What set of arterial blood gases (ABGs) would you expect to see in a client with acute chest trauma?
pH 7.53, CO2 32, HCO3 24
pH 7.30, CO2 52, HCO3 22
pH 7.49, CO2 30, HCO3 14
pH 7.26, CO2 45, HCO3 18
The Correct Answer is B
Choice A reason: pH 7.53 and low CO2 (32) indicate respiratory alkalosis from hyperventilation, not typical in chest trauma where breathing is impaired. HCO3 (24) is normal, showing no compensation yet, misaligning with trauma physiology.
Choice B reason: pH 7.30, high CO2 (52), and near-normal HCO3 (22) reflect respiratory acidosis from hypoventilation in chest trauma, like rib fractures, reducing air exchange. Compensation is minimal acutely, fitting the clinical scenario.
Choice C reason: pH 7.49 and low CO2 (30) suggest respiratory alkalosis, while low HCO3 (14) indicates metabolic compensation. This doesn’t match chest trauma’s ventilatory restriction, which elevates CO2 instead.
Choice D reason: pH 7.26, CO2 (45), and low HCO3 (18) show mixed acidosis. Chest trauma primarily causes respiratory acidosis from CO2 retention, not a significant metabolic drop acutely, making this less precise.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: Heparin prevents clotting during dialysis but doesn’t reduce hemoglobin or hematocrit directly. It’s not a primary cause of anemia in renal failure, unlike erythropoietin deficiency.
Choice B reason: Kidneys in chronic renal failure fail to produce erythropoietin, a hormone stimulating red blood cell production, leading to low hemoglobin and hematocrit, the key cause here.
Choice C reason: Minor blood loss occurs in dialysis, but it’s not the primary reason for chronic anemia. Erythropoietin deficiency from renal failure has a greater impact on counts.
Choice D reason: Poor protein intake affects overall health but isn’t the main driver of anemia in renal failure. Erythropoietin loss from kidney dysfunction is the dominant factor.
Correct Answer is B
Explanation
Choice A reason: Lactulose doesn’t lower glucose; it’s a sugar metabolized by gut bacteria, unrelated to blood sugar control in cirrhosis, where glucose issues stem elsewhere.
Choice B reason: In cirrhosis, lactulose traps ammonia in the gut by acidifying it, promoting excretion and reducing toxic levels that cause hepatic encephalopathy, the primary goal.
Choice C reason: Potassium levels aren’t directly reduced by lactulose; it affects ammonia via gut pH, not electrolytes like potassium, which may rise in renal issues.
Choice D reason: Bicarbonate isn’t targeted by lactulose; it’s a buffer altered in acid-base imbalances, not the focus in cirrhosis where ammonia reduction is critical.
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