The nurse obtains the following arterial blood gas results on a client: pH 7.2, PaO2 88 mmHg, PaCO2 40 mmHg, HCO3 19 mEq/L. Which acid-base imbalance is the client experiencing?

Respiratory alkalosis

Metabolic alkalosis

Respiratory acidosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

Choice A reason: Respiratory alkalosis is not the correct answer. Respiratory alkalosis is a condition where the blood pH is high (above 7.45) due to low carbon dioxide levels (below 35 mmHg) caused by hyperventilation. The client's blood pH is low (7.2) and the carbon dioxide level is normal (40 mmHg), which does not indicate respiratory alkalosis.

Choice B reason: Metabolic alkalosis is not the correct answer. Metabolic alkalosis is a condition where the blood pH is high (above 7.45) due to high bicarbonate levels (above 26 mEq/L) caused by excessive loss of acids or intake of alkali. The client's blood pH is low (7.2) and the bicarbonate level is low (19 mEq/L), which does not indicate metabolic alkalosis.

Choice C reason: Respiratory acidosis is not the correct answer. Respiratory acidosis is a condition where the blood pH is low (below 7.35) due to high carbon dioxide levels (above 45 mmHg) caused by hypoventilation. The client's blood pH is low (7.2) but the carbon dioxide level is normal (40 mmHg), which does not indicate respiratory acidosis.

Choice D reason: This is the correct answer. Metabolic acidosis is a condition where the blood pH is low (below 7.35) due to low bicarbonate levels (below 22 mEq/L) caused by excessive production or intake of acids or loss of alkali. The client's blood pH is low (7.2) and the bicarbonate level is low (19 mEq/L), which indicates metabolic acidosis.

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Correct Answer is C

Explanation

Choice A reason: The second intercostal space, right of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, right of sternum, is the location where the aortic valve can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice B reason: The third intercostal space, left of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The third intercostal space, left of sternum, is the location where the pulmonary valve, which separates the right ventricle and the pulmonary artery, can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice C reason: The second intercostal space, left of sternum, is the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, left of sternum, is the location where the aortic murmur will be most audible, as it is the closest to the aorta, the largest artery in the body. ³

Choice D reason: The fourth intercostal space, left mid-clavicular line, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The fourth intercostal space, left mid-clavicular line, is the location where the tricuspid valve, which separates the right atrium and the right ventricle, can be best heard, but not the location where the aortic murmur will be most audible. ³

A. Perform daily weights. B. Take the blood pressure. C. Auscultate breath sounds. D. Measure urinary output.

Correct Answer is A

Explanation

Choice A reason: Performing daily weights is the best method to evaluate the client's response to furosemide, a drug that reduces fluid retention and swelling by increasing the urine output. ¹ Daily weights can help monitor the changes in the client's fluid status and the effectiveness of the drug. The nurse should weigh the client at the same time each day, using the same scale and clothing.

Choice B reason: Taking the blood pressure is not the best method to evaluate the client's response to furosemide. Furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ However, blood pressure can be influenced by many other factors, such as heart rate, stress, or medications. Blood pressure is not a reliable indicator of the client's fluid status or the effectiveness of the drug.

Choice C reason: Auscultating breath sounds is not the best method to evaluate the client's response to furosemide. Furosemide can help improve the breath sounds by reducing the fluid accumulation in the lungs, which can cause shortness of breath or crackles. ¹ However, breath sounds can also be affected by other factors, such as lung infections, asthma, or allergies. Breath sounds are not a reliable indicator of the client's fluid status or the effectiveness of the drug.

Choice D reason: Measuring urinary output is not the best method to evaluate the client's response to furosemide. Furosemide can increase the urinary output by stimulating the kidneys to excrete more water and electrolytes. ¹ However, urinary output can also vary depending on the fluid intake, kidney function, or other medications. Urinary output is not a reliable indicator of the client's fluid status or the effectiveness of the drug.

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The nurse obtains the following arterial blood gas results on a client: pH 7.2, PaO2 88 mmHg, PaCO2 40 mmHg, HCO3 19 mEq/L. Which acid-base imbalance is the client experiencing?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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