A nurse reviewing the medical record of a patient who has metabolic acidosis should realize that which of the following findings contributes to the development of metabolic acidosis?

Diarrhea

Salicylate intoxication

Vomiting

Hyperventilation

Answer and Explanation

The Correct Answer is A

Choice A reason: Diarrhea can lead to metabolic acidosis due to the loss of bicarbonate, which is a base, leading to a relative increase in acidity.

Choice B reason: Salicylate intoxication can initially cause respiratory alkalosis due to hyperventilation, but may later lead to metabolic acidosis as the body compensates.

Choice C reason: Vomiting typically leads to a loss of gastric acid, which would cause metabolic alkalosis, not acidosis.

Choice D reason: Hyperventilation is more commonly associated with respiratory alkalosis due to the excessive loss of CO2, which is an acid, not metabolic acidosis.

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

Explanation

Choice A reason: Performing deep breathing exercises every 2 hours helps prevent postoperative complications such as pneumonia and atelectasis.

Choice B reason: While chest movement is part of breathing, the instruction is incomplete and should emphasize diaphragmatic breathing rather than shoulder movement.

Choice C reason: Taking a deep breath before coughing helps to increase the eﬀectiveness of the cough, which can clear secretions from the lungs.

Choice D reason: Sitting up straight before beginning coughing exercises helps to ensure maximum lung expansion and eﬀectiveness of the cough.

Choice E reason: Using a pillow to support the surgical area when coughing can help reduce pain and protect the incision site, making the cough more eﬀective.

A. Metabolic alkalosis B. Respiratory acidosis C. Respiratory alkalosis D. Metabolic acidosis

Correct Answer is A

Explanation

Choice A reason: Metabolic alkalosis is indicated by a high pH and a high HCO3 level. In this case, the pH is 7.5, which is above the normal range of 7.35-7.45, and the HCO3 is 32 mEq/L, which is above the normal range of 22-26 mEq/L.

Choice B reason: Respiratory acidosis is characterized by a high CO2 level and a low pH, which is not the case here as the CO2 is normal and the pH is high.

Choice C reason: Respiratory alkalosis typically presents with a low CO2 level and a high pH. Since the CO2 is normal, this condition does not fit the patient's ABG results.

Choice D reason: Metabolic acidosis would present with a low pH and a low HCO3 level. Given that both the pH and HCO3 are high, metabolic acidosis is not the correct diagnosis.

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A nurse reviewing the medical record of a patient who has metabolic acidosis should realize that which of the following findings contributes to the development of metabolic acidosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing preoperative teaching about breathing exercises to a patient. Which of the following instructions should the nurse include? Select all that apply.

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

Explanation

A nurse is reviewing the arterial blood gas (ABG) results of a patient. The patient's ABGs are: pH 7.5 CO2 40 mm Hg HCO3 32 mEq/L Which of the following acid-base conditions should the nurse identify the patient is experiencing?

Correct Answer is A

Explanation

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