The nurse is caring for a client who underwent a colon resection yesterday due to having a bowel obstruction. ABGs show metabolic alkalosis. The nurse expects this finding is because of:
The client has a nasogastric tube connected to suction
The client is having a panic attack
The client has end-stage renal disease (ESRD)
The client has an epidural catheter for pain control
The Correct Answer is A
Choice A reason: Nasogastric suction removes gastric acid (HCl), reducing hydrogen ions, raising pH, and causing metabolic alkalosis, a common post-surgical complication here.
Choice B reason: Panic attacks cause respiratory alkalosis from hyperventilation, lowering CO2, not metabolic alkalosis, which involves base excess, unrelated to this ABG.
Choice C reason: ESRD typically causes metabolic acidosis from acid retention, not alkalosis, as kidneys fail to excrete hydrogen, opposing this patient’s ABG findings.
Choice D reason: Epidural catheters manage pain with analgesics, not affecting acid-base balance or causing metabolic alkalosis, irrelevant to the ABG shift observed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Increasing oxygen to 3 L/min may help but risks CO2 retention in COPD without assessing respiratory rate, depth, and saturation first, making it premature.
Choice B reason: Coughing clears secretions, but without assessing respiratory status, it’s unclear if secretions are the issue or if the client can effectively cough, so it’s not priority.
Choice C reason: Calling emergency services assumes severity without data like oxygen saturation or distress level, delaying care by skipping initial assessment in this stable setting.
Choice D reason: Assessing respiratory status (rate, oxygen saturation, lung sounds) identifies the cause of difficulty, guiding interventions like oxygen adjustment or escalation, per ABC priority.
Correct Answer is C
Explanation
Choice A reason: Crackles indicate pulmonary edema from left-sided heart failure, where fluid backs up into lungs, not right-sided failure, which affects systemic circulation instead.
Choice B reason: Orthopnea, dyspnea when lying flat, results from left-sided failure’s pulmonary congestion, not right-sided failure, which causes systemic venous pooling, not lung issues.
Choice C reason: Jugular venous distention occurs in right-sided heart failure as the right ventricle fails, backing blood into veins, elevating neck vein pressure visibly.
Choice D reason: Blood-tinged sputum suggests pulmonary edema or infarction, tied to left-sided failure or embolism, not right-sided failure’s systemic congestion pattern.
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