A student nurse is working with their preceptor on a medical-surgical unit. While reviewing concepts related to acid-base balance, what should the preceptor state is a compensatory mechanism for metabolic alkalosis?

Kidney conservation of bicarbonate and excretion of hydrogen ions

Deep, rapid respirations to increase CO2 excretion

Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate

Shifting of bicarbonate into cells in exchange for chloride

Answer and Explanation

The Correct Answer is C

A. Kidney conservation of bicarbonate and excretion of hydrogen ions: This option is not correct for metabolic alkalosis. In metabolic alkalosis, the kidneys would typically excrete bicarbonate rather than conserve it.
B. Deep, rapid respirations to increase CO2 excretion: This is incorrect because deep, rapid respirations are more associated with compensating for metabolic acidosis by increasing CO2 excretion. In metabolic alkalosis, the body attempts to retain CO2.
C. Respiratory hypoventilation to retain CO2 and kidney excretion of bicarbonate: This is the correct choice. In metabolic alkalosis, the body compensates by reducing respiration rate (hypoventilation) to retain CO2, which helps to counteract the elevated pH. Additionally, the kidneys may excrete bicarbonate to balance the pH.
D. Shifting of bicarbonate into cells in exchange for chloride: This mechanism is more related to respiratory alkalosis rather than metabolic alkalosis. In metabolic alkalosis, the primary compensatory mechanisms involve changes in respiratory rate and renal bicarbonate excretion.

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Correct Answer is A

Explanation

A. Pulmonary embolism: Pulmonary embolism presents with sudden onset of chest pain, tachycardia, hypotension, and restlessness, which aligns with the client's symptoms. It is a common postoperative complication due to immobility and potential hypercoagulability.
B. Pneumonia: Pneumonia typically develops more gradually and presents with fever, productive cough, and respiratory distress rather than sudden chest pain and hemodynamic instability. It is less likely in the immediate postoperative period.
C. Hemorrhage: Hemorrhage would also cause tachycardia and hypotension, but it would typically present with symptoms such as excessive bleeding, swelling at the surgical site, and pallor rather than chest pain.
D. Myocardial infarction: While myocardial infarction can cause chest pain, tachycardia, and hypotension, it is less likely in this scenario compared to a pulmonary embolism, given the timing and nature of the symptoms in the immediate postoperative period.

A. Start an IV of DSNS with 40 mEq KCI at 125 mL/hr B. Elevate the feet and lower the head C. Call the surgeon and report the vital signs D. Monitor the vital signs every 15 minutes

Correct Answer is B

Explanation

A. Start an IV of DSNS with 40 mEq KCI at 125 mL/hr: Starting an IV is important but may not be the immediate first step. The client's symptoms suggest hypotension, likely due to hypovolemia, which needs immediate positional intervention before fluid administration.
B. Elevate the feet and lower the head: This position, known as the Trendelenburg position, helps increase venous return to the heart and can quickly improve blood pressure and perfusion to vital organs. It is an immediate intervention for hypotension.
C. Call the surgeon and report the vital signs: While important, calling the surgeon is not the first intervention. Immediate action to stabilize the client's condition is necessary before notifying the healthcare provider.
D. Monitor the vital signs every 15 minutes: Monitoring is important, but it is not an immediate intervention. The nurse must first address the client's low blood pressure and symptoms of hypoperfusion before continuing regular monitoring.

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A student nurse is working with their preceptor on a medical-surgical unit. While reviewing concepts related to acid-base balance, what should the preceptor state is a compensatory mechanism for metabolic alkalosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is rounding on a client who is 12 hours postoperative. Upon assessment, the client becomes tachycardic, hypotensive, and restless and complains of sudden chest pain. Which postoperative complication should the nurse conclude that the client most likely experienced?

Correct Answer is A

Explanation

The nurse is assessing a client in the post-anesthesia care unit. The client's vital signs are T 98°F, P 106, R 24, and BP 88/40. The client is awake and oriented x 3 and the skin is pale and damp. The client denies complaints of pain. What intervention should the nurse implement first?

Correct Answer is B

Explanation

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