A nurse is caring for a client with an extensive cardiac history who is sent out from a long-term care facility and has several medication prescriptions. They present to the emergency department with tachycardia and hypotension. The client's arterial blood gas results are noted below. Which of the following acid- base imbalances is the client experiencing?

pH 7.55 (pH 7.35-7.45)

PaCO2 39 (PaCO2 35-45)

PaO2 100 (PaO2 80-100)

HCO3 31 (HCO3 21-28)

Respiratory alkalosis, uncompensated

Metabolic alkalosis, uncompensated

Respiratory acidosis, partially compensated

Metabolic acidosis, partially compensated

Answer and Explanation

The Correct Answer is B

A. Respiratory alkalosis, uncompensated would show an elevated pH with a decreased PaCO₂, typically due to hyperventilation. However, the PaCO₂ here is normal, and the elevated bicarbonate indicates that the cause of alkalosis is metabolic, not respiratory, making this an incorrect choice.
B. Metabolic alkalosis, uncompensated is the correct answer because the pH is elevated above 7.45, and the bicarbonate level is also elevated at 31 mEq/L. The PaCO₂ remains within the normal range, indicating that there has been no respiratory compensation yet, thus fitting the pattern of uncompensated metabolic alkalosis.
C. Respiratory acidosis, partially compensated would present with a low pH and a high PaCO₂, which is not the case here. The client’s pH is elevated and PaCO₂ is normal, eliminating respiratory acidosis from consideration.
D. Metabolic acidosis, partially compensated would show a low pH with a low bicarbonate level, typically accompanied by a compensatory decrease in PaCO₂. This client has an elevated pH and elevated bicarbonate, ruling out metabolic acidosis as a possibility.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is ["5"]

Explanation

Calculation:

Convert the client's weight from pounds (lbs) to kilograms (kg):

Conversion factor: 1 kg = 2.2 lbs
Formula: Weight in kg = Weight in lbs / 2.2 lbs/kg

= 150 lbs / 2.2 lbs/kg

≈ 68.18 kg

Calculate the milligrams of pancuronium per hour:

Ordered dose: 0.07 mg/kg/hr
Client's weight in kg: ≈ 68.18 kg
Formula: Dosage per hour (mg/hr) = Ordered dose (mg/kg/hr) × Client's weight (kg)

= 0.07 mg/kg/hr × 68.18 kg

≈ 4.7726 mg/hr

Round the result to the nearest whole number:

mg/hr rounded to the nearest whole number is 5 mg/hr.

A. A client who has renal failure, a serum potassium of 6.1/mEq/L, and is prescribed sodium polystyrene sulfonate B. A client who has anemia, hemoglobin of 11 g/dL, and is prescribed epoetin alfa C. A client who has pneumonia, a WBC count of 11,500/mm3, and is prescribed piperacillin. D. A client who is post-coronary artery bypass graft (CABG), has total cholesterol of 318 mg/dL, and is prescribed atorvastatin

Correct Answer is A

Explanation

A. A client who has renal failure, a serum potassium of 6.1 mEq/L, and is prescribed sodium polystyrene sulfonate should receive medications first because hyperkalemia is a life-threatening electrolyte imbalance. Elevated potassium levels can cause fatal cardiac arrhythmias, and immediate treatment is needed to lower serum potassium and stabilize cardiac function.
B. A client who has anemia, hemoglobin of 11 g/dL, and is prescribed epoetin alfa is stable because mild anemia at this level does not pose an immediate threat to life. While treatment is important for managing chronic anemia, it does not take precedence over urgent electrolyte correction.
C. A client who has pneumonia, a WBC count of 11,500/mm³, and is prescribed piperacillin needs prompt antibiotic therapy, but a slightly elevated WBC count suggests an active infection without immediate critical deterioration. The situation is urgent but not as acutely life-threatening as hyperkalemia.
D. A client who is post-coronary artery bypass graft (CABG) and has a total cholesterol of 318 mg/dL, prescribed atorvastatin, requires lipid management for long-term cardiovascular risk reduction. However, administering atorvastatin is not urgent compared to correcting potentially fatal electrolyte imbalances.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is received orders to continue neuromuscular blockade on a 150 lbs client with ARDS. The pancuronium is ordered at 0.07 mg/kg/hr and to titrate per parameters. How many milligrams per hour will the nurse set the IV pump to? (Round to the nearest whole number.)

Correct Answer is ["5"]

Explanation

A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?

Correct Answer is A

Explanation

A nurse is planning care for a client who ingested a large amount of acetylsalicylic acid. Which of the following actions should the nurse take?

A nurse is planning care for a client who is to receive a neuromuscular blocking agent. Which of the following items should the nurse plan to have at the client's bedside?

A nurse is planning care for a client who has acute respiratory distress syndrome (ARDS). Which of the following interventions is the most appropriate for the nurse to include in the care plan?

A nurse is caring for a client who has acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

A nurse is monitoring a client who has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should the nurse take?

A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia and hypoxia in the older adult client?

A nurse is caring for a client who has a pneumothorax. Exhibits For each potential provider's order, click to specify if the potential order is anticipated, non-essential, or contraindicated for the client.

A nurse is caring for a client who sustained frostbite injuries after being found stranded on a snowy hiking trail. Which of the following interventions is contraindicated in preventing hypothermia?