A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is A

A) Respiratory acidosis: This condition is indicated by a low pH (7.32) and an elevated PaCO2 (48 mm Hg), while HCO3 remains normal (24 mEq/L). Respiratory acidosis occurs when there is an accumulation of carbon dioxide in the blood, usually due to hypoventilation or impaired gas exchange in the lungs.

B) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. In this scenario, the HCO3 level is normal, ruling out metabolic acidosis.

C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH and a decreased PaCO2. In this case, the pH is low, and the PaCO2 is elevated, which contradicts the characteristics of respiratory alkalosis.

D) Metabolic alkalosis: Metabolic alkalosis would show a high pH and an elevated HCO3 level. Since the pH is low and the HCO3 is normal, this condition does not fit the criteria for metabolic alkalosis.

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Correct Answer is A

Explanation

A) "I have been taking acetaminophen when my knees start to hurt.":
Taking acetaminophen for pain relief indicates that the client is managing the osteoarthritis symptoms appropriately. Acetaminophen is a recommended first-line treatment for mild to moderate pain associated with osteoarthritis and can help improve the client's quality of life by reducing discomfort.

B) "I've been sleeping on my back with a large pillow under my knees.":
Sleeping with a large pillow under the knees can cause the knees to remain in a flexed position for prolonged periods, potentially leading to joint stiffness and worsening pain. This practice is not typically recommended for clients with osteoarthritis as it can exacerbate symptoms.

C) "I have been exercising every day, even when I have pain.":
While regular exercise is beneficial for managing osteoarthritis, it is important to avoid exercising through significant pain. Pain during exercise may indicate overuse or joint damage. Clients should be encouraged to modify their activities to prevent further joint stress and manage symptoms effectively.

D) "I've been changing my lidocaine patches every 18 hours.":
Lidocaine patches are typically designed for 12-hour application periods, followed by a 12-hour off period. Changing the patches every 18 hours may not provide the intended relief and could lead to inconsistent pain management. Proper use of pain management techniques is essential for effective disease management.

A. "I will expect to have to strain while having a bowel movement." B. "I'll plan to restrict my fluid intake to 1 liter per day." C. "I might have the urge to urinate while I have the catheter in place." D. "I'll keep my leg flexed if the catheter is taped to my leg."

Correct Answer is C

Explanation

A) "I will expect to have to strain while having a bowel movement":
Straining during bowel movements should be avoided as it can increase abdominal pressure and strain on the surgical site, potentially leading to complications such as bleeding or increased discomfort.

B) "I'll plan to restrict my fluid intake to 1 liter per day":
Fluid restriction is not typically advised after a transurethral resection of the prostate (TURP). Adequate fluid intake is important to help flush the bladder and reduce the risk of blood clots and urinary tract infections.

C) "I might have the urge to urinate while I have the catheter in place":
It is common for clients to feel the urge to urinate while a catheter is in place due to the pressure of the catheter on the bladder neck. This statement indicates an understanding of the postoperative experience and normal sensations.

D) "I'll keep my leg flexed if the catheter is taped to my leg":
Keeping the leg flexed is not necessary for catheter management. The catheter should be securely taped to the leg to prevent movement and minimize discomfort, but the position of the leg is not a critical factor in its management.

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A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client's adaptation to a new diagnosis of osteoarthritis. Which of the following client statements should indicate to the nurse that the client is managing the disease?

Correct Answer is A

Explanation

A nurse is providing preoperative teaching to a client who is to undergo a transurethral resection of the prostate to treat benign prostatic hypertrophy. Which of the following client statements should the nurse identify as an understanding of the teaching?

Correct Answer is C

Explanation

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