A nurse is reviewing the ABG values of a client who has chronic bronchitis and reports dyspnea with minimal exertion. Which of the following acid- base imbalances should the nurse suspect?

Metabolic acidosis

Respiratory alkalosis

Respiratory acidosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is C

Answer: C. Respiratory acidosis

Rationale:

A) Metabolic acidosis: This occurs when there is an excess of acid in the body or a loss of bicarbonate, often due to conditions such as renal failure or severe diarrhea. In chronic bronchitis, the primary issue is related to respiratory function rather than metabolic disturbances.

B) Respiratory alkalosis: This condition results from hyperventilation, leading to excessive loss of carbon dioxide. It is unlikely in a client with chronic bronchitis, who typically experiences difficulty in exhaling fully rather than hyperventilating.

C) Respiratory acidosis: In chronic bronchitis, airflow obstruction and reduced gas exchange can lead to carbon dioxide retention, resulting in respiratory acidosis. Symptoms like dyspnea and increased work of breathing support this imbalance, as the body is unable to adequately expel carbon dioxide.

D) Metabolic alkalosis: This imbalance results from excessive bicarbonate or loss of hydrogen ions, often related to prolonged vomiting or diuretics. It is not characteristic of chronic bronchitis, where the primary concern is respiratory function rather than metabolic processes.

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Correct Answer is D

Explanation

A. Qualitative studies are considered to be one type of Level I evidence: Qualitative studies are not typically considered Level I evidence. The hierarchy of evidence is a rating system used to evaluate the strength of evidence presented in medical research. Level I evidence usually includes systematic reviews, meta-analyses, and randomized controlled trials.

B. Level Vil evidence comes from a meta-analysis of multiple peer-reviewed studies: This statement is not accurate. Meta-analyses and systematic reviews are usually considered Level I evidence, as they provide the highest level of evidence. They synthesize and analyze multiple studies on a topic to provide a comprehensive view of the current evidence.

C. Level I evidence includes evidence found in nursing textbooks: Nursing textbooks are not considered Level I evidence. They often include a mix of different levels of evidence, from expert opinion to systematic reviews. While they are a valuable resource for background information and clinical guidelines, they do not represent the highest level of evidence.

D. Level I evidence is considered to be the best evidence to support EBP: This is correct. Level I evidence, which includes systematic reviews, meta-analyses, and randomized controlled trials, is considered the highest level of evidence and provides the most reliable basis for decision-making in evidence-based practice

A. An adolescent who asks to stay in the hospital because he likes the room B. A toddler who has multiple bruises on the shins of both legs and his parents report that he is clumsy C. A school-age child who cries when the nurse is giving him an injection D. A preschooler who has a BMI indicating obesity

Correct Answer is A

Explanation

Answer: A. An adolescent who asks to stay in the hospital because he likes the room

Rationale:

A) An adolescent who asks to stay in the hospital because he likes the room: This finding may indicate that the adolescent is experiencing abuse or neglect at home. A desire to remain in the hospital could suggest that the child views it as a safe space compared to their home environment, warranting further assessment for possible abuse.

B) A toddler who has multiple bruises on the shins of both legs and his parents report that he is clumsy: Bruising on the shins is common in toddlers due to normal exploratory behavior and frequent falls. The parent's explanation aligns with developmental norms, making this finding less indicative of abuse.

C) A school-age child who cries when the nurse is giving him an injection: Crying during injections is a typical reaction for school-age children and does not suggest abuse. Emotional responses to medical procedures are age-appropriate and expected.

D) A preschooler who has a BMI indicating obesity: While obesity in children may raise concerns about diet and lifestyle, it is not inherently indicative of abuse. Further evaluation may be needed for nutritional and health interventions but does not typically suggest maltreatment.

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A nurse is reviewing the ABG values of a client who has chronic bronchitis and reports dyspnea with minimal exertion. Which of the following acid- base imbalances should the nurse suspect?

Nursing Test Bank

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