A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?

Bicarbonate 26 mEq/L

Serum pH 7.32

Creatinine 1.2 mg/dL

BUN 20 mg/dL

Answer and Explanation

The Correct Answer is B

A) Bicarbonate 26 mEq/L: A bicarbonate level of 26 mEq/L is within the normal range (22-28 mEq/L) and does not indicate metabolic acidosis, which is characteristic of diabetic ketoacidosis (DKA). In DKA, bicarbonate levels are usually decreased due to buffering of the excess acids.

B) Serum pH 7.32: A serum pH of 7.32 is indicative of acidemia, which is consistent with metabolic acidosis seen in DKA. The pH is typically lower than the normal range (7.35-7.45) in DKA due to the accumulation of ketoacids.

C) Creatinine 1.2 mg/dL: A creatinine level of 1.2 mg/dL is slightly elevated but does not specifically indicate metabolic acidosis. Elevated creatinine may suggest renal impairment but is not directly linked to the acid-base disturbance seen in DKA.

D) BUN 20 mg/dL: A blood urea nitrogen (BUN) level of 20 mg/dL is elevated and may indicate dehydration or kidney dysfunction but does not specifically diagnose the acid-base imbalance associated with DKA. In DKA, bicarbonate and pH levels are more directly affected.

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Correct Answer is A

Explanation

A) Lymphocytes 30%:
Lymphocyte levels are typically elevated during the acute phase of mononucleosis as the body fights the Epstein-Barr virus. A level of 30% indicates that the lymphocyte count is returning to a more normal range, which suggests the client is recovering from the infection.

B) RBC 4.4:
The red blood cell count is not directly indicative of recovery from mononucleosis. While it provides information about the client's overall hematologic status, it does not specifically reflect the status of the viral infection.

C) Hgb 14 g/dL:
Hemoglobin levels can provide information about the client's oxygen-carrying capacity but do not specifically indicate recovery from mononucleosis. Normal hemoglobin levels are reassuring but not directly related to the viral infection's resolution.

D) Hct 42%:
Hematocrit levels, like hemoglobin, offer information about the client's blood composition but do not directly indicate recovery from mononucleosis. While normal hematocrit levels are desirable, they are not specific to the recovery status of the viral illness.

A. "I will remain in the hospital until my treatment is completed." B. "I will wear a surgical mask around my family." C. "I will need medication to treat my condition for the rest of my life." D. "I will need to provide a sputum specimen every 4 weeks until I test negative."

Correct Answer is D

Explanation

A) "I will remain in the hospital until my treatment is completed.": Hospitalization is not typically required for the entire duration of tuberculosis (TB) treatment. Most patients with TB can continue their treatment at home with proper medication and infection control measures, unless they have severe disease or complications.

B) "I will wear a surgical mask around my family.": A surgical mask is not sufficient to protect others from TB. Patients with active TB should wear an N95 respirator mask to reduce the risk of spreading the infection, especially in situations where close contact is unavoidable.

C) "I will need medication to treat my condition for the rest of my life.": TB treatment generally involves a course of medication lasting 6 to 9 months. Long-term, lifelong medication is not required; however, adherence to the full course of prescribed antibiotics is crucial to ensure the infection is fully eradicated.

D) "I will need to provide a sputum specimen every 4 weeks until I test negative.": Monitoring sputum samples every 4 weeks is a standard practice to assess the effectiveness of TB treatment and confirm that the patient is no longer infectious. This statement indicates an understanding of the ongoing evaluation needed during treatment.

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A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?

Nursing Test Bank

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Explanation

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