The nurse reviews the client's arterial blood gases and has the following results: pH 7.30. PaCO2 58, and HCO3 of 26. The nurse interprets these results that the client has which acid-base imbalance?
Respiratory Alkalosis
Metabolic Acidosis
Metabolic alkalosis
Respiratory acidosis
The Correct Answer is D
A. Respiratory Alkalosis: Would have high pH (>7.45) and low PaCO2 (<35 mmHg).
B. Metabolic Acidosis: Would have low pH and low HCO3 (<22 mEq/L).
C. Metabolic Alkalosis: Would have high pH and high HCO3 (>26 mEq/L).
D. Respiratory Acidosis: A low pH (<7.35) and high PaCO2 (>45 mmHg) indicate respiratory acidosis, which occurs due to hypoventilation, COPD, or respiratory failure. The bicarbonate (HCO3) is normal, meaning there is no metabolic compensation yet.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Oliguria: Reduced urine output (oliguria) can indicate acute rejection due to decreased renal function. Other signs include fever, hypertension, graft tenderness, and swelling.
B. Temperature 36.1° C (97.0° F): Rejection often causes fever, not a low temperature.
C. Weight loss: Weight gain (fluid retention) is more common with rejection.
D. Insomnia: Insomnia is not a direct sign of rejection.
Correct Answer is B
Explanation
A. Assess the fistula with a large bore needle: Large bore needles are used during dialysis sessions, not for routine assessment. Inappropriate needling can damage the fistula.
B. Auscultate the fistula site for a bruit: A functional AV fistula should have a palpable thrill (vibration) and an audible bruit (whooshing sound) when auscultated with a stethoscope. These findings confirm adequate blood flow and patency.
C. Measure the blood pressure in the affected arm: Blood pressure measurements should never be taken on the fistula arm to prevent compression and potential fistula failure.
D. Assess the rate and quality of the radial pulse on the affected arm: The radial pulse does not accurately assess AV fistula patency; the focus should be on the thrill and bruit.
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