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 D

Explanation

Choice A reason: The statement about the medication taking a few weeks to work fully is accurate and does not require follow-up.

Choice B reason: The statement that levothyroxine replaces the hormone the body used to produce is correct and reflects an understanding of the therapy.

Choice C reason: Acknowledging the possibility of lifelong medication is appropriate for levothyroxine therapy in the case of hypothyroidism.

Choice D reason: Levothyroxine should be taken on an empty stomach, typically 30 minutes to an hour before breakfast, to ensure proper absorption. This statement indicates a misunderstanding that requires nurse follow-up.

A. "I always need to have a sweater or jacket on." B. "I am always warm and sometimes even hot during cold weather." C. "I seem to have episodes of hot and cold without regard to what I am wearing." D. "My fingers are sometimes cold during the cooler weather."

Correct Answer is B

Explanation

Choice A reason: Needing a sweater or jacket is not typical for Graves' disease, which often causes intolerance to heat rather than cold.

Choice B reason: This response is typical for Graves' disease, as hyperthyroidism can increase metabolism, leading to feeling warm or hot even in cold weather.

Choice C reason: While temperature dysregulation can occur, the specific symptom of feeling warm in cold weather is more directly associated with Graves' disease.

Choice D reason: Cold fingers can be a symptom of many conditions, but it is not specifically indicative of Graves' disease.

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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

The client has been instructed about levothyroxine (Synthroid) therapy. Which statement by the client requires follow-up by the nurse?

Correct Answer is D

Explanation

The nurse is interviewing a client with possible Graves' disease. Which response would the nurse expect when asking the client about her comfort in cold weather?

Correct Answer is B

Explanation

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