A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

Increased release of acids from the kidneys.

Increased urinary output.

Increased thirst and hunger.

Increased rate and depth of respirations.

Answer and Explanation

The Correct Answer is D

A.   This is not a compensatory mechanism for metabolic acidosis. In fact, during metabolic acidosis, the kidneys excrete hydrogen ions (acid) and reabsorb bicarbonate (base) to help normalize the pH of the blood.
B.   Increased urinary output (polyuria) is not typically a direct compensatory response to metabolic acidosis. However, metabolic acidosis can lead to osmotic diuresis in certain conditions, which may increase urinary output as the body tries to excrete excess acids and maintain electrolyte balance.
C.   Increased thirst (polydipsia) and hunger (polyphagia) are not typical compensatory responses to metabolic acidosis. These symptoms are more associated with hyperglycemia in diabetes rather than acid-base disturbances.
D.   During metabolic acidosis, the respiratory system compensates by increasing the rate and depth of respirations (hyperventilation). By blowing off more CO2 (carbon dioxide), the body tries to decrease the

amount of carbonic acid in the blood, thereby increasing the pH towards normal. This compensatory mechanism helps to raise the pH back towards the normal range (7.35-7.45).

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Correct Answer is B

Explanation

A. It is particularly sensitive to deficiencies in clotting factors, but it does not measure the deficiencies themselves
B. The activated partial thromboplastin time (aPTT) test measures the effectiveness of the intrinsic and common pathways of the coagulation cascade.
C. There is no need to skip breakfast or alter diet for an aPTT test. It is not affected by food intake or fasting status.

D. While aPTT is used to monitor heparin therapy, it is not typically used to monitor warfarin (a vitamin K antagonist) therapy. Warfarin therapy is usually monitored using the prothrombin time (PT) and international normalized ratio (INR) tests.

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

Correct Answer is D

Explanation

A. Metabolic alkalosis is characterized by an increase in bicarbonate (HCO3-) levels in the blood, resulting in an elevated pH (>7.45). Shallow respirations are less likely to cause metabolic alkalosis directly.
B. This is not likely the initial risk. Respiratory alkalosis occurs due to hyperventilation, leading to excessive elimination of CO2 (carbon dioxide), which raises the blood pH (>7.45). Shallow respirations typically result in retention of CO2, leading to respiratory acidosis rather than alkalosis.
C. Metabolic acidosis occurs when there is an increase in acid (decreased pH <7.35) or a decrease in bicarbonate levels in the blood. Shallow respirations can lead to hypoventilation and retention of CO2, resulting in respiratory acidosis initially.
D. Shallow respirations at a rate of 9 breaths per minute reduce the elimination of CO2, leading to its accumulation in the blood. This accumulation lowers the blood pH (<7.35), causing respiratory acidosis. Therefore, the client is initially at risk for developing respiratory acidosis due to ineffective ventilation.

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A nurse assesses a diabetic client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.39, PaCO2 27 mm Hg, and HCO3 19 mEq/L. Which sign or symptom does the nurse identify as an example of the client's compensatory mechanisms?

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client scheduled for an activated partial thromboplastin time (aPTT). Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who is postoperative and whose respirations are shallow and 9/min. Which of the following acid-based imbalances should the nurse identify the client as being at risk for developing initially?

Correct Answer is D

Explanation

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