A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?

Metabolic acidosis.

Metabolic alkalosis.

Respiratory acidosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. The patient's bicarbonate ion level (24 mEq/L) is within the normal range, and the low pH (7.32) and elevated PaCO2 (56 mm Hg) indicate respiratory acidosis, not metabolic acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's pH is low (7.32), and the bicarbonate ion level (24 mEq/L) is within the normal range, indicating respiratory acidosis rather than metabolic alkalosis.

Choice C rationale:

Respiratory acidosis is characterized by low blood pH and high PaCO2 levels. In this case, the patient has a low pH (7.32) and elevated PaCO2 (56 mm Hg), indicating respiratory acidosis. The bicarbonate ion level (24 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.

Choice D rationale:

Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (56 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.32) further supports the diagnosis of respiratory acidosis.

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Correct Answer is C

Explanation

Choice A rationale:

While pregnancy can contribute to increased blood pressure, it is not the priority question in this scenario. The sudden rise in blood pressure could indicate a hypertensive crisis, which needs immediate attention.

Choice B rationale:

Urination is not directly related to sudden rises in blood pressure. While urinary issues could be a sign of certain conditions, they are not the priority when dealing with a hypertensive emergency.

Choice C rationale:

A sudden rise in blood pressure can lead to symptoms such as headache and confusion, which could indicate a hypertensive crisis. This question is crucial to assess neurological symptoms, which can be indicative of target organ damage due to hypertension.

Choice D rationale:

Antiseizure medications are not directly related to sudden increases in blood pressure. Neurological symptoms (like those in choice C) are more indicative of a hypertensive crisis and require immediate attention.

A. Formation of thrombus in the coronary artery. B. Formation of fibrous plaque in the endothelium. C. Reduction of blood flow through the coronary arteries. D. Development of fatty streaks in the smooth muscles of the endothelium.

Correct Answer is D

Explanation

Choice A rationale:

Thrombus formation is a later stage event in coronary artery disease (CAD) and occurs after the development of fatty streaks. Thrombus formation usually happens due to the rupture of atherosclerotic plaques, leading to platelet aggregation and clot formation.

Choice B rationale:

Formation of fibrous plaque in the endothelium is a progression that occurs after the initial development of fatty streaks. Fibrous plaques are formed as a response to the inflammation caused by fatty deposits. They are more stable than fatty streaks but can still lead to narrowing of the arteries.

Choice C rationale:

Reduction of blood flow through the coronary arteries is a consequence of atherosclerosis, which occurs after the initial development of fatty streaks. As the fatty deposits accumulate, they narrow the arteries, leading to reduced blood flow. However, this is not the initial change that makes patients susceptible to CAD.

Choice D rationale:

Development of fatty streaks in the smooth muscles of the endothelium is the initial change that occurs in the development of atherosclerosis, making patients susceptible to coronary artery disease. Fatty streaks are composed of lipid-laden macrophages and smooth muscle cells. Over time, these fatty streaks can progress into fibrous plaques and eventually lead to complications such as thrombus formation and reduced blood flow.

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A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female patient with chronic hypertension is admitted to the emergency department with a sudden rise in blood pressure (BP) Which question is the priority for the nurse to ask the patient?

Correct Answer is C

Explanation

Which change occurs first, making patients susceptible to coronary artery disease?

Correct Answer is D

Explanation

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