lizard - Acid Base Balance

When arterial blood gas results for an alert client who is in the postanesthesia care unit (PACU) after abdominal surgery are pH 7.37 PaCO2 : 42mm Hg (5.59 kPA) HCO3: 25 mEq (25 mmol/L) PaO2: 65 mm Hg (8.64 kPa) SaO2 : 90% (0.90) Which action would the nurse take? a. increase the oxygen flow rate b. insert an oropharyngeal airway c. suction the oropharynx and upper trachea d. prepare to transfer the client out of the PACU

a. increase the oxygen flow rate

A client is experiencing persistent vomiting, and serum electrolytes have been prescribed. The nurse would monitor which laboratory results? a. sodium and chloride levels b. bicarbonate and sulfate levels c. magnesium and protein levels d. calcium and phosphate levels

a. sodium and chloride levels

Which process is the origin of metabolic acidosis caused by aspirin toxicity? a. deep, rapid breathing b. higher pH of gastric contents c. rapid absorption of salicylate d. increased renal excretion of bicarbonate

c. rapid absorption of salicylate

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and PCO2 of 60 mm Hg. These blood gas results require nursing attention because they indicate which condition? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

c. respiratory acidosis

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and a partial pressure of carbon dioxide (PCO2) of 60 mm Hg. Which complication would the nurse suspect the client is experiencing? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

c. respiratory acidosis

The nurse is caring for a client after abdominal surgery and encourages the client to engage in deep-breathing exercises and return from side to side. Which complication is the nurse trying to prevent? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

c. respiratory acidosis

Which type of acid-base imbalance would the nurse expect in a child admitted with a severe asthma exacerbation? a. metabolic alkalosis caused by excessive production of acid metabolites b. respiratory alkalosis caused by accelerated respirations and loss of carbon dioxide c. respiratory acidosis caused by impaired respirations and increased formation of carbonic acid d. metabolic acidosis caused by the kidneys' inability to compensate for increased carbonic acid formation

c. respiratory acidosis caused by impaired respirations and increased formation of carbonic acid

For a client admitted with metabolic acidosis, which two body systems would the nurse assess for compensatory changes? a. skeletal and nervous b. circulatory and urinary c. respiratory and urinary d. muscular and endocrine

c. respiratory and urinary

The nurse observes that a client's urine has a sweet fruity odor. Which information is important to evaluate when performing a further client assessment? a. vital signs b. fluid balance c. serum glucose level d. dietary calorie count

c. serum glucose level

Which advantage does aluminum and magnesium hydroxide have over baking soda (sodium bicarbonate) for the treatment of heartburn? a. they can be used for short-term relief b. absorption by the stomach mucosa is markedly enhanced c. there is no direct effect on the systemic acid-base balance when taken as directed d. fewer side effects, such as diarrhea or constipation, are experienced when they are used properly

c. there is no direct effect on the systemic acid-base balance when taken as directed

A client with severe gastritis vomits a large amount of blood. The nurse performs gastric lavage, as prescribed, using an irrigating solution that is room temperature. Which response would the nurse expect? a. coagulation of blood b. neutralization of acids c. constriction of blood vessels d. stimulation of the vagus nerve

c. constriction of blood vessels

Which finding would the nurse expect when assessing a client with compensated metabolic acidosis? a. muscle twitching b. mental instability c. deep and rapid respirations d. tachycardia and cardiac dysrhythmias

c. deep and rapid respirations

The nurse is caring for a client with emphysema. During assessment, the nurse would expect to auscultate which type of breath sounds? a. crackles b. pleural friction rub c. diminished breath sounds d. expiratory wheezes

c. diminished breath sounds

The nurse is caring for a client who is vomiting. When caring for this client, the nurse recalls that the vomiting reflex follows a set pattern. List the steps in the order that they occur.

1. Initiation of reverse peristalsis in the stomach 2. contraction of abdominal muscle 3. relaxation of the upper esophageal sphincter 4. Closure of the trachea to prevent aspiration

What is the sequence of events that occurs in the child's respiratory response to acidosis? Place the physiologic responses in the order in which they occur.

1. hyperventilation 2. increased CO2 elimination 3. decreased blood H+ ions 4. increased pH

During an 8-hour shift a client drinks two 6-oz (180 mL) cups of tea and vomits 125 mL of fluid. Intravenous fluids absorbed equaled the urinary output. What is the client's fluid balance during this 8-hour period?

235 mL

Assessment findings of a client with smoke inhalation include a negative chest x-ray and arterial blood gases that show a PO 2 of 85 mm Hg, a PCO 2 of 45 mm Hg, and a pH of 7.35. Which interventions would the nurse anticipate will be prescribed? SATA A. Coughing B. Deep breathing C. Bronchodilators D. Humidified oxygen E. Bronchial suctioning

A. Coughing B. Deep breathing D. Humidified oxygen

Which component of the client's nephron acts as a receptor site for the antidiuretic hormone to regulate water balance? a. collecting ducts b. bowman's capsule c. distal convoluted tubule d. proximal convoluted tubule

a. collecting ducts

Which arterial blood pH would the nurse expect a client in a state of uncompensated acidosis to have? a. 7.20 b. 7.35 c. 7.45 d. 7.48

a. 7.20

How can the nurse prevent vomiting in a client who reports feeling nauseated after a cataract surgery? a. Administer the prescribed antiemetic medication. b. Provide some dry crackers for the client to eat. c. Explain that this is expected after surgery. d. Teach how to breathe deeply until the nausea subsides.

a. Administer the prescribed antiemetic medication.

Which condition is a cardiovascular manifestation of alkalosis? SATA a. Increased heart rate b. Decreased heart rate c. widened QRS complex d. Increased digitalis toxicity e. prolonged PR interval

a. Increased heart rate d. Increased digitalis toxicity

A high school student arrives at the local blood drive center to donate blood for the first time and as the site is being prepared for needle insertion, the student becomes agitated and starts to hyperventilate. Which instruction would the nurse provide the student? a. breathe into cupped hands b. pant using rapid, shallow breaths c. use a rapid deep-breathing pattern d. hold breath for as long as possible

a. breathe into cupped hands

Which nursing intervention would be essential for a newly admitted client with bulimia nervosa? a. check on the client continually b. observe the client during meals c. teach the client to measure intake and output d. involve the client in developing a daily meal plan

a. check on the client continually

Which manifestation would the nurse include when teaching a client about ketoacidosis? SATA a. confusion b. hyperactivity c. excessive thirst d. fruity-scented breath e. decreased urinary output

a. confusion c. excessive thirst d. fruity-scented breath

A client has been on a hunger strike for 5 days. During this time, which hormones provide glucose as energy through catabolism? SATA a. cortisol b. prolactin c. glucagon d. calcitonin e. aldosterone

a. cortisol c. glucagon

The regulation of type 1 diabetes in an 8-year-old child is best attained with a combination of therapeutic modalities in addition to the administration of insulin. Which modalities would the nurse include in the teaching plan? a. dietary control b. regular exercise c. urine testing for glucose d. blood glucose monitoring e. use of oral hypoglycemic agents

a. dietary control b. regular exercise d. blood glucose monitoring

The nurse is assessing a client with diabetic ketoacidosis. Which clinical manifestations would the nurse expect? SATA a. dry skin b. abdominal pain c. kussmaul respirations d. absence of ketones in the urine e. blood glucose level of less than 72 mg/dL (3.3 mmol/L)

a. dry skin b. abdominal pain c. kussmaul respirations

Which priority nursing intervention would the nurse implement for a client on diuretic therapy who has developed metabolic alkalosis? a. fall prevention measures b. monitoring electrolytes c. administering antiemetics d. adjusting the diuretic therapy

a. fall prevention measures

Which nutrient causes elevated ketones in diabetic acidosis by incomplete oxidation? a. fats b. proteins c. potassium d. carbohydrates

a. fats

Which early sign of respiratory acidosis would the nurse expect the client with a restrictive airway disease to exhibit? SATA a. headache b. irritability c. restlessness d. hypertension e. lightheadedness

a. headache b. irritability c. restlessness

An infant with persistent diarrhea is subject to significant fluid and electrolyte alterations. Which physiologic imbalance would the nurse most likely encounter? SATA a. hypovolemia b. hyperkalemia c. hypercalcemia d. metabolic acidosis e. decreased hematocrit

a. hypovolemia d. metabolic acidosis

Which statement explains why metabolic acidosis develops with kidney failure? a. inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate b. depressed respiratory rate due to metabolic wastes, causing carbon dioxide c. inability of the renal tubules to reabsorb water to dilute the acid contents of blood d. impaired glomerular filtration, causing retention of sodium and metabolic waste products

a. inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate

Which initial intervention would the nurse expect the primary health care provider to order for a client admitted to the hospital with diagnosis of diabetic ketoacidosis? a. intravenous (IV) fluids b. Potassium c. NPH insulin (Novolin N) d. Sodium polystyrene sulfaonate (Kayexalate)

a. intravenous (IV) fluids

An increase in which blood component is responsible for the acidosis related to untreated diabetes mellitus? a. ketones b. glucose c. lactic acid d. glutamic acid

a. ketones

Which would the nurse consider carefully regarding a preterm infant's kidney function? a. large amounts of urine are excreted b. it is the same as in a full-term newborn c. urine is concentrated, with an increased specific gravity d. fluid and electrolyte balance are adequately maintained

a. large amounts of urine are excreted

A 3-month-old infant with a 3-day history of diarrhea has an arterial blood gas drawn. Which acid-base imbalance would the nurse suspect? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

a. metabolic acidosis

Which initial change in acid-base balance will the nurse expect when a client is in the progressive stage of shock? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

a. metabolic acidosis

Which independent nursing action would be included in the plan of care after an episode of ketoacidosis? a. monitoring for signs of hypoglycemia resulting from treatment b. withholding glucose in any form until the situation is corrected c. giving fruit juices, broth, and milk as soon as the client is able to take fluids orally d. regulating insulin dosage according to the client's urinary ketone levels

a. monitoring for signs of hypoglycemia resulting from treatment

A client is admitted to the hospital after taking an overdose of aspirin. A nasogastric tube is inserted for lavage. Which solution would the nurse obtain for the gastric lavage? a. normal saline b. lactated ringer c. citrate magnesium d. sodium bicarbonate

a. normal saline

Which arterial blood gas results are associated with diabetic ketoacidosis? a. pH: 7.28; PCO2: 28; HCO3: 18 b. pH: 7.30; PCO2: 54; HCO3: 28 c. pH: 7.50; PCO2: 49; HCO3: 32 d. pH: 7.52; PCO2: 26; HCO3: 20

a. pH: 7.28; PCO2: 28; HCO3: 18

Which electrolyte, if found on urinalysis, would alert the nurse to the possibility of kidney damage? a. protein b. calcium c. potassium d. phosphate

a. protein

Which ion is the regulator of extracellular osmolarity? a. sodium b. potassium c. chloride d. calcium

a. sodium

Which situation associated with the physiological finding of ketones in the blood and urine would be the nurse's focus when collecting additional data about a client? a. starvation b. alcoholism c. bone healing d. positive nitrogen balance

a. starvation

Which statement made by the nurse about neuromuscular manifestations of alkalosis with hypocalcemia is correct? SATA a. the client would show signs of twitching b. the client would show signs of hyporeflexia c. the client would show signs of paresthesias d. the client would show signs of muscle cramping e. the client would show signs of skeletal muscle weakness

a. the client would show signs of twitching d. the client would show signs of muscle cramping e. the client would show signs of skeletal muscle weakness

A client is transferred to the postanesthesia care unit after abdominal surgery. The client begins vomiting. Which nursing action is most important when caring for this client? a. turning the client onto the side b. measuring the amount of vomitus c. assessing the wound for dehiscence d. administering the prescribed antiemetic to the client

a. turning the client onto the side

A client with chronic obstructive pulmonary disease (COPD) reports chest congestion, especially upon awaking in the morning. To address the concern, the nurse would make which suggestion? a. use a clean and disinfected humidifier in the bedroom. b. sleep with two or more pillows c. cough regularly even if the cough does not produce sputum d. cough and deep-breathe each night before going to sleep.

a. use a clean and disinfected humidifier in the bedroom.

Which action by the nurse will be most effective in determining whether fluid overload is improving when caring for a client who was admitted with heart failure? a. weighing the client b. monitoring the intake and output c. assessing the extent of pitting edema d. asking the client about subjective symptoms

a. weighing the client

Which assessment finding in a laboring client indicates respiratory alkalosis? a. a change in the respiratory rate b. a tingling sensation in the hands c. periodic changes in the fetal heart rate d. a pulse oximetry reading of less than 98%

b. a tingling sensation in the hands

Which statement made by the client identifies a regulatory function of the kidney? SATA a. erythropoiesis b. acid-base balance c. vitamin d activation d. blood pressure control e. fluid and electrolyte balance

b. acid-base balance e. fluid and electrolyte balance

Which statement made by the nurse is accurate about the manifestation of alkalosis in the central nervous system? SATA a. A client's Chvostek sign would be negative b. A client's Trousseau sign would be positive c. A client would be suffering from paresthesias d. A client would show signs of anxiety and irratibility e. A client's central nervous system should have decreased activity

b. A client's Trousseau sign would be positive c. A client would be suffering from paresthesias d. A client would show signs of anxiety and irratibility

When ammonia is excreted by healthy kidneys, which mechanism usually is maintained? a. osmotic pressure of the blood b. acid-base balance of the body c. low bacterial levels in the urine d. normal red blood cell production

b. acid-base balance of the body

Which complication would the nurse monitor for when caring for an infant with intractable vomiting? a. acidosis b. alkalosis c. hyperkalemia d. hypernatremia

b. alkalosis

When the nurse is reviewing a client's arterial blood gas results, which finding would the nurse identify as being consistent with respiratory alkalosis? a. a decreased pH, elevated PCO2 b. an elevated pH, decreased PCO2 c. a decreased pH, decreased PCO2 d. an elevated pH, elevated partial pressure of carbon dioxide (PCO2)

b. an elevated pH, decreased PCO2

The nurse recognizes which statements are true regarding the pharmacokinetic changes observed in infants? SATA a. an infant's fat content is higher b. an infant's gastric pH is less acidic c. an infant's gastric emptying is slow d. an infant's first-pass metabolism is slow e. an infant's transdermal absorption is rapid

b. an infant's gastric pH is less acidic c. an infant's gastric emptying is slow d. an infant's first-pass metabolism is slow

Which complication would the nurse prevent by addressing the needs of a hyperventilating client? a. cardiac arrest b. carbonic acid deficit c. reduction in serum pH d. excess oxygen saturation

b. carbonic acid deficit

When a client who has had a thoracotomy develops respiratory acidosis, which action would the nurse take? a. administer oral fluids b. encourage deep breathing c. increase the oxygen flow rate d. perform nasotracheal suctioning

b. encourage deep breathing

A client appears anxious, exhibiting 40 shallow respirations per minute. The client reports dizziness, light-headedness, and tingling sensations of the fingertips and around the lips. The nurse concludes that the client's symptoms are most likely related to which condition? a. eupnea b. hyperventilation c. kussmaul respirations d. carbon dioxide intoxication

b. hyperventilation

Which process is a function of antidiuretic hormone? SATA a. controlling calcium balance b. increasing arteriole constriction c. increasing tubular permeability to water d. stimulating the bone marrow to make red blood cells e. promoting sodium reabsorption in the distal convoluted tubule (DCT)

b. increasing arteriole constriction c. increasing tubular permeability to wate

The nurse assesses a client who is experiencing profound (late) hypovolemic shock. When monitoring the client's arterial blood gas results, which response would the nurse expect? a. hypokalemia b. metabolic acidosis c. respiratory alkalosis d. decreased carbo dioxide level

b. metabolic acidosis

Which complication will the nurse anticipate when caring for a client in late hypovolemic shock? a. hypokalemia b. metabolic acidosis c. respiratory alkalosis d. decreased PCO2 levels

b. metabolic acidosis

Which effect of sodium bicarbonate is the nurse trying to prevent when teaching a client about the dangers of using sodium bicarbonate regularly? a. gastric distention b. metabolic alkalosis c. chronic constipation d. cardiac dysrhythmias

b. metabolic alkalosis

Which manifestation would the nurse expect to find when assessing a client with hypoglycemia? SATA a. thirst b. palpations c. diaphoresis d. slurred speech e. hyperventilation

b. palpations c. diaphoresis d. slurred speech

Which goal is the nurse trying to achieve when instructing a client with a history of frequent urinary tract infections to drink cranberry juice? a. exert a bactericidal effect against the bacteria b. prevent bacterial attachment to the bladder wall c. improve glomerular filtration rate d. relieve the symptom of dysuria

b. prevent bacterial attachment to the bladder wall

Which information would the nurse include when teaching a client about the administration of ranitidine? a. ranitidine increases gastrointestinal peristalsis b. ranitidine reduces acidity in the stomach c. ranitidine neutralizes the acid that is present in the stomach d. ranitidine stops the production of hydrochloric acid in the stomach

b. ranitidine reduces acidity in the stomach

Which chemical buffers excessive acetoacetic acid? a. potassium b. sodium bicarbonate c. carbon dioxide d. sodium chloride

b. sodium bicarbonate

A client has a fractured mandible that is immobilized with wires. For which life-threatening postoperative problem would the nurse monitor for the client? a. infection b. vomiting c. osteomyelitis d. bronchospasm

b. vomiting

Which information would the nurse include in response to a client's questioning a protein-restricted dietary change required for acute kidney injury? a. "A high-protein intake ensures an adequate daily supply of amino acids to compensate for losses." b. "Essential and nonessential amino acids are necessary in the diet to supply materials for tissue protein synthesis." c. "This diet supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the

c. "This diet supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys."

Which number would a nurse document as the client's fluid balance after an 8-hour shift where a client has 6-oz (180-mL) cup of tea and 360 mL of water, vomits 100 mL and the instilled intravenous (IV) fluids equaled the urinary output? a. 240 mL b. -340 mL c. 440 mL d. 540 mL

c. 440 mL

The nurse determined a client's arterial blood gases reflected a compensated respiratory acidosis. The pH was 7.34; which additional laboratory value did the nurse consider? a. the partial pressure of oxygen (PO2) value is 80 mmHg b. The partial pressure of carbon dioxide (PCO2) value is 60 mm Hg c. The bicarbonate (HCO3) value is 50 mEq/L (50 mmol/L) d. serum potassium value is 4 mEq/L (4 mmol/L)

c. The bicarbonate (HCO3) value is 50 mEq/L (50 mmol/L)

Which assessment finding would the nurse associate with a client with diabetic ketoacidosis? SATA a. diaphoresis b. retinopathy c. acetone breath d. increased arterial bicarbonate e. decreased arterial carbon dioxide level

c. acetone breath e. decreased arterial carbon dioxide level

When a client is newly diagnosed with chronic obstructive pulmonary disease (COPD), which action by the nurse has the highest priority? a. teach the client how to use the prescribed inhalers b. discuss the normal progression of the disease process c. ask whether the client is interested in quitting smoking d. explain the purpose of a pulmonary rehabilitation program

c. ask whether the client is interested in quitting smoking

Which factors can predispose a client with type 1 diabetes to a diabetic ketoacidotic coma? SATA a. taking too much insulin b. getting too much exercise c. excessive emotional stress d. running a fever with the flu e. eating fewer calories than prescribed

c. excessive emotional stress d. running a fever with the flu

The nurse is caring for a child with severe dehydration and its associated acid-base imbalance. Which compensatory mechanism within the body is activated to counteract the effects of the child's acid-base imbalance? a. profuse diaphoresis b. increased temperature c. increased respiratory rate d. renal retention of hydrogen ions

c. increased respiratory rate

Which insulin will the nurse prepare for the emergency treatment of ketoacidosis? a. glargine b. NPH insulin c. insulin aspart d. insulin detemir

c. insulin aspart

Which unique response is associated with diabetic ketoacidosis (DKA) that is not exhibited with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)? a. fluid loss b. glycosuria c. kussmaul respirations d. increased blood glucose level

c. kussmaul respirations

Which factor is the likely cause of the laboratory result when arterial blood gases done on a client who is being resuscitated after cardiac arrest show a low pH? a. ketoacidosis b. irregular heartbeat c. lactic acid production d. sodium bicarbonate administration

c. lactic acid production

An infant has been vomiting after each feeding and the physical assessment reveals poor skin turgor, a sunken anterior fontanel, and tremors. Which process would the nurse suspect as causing the infant's acid-base imbalance? a. retention of potassium in the cells b. loss of fluid by way of the kidneys c. loss of chloride ions through vomiting d. reduction of blood supply to body cells

c. loss of chloride ions through vomiting

A 4-month-old infant is brought to the emergency department after 2 days of diarrhea. The infant is listless and has sunken eyeballs, a depressed anterior fontanel, and poor tissue turgor. Breathing is deep, rapid, and unlabored. Stools are liquid and there ahs been no obvious urine output. Which problem would the nurse be concerned about? a. kidney failure b. mild dehydration c. metabolic acidosis d. respiratory alkalosis

c. metabolic acidosis

Which condition will improve if an intravenous (IV) solution of lactated ringer solution to replace the T-Tube output of a client who had a cholecystectomy and common bile duct exploration is effective? a. urinary stasis b. paralytic ileus c. metabolic acidosis d. increased potassium level

c. metabolic acidosis

A client arrives in the emergency department with epigastric pain and prolonged vomiting. Assessment findings include rapid and shallow respirations, dry and flushed skin, weakness, and lethargy. Which is the primary nursing concern? a. acute pain b. risk for injury c. metabolic alkalosis d. ineffective breathing

c. metabolic alkalosis

A client is hospitalized after 4 days of epigastric pain, nausea, and vomiting. The nurse reviews the laboratory test results: plasma pH: 7.51 pCO2: 50 mm Hg Bicarbonate 58 mEq/L (58 mmol/L) Chloride 55 mEq/L (3.8 mmol/L) Sodium 132 mEq/L (132 mmol/L) Potassium 3.8 mEq/L (3.8 mmol/L) Which condition does the nurse determine the results indicate? a. hypernatremia b. hyperchloremia c. metabolic alkalosis d. respiratory acidosis

c. metabolic alkalosis

Which diagnosis is suspected by the nurse when the laboratory data for a client with prolonged vomiting reveal arterial blood gases of pH 7.51 PCO2 : 45 mmHg HCO3 : 58 mEq/L (59 mmol/L) Serum potassium level of 3.8 mEq/L (3.8)? a. hypocapnia b. hyperkalemia c. metabolic alkalosis d. respiratory acidosis

c. metabolic alkalosis

The nurse is caring for a client with following arterial blood gas (ABG) values: PO2: 89 PCO2: 35 pH: 7.37 These findings indicate that the client is experiencing which condition? a. respiratory alkalosis b. poor oxygen perfusion c. normal acid-base balance d. compensated metabolic acidosis

c. normal acid-base balance

A child with type 1 diabetes is admitted to the hospital with deep, rapid respirations; flushed, dry cheeks; abdominal pain with nausea; and increased thirst. Which laboratory findings are the nurse most likely to observe? a. pH 7.25; glucose 60 mg/dL (3.3 mmol/L) b. pH 7.50; glucose 60 mg/dL (3.3 mmol/L) c. pH 7.25; glucose 460 mg/dL (25.5 mmol/L) d. pH 7.50; glucose 460 mg/dL (25.5 mmol/L)

c. pH 7.25; glucose 460 mg/dL (25.5 mmol/L)

Which blood gas report most likely reflects the acid-base balance of an infant with severe dehydration? a. pH of 7.50 and Pco2 of 34 mm Hg b. pH of 7.23 and Pco2 of 70 mm Hg c. pH of 7.20 and HCO3 of 20 mEq/L (20 mmol/L) d. pH of 7.56 and HCO3 of 30 mEq/L (30 mmol/L)

c. pH of 7.20 and HCO3 of 20 mEq/L (20 mmol/L)

After a gastrectomy, a client has a nasogastric tube set to low continuous suction. The client begins to hyperventilate. How would the nurse anticipate that this breathing pattern will alter the client's arterial blood gases? a. Increased the PO2 level b. Decrease the pH level c. Increase the HCO3 level d. Decrease the pCO2 level

d. Decrease the pCO2 level

The arterial blood gases for a client with acute respiratory distress are pH 7.30 PaO2: 80 mm Hg (10.64 kPa) PaCO2: 55 mm Hg (7.32 kPa) HCO3: 23 mEq/L (23 mmol) How would the nurse interpret these findings? a. Hypoxemia b. Hypocapnia c. Compensated metabolic acidosis d. Uncompensated respiratory acidosis

d. Uncompensated respiratory acidosis

The assessment of a newly admitted client reveals malnourishment, nausea, distention, and a firm abdomen with ascites. The client has tachycardia and is hypotensive. Which physiological change occurred that resulted in the client's development of ascites? a. an increase in vitamins to maintain cell coenzyme functions b. an increase in iron to maintain adequate hemoglobin synthesis c. a decrease in sodium to maintain its concentration in tissue fluid d. a decrease in plasma protein to maintain a

d. a decrease in plasma protein to maintain adequate capillary-tissue circulation

Which information would the nurse reinforce when teaching a client with gastroesophageal reflux disease (GERD) about antacid therapy? a. Antacids should be taken 1 hour before meals b. these should be scheduled at 4 hour intervals c. antacid tablets are just as fast and effective as the liquid form d. antacids commonly interfere with the absorption of other medications

d. antacids commonly interfere with the absorption of other medications

Which laboratory results support the nurse's suspicion that a client diagnosed with type 1 diabetes is experiencing ketoacidosis? a. blood glucose of 40 mg/100 mL (2.2 mmol/L), blood pH of 7.37 b. blood glucose of 130 mg/100 mL (7.2 mmol/L), blood pH of 7.35 c. blood glucose of 650 mg/100 mL (36.1 mmol/L), blood pH of 7.42 d. blood glucose of 300 mg/100 mL (16.7 mmol/L), blood pH of 7.20

d. blood glucose of 300 mg/100 mL (16.7 mmol/L), blood pH of 7.20

Which complication is the most serious for a client with kidney failure? a. anemia b. weight loss c. uremic frost d. hyperkalemia

d. hyperkalemia

The nurse is taking the sexual health history of and adolescent when the adolescent begins to perspire and hyperventilate. The client reports feeling dizzy and short of breath. Which condition would the nurse suspect? a. metabolic alkalosis b. respiratory acidosis c. pulmonary hypertension d. hyperventilation syndrome

d. hyperventilation syndrome

A critically ill 5-year-old child exhibits Kussmaul respirations. Which response would the nurse suspect may be causing an increasing acid-base imbalance? a. metabolic alkalosis caused by an increase in base bicarbonate b. respiratory alkalosis caused by excess carbon dioxide (CO2) output c. respiratory acidosis caused by an accumulation of CO2 d. metabolic acidosis caused by a concentration of cations in body fluids

d. metabolic acidosis caused by a concentration of cations in body fluids

The nurse providing postoperative care for a client who had kidney surgery review the client's urinalysis report. Which urinary finding indicates the need to notify the primary health care provider? a. acidic pH b. glucose negative c. bacteria negative d. presence of large proteins

d. presence of large proteins

Which caring intervention helps provide comfort, dignity, respect, and peace to a client? a. listening b. spiritual caring c. providing presence d. relieving pain and suffering

d. relieving pain and suffering

Which rationale explains why intravenous (IV) potassium is prescribed in addition to regular insulin for clients in diabetic ketosis? a. potassium loss occurs rapidly from diaphoresis present during coma b. potassium is carried with glucose to the kidneys to be excreted in the urine in increased amounts c. potassium is quickly used up during the rapid series of catabolic reactions stimulated by insulin and glucose d. serum potassium levels will decrease as potassium ions shift from the extracel

d. serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment

Which medication corrects for deleterious effects of anaerobic energy production when a client's cells are deprived of oxygen during a cardiac arrest? a. regular insulin b. calcium gluconate c. potassium chloride d. sodium bicarbonate

d. sodium bicarbonate

An infant with a 3-day history of decreased fluid intake and diarrhea is admitted with dehydration and lethargy. Which explanation would the nurse give the parent for the infant's rapid deterioration? a. cellular metabolism is unstable in young children b. renal function is immature in children until they reach school age c. the proportion of water in the body is less in infants than that in adults d. the extracellular fluid requirement per unit of body weight i greater in infants than in adults

d. the extracellular fluid requirement per unit of body weight i greater in infants than in adults

An older adult is hospitalized for weight loss and dehydration due to nutritional deficit. Which factor would the nurse consider when planning care for this client? a. financial resources usually are unrelated to nutritional status b. an older adults daily intake must be markedly increased c. the client's diet should be high in carbohydrates and low in proteins d. the nutritional needs of an older adult are basically unchanged except for a decreased need for calories

d. the nutritional needs of an older adult are basically unchanged except for a decreased need for calories

Which factor may have precipitated ketoacidosis in a client with type 1 diabetes who has been adhering to a prescribed insulin regimen? a. increased exercise b. decreased food intake c. working the night shift d. upper respiratory infection

d. upper respiratory infection