Mrs. Jamerson, who had undergone surgery in the post-anesthesia care unit (PACU), is difficult to arouse two hours following surgery. Nurse Williams in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The client's respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and obtains ABGS STAT! Arterial blood gas measurement shows pH 7.10. PaCO2 70 mm Hg, and HCO3 24 mEq/L

What does this mean?

Metabolic Acidosis, Uncompensated

Respiratory Alkalosis. Partially Compensated

Respiratory Acidosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

Answer and Explanation

The Correct Answer is C

A.   Metabolic Acidosis, Uncompensated, is ruled out because the elevated PaCO2 and low pH indicate a respiratory problem rather than a metabolic one.
B.   Respiratory Alkalosis. Partially Compensated is ruled out because the pH and PaCO2 levels are both abnormal and indicate acidosis rather than alkalosis.
C.   The low pH (acidosis) along with the high PaCO2 indicate respiratory acidosis, and there is no evidence of compensation by the kidneys (normal HCO3).
D.   Metabolic Alkalosis. Partially Compensated, is ruled out because the pH is low (acidosis) rather than high (alkalosis), and the PaCO2 is elevated, suggesting a respiratory problem rather than a metabolic one.

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Correct Answer is A

Explanation

A. Certain malignancies, particularly lung cancer, can produce ectopic antidiuretic hormone (ADH) or ADH-like substances, leading to SIADH. It's important to inquire about a history of lung cancer due to its association with SIADH.

B. Osteoarthritis is a degenerative joint disease and is not known to cause SIADH.

C. Dyspepsia refers to upper gastrointestinal discomfort and is not associated with SIADH.

D. Liver cirrhosis can lead to various complications, including hepatic encephalopathy and ascites, but it is not typically associated with SIADH.

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

Correct Answer is B

Explanation

A. Hypernatremia is usually due to an excess of sodium or a deficit of water, not directly related to prerenal causes.
B. Prerenal AKI is characterized by a decrease in renal blood flow, which leads to a reduction in glomerular filtration rate and a subsequent accumulation of waste products, including potassium. Hyperkalemia occurs because the kidneys are unable to excrete potassium effectively.
C. Hypercalcemia is not typically associated with AKI.
D. Hypophosphatemia is generally associated with malnutrition or malabsorption syndromes and is not a direct result of prerenal AKI.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting the medical history from a client who has manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH?

Correct Answer is A

Explanation

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

Correct Answer is B

Explanation

A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?

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?

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 providing dietary teaching to client who has calcium oxalate kidney stones. Which of the following statements indicates an understanding of the teaching?

A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?

A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

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?