A client's arterial blood gas (ABG) reads: pH 7.18, PaCO2 54 mm Hg, HCO3 26 mEq/L. What condition does the nurse recognize may contribute to the development of this result? Normal values: pH: 7.35-7.45, PaCO2: 35-45 mm Hg, HCO3: 22-26 mEq/L

Prolonged vomiting

COPD

Chronic renal failure

Anxiety and hyperventilation

Answer and Explanation

The Correct Answer is B

Choice A reason: Prolonged vomiting typically leads to metabolic alkalosis due to the loss of gastric acid, which is not consistent with the ABG results showing acidosis.

Choice B reason: COPD can lead to respiratory acidosis, as indicated by the elevated PaCO2 and low pH in the ABG results, making it a likely contributor to these findings.

Choice C reason: Chronic renal failure can lead to metabolic acidosis, but the HCO3 level is within the normal range, which does not support this as the primary condition.

Choice D reason: Anxiety and hyperventilation usually result in respiratory alkalosis due to the excessive exhalation of CO2, which is the opposite of what the ABG results show.

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Correct Answer is A

Explanation

Choice A reason: The serum lactate level of 3.9 mmol/L is significantly higher than the normal range of 0.5-2 mmol/L. This is a critical value to report as it indicates a high likelihood of sepsis, which is a life-threatening condition requiring immediate intervention. Elevated lactate levels suggest that the tissues are not adequately oxygenated, a state known as tissue hypoxia, which is a hallmark of sepsis.

Choice B reason: While the vital signs show a slight fever (100°F), the heart rate, respiratory rate, and blood pressure are within normal limits for an adult and do not indicate an immediate life-threatening condition.

Choice C reason: A pulse oximetry reading of 96% on supplemental oxygen is within the acceptable range, indicating adequate oxygen saturation and not a direct sign of sepsis.

Choice D reason: The presence of rhonchi bilaterally suggests airway obstruction due to mucus, which can be associated with pneumonia. However, this finding alone does not carry the same immediate risk of morbidity and mortality as an elevated lactate level indicative of sepsis.

A. ABG: pH 7.36 (normal range 7.35-7.45), PaO2 80 mm Hg (normal range 75-100 mm Hg) B. Temperature 100.8°F C. Platelets 99,000/mm^3 (normal range 150,000-400,000/mm^3) D. Urine culture positive for gram-negative bacteria

Correct Answer is C

Explanation

Choice A reason: The ABG values provided are within normal limits and do not indicate a complication of sepsis.

Choice B reason: A temperature of 100.8°F suggests an infection but is not specific enough to indicate a complication of sepsis.

Choice C reason: A platelet count of 99,000/mm3 is below the normal range and can indicate a complication of sepsis known as disseminated intravascular coagulation (DIC), which is a serious condition that can lead to severe bleeding or blood clots.

Choice D reason: A urine culture positive for gram-negative bacteria indicates an infection, which could be the source of sepsis, but it does not specifically indicate a complication of sepsis.

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A client's arterial blood gas (ABG) reads: pH 7.18, PaCO2 54 mm Hg, HCO3 26 mEq/L. What condition does the nurse recognize may contribute to the development of this result? Normal values: pH: 7.35-7.45, PaCO2: 35-45 mm Hg, HCO3: 22-26 mEq/L

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is C

Explanation

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