A nurse in an emergency department is caring for a client who is receiving treatment for excessive ingestion of antacids. The nurse should identify that this client is at risk for which of the following acid- base imbalances?
Metabolic acidosis
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
The Correct Answer is C
C. Metabolic alkalosis is characterized by an increase in serum bicarbonate levels, resulting in an imbalance in the body's acid-base equilibrium towards alkalinity. Excessive ingestion of antacids, particularly those containing bicarbonate or calcium carbonate, can lead to an excessive accumulation of bicarbonate ions in the body, causing metabolic alkalosis.
A. Excessive ingestion of antacids would not typically cause metabolic acidosis because antacids containing bicarbonate or calcium carbonate actually increase bicarbonate levels, leading to alkalosis rather than acidosis.
B. Respiratory alkalosis occurs due to hyperventilation, leading to a decrease in carbon dioxide levels and subsequent alkalosis. Excessive ingestion of antacids is not typically associated with respiratory alkalosis.
D. Respiratory acidosis occurs due to hypoventilation, leading to an increase in carbon dioxide levels and subsequent acidosis. Excessive ingestion of antacids is not typically associated with respiratory acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Capillary refill time greater than 2 seconds suggests impaired peripheral circulation, which could indicate vascular compromise or inadequate perfusion to the extremity. In a client with an external fixator, compromised circulation could lead to serious complications such as compartment syndrome or tissue necrosis.
A. This finding may be within the expected range for drainage following surgery, particularly if the client has undergone orthopedic surgery involving the placement of an external fixator. However, the nurse should continue to monitor the drainage and assess for any signs of increased bleeding or hematoma formation.
B. While a low-grade fever alone may not require immediate intervention, the nurse should assess the client further for other signs and symptoms of infection, such as increased pain, redness, warmth, or drainage at the surgical site.
C. While the client's pain level of 7 may require intervention to manage discomfort, it does not necessarily indicate an immediate threat to the client's safety or well-being.
Correct Answer is B
Explanation
This response acknowledges the client's fear and invites them to express their concerns, allowing the nurse to address them effectively and provide necessary information or support.
A. This response focuses specifically on the fear of needles and may not address the client's overall apprehension about the procedure or their specific concerns.
C. This response directly asks the client to articulate their fears, which can help the nurse understand the specific reasons behind their anxiety and tailor their support and education accordingly.
D. While this response attempts to offer reassurance, it may come across as dismissive of the client's current fears and may not effectively address their concerns or provide the support they need before undergoing the procedure.
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