A female client is in the first trimester of pregnancy. She has experienced approximately one week of severe nausea with frequent vomiting. Interpret the following ABG for this patient. pH 7.44, pCO2 30. HCO3 30.

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

Normal ABG

Answer and Explanation

The Correct Answer is A

Rationale:
A. The pH is on the upper edge of normal, indicating alkalosis. The HCO₃ is elevated (30 mEq/L), pointing to a metabolic cause (consistent with vomiting, which leads to hydrogen ion loss). The low pCO₂ (30 mmHg) suggests respiratory compensation for the metabolic alkalosis.
B. Respiratory acidosis is associated with low pH and high pCO₂, which are not present here.
C. Respiratory alkalosis would show high pH and low pCO₂ with normal or low HCO₃ — not elevated HCO₃.
D. Although the pH is within the normal range (7.35–7.45), the values of pCO₂ and HCO₃ are both abnormal, indicating compensated metabolic alkalosis, not a normal ABG.

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Correct Answer is D

Explanation

Rationale:
A. Metabolic acidosis is characterized by Kussmaul respirations (deep and rapid breathing), but not typically lightheadedness or paresthesias.
B. Metabolic alkalosis often presents with hypoventilation as the body tries to retain CO₂, not hyperventilation.
C. Respiratory acidosis results from hypoventilation, leading to CO₂ retention, not the excessive breathing seen in this case.
D. Respiratory alkalosis is caused by hyperventilation, which leads to excessive loss of CO₂, resulting in symptoms such as lightheadedness, confusion, paresthesias, and blurred vision — all present in this client.

A. An indwelling urinary catheter to gravity drainage B. A chest tube to water-seal drainage C. ANG tube to suction D. A nephrostomy tube to a drainage bag

Correct Answer is C

Explanation

Rationale:
A. Urinary catheters drain urine but do not typically cause significant electrolyte loss leading to hypokalemia.
B. Chest tubes remove air, blood, or fluid from the pleural space but do not significantly affect potassium levels.
C. NG (nasogastric) tubes to suction can lead to hypokalemia because they remove gastric contents, which include potassium and other electrolytes. Prolonged suctioning can cause significant electrolyte imbalances.
D. Nephrostomy tubes drain urine directly from the kidney and do not typically lead to potassium depletion unless there is a high-output or concurrent renal dysfunction.

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A female client is in the first trimester of pregnancy. She has experienced approximately one week of severe nausea with frequent vomiting. Interpret the following ABG for this patient. pH 7.44, pCO2 30. HCO3 30.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the admission of a client who is hyperventilating, reports lightheadedness and paresthesias, has blurred vision, and a new onset of confusion. The nurse should suspect that the client has developed which of the following imbalances?

Correct Answer is D

Explanation

A nurse is caring for four clients who have drainage tubes, The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

Correct Answer is C

Explanation

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