetes D. The fact that clients with diabetes have an elevated risk of myocardial infarction

Correct Answer is D

Explanation

A. The need to monitor urine for the presence of albumin:
Explanation: Monitoring urine for albumin is more associated with microvascular complications, particularly diabetic nephropathy. When the kidneys are affected, albumin may leak into the urine. This is not a macrovascular complication.

B. The relationship between kidney function and blood glucose levels:
Explanation: The relationship between kidney function and blood glucose levels is important, but it is more directly related to microvascular complications, particularly diabetic nephropathy. High blood glucose levels over time can damage the small blood vessels in the kidneys.

C. The need for frequent eye examinations for clients with diabetes:
Explanation: This is related to microvascular complications, specifically diabetic retinopathy. Changes in the small blood vessels of the retina can lead to vision problems. While important, it's not directly addressing macrovascular complications.

D. The fact that clients with diabetes have an elevated risk of myocardial infarction:
Explanation: This is the correct answer. Macrovascular complications involve large blood vessels and are associated with conditions such as coronary artery disease, which increases the risk of myocardial infarction in individuals with diabetes.

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Naxlex Comprehensive Predictor Exams

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?

Correct Answer is A

Explanation

The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue?

Correct Answer is D

Explanation

A client is being treated on the medical unit for a sickle cell crisis. The nurse's most recent assessment reveals an oral temperature of 100.5°F and a new onset of fine crackles on lung auscultation. What is the nurse's most appropriate action?

The nurse is monitoring a client who was diagnosed with Type 1 Diabetes Mellitus and is being treated with NPH and regular insulin. Which manifestations alert the nurse to the presence of a possible hypoglycemic reaction? (SELECT ALL THAT APPLY)

A nurse is caring for a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report?

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?

The nurse is preparing to administer Insulin Lispro (Humalog) to a client with Type 2 Diabetes Mellitus for carbohydrate coverage. The nurse understands the injection should be administered:

The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy?

A nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?