A nurse is collecting data from a client with a suspected diagnosis of gastric ulcer. The client tells the nurse that she takes TUMS frequently throughout the day to control her symptoms. The nurse continues to collect data from the client, understanding that the client is at risk for which acid-base imbalance?

metabolic alkalosis

metabolic acidosis

respiratory acidosis

respiratory alkalosis

Answer and Explanation

The Correct Answer is A

Rationale:

A. TUMS (calcium carbonate) is an alkaline antacid. Excessive use can lead to increased bicarbonate levels in the blood, causing metabolic alkalosis, especially when used to neutralize gastric acid frequently.

B. Metabolic acidosis would be more likely with diarrhea, renal failure, or overuse of acidic substances, not antacids.

C. Respiratory acidosis is caused by hypoventilation and CO₂ retention, such as in chronic lung disease, not by taking antacids.

D. Respiratory alkalosis is associated with hyperventilation, anxiety, or high altitude—not relevant to antacid use.

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Correct Answer is B

Explanation

Rationale:

A. Increased urine output: Mr. Allen's urine output is actually low (600 mL/24 hrs), and his urine is dark and concentrated, suggesting dehydration, not excessive urinary losses.

B. Loss of gastric secretions: Continuous suction via the nasogastric (NG) tube removes gastric fluids, which are rich in potassium, chloride, hydrogen ions, and magnesium. This is the main reason for his observed hypokalemia (K = 2.9), hypochloremia (Cl = 94), and low magnesium (Mg = 1.2).

C. Decreased oral intake: While Mr. Allen is NPO, reduced intake alone is not sufficient to cause such significant electrolyte imbalances in a short period. The active loss of electrolytes through NG suction is the primary contributor.

D. Fever is not mentioned in the scenario. Fever can lead to insensible fluid losses, but this is not relevant here and not the primary mechanism of electrolyte depletion.

A. PH B. PaCO2 C. HCO3 D. PaO2 E. blood glucose

Correct Answer is ["A","B","C","D"]

Explanation

Rationale:
A. pH indicates the overall acid-base status (acidosis or alkalosis) and is critical in determining the presence of an imbalance.
B. PaCO₂ reflects the respiratory component of acid-base balance and helps assess respiratory acidosis or alkalosis.
C. HCO₃ (bicarbonate) reflects the metabolic component of acid-base balance and is essential for evaluating metabolic acidosis or alkalosis.
D. PaO₂ indicates the oxygenation status of the client, which is important in assessing respiratory function, though not a direct marker of acid-base imbalance.
E. Blood glucose is not part of arterial blood gas analysis and is unrelated to acid-base balance interpretation.

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Naxlex Comprehensive Predictor Exams

Use the scenario to guide your answer Exhibits What is the primary reason for electrolyte loss in a patient with an NG tube to suction?

Correct Answer is B

Explanation

Rationale:

A nurse prepares to interpret the ABG values of a client diagnosed with an acid-base imbalance. Which values are most important for the nurse to consider? (Select 4 options that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

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