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

Answer and Explanation

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.

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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.

A. Hyperplasia B. Metaplasia C. Neoplasia D. Dysplasia

Correct Answer is B

Explanation

Choice A reason: Hyperplasia is not the best term because it is a condition where the number of cells in a tissue or organ increases, which can be caused by various factors, such as hormones, inflammation, or stress. Hyperplasia does not involve the change of cell type, but the increase of cell number.

Choice B reason: Metaplasia is the best term because it is a condition where the type of cells in a tissue or organ changes, usually in response to chronic irritation or injury. Metaplasia involves the replacement of one type of cell with another type of cell that is more resistant to the harmful stimulus, but less specialized in function. Metaplasia can occur in the bronchi, which are the airways that branch from the trachea to the lungs, and are normally lined with ciliated columnar cells, which are cells that have hair-like projections that help to move mucus and foreign particles out of the respiratory tract. Metaplasia can replace the ciliated columnar cells with stratified squamous epithelial cells, which are cells that have multiple layers and a flat shape, and are more durable, but less effective in clearing the airways.

Choice C reason: Neoplasia is not the best term because it is a condition where the growth of cells in a tissue or organ is abnormal and uncontrolled, which can result in the formation of tumors, which are masses of abnormal cells that can be benign or malignant. Neoplasia does not involve the change of cell type, but the abnormal proliferation of cells.

Choice D reason: Dysplasia is not the best term because it is a condition where the shape, size, and organization of cells in a tissue or organ are abnormal, which can be caused by various factors, such as chronic inflammation, infection, or precancerous changes. Dysplasia does not involve the change of cell type, but the alteration of cell morphology and arrangement.

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The nurse provides care for several clients. Which client is most at risk to develop metabolic acidosis?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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