A client is admitted to the medical-surgical unit with a chief complaint of prolonged vomiting over the past 24 hours. Based on the arterial blood gas (ABG) results of pH 7.5. PaCO2 36, HCO3 40, the nurse determines that the client is experiencing:

respiratory alkalosis.

respiratory acidosis.

metabolic acidosis.

metabolic alkalosis.

Answer and Explanation

The Correct Answer is D

D. Metabolic alkalosis is characterized by an increased pH (alkalosis) and an increased HCO3. In this case, the pH is elevated (7.5), indicating alkalosis, which supports metabolic alkalosis. The HCO3 is elevated at 40 mEq/L, which further supports metabolic alkalosis. The PaCO2 is normal or slightly low (36 mmHg), which can occur as a compensatory response to metabolic alkalosis.

A. Respiratory alkalosis is characterized by an increase in pH (alkalosis) and a decrease in PaCO2 (hypocapnia). In this scenario, the pH is elevated (7.5), which indicates alkalosis. The PaCO2 is 36 mmHg, which is within the normal range (35-45 mmHg) but slightly on the lower side (slight hypocapnia). The HCO3 is elevated at 40 mEq/L, which suggests a compensatory response by the kidneys to retain bicarbonate to counteract the alkalosis.

B. Respiratory acidosis is characterized by a decrease in pH (acidosis) and an increase in PaCO2 (hypercapnia). In this case, the pH is elevated (7.5), indicating alkalosis, which contradicts respiratory acidosis. The PaCO2 is 36 mmHg, which is normal or slightly low, not high as expected in respiratory acidosis. The elevated HCO3 (40 mEq/L) suggests a compensatory metabolic response to the alkalosis, not to acidosis.

C. Metabolic acidosis is characterized by a decreased pH (acidosis) and a decreased HCO3. In this scenario, the pH is elevated (7.5), indicating alkalosis, which contradicts metabolic acidosis. The HCO3 is elevated at 40 mEq/L, indicating metabolic alkalosis rather than metabolic acidosis.

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Correct Answer is C

Explanation

C. Chvostek's sign is assessed by tapping or lightly percussing the facial nerve (facial muscles) at the angle of the jaw, just in front of the earlobe. A positive Chvostek's sign is indicated by facial twitching, especially around the mouth, nose, and eye, in response to this percussion. It indicates neuromuscular irritability due to low calcium levels.

A. Straining urine is typically done to collect urine for analysis or to detect urinary stones. It does not relate to the assessment of neuromuscular irritability, which is what Chvostek's sign evaluates.

B. This option does not pertain to assessing Chvostek's sign either. Inflating a blood pressure cuff above systolic measurement is a technique used to assess for Trousseau's sign, which is another clinical indicator of hypocalcemia but involves different physiological mechanisms than Chvostek's sign.

D. This option is unrelated to assessing Chvostek's sign or hypocalcemia. Baseline height and weight are typically obtained for nutritional assessment, growth monitoring, or as part of a general health assessment. They do not help in evaluating neuromuscular irritability associated with calcium levels.

A. nonmaleficence. B. justice. C. fidelity. D. autonomy.

Correct Answer is A

Explanation

A. This principle emphasizes the duty to do no harm. In the case of the client undergoing chemotherapy and experiencing severe side effects that significantly reduce their quality of life, the principle of nonmaleficence comes into question. Chemotherapy, while aimed at treating cancer, often causes substantial side effects that can impact a patient's well-being

BThis principle relates to fairness and equality in the distribution of resources, treatments, and outcomes. In the context of cancer treatment, justice could be considered in terms of ensuring equitable access to chemotherapy and supportive care, regardless of socioeconomic status or other factors.

C Fidelity refers to the duty to be faithful, keep promises, and maintain trust in the patient-nurse relationship. In this context, fidelity would involve the nurse advocating for the client's best interests, including addressing their concerns about the severe side effects of chemotherapy and their impact on quality of life.

D. Autonomy refers to respecting the right of the patient to make their own decisions about their care and treatment. In the context of cancer treatment, autonomy would involve ensuring that the client has sufficient information about their condition, prognosis, treatment options, and potential side effects to make informed decisions. However, autonomy may also be challenged when severe side effects significantly impact the client's ability to maintain their desired quality of life despite ongoing treatment.

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A client is admitted to the medical-surgical unit with a chief complaint of prolonged vomiting over the past 24 hours. Based on the arterial blood gas (ABG) results of pH 7.5. PaCO2 36, HCO3 40, the nurse determines that the client is experiencing:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a total calcium level of 7.0 mg/dL. To assess for Chvostek's sign, the nurse would:

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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