An unresponsive client was brought to the emergency room and had an arterial blood gas drawn. Ten minutes later, the laboratory calls with the following results: PaO2 74%, pH 7.22, PaCO2 85 mm Hg, and HCO3 23 mEq/L. The nurse interprets the results as indicating which imbalance?

Respiratory acidosis without compensation

Metabolic acidosis with full compensation

Respiratory acidosis with partial compensation

Metabolic acidosis without compensation

Answer and Explanation

The Correct Answer is C

A. Respiratory acidosis without compensation: The pH of 7.22 indicates acidosis, but the HCO3 level of 23 mEq/L suggests that compensation is occurring because the HCO3 is within the normal range for respiratory acidosis.
B. Metabolic acidosis with full compensation: The high PaCO2 level is more indicative of respiratory issues, not metabolic acidosis. Additionally, compensation for metabolic acidosis would show elevated HCO3.
C. Respiratory acidosis with partial compensation: The elevated PaCO2 and low pH indicate respiratory acidosis. The normal HCO3 level suggests partial compensation by the kidneys.
D. Metabolic acidosis without compensation: The elevated PaCO2 and normal HCO3 suggest respiratory acidosis rather than metabolic acidosis.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

Review with the client and spouse when to notify the physician: Appropriate
Rationale: It is essential to inform the client and their spouse about signs and symptoms that would require notifying the physician, such as increased pain, fever, or unusual symptoms. This helps ensure the client can recognize and report any issues promptly.
Instruct the client to sign their advance directive form: Inappropriate
Rationale: Advance directive forms should be completed well before a surgical procedure and are not typically addressed at the time of discharge following a minor same-day surgery. This is not directly related to the immediate postoperative care and discharge instructions.
Discuss appropriate wound care: Appropriate
Rationale: Providing instructions on how to care for the wound is crucial for preventing infection and promoting proper healing. This information is essential for the client's recovery and should be reviewed before discharge.
Educate on activity limitations: Appropriate
Rationale: Informing the client about activity restrictions helps prevent complications and supports appropriate healing. This education is crucial for ensuring the client follows guidelines that will aid in their recovery.
Provide information about dietary restrictions: Appropriate
Rationale: Depending on the type of surgery and sedation, there may be dietary restrictions or guidelines to follow. Providing this information helps the client manage their diet appropriately after discharge.

A. Hypernatremia B. Hyperglycemia C. Hypercalcemia D. Hyperkalemia

Correct Answer is B

Explanation

A. Hypernatremia: This condition involves elevated sodium levels, which is not directly addressed by the insulin and dextrose order.
B. Hyperglycemia: While dextrose can exacerbate hyperglycemia, the order of insulin and dextrose is not for managing hyperglycemia but for another purpose.
C. Hypercalcemia: This condition involves elevated calcium levels and is not related to the use of insulin and dextrose.
D. Hyperkalemia: The administration of regular insulin with dextrose is often used to manage hyperkalemia. Insulin helps shift potassium into cells, while dextrose prevents hypoglycemia resulting from the insulin.

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An unresponsive client was brought to the emergency room and had an arterial blood gas drawn. Ten minutes later, the laboratory calls with the following results: PaO2 74%, pH 7.22, PaCO2 85 mm Hg, and HCO3 23 mEq/L. The nurse interprets the results as indicating which imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

Correct Answer is B

Explanation

The nurse is taking a medication history of a client scheduled for surgery the next morning. Which medication requires the nurse to immediately notify the surgeon?

A home health nurse is assessing a client receiving TPN infusion for malabsorption after extensive bowel surgery. What finding is most important for the nurse to report to the health care provider?

Arterial blood gases on a postoperative client with pneumonia indicate the client is in respiratory acidosis. To best improve this acid-base imbalance, which intervention should the nurse implement?

Which assessment data indicate the postoperative client who had spinal anesthesia is suffering a complication of the anesthesia?

The nurse is caring for a client being treated for fluid volume excess. Which assessment finding indicates that treatment has been effective?

The nurse is asked to witness surgical consent forms were obtained for clients, in the preoperative holding area. What client would not be able to consent legally to surgery?

The illustration reflects a client's upper extremity while the nurse obtains a manual blood pressure. Which electrolyte abnormality is the nurse most likely to see in the client's blood chemistry results?