The nurse is providing care for several clients at risk for acid-base imbalance. Which client has the greatest risk for respiratory acidosis?

A 58-year-old client who uses antacids every day

A 48-year-old client with an anxiety disorder

A 68-year-old client with chronic lung disease

A 28-year-old client with salicylate intoxication

Answer and Explanation

The Correct Answer is C

A. A 58-year-old client who uses antacids every day: Antacids primarily affect gastric acid levels and are not typically associated with respiratory acidosis. They might affect metabolic balance but not respiratory acidosis.
B. A 48-year-old client with an anxiety disorder: Anxiety disorders are more commonly associated with respiratory alkalosis due to hyperventilation, not respiratory acidosis.
C. A 68-year-old client with chronic lung disease: This is the correct choice because chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), often impair CO2 elimination, leading to respiratory acidosis due to CO2 retention.
D. A 28-year-old client with salicylate intoxication: Salicylate intoxication is often associated with metabolic acidosis, and initially, it can cause respiratory alkalosis due to hyperventilation, rather than respiratory acidosis.

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Correct Answer is C

Explanation

A. 10% dextrose in water: This solution is used primarily for providing calories and is not suitable for volume replacement.
B. 10% dextrose in 0.45% sodium chloride: This solution combines dextrose and a hypotonic sodium chloride solution, which is not ideal for immediate volume replacement in severe bleeding cases.
C. 0.9% sodium chloride: This is the correct choice. Normal saline (0.9% sodium chloride) is an isotonic solution used for volume replacement, especially in cases of significant blood loss.
D. 2.5% sodium chloride: This is a hypotonic solution and would not be appropriate for volume replacement in severe bleeding as it does not adequately address the need for fluid resuscitation.

A. Ask why the client is taking steroid therapy B. Notify the surgeon immediately C. Administer an IV equivalent dose of Prednisone D. Give the oral steroid with a small sip of water

Correct Answer is C

Explanation

A. Ask why the client is taking steroid therapy: While understanding the reason for steroid therapy is important, it does not address the immediate need to manage the medication administration.
B. Notify the surgeon immediately: Notifying the surgeon might be necessary if there are specific concerns, but it is not the most immediate action regarding medication administration.
C. Administer an IV equivalent dose of Prednisone: Since the client is NPO, administering an oral medication could be contraindicated. Administering an IV equivalent ensures the client receives the necessary steroid therapy without risking complications from taking oral medication while fasting.
D. Give the oral steroid with a small sip of water: This may not be appropriate due to the NPO status, which typically restricts oral intake.

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The nurse is providing care for several clients at risk for acid-base imbalance. Which client has the greatest risk for respiratory acidosis?

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Naxlex Comprehensive Predictor Exams

A 28-year-old client is admitted to the hospital with severe bleeding from a fractured femur. Which intravenous fluid should the nurse anticipate will be ordered for volume replacement?

Correct Answer is C

Explanation

A client is scheduled for surgery at 0800 and has been NPO (nothing by mouth) since midnight. They have been taking long-term oral steroids and are scheduled for their routine dose of Prednisone 30 mg PO to be administered at 0600. Which nursing action is most appropriate?

Correct Answer is C

Explanation

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