A client is brought to the Emergency Department after passing out in a local department store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse expect to assess in this client?

Metabolic acidosis

Metabolic alkalosis

Respiratory alkalosis

Respiratory acidosis

Answer and Explanation

The Correct Answer is A

A. Metabolic acidosis: Fasting can lead to the production of ketones as the body breaks down fat for energy in the absence of sufficient glucose. Ketones are acidic, and their accumulation in the blood leads to a decrease in pH, causing metabolic acidosis.

B. Metabolic alkalosis: This condition occurs when there is an excessive loss of acid or an increase in bicarbonate levels. It is not typically associated with fasting or the production of ketones.

C. Respiratory alkalosis: Respiratory alkalosis occurs when excessive CO2 is exhaled, leading to an increase in blood pH. This is typically due to hyperventilation and is not related to fasting or ketone production.

D. Respiratory acidosis: Respiratory acidosis results from the retention of CO2 due to hypoventilation, which leads to a decrease in blood pH. This condition is not associated with fasting or ketosis and is not likely to be the cause of the client’s symptoms.

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Correct Answer is D

Explanation

A. Respirations that cease for several seconds: This describes periodic breathing or Cheyne-Stokes respirations, which are not characteristic of Kussmaul’s respirations. Kussmaul’s respirations are marked by rapid and deep breathing, not cessation of breathing.

B. Respirations that are regular but abnormally slow: This describes bradypnea, which is not associated with diabetic ketoacidosis (DKA). Kussmaul’s respirations are fast and deep, not slow.

C. Respirations that are labored, and decreased in depth and rate: Labored, shallow breathing is not characteristic of Kussmaul’s respirations. Instead, Kussmaul’s respirations are deep and rapid, a compensatory mechanism for metabolic acidosis in DKA.

D. Respirations that are abnormally deep, regular, and increased in rate: Kussmaul’s respirations are deep, rapid, and regular, which are a physiological response to help decrease CO2 levels and correct the acidosis seen in DKA.

A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis

Correct Answer is B

Explanation

A. Metabolic acidosis: Metabolic acidosis is caused by an accumulation of acid or loss of bicarbonate, not by carbon dioxide retention. While hypoventilation can cause a buildup of CO2, this condition is primarily associated with respiratory acidosis.

B. Respiratory acidosis: Hypoventilation leads to the retention of carbon dioxide (CO2), which increases the concentration of carbonic acid in the blood, causing a decrease in blood pH. This results in respiratory acidosis, making it the correct acid-base imbalance to focus on.

C. Metabolic alkalosis: Metabolic alkalosis occurs when there is an excess of bicarbonate or a loss of hydrogen ions, and it is not related to the retention of CO2 from hypoventilation.

D. Respiratory alkalosis:This occurs when excessive CO2 is exhaled due to hyperventilation, not hypoventilation. Hypoventilation results in CO2 retention, which leads to acidosis, not alkalosis.

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A client is brought to the Emergency Department after passing out in a local department store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse expect to assess in this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with diabetic ketoacidosis (DKA) and documents that the client is experiencing Kussmaul's respirations. Based on this documentation, which of the following did the nurse most likely observe?

Correct Answer is D

Explanation

A patient is hypoventilating and retaining carbon dioxide. On which acid-base imbalance should the nurse focus when caring for this patient?

Correct Answer is B

Explanation

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