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Arterial blood gas levels are obtained for the client. If the client’s results are pH 7.48, CO2 42 mm Hg, and HCO3 32 mEq/L, the client is exhibiting which one of the following acid-base imbalances? Selected Answer: D. Metabolic alkalosis Correct Answer: D. Metabolic alkalosis Response Feedback: The client’s pH is elevated at 7.48 (normal 7.35 to 7.45), the CO2 is normal at 42 mm Hg (normal 35 to 45 mm Hg), and the bicarbonate is elevated at 32 mEq/L (normal 22 to 26 mEq/L). The client is experiencing metabolic alkalosis. In metabolic acidosis the client’s pH would be below 7.35, and the bicarbonate would be below 22 mEq/L. In respiratory acidosis the client’s pH would be below 7.35, and the CO2 would be elevated above 45 mm Hg. In respiratory alkalosis the client’s pH would be above 7.45, and the CO2 would be below 35 mm Hg.Cognitive Level: analysisNCLEX Blueprint: Physiological Adaptation • Question 2 1 out of 1 points The nurse would suspect that a client who frequently uses which medication is at risk for developing metabolic alkalosis? Selected Answer: A. Calcium carbonate (Tums) Correct Answer: A. Calcium carbonate (Tums) Response Feedback: Excessive use of oral antacids can lead to metabolic alkalosis. Use of ibuprofen and Tylenol is not associated with the development of metabolic alkalosis. Overdoses of aspirin can be associated with the development of respiratory alkalosis, and eventually can lead to metabolic acidosis. Cognitive Level: ApplicationNCLEX Blueprint: Physiological Adaptation • Question 3 1 out of 1 points The nurse records a patient’s hourly urine output from an indwelling catheter as follows:0700: 36 mL0800: 45 mL0900: 85 mL1000: 62 mL1100: 50 mL1200: 48 mL1300: 94 mL1400: 78 mL1500: 60 mLThe nurse can conclude that the patient’s urine output should be described as which of the following? Selected Answer: B. Within normal limits Correct Answer: B. Within normal limits Response Feedback: Urine accounts for the greatest amount of fluid loss. Normal urine output for an average-sized adult is approximately 1,500 mL in 24 hr. Urine output varies according to intake and activity but should remain at least 30 to 50 mL per hour. The patient’s urine output is within the normal range. This patient has an indwelling catheter, which will result in continual flow of urine.Cognitive level: analysisNCLEX Blueprint: basic care and comfort • Question 4 1 out of 1 points A client is admitted with severe diarrhea. Arterial blood gas (ABG) results are pH 7.33; PaCO 2 42; HCO 3 – 20. The nurse concludes this client has which acid–base imbalance? Selected Answer: A. Uncompensated metabolic acidosis Correct Answer: A. Uncompensated metabolic acidosis Response Feedback: The pH and HCO3– are decreased, indicating metabolic acidosis. The PaCO2 is normal, indicating that compensatory mechanisms have not started working. Compensated or uncompensated respiratory acidosis is incorrect because the primary disturbance is metabolic, as indicated by the low bicarbonate level. Compensated metabolic acidosis is incorrect because with compensation, a decrease in PaCO2 to restore balance would be expected. Cognitive Level: AnalyzingNCLEX Blueprint: Physiological Adaptation • Question 5 1 out of 1 points Identify the appropriate intervention(s) for a patient with hypovolemia. Choose all that apply.
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