A client is admitted for a diagnosis of sepsis secondary to a urinary tract infection. The client's repeat ABG is: pH 7.37, PC02 30, HCO3 of 18. Which acid-base imbalance is the client exhibiting?

normal ABG

respiratory acidosis

metabolic alkalosis

metabolic acidosis

Answer and Explanation

The Correct Answer is D

Rationale:
A. The pH is at the lower limit of normal but combined with low bicarbonate indicates imbalance, so not normal.
B. Respiratory acidosis would show increased PaCO₂, but here PaCO₂ is low.
C. Metabolic alkalosis is characterized by elevated bicarbonate, which is not present.
D. Metabolic acidosis is indicated by low HCO₃ (18) and compensatory respiratory alkalosis (low PaCO₂ of 30) to maintain near-normal pH. This fits the ABG results.

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Correct Answer is A

Explanation

Rationale:

A. Request a potassium replacement: The client's potassium level is 3.0 mEq/L, which indicates hypokalemia (normal range: 3.5–5.0 mEq/L). TPN can cause electrolyte shifts, so potassium supplementation is appropriate and should be initiated to prevent complications like arrhythmias and muscle weakness.

B. Administer glucagon IM: This is used to treat severe hypoglycemia. The client’s glucose is 72 mg/dL, which is within the normal range (70–100 mg/dL fasting), so glucagon is not needed.

C. Check the client for a positive Chvostek's sign: Chvostek’s sign is associated with hypocalcemia, not hypokalemia, and calcium levels were not mentioned as abnormal here.

D. Discontinue the TPN infusion: Discontinuing TPN is not appropriate without a critical reason. Electrolyte imbalances are common during TPN therapy and are typically managed by adjusting the TPN formulation rather than stopping it altogether.

A. Applesauce B. Pretzels C. Chicken hotdog D. Lemonade E. Tomato juice

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

Explanation

Rationale:
A. Applesauce is naturally low in sodium and is appropriate for a low-sodium diet.
B. Pretzels are typically high in sodium and should be avoided or eaten in moderation.
C. Chicken hotdogs are processed meats that contain high levels of sodium and should be avoided.
D. Lemonade is low in sodium and generally acceptable unless other health concerns are present (e.g., diabetes).
E. Tomato juice often contains added salt and is high in sodium unless specifically labeled as low-sodium.

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A client is admitted for a diagnosis of sepsis secondary to a urinary tract infection. The client's repeat ABG is: pH 7.37, PC02 30, HCO3 of 18. Which acid-base imbalance is the client exhibiting?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L. sodium 138 mEq/L. and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

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