Based on your patient's ABG's what acid-base imbalance is present? pH 7.30 HCO3 23 PaCO2 49.
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
The Correct Answer is B
A. Respiratory alkalosis – Respiratory alkalosis is characterized by elevated pH (>7.45) and low PaCO₂ (<35 mm Hg) due to hyperventilation.
B. Respiratory acidosis – The pH is low (7.30) indicating acidosis, and the PaCO₂ is elevated (49 mm Hg), indicating that the cause is respiratory (CO₂ retention due to hypoventilation). The HCO₃ is normal (23 mEq/L), which supports that the cause is not metabolic.
C. Metabolic alkalosis – This would show an elevated pH (>7.45) and elevated HCO₃ (>28 mEq/L), which is not present here.
D. Metabolic acidosis – Metabolic acidosis is indicated by low pH and low HCO₃ (<21 mEq/L), which is not the case in these ABG values.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Give the ordered KCL as prescribed – A potassium level of 3.2 mEq/L indicates hypokalemia (normal range: 3.5–5.0 mEq/L). Administering potassium chloride as prescribed is appropriate to correct this deficiency, especially since the client is on diuretics, which can further lower potassium levels.
B. Call the lab to verify the client's results – This is unnecessary unless the value is critically abnormal or inconsistent with the client’s condition. A level of 3.2 is low but not critically so.
C. Omit the KCL dose and document that it was not given – This would be inappropriate and potentially harmful, as withholding potassium in the presence of hypokalemia could lead to serious complications such as cardiac arrhythmias.
D. Hold the prescribed dose and notify the provider of the serum potassium level – This is not necessary. The potassium is already prescribed and the level confirms the need for supplementation.
Correct Answer is D
Explanation
A. Discard the extra medication in a sharps container. – Narcotics like morphine must be wasted properly, and not simply discarded without documentation and a witness.
B. Send the waste amount to the pharmacy. – This is not the standard protocol for controlled substances. They must be disposed of at the unit level, per facility policy, with proper witnessing.
C. Save the extra medication for a later dosing. – Saving unused portions of a controlled substance is unsafe, violates medication safety policies, and may be illegal.
D. Have another nurse witness the disposal of the extra medication. – When administering only a portion of a controlled substance (e.g., 4 mg from a 10 mg/mL vial), the remaining amount must be wasted in the presence of another licensed nurse, who then documents the waste to ensure proper accountability and safety.
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