A nurse is caring for multiple clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for respiratory alkalosis?

chest wall trauma with broken ribs

excessive mechanical ventilation

renal insufficiency

overuse of antacids

Answer and Explanation

The Correct Answer is B

Rationale:
A. Chest wall trauma with broken ribs can cause hypoventilation due to pain, potentially leading to respiratory acidosis, not alkalosis.
B. Excessive mechanical ventilation can lead to hyperventilation, which causes too much CO₂ to be expelled. This decreases the carbonic acid concentration in the blood, resulting in respiratory alkalosis.
C. Renal insufficiency primarily contributes to metabolic acidosis due to poor acid excretion.
D. Overuse of antacids is associated with metabolic alkalosis due to increased bicarbonate intake, not respiratory alkalosis.

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Correct Answer is D

Explanation

Rationale:
A. An erythrocyte sedimentation rate (ESR) is used to detect inflammation but is not relevant in the immediate management of hyperkalemia.
B. Administering potassium would worsen the client's already elevated potassium level.
C. Restricting fluids is not an appropriate initial response for hyperkalemia and can increase the risk of complications.
D. A potassium level of 6.8 mEq/L is critically high and can cause life-threatening cardiac dysrhythmias. A 12-lead ECG is essential to assess for cardiac effects of hyperkalemia, such as peaked T waves or widened QRS complexes.

A. A serum potassium of 6.5 mEq/L and flaccid paralysis B. A serum potassium of 4.5 mEq/L and hyperactive deep tendon reflexes (DTRS) C. A serum sodium of 144 mEq/L and tachycardia D. A serum sodium of 130 mEq/L and peripheral edema

Correct Answer is A

Explanation

Rationale:
A. A serum potassium of 6.5 mEq/L indicates hyperkalemia, which can occur in acidosis as hydrogen ions shift into cells and potassium shifts out. Flaccid paralysis is a serious neuromuscular manifestation of severe hyperkalemia and supports a diagnosis of acidosis.
B. A potassium level of 4.5 mEq/L is normal, and hyperactive DTRs are more often associated with alkalosis, not acidosis.
C. A sodium level of 144 mEq/L is normal, and while tachycardia may occur in many conditions, it is nonspecific and does not indicate acidosis.
D. A sodium level of 130 mEq/L indicates hyponatremia, and peripheral edema is more related to fluid imbalance or heart failure, not acidosis.

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A nurse is caring for multiple clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for respiratory alkalosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L. The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Correct Answer is D

Explanation

Which laboratory data and clinical manifestations cause you to suspect your client may be experiencing acidosis?

Correct Answer is A

Explanation

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