A client is experiencing metabolic acidosis.
The nurse anticipates that the client’s respiratory rate will be:
Increased.
Decreased.
Normal.
Irregular.
The Correct Answer is A
Metabolic acidosis is a condition in which there is excess acid in the body fluids.
It causes rapid breathing, confusion, tiredness, headache, and increased heart rate.
Rapid breathing is a compensatory mechanism that helps to lower the carbon dioxide levels and increase the pH of the blood.
Choice B is wrong because decreased respiratory rate would worsen the acidosis by retaining more carbon dioxide and lowering the pH of the blood.
Choice C is wrong because normal respiratory rate would not be adequate to compensate for the metabolic acidosis and would result in acidemia (low blood pH).
Choice D is wrong because irregular respiratory rate is not a typical response to metabolic acidosis and could indicate other problems such as brain injury or drug overdose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Trousseau’s sign is a test for hypocalcemia that involves inflating a blood pressure cuff on the arm and observing for carpal spasm. A positive sign indicates low calcium levels in the blood, which can cause neuromuscular irritability.
Choice B is wrong because hyperactive deep tendon reflexes are a sign of hypomagnesemia, which is a low level of magnesium in the blood.
Choice C is wrong because hyperactive bowel sounds are a sign of hyperkalemia, which is a high level of potassium in the blood.
Choice D is wrong because muscle twitching can be caused by many factors, such as anxiety, caffeine, or electrolyte imbalance, and is not specific to hypocalcemia.
Correct Answer is C
Explanation
This is because acute renal failure is a condition where the kidneys lose their ability to filter waste and excess fluid from the blood. This can lead to fluid overload, electrolyte imbalances, and metabolic acidosis. Therefore, the nurse should monitor the patient’s urine output and fluid balance to assess the severity of the renal impairment and prevent complications.
Choice A is wrong because administering a potassium-sparing diuretic would worsen the patient’s hyperkalemia, which is a common complication of acute renal failure.
Choice B is wrong because encouraging the patient to consume a high-sodium diet would increase the patient’s fluid retention and blood pressure, which can further damage the kidneys.
Choice D is wrong because administering intravenous antibiotics is not a priority intervention for acute renal failure unless there is a specific indication of infection.
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