A client is admited to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs?

Metabolic alkalosis

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Answer and Explanation

The Correct Answer is B

Choice A: Metabolic alkalosis is incorrect because it is characterized by a high pH and a high HCO3, not a low pH and a normal HCO3. Metabolic alkalosis occurs when there is a loss of metabolic acids or an excess of bicarbonate in the body, such as from vomiting, gastric suctioning, or diuretic therapy.

Choice B: Respiratory acidosis is correct because it is characterized by a low pH and a high PaCO2. Respiratory acidosis occurs when there is impaired gas exchange or hypoventilation, resulting in accumulation of carbon dioxide in the blood. This can be caused by conditions such as chronic obstructive pulmonary disease (COPD), pneumonia, asthma, or chest trauma.

Choice C: Metabolic acidosis is incorrect because it is characterized by a low pH and a low HCO3, not a low pH and a normal HCO3. Metabolic acidosis occurs when there is an excess of metabolic acids in the body, such as lactic acid, ketoacids, or salicylates.

Choice D: Respiratory alkalosis is incorrect because it is characterized by a high pH and a low PaCO2, not a low pH and a high PaCO2. Respiratory alkalosis occurs when there is excessive loss of carbon dioxide through hyperventilation, such as in anxiety, fever, or aspirin overdose.

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Correct Answer is ["B","C","D","E"]

Explanation

Choice A: Furosemide (Lasix) is incorrect because it is a diuretic that increases urine output and potassium excretion. However, this medication is not eﬀective for patients with chronic renal failure who have oliguria or anuria.

Furosemide can also cause hypokalemia, which is a low potassium level.

Choice B: Sodium polystyrene sulfonate (Kayexalate) is correct because it is a cation exchange resin that binds to potassium in the gastrointestinal tract and removes it from the body through feces. This medication can lower the serum potassium level and prevent hyperkalemia, which is a high potassium level.

Choice C: Dextrose 10% is correct because it is a hypertonic solution that raises the blood glucose level and stimulates the release of insulin. Insulin helps to move potassium from the extracellular ﬂuid into the cells, thus lowering the serum potassium level.

Choice D: Sodium bicarbonate is correct because it is an alkalizing agent that corrects metabolic acidosis, which is a common complication of chronic renal failure. Metabolic acidosis can cause potassium to shift from the intracellular ﬂuid to the extracellular ﬂuid, thus raising the serum potassium level. Sodium bicarbonate can reverse this eﬀect and lower the serum potassium level.

Choice E: Insulin is correct because it also helps to move potassium from the extracellular ﬂuid into the cells, thus lowering the serum potassium level. Insulin can be given intravenously with dextrose 10% to prevent hypoglycemia, which is a low blood glucose level.

A. Kussmaul respirations B. Cold, clammy skin C. Dysrhythmias D. Tachycardia E. Weakness

Correct Answer is ["A","C","D","E"]

Explanation

Choice A: Kussmaul respirations are a sign of metabolic acidosis, which is a condition that occurs when the body produces too much acid or loses too much bicarbonate. This can happen in patients with diabetes mellitus who develop diabetic ketoacidosis (DKA), a serious complication that results from insufficient insulin and high blood glucose levels. Kussmaul respirations are deep, rapid, and labored breathing that helps to eliminate excess carbon dioxide and acid from the blood.

Choice B: Cold, clammy skin is not a sign of metabolic acidosis, but rather of hypoglycemia, which is a condition that occurs when the blood glucose level is too low. This can happen in patients with diabetes mellitus who take too much insulin or oral hypoglycemic agents, skip meals, or exercise excessively. Cold, clammy skin is caused by vasoconstriction and sweating that occur as the body tries to increase blood glucose levels.

Choice C: Dysrhythmias are a sign of metabolic acidosis, because acidosis aﬀects the electrical activity of the heart and can cause irregular heartbeats. Dysrhythmias can also result from electrolyte imbalances, such as hyperkalemia, which is a condition that occurs when the blood potassium level is too high. This can happen in patients with metabolic acidosis who have impaired renal function and cannot excrete excess potassium.

Choice D: Tachycardia is a sign of metabolic acidosis, because acidosis stimulates the sympathetic nervous system and increases the heart rate. Tachycardia can also result from dehydration, which is a common complication of DKA due to excessive ﬂuid loss from vomiting, diarrhea, and polyuria.

Choice E: Weakness is a sign of metabolic acidosis because acidosis reduces the availability of oxygen and nutrients to the tissues and muscles. Weakness can also result from hypovolemia, which is a condition that occurs when the blood volume is too low. This can happen in patients with metabolic acidosis who have severe ﬂuid loss and hypotension.

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A client is admited to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs?

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Naxlex Comprehensive Predictor Exams

A patient with chronic renal failure has an occluded arteriovenous fistula, and routine hemodialysis is delayed. However, the patient's serum potassium level is 6.0 mEq/L. What should the nurse expect to be prescribed for this patient? (Select all that apply.)

Correct Answer is ["B","C","D","E"]

Explanation

A patient newly diagnosed with diabetes mellitus is admitted to the emergency department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2 and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse anticipate in this patient? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

The nurse is reviewing the health problems for a group of assigned patients. Which patient does the nurse recognize as being at increased risk for developing metabolic alkalosis?

A patient with chronic renal failure has an occluded arteriovenous fistula, and routine hemodialysis is delayed. However, the patient's serum potassium level is 6.0 mEq/L. What should the nurse expect to be prescribed for this patient? (Select all that apply.)

A patient with a history of stomach ulcers is diagnosed with hypophosphatemia. What intervention should the nurse include in this patient's plan of care?

A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for ﬂuid volume deficit?

A nurse is assessing a client who has ﬂuid volume deficit. The nurse should expect which of the following findings?

A patient's blood gases show a pH of 7.53 and bicarbonate level of 36 mEq/L. The nurse realizes that the patient is demonstrating which acid-base disorder?

A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?

The nurse is concerned that a patient recovering from a thyroidectomy is developing hypocalcemia. What findings did the nurse use to come to this conclusion? (Select all that apply)