Anna's mother has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L.

What acid-base disorder is shown?

Respiratory Acidosis. Partially Compensated

Metabolic Alkalosis, Partially Compensated

Respiratory Alkalosis. Uncompensated

Metabolic Alkalosis, Uncompensated

Answer and Explanation

The Correct Answer is B

A.   Respiratory Acidosis, both compensated and uncompensated, is characterized by an elevated PaCO2, which is not present in this case.
B.   The elevated pH (7.5) and HCO3 (34 mmol/L) indicate metabolic alkalosis. The elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest the partially compensated state, which is the respiratory compensation attempting to correct the alkalosis.
C.   The fact that the PaCO2 is not low rules out respiratory alkalosis.
D.   The arterial blood gas values indicate a high pH (7.5), a normal PaCO2 (40 mm Hg), and an elevated HCO3 (34 mmol/L), which are indicative of metabolic alkalosis. However, the elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest a partially compensated state.

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Correct Answer is D

Explanation

A. Furosemide use is more commonly associated with hyponatremia rather than hypernatremia due to its diuretic effect.
B. Furosemide does not typically cause hypercalcemia; instead, it may lead to hypocalcemia.
C. Hyperchloremia is not a primary concern with furosemide, as the drug can cause a loss of chloride ions alongside sodium.
D. Furosemide can cause an increase in uric acid levels by reducing its excretion through the kidneys.

A. Creatinine levels are increased in clients who have acute kidney injury. B. BUN is decreased in clients who have dehydration C. Specific gravity is decreased in clients who have hypovolemia. D. Potassium levels are increased in clients who have polyuria.

Correct Answer is A

Explanation

A. Creatinine levels rise in acute kidney injury due to impaired kidney function, as the kidneys are unable to effectively filter creatinine from the blood.
B. BUN (blood urea nitrogen) levels typically increase in dehydration due to reduced kidney perfusion, leading to decreased urine output and increased concentration of waste products in the blood.
C. Specific gravity increases in hypovolemia because urine becomes more concentrated as the body tries to conserve water.
D. Potassium levels may vary depending on the cause of polyuria, but polyuria itself does not necessarily cause hyperkalemia. It can be caused by various factors including diabetes insipidus or diabetes mellitus.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

Correct Answer is D

Explanation

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?

Correct Answer is A

Explanation

A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism?

A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect?

A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take?

A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function?

A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate IV. The client's respiratory rate is 10/min and deep-tendon reflexes are absent. Which of the following actions should the nurse take?

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?