What laboratory finding is expected when a person has chronic renal failure?

Choice A reason: Prolonged nasogastric suctioning removes gastric acid (HCl), reducing hydrogen ions in the blood, leading to metabolic alkalosis. This is reflected by elevated pH (7.50) and increased HCO3 (28 mEq/L), with normal PaCO2 as the lungs have not yet compensated. This matches the expected acid-base imbalance, making it correct.

Choice B reason: This result shows a slightly acidic pH (7.34) with normal PaCO2 and low HCO3, suggesting metabolic acidosis. Nasogastric suctioning causes loss of acid, not base, so it does not lead to acidosis. This imbalance is inconsistent with the alkalosis expected from gastric acid loss, making it incorrect.

Choice C reason: This result indicates a low pH (7.32) and elevated PaCO2, suggesting respiratory acidosis with partial compensation (normal HCO3). Nasogastric suctioning affects gastric acid, causing metabolic, not respiratory, alkalosis. The respiratory parameters here do not align with the condition’s pathophysiology, making this choice incorrect.

Choice D reason: This result shows an elevated pH (7.46) and low PaCO2, indicating respiratory alkalosis, likely from hyperventilation, with normal HCO3. Nasogastric suctioning causes metabolic alkalosis due to acid loss, not respiratory changes. The low PaCO2 does not fit the expected metabolic profile, making this choice incorrect.

Choice A reason: High adipokine levels, as in obesity, promote insulin resistance by interfering with insulin signaling, not increasing glucose uptake. This reduces glucose uptake, contributing to hyperglycemia, but the description is inaccurate, making this choice incorrect.

Choice B reason: Type 2 diabetes involves insulin resistance due to insufficient or dysfunctional insulin receptors, reducing glucose uptake in cells, leading to hyperglycemia. This is a primary pathophysiological mechanism, often linked to obesity, making this the correct choice.

Choice C reason: Increased insulin secretion occurs early in type 2 diabetes to compensate for insulin resistance, but the primary issue is receptor dysfunction, not increased secretion. Over time, beta cells may fail, making this choice incorrect.

Choice D reason: Autoimmune destruction of beta cells describes type 1 diabetes, not type 2. Type 2 involves insulin resistance and relative insulin deficiency, not massive beta cell loss, making this choice incorrect for type 2 diabetes.