A client with a bowel obstruction is experiencing intractable vomiting for the last several hours despite the administration of prescribed antiemetics. The nurse obtains the client's arterial blood gas (ABG) results which identify a pH of 7.50, a PaCO2 of 42 mm Hg, and an HCO3 of 33 me/L (33 mmol/L). The nurse should interpret these results as confirming which acid-base imbalance?

Respiratory acidosis.

Metabolic acidosis.

Metabolic alkalosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is C

Choice A reason: Respiratory acidosis is characterized by a low pH and an elevated PaCO2 due to hypoventilation, which results in CO2 retention. The ABG results in this case show a normal PaCO2, making this option incorrect.

Choice B reason: Metabolic acidosis is characterized by a low pH and a low HCO3 due to an accumulation of acids or loss of bicarbonate. The ABG results show a high pH and a high HCO3, which are opposite to the findings of metabolic acidosis.

Choice C reason: Metabolic alkalosis is characterized by a high pH and an elevated HCO3. This condition can result from excessive loss of stomach acid due to vomiting or the use of diuretics. The ABG results show a pH of 7.50 and HCO3 of 33 me/L, both indicative of metabolic alkalosis.

Choice D reason: Respiratory alkalosis is characterized by a high pH and a low PaCO2 due to hyperventilation, which leads to CO2 loss. The ABG results show a normal PaCO2, ruling out respiratory alkalosis as the correct diagnosis.

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Correct Answer is B

Explanation

Choice A reason: Jugular vein distention is more commonly associated with right ventricular heart failure, as it indicates increased central venous pressure.

Choice B reason: Bilateral basilar crackles are a hallmark sign of left ventricular heart failure. They occur due to pulmonary congestion and enema, resulting from the left ventricle's inability to effectively pump blood out to the body, causing fluid to back up into the lungs.

Choice C reason: 3+ pitting enema in the ankles is more characteristic of right ventricular heart failure, where fluid accumulates in the peripheral tissues.

Choice D reason: Hepatomegaly with right upper quadrant (RUQ) tenderness is also more indicative of right ventricular heart failure, as it reflects congestion in the liver due to increased venous pressure.

A. Occult positive emesis. B. Strong foul-smelling flatus. C. Report of poor night vision. D. Loose bowel movements.

Correct Answer is A

Explanation

Choice A reason: Occult positive emesis, which indicates the presence of blood in vomit, is a critical finding. It suggests potential gastrointestinal bleeding, which requires immediate medical intervention. This condition can lead to significant blood loss and further complications if not addressed promptly.

Choice B reason: Strong foul-smelling flatus can indicate malabsorption or changes in gut flora, which are common after biliopancreatic diversion. While it can be unpleasant and concerning, it is not as immediately dangerous as gastrointestinal bleeding.

Choice C reason: A report of poor night vision could be related to vitamin A deficiency, which can occur after malabsorptive procedures like BPD. However, it is not an immediate threat compared to the risk of gastrointestinal bleeding.

Choice D reason: Loose bowel movements are common after BPD due to changes in digestion and absorption. While they can contribute to dehydration, they are not as urgent as the presence of blood in vomit.

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a client who has left ventricular heart failure. Which assessment finding is this client most likely to exhibit?

Correct Answer is B

Explanation

A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

Correct Answer is A

Explanation

A client with heart failure (HF) is waiting in the preoperative area for a scheduled procedure and tells the nurse, "My heart feels like it is beating too fast and I feel faint." After initiating a call for an electrocardiogram (ECG), which assessment data is most important for the nurse to obtain?

During a home visit, the nurse should evaluate the effectiveness of a client's treatment for chronic obstructive pulmonary disease (COPD) by assessing for which primary symptom?

A client with Crohn's disease is admitted to the medical unit with a three-day history of abdominal cramping, nausea, and vomiting. Which prescription should the nurse implement first?

Which diet modification should the nurse suggest to a client who was recently diagnosed with diverticulitis?

A client with fluid volume overload is admitted to the hospital for diuresis. Which assessment should the nurse perform to evaluate the client's fluid balance?

A client with type 1 diabetes mellitus calls the home care nurse and reports taking a morning dose of 70/30 insulin before realizing they have a stomach virus and are now unable to eat breakfast due to nausea. Which initial instruction should the nurse provide the client?

The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)