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 D

Explanation

Rationale:
A. Respiratory alkalosis results from hyperventilation, which is unlikely with opioid overdose.
B. Metabolic acidosis can occur from other causes but is not the primary imbalance here.
C. Metabolic alkalosis is not associated with opioid overdose.
D. Respiratory acidosis occurs due to hypoventilation caused by opioid-induced respiratory depression, leading to CO₂ retention and decreased pH.

A. Hold the medication and Inform the provider of the client's potassium level. B. Obtain an order to increase the dosage of the medication. C. Hold the medication until the client has his evening meal. D. Give the medication as prescribed.

Correct Answer is A

Explanation

Rationale:

A. Hold the medication and inform the provider of the client's potassium level: A potassium level of 5.8 mEq/L indicates hyperkalemia (normal range is 3.5–5.0 mEq/L). Administering potassium chloride in this situation could worsen the hyperkalemia and lead to serious cardiac complications. The provider should be notified immediately.

B. Obtain an order to increase the dosage of the medication: This would be unsafe and inappropriate since the potassium level is already elevated.

C. Hold the medication until the client has his evening meal: Delaying the dose does not address the issue. The problem is the elevated potassium, not the timing.

D. Give the medication as prescribed: Administering potassium in the presence of hyperkalemia is dangerous and could result in life-threatening arrhythmias.

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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

An emergency department nurse admits a client who has tried to commit suicide by taking an overdose of hydromorphone (Dilaudid), a narcotic. For which acid-base imbalance should the nurse assess this client for?

Correct Answer is D

Explanation

A nurse received an order to administer potassium chloride to a client who has a potassium level of 5.8 mEq/L. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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