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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Rotating the earmold forward when inserting the hearing aid is a correct technique. This ensures a proper fit and helps to position the hearing aid comfortably in the ear canal, which can enhance the effectiveness and comfort of the device.
B) Cleaning the hearing aid with alcohol swabs can damage the delicate components of the device. Instead, hearing aids should be cleaned with a dry cloth or a soft brush specifically designed for this purpose to avoid damaging the hearing aid.
C) Turning the hearing aid on before inserting it may result in feedback or a whistling sound. It's usually recommended to insert the hearing aid first and then turn it on to avoid any discomfort or unwanted noise.
D) If the hearing aid whistles, it is not typically related to the battery. Whistling is often caused by improper fit, earwax buildup, or feedback issues. Changing the battery is unlikely to resolve the whistling problem and is not the recommended solution.
Correct Answer is C
Explanation
A) Hematocrit 37% is within the normal range for adults, indicating that the client’s red blood cell volume is adequate. While anemia can be a concern in clients with Crohn's disease, this value does not specifically indicate malnutrition.
B) Iron 160 mcg/dL is above the normal range (typically 50-170 mcg/dL). Elevated iron levels can result from supplementation or other factors, but it does not directly indicate malnutrition. Iron status alone is not a reliable marker for overall nutritional status.
C) Prealbumin 9 mg/dL is significantly below the normal range (15-36 mg/dL). Low prealbumin levels are a strong indicator of malnutrition because prealbumin has a short half-life and reflects recent changes in protein status and dietary intake. This result suggests the client has been experiencing inadequate nutritional intake or absorption.
D) C-reactive protein (CRP) 15 mg/L indicates inflammation, which is common during an exacerbation of Crohn's disease. While elevated CRP levels signal active inflammation, they do not specifically indicate malnutrition. CRP is more commonly used as a marker of inflammatory activity rather than nutritional status.
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