A nurse is reviewing arterial blood gas results for a client who has metabolic acidosis. Which of the following values should the nurse expect?

PaCO2 32 mm Hg (35 to 45 mm Hg)

PaO2 64 mm Hg (80 to 100 mm Hg)

HCO3 20 mEq/L (22 to 26 mEq/L)

pH 7.48 (7.35 to 7.45)

Answer and Explanation

The Correct Answer is C

Interpretation of arterial blood gas (ABG) results in a client with metabolic acidosis involves evaluating acid-base balance, particularly the bicarbonate level as the primary indicator of metabolic status. Metabolic acidosis occurs when there is an accumulation of hydrogen ions or loss of bicarbonate, leading to a decreased blood pH. The respiratory system may attempt compensation by altering carbon dioxide levels, but the defining abnormality remains reduced bicarbonate concentration. Accurate interpretation helps guide treatment of underlying causes such as renal failure, diabetic ketoacidosis, or severe diarrhea.

Rationale:
A. A PaCO₂ of 32 mm Hg reflects respiratory alkalosis or compensatory respiratory response to metabolic acidosis. In metabolic acidosis, the lungs often hyperventilate to “blow off” carbon dioxide in an attempt to raise pH. Therefore, this value represents compensation rather than the primary disorder.

B. A PaO₂ of 64 mm Hg indicates hypoxemia but is not specific to metabolic acidosis. While oxygenation status is important in overall patient assessment, it does not define acid-base imbalance. This value may suggest a respiratory or perfusion issue but is not diagnostic for metabolic acidosis.

C. A bicarbonate (HCO₃) level of 20 mEq/L is consistent with metabolic acidosis because it reflects a primary decrease in base concentration. In conditions such as renal failure or lactic acidosis, bicarbonate is consumed or not adequately regenerated. This reduction is the hallmark laboratory finding in metabolic acidosis.

D. A pH of 7.48 indicates alkalemia, not acidosis. This value is associated with either metabolic alkalosis or respiratory alkalosis depending on associated CO₂ and bicarbonate levels. Therefore, it is inconsistent with the diagnosis of metabolic acidosis.

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Correct Answer is C

Explanation

Management of hypoglycemia in a client with Type 1 diabetes mellitus involves rapid recognition and prompt administration of fast-acting carbohydrates to restore blood glucose levels. Mild hypoglycemia commonly presents with symptoms such as shakiness, sweating, hunger, irritability, or dizziness when blood glucose falls below normal levels. The priority treatment for a conscious client is administration of rapidly absorbable carbohydrates that can quickly raise serum glucose. Timely intervention helps prevent progression to severe neurological impairment or loss of consciousness.

Rationale:
A. Glucagon injection is typically reserved for severe hypoglycemia when the client is unconscious, unable to swallow safely, or experiencing seizures. Since the adolescent has only mild symptoms and is presumably alert enough to take oral carbohydrates, injectable glucagon is unnecessary at this stage. Oral treatment is preferred for mild hypoglycemic episodes.

B. One teaspoon of sugar alone does not provide an adequate amount of carbohydrate to effectively correct hypoglycemia. Standard treatment recommendations usually involve approximately 15 g of rapid-acting carbohydrate. A single teaspoon contains too little glucose and may not raise serum glucose sufficiently or rapidly enough.

C. A glass of orange juice is appropriate because it contains rapidly absorbed simple carbohydrates that quickly increase blood glucose levels. Fruit juice is commonly recommended for conscious clients experiencing mild hypoglycemia due to its fast onset of action. This intervention follows the “15-15 rule” commonly used in hypoglycemia management.

D. Peanut butter is not appropriate for immediate correction of hypoglycemia because its fat and protein content slows glucose absorption. Although it may help maintain glucose levels after initial correction, it does not act quickly enough to treat acute low blood sugar. Rapid-acting carbohydrates are needed first.

A. Medications B. Supplement use C. Total cholesterol level D. Diet

Correct Answer is A

Explanation

Risk factor identification in a client with coronary artery disease (Coronary artery disease) involves evaluating lifestyle, laboratory findings, and medication use that may influence thrombotic risk, lipid balance, and vascular function. Coronary artery disease results from progressive atherosclerosis, leading to reduced myocardial perfusion and recurrent anginal symptoms. In postmenopausal women, certain hormone therapies can significantly increase cardiovascular risk by promoting a prothrombotic and lipid-altering state. Nurses must recognize modifiable and iatrogenic contributors to worsening coronary perfusion.

Rationale:
A. The use of conjugated estrogen is a significant cardiovascular risk factor because exogenous estrogen therapy increases the risk of thromboembolic events and may worsen coronary artery disease. Estrogen can promote hypercoagulability, increase inflammatory mediators, and negatively influence vascular endothelial function. In a client already experiencing frequent angina, this medication may further destabilize coronary perfusion and should be reviewed carefully with the provider.

B. Fish oil supplementation is generally considered cardioprotective due to its potential triglyceride-lowering and anti-inflammatory effects. It is not associated with increased coronary artery disease risk and may support cardiovascular health when used appropriately. Therefore, it is not a risk factor in this clinical context.

C. A total cholesterol level of 150 mg/dL falls within a generally acceptable range and does not indicate hypercholesterolemia. While lipid management remains important in coronary artery disease, this value alone does not represent a current risk factor contributing to disease progression. LDL is also within near-normal limits.

D. The client’s vegan diet is typically associated with reduced cardiovascular risk due to lower saturated fat intake and improved lipid profiles. Plant-based diets are often protective against atherosclerosis when balanced appropriately. Therefore, diet in this case is not contributing as a risk factor for coronary artery disease progression.

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Area assessed	Findings
Neurological	Drowsy but easy to arouse.
Vital Signs	Temperature 35.3° C (95.5° F) Heart rate 60/min Respiratory rate 16/min Blood pressure 90/60 mm Hg Oxygen saturation 94% (oxygen at 2 L/min via nasal cannula) Rates pain as 1 on 0/10 pain scale.
Integumentary	Skin cool and moist to touch.

A nurse is reviewing arterial blood gas results for a client who has metabolic acidosis. Which of the following values should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for an adolescent client who has type 1 diabetes mellitus. The adolescent reports mild symptoms and a serum glucose level of 55 g/dL. Which of the following should the nurse give the client?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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