A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?

Metabolic acidosis.

Metabolic alkalosis.

Respiratory acidosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L) The given arterial blood gas (ABG) values indicate a pH of 7.48 (which is alkalotic), a PaCO2 of 38 (within the normal range of 35-45 mm Hg), and an HCO3- of 30 (which is elevated) These values indicate metabolic alkalosis, not metabolic acidosis.

Choice B rationale:

Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L) The given ABG values indicate a pH of 7.48 (which is alkalotic) and an elevated HCO3- of 30, indicating metabolic alkalosis. This condition can result from excessive loss of acids (e.g., vomiting) or excessive intake of bicarbonate or alkali substances.

Choice C rationale:

Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg) The given ABG values indicate a normal pH of 7.48 and a PaCO2 of 38 (within the normal range), ruling out respiratory acidosis.

Choice D rationale:

Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg) The given ABG values indicate a pH of 7.48 (which is alkalotic) and a PaCO2 of 38 (within the normal range), ruling out respiratory alkalosis.

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Correct Answer is C

Explanation

The correct answer is c. Respiratory acidosis.

Choice A reason: Metabolic acidosis is incorrect because the HCO3 level is normal. In metabolic acidosis, we would expect to see a decreased HCO3.

Choice B reason: Metabolic alkalosis is incorrect because the HCO3 level is normal. In metabolic alkalosis, we would expect to see an increased HCO3.

Choice C reason: The given ABG results indicate a low pH (acidosis), an elevated PaCO2 (respiratory component), and a normal HCO3 (metabolic component). The low pH and increased PaCO2 suggest respiratory acidosis.

Choice D reason: Respiratory alkalosis is incorrect because the PaCO2 level is elevated, not decreased. In respiratory alkalosis, we would expect to see a decreased PaCO2.

A. The patient has neutropenia. B. The patient has polycythemia. C. The patient has pernicious anemia. D. The patient has elevated estrogen levels.

Correct Answer is C

Explanation

Choice A rationale:

Neutropenia is a condition characterized by a low number of neutrophils, a type of white blood cell. Neutropenic patients are at increased risk of infections, but neutropenia does not cause specific changes in the tongue surface. The smooth and shiny tongue surface described in the question is not indicative of neutropenia.

Choice B rationale:

Polycythemia is a condition characterized by an abnormally high concentration of hemoglobin in the blood. It can cause the skin to appear reddish or flushed, but it does not directly cause changes in the tongue surface such as smoothness and shininess.

Choice C rationale:

Pernicious anemia is a type of anemia caused by a deficiency of vitamin B12, which is essential for the formation of red blood cells and the maintenance of the nervous system. One of the characteristic signs of pernicious anemia is glossitis, which is inflammation of the tongue that can make the tongue appear smooth and shiny. This finding aligns with the description provided in the question.

Choice D rationale:

Elevated estrogen levels can cause changes in the skin, such as increased pigmentation or the development of spider veins, but they do not directly cause changes in the tongue surface as described in the question.

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A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?

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Naxlex Comprehensive Predictor Exams

The arterial blood gas (ABG) results for a patient who overdosed on barbiturates are pH = 7.32, PaCO2 = 52, and HCO3 = 23. Which interpretation would the nurse rely on when planning the patient's care?

Correct Answer is C

Explanation

The nurse notes that a patient has a smooth and shiny tongue surface.The nurse would attribute these findings to which condition?

Correct Answer is C

Explanation

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