The nurse is caring for a patient with metabolic acidosis. Which assessment finding reveals that the compensatory mechanism to correct this imbalance is in effect?

Increased urinary output

Reduced abdominal distention

Kussmaul respirations

Decreased blood pressure

Answer and Explanation

The Correct Answer is C

A. Increased urinary output: Increased urinary output is not a primary compensatory mechanism for metabolic acidosis. The kidneys help compensate by excreting hydrogen ions and reabsorbing bicarbonate, but this does not directly lead to increased urinary output.

B. Reduced abdominal distention: Abdominal distention is unrelated to the compensatory mechanism for metabolic acidosis. The primary compensatory mechanism is respiratory, not gastrointestinal.

C. Kussmaul respirations: Kussmaul respirations are deep, rapid breaths that occur as a compensatory mechanism for metabolic acidosis. The body increases the respiratory rate and depth to expel CO2, which is acidic and raise the blood pH, helping to correct the acid-base imbalance.

D. Decreased blood pressure: Decreased blood pressure can occur in various conditions, including metabolic acidosis, but it is not part of the compensatory mechanism. The body's response to metabolic acidosis is increasing ventilation to expel CO2 and correct the pH imbalance.

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Correct Answer is C

Explanation

A. 0.225% sodium chloride (1/4 NS): This hypotonic solution can shift fluids into cells but is not ideal for isotonic therapy. It may cause fluid imbalance and not restore extracellular fluid balance effectively in vomiting and diarrhea.

B. 0.45% sodium chloride (1/2 NS): This is another hypotonic solution that may cause fluid shifts into the cells. It is not isotonic, making it less appropriate for fluid replacement in this case.

C. 0.9% sodium chloride (NS): Normal saline is an isotonic solution that closely matches the osmolality of body fluids. It is the best choice to replace extracellular fluid lost from vomiting and diarrhea.

D. 3% sodium chloride (3% NaCl): This hypertonic solution is used for severe hyponatremia and shifts fluids out of cells. It is inappropriate for fluid replacement in vomiting and diarrhea, as it could lead to fluid overload.

A. Tenderness at the IV site B. Urine specific gravity is 1.018 C. Capillary refill is < 3 seconds D. Newly noted crackles in the lungs

Correct Answer is D

Explanation

A. Tenderness at the IV site: Tenderness at the IV site could indicate irritation or minor inflammation, but it is not the most concerning finding in this situation. It is a common issue with IV therapy and does not indicate a life-threatening condition.

B. Urine specific gravity is 1.018: A urine specific gravity of 1.018 is within the normal range (1.005 to 1.030), indicating adequate hydration. This is not an alarming finding in the context of IV fluid infusion.

C. Capillary refill is < 3 seconds: A capillary refill time of less than 3 seconds indicates good peripheral circulation, which is a positive sign and does not raise immediate concern regarding fluid status or complications from the IV infusion.

D. Newly noted crackles in the lungs: Crackles in the lungs can indicate fluid overload, which is a serious concern in older adults, particularly when receiving IV fluids like 0.45% normal saline. This suggests that the body is struggling to manage the fluid volume, leading to pulmonary complications.

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The nurse is caring for a patient with metabolic acidosis. Which assessment finding reveals that the compensatory mechanism to correct this imbalance is in effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient presents to the emergency department with reports of vomiting and diarrhea for the past 48 hours. The health care provider orders isotonic intravenous (IV) therapy. Which IV will the nurse prepare?

Correct Answer is C

Explanation

An older adult patient has an intravenous infusion of 0.45% normal saline infusing at 150 mL/hr. The nurse is most concerned by which of the following assessment findings?

Correct Answer is D

Explanation

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The failure of the lungs to adequately eliminate CO2 results in?

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