Mrs. Jamerson, who is in the post anesthesia care unit (PACU) following surgery, is difficult to arouse and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the patient and obtains arterial blood gas (ABG) measurements STAT. The ABG shows a pH of 7.10, PaCO2 of 70 mm Hg, and HCO3 of 24 mEq/L. What does this mean?

Respiratory Alkalosis Partially Compensated

Respiratory Acidosis Uncompensated

Metabolic Alkalosis Partially Compensated

Metabolic Acidosis Uncompensated

Answer and Explanation

The Correct Answer is B

Choice A reason: Respiratory Alkalosis Partially Compensated is characterized by an elevated pH over 7.45 and a PaCO2 under 35 mmHg, with a compensatory acidic HCO3 under 22 mEq/L. This does not match the patient's ABG results.

Choice B reason: Respiratory Acidosis Uncompensated is indicated by an acidic pH under 7.35 and an elevated PaCO2 over 45 mmHg, with HCO3 in the normal range of 2226 mEq/L. The patient's ABG results show a low pH and high PaCO2, which aligns with this condition.

Choice C reason: Metabolic Alkalosis Partially Compensated would show a basic pH over 7.45 and a basic HCO3 over 26 mEq/L, with a compensatory acidic PaCO2 over 45 mmHg[^10^]. The patient's ABG values do not support this diagnosis.

Choice D reason: Metabolic Acidosis Uncompensated would present with an acidic pH under 7.35 and an acidic HCO3 under 22 mEq/L, with PaCO2 in the normal range of 3545 mmHg⁸. The patient's normal HCO3 level does not indicate metabolic acidosis.

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Correct Answer is A

Explanation

Choice A reason: Serum creatinine is a waste product from the normal breakdown of muscle tissue. A level of 1.8 mg/dL is higher than the normal range (0.61.2 mg/dL for females), indicating impaired kidney function and an increased risk of AKI.

Choice B reason: A magnesium level of 2.0 mEq/L is within the normal range (1.72.2 mEq/L) and does not typically indicate an increased risk of AKI.

Choice C reason: A BUN level of 20 mg/dL is within the normal range (720 mg/dL) and does not suggest an increased risk of AKI by itself.

Choice D reason: A serum osmolality of 290 mOsm/kg H2O is within the normal range (275295 mOsm/kg H2O) and does not indicate an increased risk of AKI.

A. Drink 2 liters of fluid each day while taking the medication. B. Take a 650 milligram dose of aspirin for joint pain. C. Take the medication on an empty stomach. D. Do not crush the medication before taking it.

Correct Answer is A

Explanation

Choice A reason: This is correct because staying well hydrated can help prevent gout attacks and kidney stones, which can be a side effect of allopurinol.

Choice B reason: This is incorrect. Aspirin can interfere with allopurinol and may increase the risk of gout attacks; therefore, it is not recommended without consulting a healthcare provider.

Choice C reason: This is incorrect. Allopurinol does not need to be taken on an empty stomach; it can be taken with or without food.

Choice D reason: This is correct. Allopurinol should not be crushed or chewed; it should be swallowed whole.

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Naxlex Comprehensive Predictor Exams

A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

Correct Answer is A

Explanation

A nurse is teaching a client who has a new prescription for allopurinol for the treatment of gout. Which of the following instructions should the nurse include?

Correct Answer is A

Explanation

A nurse is preparing to administer a unit of red blood cells. The nurse's responsibility is to compare and verify the information on the blood label with the client's information. Which of the following should the nurse use as the priority source of verification?

A nurse is reviewing discharge instructions with a client who has Raynaud's disease. Which of the following client statements indicates an understanding of the teaching?

A nurse is admitting a client with suspected appendicitis. Identify where the nurse will palpate to assess for pain at McBurney's point.

A nurse is performing an integumentary assessment for a client. Which of the following findings should the nurse identify as possible squamous cell carcinoma?

A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the client’s affected arm?

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his blood pressure of 124/79 mm Hg places him in which of the following categories?

A nurse is caring for a client who reports low back pain and asks the nurse for specific exercise recommendations. Which of the following activities should the nurse suggest?

A charge nurse is teaching a group of nurses about clients who report using garlic, ginger, and ginkgo biloba. The charge nurse should identify which of the following as an adverse effect of these supplements?