Which arterial blood gas result is most likely to result from renal failure?
pH 7.31, HCO3- 18 mEq/L, PaCO2 32 mm Hg
pH 7.29, HCO3- 25 mEq/L, PaCO2 51 mm Hg
pH 7.48, HCO3- 19 mEq/L, PaCO2 28 mm Hg
pH 7.52, HCO3- 28 mEq/L, PaCO2 36 mm Hg
The Correct Answer is A
Choice A reason: Renal failure causes metabolic acidosis (low pH, low HCO3) due to impaired acid excretion and bicarbonate reabsorption. The low PaCO2 indicates respiratory compensation (hyperventilation) to reduce acidity, matching renal failure’s acid-base profile, making this the correct choice.
Choice B reason: This shows respiratory acidosis (low pH, high PaCO2) with normal HCO3, suggesting lung dysfunction, not renal failure. Renal failure causes metabolic acidosis due to acid retention, not CO2 accumulation, making this choice incorrect.
Choice C reason: This indicates respiratory alkalosis (high pH, low PaCO2) with low HCO3, suggesting hyperventilation, not renal failure. Renal failure leads to metabolic acidosis from acid accumulation, not respiratory changes, making this choice incorrect.
Choice D reason: This shows metabolic alkalosis (high pH, high HCO3), not typical of renal failure, which causes acidosis due to impaired acid excretion. The normal PaCO2 suggests no respiratory compensation, making this choice incorrect for renal failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A reason: Coronary artery vasospasm causes transient vessel constriction, reducing blood flow to the myocardium, leading to ischemia and potentially infarction. This is a recognized cause, particularly in variant angina, making this a correct mechanism for myocardial infarction.
Choice B reason: A thrombus forming in a coronary artery, often due to plaque rupture, obstructs blood flow, causing myocardial ischemia and infarction. This is the most common cause of myocardial infarction, making this a correct mechanism.
Choice C reason: Chest wall bruising from trauma does not directly cause myocardial infarction, which requires coronary artery occlusion. Trauma may cause cardiac contusion but not infarction, making this choice incorrect for myocardial infarction development.
Choice D reason: An embolus, such as from a clot elsewhere, can block a coronary artery, stopping blood flow to the myocardium, causing infarction. Though less common than thrombosis, it is a valid mechanism, making this a correct choice.
Choice E reason: Systemic infection with hyperthermia does not directly cause myocardial infarction. It may increase cardiac demand, potentially exacerbating ischemia, but infarction requires coronary occlusion, not just fever, making this choice incorrect.
Correct Answer is D
Explanation
Choice A reason: Type 2 diabetes involves insulin resistance, not excessive insulin production, which declines over time. Insulin does not cause renal toxicity; hyperglycemia damages kidneys, making this choice incorrect for the mechanism of renal failure.
Choice B reason: Glucose crystals do not form in type 2 diabetes to obstruct ureters. Hyperglycemia damages renal vasculature, not urine flow, leading to diabetic nephropathy, making this choice incorrect for chronic renal failure’s mechanism.
Choice C reason: An autoimmune process destroying renal tissue is not typical of type 2 diabetes. Autoimmune damage occurs in type 1 diabetes or glomerulonephritis, not type 2-related renal failure, making this choice incorrect.
Choice D reason: High blood sugar in type 2 diabetes damages renal microvasculature, particularly glomerular capillaries, causing diabetic nephropathy. This leads to proteinuria, glomerulosclerosis, and chronic renal failure, making this the correct mechanism for kidney damage.
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