A nurse is caring for a client with the following Arterial Blood Gases (ABG) pH 7.48, PaCO2 53, and HCO3 31. How would these be interpreted?

Respiratory alkalosis

Partially Compensated Metabolic Alkalosis

Metabolic Acidosis

Fully Compensated Respiratory Acidosis

Answer and Explanation

The Correct Answer is B

A. Respiratory Alkalosis: Would have low PaCO2 (<35 mmHg), not high.

B. Partially Compensated Metabolic Alkalosis: The pH is high (alkalosis), and the HCO3 is elevated, which indicates metabolic alkalosis. The PaCO2 is high, meaning the lungs are attempting to compensate by retaining CO₂ to lower the pH. Because the pH is still abnormal, this is partial compensation.

C. Metabolic Acidosis: Would have low pH and low HCO3 (<22 mEq/L).

D. Fully Compensated Respiratory Acidosis: The primary problem is metabolic, not respiratory.

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Correct Answer is B

Explanation

A. Assess the fistula with a large bore needle: Large bore needles are used during dialysis sessions, not for routine assessment. Inappropriate needling can damage the fistula.

B. Auscultate the fistula site for a bruit: A functional AV fistula should have a palpable thrill (vibration) and an audible bruit (whooshing sound) when auscultated with a stethoscope. These findings confirm adequate blood flow and patency.

C. Measure the blood pressure in the affected arm: Blood pressure measurements should never be taken on the fistula arm to prevent compression and potential fistula failure.

D. Assess the rate and quality of the radial pulse on the affected arm: The radial pulse does not accurately assess AV fistula patency; the focus should be on the thrill and bruit.

A. Electrolytes are within normal limits. B. Blood pressure is decreased to 120/80 C. Decrease of pain by 3 points on a 1-10 scale. D. The client will understand how to care for the AV fistula

Correct Answer is A

Explanation

A. Electrolytes are within normal limits: Acute Renal Failure (ARF) leads to electrolyte imbalances (↑ K+, ↑ BUN/creatinine, metabolic acidosis). A successful treatment goal is restoring normal electrolyte balance.

B. Blood pressure is decreased to 120/80. BP control is important but not the primary goal in ARF.

C. Decrease of pain by 3 points on a 1-10 scale. Pain control is important, but not the main indicator of ARF improvement.

D. The client will understand how to care for the AV fistula. This applies to chronic kidney disease clients on hemodialysis, not ARF management.

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A nurse is caring for a client with the following Arterial Blood Gases (ABG) pH 7.48, PaCO2 53, and HCO3 31. How would these be interpreted?

Nursing Test Bank

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