The nurse is reviewing arterial blood gas (ABG) results for a client with diabetic ketoacidosis. Which result is consistent with this diagnosis?

pH 7.48, PaCO2 31 mm Hg, HCO3 26 mEq/L

pH 7.42, PaCO2 39 mm Hg, HCO3 25 mEq/L

pH 7.34, PaCO2 40 mm Hg, HCO3 21 mEq/L

pH 7.17, PaCO2 69 mm Hg, HCO3 25 mEq/L

Answer and Explanation

The Correct Answer is D

Choice A reason: A pH of 7.48 is above the normal range (7.35–7.45), indicating a state of alkalosis, not acidosis. A PaCO2 of 31 mm Hg is below the normal range (35–45 mm Hg), which could indicate respiratory alkalosis if it were the primary disorder. An HCO3 level of 26 mEq/L is within the normal range (22–26 mEq/L) and does not suggest metabolic acidosis. Therefore, this choice does not reflect the metabolic acidosis seen in diabetic ketoacidosis (DKA).
Choice B reason: A pH of 7.42 is within the normal range, and a PaCO2 of 39 mm Hg is also within the normal range, suggesting neither acidosis nor alkalosis. An HCO3 level of 25 mEq/L is within the normal range and does not indicate the metabolic acidosis characteristic of DKA. Thus, this choice does not match the expected ABG results for DKA.
Choice C reason: A pH of 7.34 is just below the normal range, indicating a slight acidosis1. A PaCO2 of 40 mm Hg is within the normal range, suggesting that the primary issue is not respiratory. An HCO3 level of 21 mEq/L is slightly below the normal range, which could suggest a mild metabolic acidosis. However, the changes are not as pronounced as typically seen in DKA, where more significant acidosis is expected.
Choice D reason: A pH of 7.17 is significantly below the normal range, indicating severe acidosis1. A PaCO2 of 69 mm Hg is well above the normal range, which would usually suggest respiratory acidosis. However, in the context of DKA, a compensatory respiratory alkalosis often occurs, and the elevated PaCO2 may indicate a mixed acid-base disorder. An HCO3 level of 25 mEq/L is within the normal range, but given the low pH, it suggests that the body has been compensating for an acid-base disturbance. This choice most closely aligns with the metabolic acidosis and the compensatory respiratory changes expected in DKA.

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Correct Answer is C

Explanation

Choice A reason: While assessing temperature is important for monitoring infection, it is not the immediate priority in the treatment of UTI and sepsis.

Choice B reason: Monitoring urine output is crucial for a UTI but does not address the systemic infection that sepsis represents.

Choice C reason: Administering antibiotics is the most critical intervention for a client with sepsis due to a UTI, as it directly addresses the underlying infection and can be life-saving.

Choice D reason: Evaluating the current CBC is important for understanding the client's baseline and response to infection but is secondary to the administration of antibiotics.

A. Encourage ambulation. B. Send urine sample for culture. C. Monitor temperature. D. Administer levothyroxine.

Correct Answer is C

Explanation

Choice A reason: Encouraging ambulation is not a priority during a thyroid storm, as it can exacerbate symptoms.

Choice B reason: Sending a urine sample for culture is not related to the immediate management of thyroid storm.

Choice C reason: Monitoring temperature is crucial in the management of thyroid storm, as hyperthermia is a common and serious symptom.

Choice D reason: Administering levothyroxine during a thyroid storm would be contraindicated, as it could worsen the condition.

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The nurse is reviewing arterial blood gas (ABG) results for a client with diabetic ketoacidosis. Which result is consistent with this diagnosis?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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