The nurse is caring for a diabetic patient in renal failure who is in metabolic acidosis. Which laboratory findings are consistent with metabolic acidosis?

pH 7.35, PaCO2 40 mm Hg, HCO3-25 mEq/L

pH 7.32, PaCO2 47 mm Hg. HCO3-23 mEq/L

pH 7.3, PaCO2 36 mm Hg. HCO3- 19 mEq/L

pH 7.5, PaCO2 35 mm Hg, HCO3- 35 mEq/L

Answer and Explanation

The Correct Answer is C

A.   pH 7.35, PaCO2 40 mm Hg, HCO3-25 mEq/L: This is within normal ranges and does not indicate acidosis.
B.   pH 7.32, PaCO2 47 mm Hg. HCO3-23 mEq/L: This indicates respiratory acidosis, not metabolic.
C.   pH 7.3, PaCO2 36 mm Hg. HCO3- 19 mEq/L: This indicates metabolic acidosis. The pH is low (acidic), and the HCO3- (bicarbonate) is decreased. The PaCO2 is within normal limits, indicating the respiratory system is compensating for the metabolic acidosis.
D.   pH 7.5, PaCO2 35 mm Hg, HCO3- 35 mEq/L: This indicates alkalosis, not acidosis.

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Correct Answer is D

Explanation

A. While asking appropriate questions demonstrates that the partner is engaged and seeking understanding, it alone does not indicate that they are ready to perform the procedure independently.

B. Being able to verbalize all steps in the procedure shows that the partner has knowledge and understanding of the process. However, verbalizing alone does not confirm that they can perform the procedure accurately and safely. Practical skills and hands-on competence are crucial for readiness.
C. Attending a class provides important theoretical knowledge and information about tracheostomy care. However, attending a class by itself does not guarantee that the partner has developed the necessary skills to perform suctioning independently.
D. The ability to perform the procedure independently indicates that the partner has acquired the necessary skills and confidence to carry out suctioning safely and effectively. It shows practical proficiency, which is essential for readiness for discharge. The partner’s ability to perform suctioning without assistance demonstrates that they can handle the procedure in real-life situations.

A. "I will perform deep breathing exercises only when the pain is minimal." B. "I will perform deep breathing exercises every hour while awake." C. “I will perform coughing exercises only if I feel short of breath." D. "I will avoid deep breathing exercises to prevent straining my incision."

Correct Answer is B

Explanation

A. Deep breathing exercises should be performed regularly, regardless of the level of pain. The exercises are crucial for preventing lung complications, and pain management should be addressed so that the client can perform these exercises effectively.
B. This statement reflects a proper understanding of the importance of regular deep breathing exercises. Performing these exercises every hour while awake helps to keep the alveoli open and reduces the risk of atelectasis and pneumonia. Consistent practice is essential for maximizing lung expansion and preventing complications.
C. Coughing exercises should be performed regularly, not just when experiencing shortness of breath. Coughing helps to clear secretions from the airways and prevent their accumulation, which can lead to respiratory infections and other complications.
D. Avoiding deep breathing exercises is not advisable. While there may be some discomfort, deep breathing is essential for lung health post-operatively. The exercises help prevent complications such as atelectasis.

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The nurse is caring for a diabetic patient in renal failure who is in metabolic acidosis. Which laboratory findings are consistent with metabolic acidosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with a tracheostomy. The client's partner has been taught to perform suctioning. Which of the following actions by the partner should indicate to the nurse a readiness for the client's discharge?

Correct Answer is D

Explanation

The nurse emphasizes the importance of deep breathing and coughing exercises post-operatively to prevent complications. Which statement by the client indicates understanding of these exercises?

Correct Answer is B

Explanation

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