A nurse is assessing a patient on the medical floor who is being treated for pneumonia and reports sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 24 mm Hg. Which condition does the ABG reflect?
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
The Correct Answer is A
A. Respiratory acidosis is indicated by a low pH (< 7.35) and elevated PaCO₂ (> 45 mm Hg), which fits this ABG profile: pH 7.21 (acidic), PaCO₂ 64 mm Hg (elevated), HCO₃ normal — confirming an uncompensated respiratory acidosis.
B. Metabolic alkalosis would present with a high pH and elevated HCO₃, which is not the case here.
C. Respiratory alkalosis involves high pH and low PaCO₂, the opposite of this patient's values.
D. Metabolic acidosis presents with low pH and low HCO₃, but the bicarbonate here is normal (24 mm Hg), ruling this out.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Cryosurgery is used for tumors in patients who are not surgical candidates but is not the primary treatment for resectable, localized liver cancer.
B. Liver transplantation is considered when cancer involves both lobes or in the presence of underlying liver disease (e.g., cirrhosis), not when the tumor is confined to one lobe.
C. Lobectomy (surgical resection of the affected lobe) is the preferred treatment when hepatocellular carcinoma is localized to one lobe and the remaining liver tissue is healthy.
D. Laser hyperthermia is an investigational or palliative technique and is not considered first-line treatment for localized HCC.
Correct Answer is A
Explanation
A. IV administration of 50% dextrose (D50W) is the appropriate emergency treatment for severe hypoglycemia in an unconscious patient. It rapidly raises blood glucose levels and is the standard of care in emergency situations.
B. Administering insulin (Humalog) would worsen hypoglycemia and is contraindicated.
C. Giving additional insulin in any form would further lower the already critically low blood glucose.
D. 5% dextrose in 0.45% NaCl is used for maintenance fluid therapy, not for treating acute, severe hypoglycemia.
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