The nurse provides care for several clients. Which client is most at risk to develop metabolic acidosis?
A client with a 10-year history of chronic lung disease
A client receiving parenteral nutrition for 2 weeks
A client with a history of severe diarrhea for 5 days
A client with a temperature of 102°F (38.9°C) for 48 hours
The Correct Answer is C
Choice A reason: A client with a 10-year history of chronic lung disease is not the most at risk to develop metabolic acidosis because chronic lung disease causes respiratory acidosis, not metabolic acidosis. Respiratory acidosis is a condition where the lungs cannot eliminate enough carbon dioxide, resulting in a low pH and a high bicarbonate level in the blood.
Choice B reason: A client receiving parenteral nutrition for 2 weeks is not the most at risk to develop metabolic acidosis because parenteral nutrition does not affect the acid-base balance of the body, unless there is an infection or a complication. Parenteral nutrition is a method of providing nutrients through a vein, bypassing the digestive system.
Choice C reason: A client with a history of severe diarrhea for 5 days is the most at risk to develop metabolic acidosis because diarrhea causes loss of bicarbonate, which is a base that helps maintain the pH of the blood. Loss of bicarbonate leads to a low pH and a low bicarbonate level in the blood, indicating metabolic acidosis.
Choice D reason: A client with a temperature of 102°F (38.9°C) for 48 hours is not the most at risk to develop metabolic acidosis because fever does not directly cause metabolic acidosis, unless there is dehydration or sepsis. Fever is a symptom of an infection or inflammation, which can increase the metabolic rate and the production of carbon dioxide, but the lungs can usually compensate by increasing the ventilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Non-Hodgkin lymphoma is not the correct answer because it is a type of cancer that affects the lymphocytes, which are a type of white blood cell that are part of the immune system. Non-Hodgkin lymphoma does not have Reed-Sternberg cells, which are abnormal, large, and multinucleated cells that are characteristic of Hodgkin lymphoma.
Choice B reason: Multiple myeloma is not the correct answer because it is a type of cancer that affects the plasma cells, which are a type of lymphocyte that produce antibodies. Multiple myeloma does not have Reed-Sternberg cells, but it can have abnormal plasma cells that are called myeloma cells.
Choice C reason: Hodgkin lymphoma is the correct answer because it is a type of cancer that affects the lymphatic system, which is a network of organs, tissues, and vessels that help fight infections and diseases. Hodgkin lymphoma has Reed-Sternberg cells, which are the hallmark of this disease. Reed-Sternberg cells are thought to be derived from B lymphocytes, which are a type of lymphocyte that produce antibodies.
Choice D reason: Acute lymphocytic leukemia is not the correct answer because it is a type of cancer that affects the immature lymphocytes, which are called lymphoblasts. Acute lymphocytic leukemia does not have Reed-Sternberg cells, but it can have abnormal lymphoblasts that are called leukemic cells.
Correct Answer is A
Explanation
Choice A:
Thrombosis of the small blood vessels in the substantia nigra is the best explanation for the clinical manifestations observed in the patient. The substantia nigra is an area in the brain responsible for producing dopamine, a neurotransmitter involved in motor control. Thrombosis, or the formation of blood clots, in the small blood vessels of the substantia nigra can lead to a decrease in dopamine production, resulting in the symptoms of Parkinson's disease.
Choice B:
Increased acetylcholine levels and cholinergic activity in the brain are not the primary factors causing the manifestations of Parkinson's disease. In fact, Parkinson's disease is characterized by a decrease in dopamine levels, not an increase in acetylcholine.
Choice C:
Cell-mediated immune response and muscle fiber damage are not the main mechanisms underlying the clinical manifestations of Parkinson's disease. While inflammation and immune responses may play a role in the progression of the disease, they are not the primary cause of the symptoms observed.
Choice D:
Increased production of dopamine in the motor cortex is not the cause of the symptoms in Parkinson's disease. In fact, patients with Parkinson's disease experience a decrease in dopamine production due to the degeneration of dopamine-producing neurons in the substantia nigra.
Overall, the most plausible explanation for the patient's clinical manifestations is thrombosis of the small blood vessels in the substantia nigra, leading to a decrease in dopamine production.
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