Care Management Medsurg Evolve questions

An arterial blood gas report indicates the client's pH is 7.25, PCO2 is 60 mmHg, and HCO3 is 26 mEq/L. Which client is most likely to exhibit these blood gas results? - A client with pulmonary fibrosis - A client with uncontrolled Type 1 DM - A client who has been vomiting for 3 days - A client who takes sodium bicarbonate for indigestion

A client with pulmonary fibrosis

Which assessment finding in a laboring client indicates respiratory alkalosis? - A change in the respiratory rate - A tingling sensation in the hands - Periodic changes in the fetal heart rate - A pulse oximetry reading of less than 98%

A tingling sensation in the hands

Which complication would the nurse monitor for when caring for an infant with intractable vomiting? - Acidosis - Alkalosis - Hyperkalemia - Hypernatremia

Alkalosis

When the nurse is reviewing a client's ABG results, which finding would the nurse identify as being consistent with respiratory alkalosis? - A decreased pH, elevated PCO2 - An elevated pH, decreased PCO2 - A decreased pH, decreased PCO2 - An elevated pH, elevated PCO2

An elevated pH, decreased PCO2

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 agitate and starts to hyperventilate. Which instruction would the nurse provide the student? - Breathe into cupped hands - Pant using rapid, shallow breaths - Use a rapid deep=breathing pattern - Hold breathe for as long as possible

Breathe into cupped hands

The nurse assess a client who is experiencing profound (late) hypovolemic shock. When monitoring the client's ABG results, which response would the nurse expect? - Hypokalemia - Metabolic acidosis - Respiratory alkalosis - Decreased carbon dioxide level

Metabolic acidosis

Which diagnosis is suspected by the nurse when the lab data for a client with prolonged vomiting reveal ABG of pH 7.51, PCO2 45 mmHg, HCO3 58 mEq/L, and a serum potassium level of 3.8 mEq/L? - Hypocapnia - Hyperkalemia - Metabolic alkalosis - Respiratory acidosis

Metabolic alkalosis

A client with COPD has a blood pH of 7.25 and a partial pressure of CO2 of 60 mmHg. These blood gas results require nursing attention because they indicate which condition? - Metabolic acidosis - Metabolic alkalosis - Respiratory acidosis - Respiratory alkalosis

Respiratory acidosis

Which blood gas report most likely reflects the acid-base balance of an infant with severe dehydration? - pH of 7.50 and PCO2 of 34 mmHg - pH of 7.23 and PCO2 of 70 mmHg - pH of 7.20 and HCO3 of 20 mEq/L - pH of 7.56 and HCO3 of 30 mEq/L

pH of 7.20 and HCO3 of 20 mEq/L

Which complication would the nurse prevent by addressing the needs of a hyperventilating client? - Cardiac arrest - Carbonic acid deficit - Reduction in serum pH - Excess oxygen saturation

Carbonic acid deficit

The nurse is caring for a client with the following ABG values: PO2 89 mmHg, PCO2 35 mmHg, pH 7.37. These findings indicate the the client is experiencing with condition? - Respiratory alkalosis - Poor oxygen perfusion - Normal acid-base balance - Compensated metabolic acidosis

Normal acid-base balance

Which complication will the nurse anticipate when caring for a client in late hypovolemic shock? - Hypokalemia - Metabolic acidosis - Respiratory acidosis - Decreased PCO2 levels

Metabolic acidosis

A client's ABG report indicates the pH is 7.52, PCO2 is 32 mmHg and HCO3 is 24 mEq/L. Which does the nurse identify as a possible cause of these results? - Airway obstruction - Inadequate nutrition - Prolonged gastric suction - Excessive mechanical ventilation

Excessive mechanical ventilation

Which early sign of respiratory acidosis would the nurse expect the client with a restrictive airway disease to exhibit? - Headache - Irritability - Restlessness - Hypertension - Lightheadedness

Headache, irritability, restlessness

Surgery is preformed on a client with a parotid tumor. Postoperative ABG values are pH: 7.32, PCO2: 53 mmHg, and HCO3: 25 mEq/L. Which action would the nurse take? - Administer a potent diuretic - Obtain a prescription for an alkalinizing agent - Have the client breathe into a rebreather bag at a slow rate - Encourage the client to cough and then take deep breaths between coughs

Encourage the client to cough and then take deep breaths between coughs

A 3 month-old infant with a 3-day hx of diarrhea has an ABG drawn. Which acid-base imbalance would the nurse suspect? - Metabolic acidosis - Metabolic alkalosis - Respiratory acidosis - Respiratory alkalosis

Metabolic acidosis

A client arrives in the ED with epigastric pain and prolonged vomiting. Assessment findings include rapid shallow respirations, dry and flushed skin, weakness, and lethargy. Which is the primary nursing concern? - Acute pain - Risk for injury - Metabolic alkalosis - Ineffective breathing

Metabolic alkalosis

Postoperative ABG values for a client on the PACU are pH: 7.32, PaCO2: 53 mmHg, HCO3: 25 mEq/L, PaO2: 85 mmHg. Which action would the nurse take? - Plan to sent the client to the medical-surgical unit - Ask the anesthesiologist to consider reintubation - Encourage the client to take deep breaths and cough - Increase the oxygen flow rate from 4 to 6 L/min

Encourage the client to take deep breaths and cough

A client appears anxious, exhibiting 40 shallow respirations per minute. The client reports dizziness, lightheadedness, 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? - Eupnea - Hyperventilation - Kussmaul respirations - Carbon dioxide intoxication

Hyperventilation

An ABG report indicates the client's pH is 7.25, PCO2 is 35 mmHg, and HCO3 is 20 mEq/L. Which disturbance would the nurse identify based on these results? - Metabolic acidosis - Metabolic alkalosis - Respiratory acidosis - Respiratory alkalosis

Metabolic acidosis

A 4-month-old infant is brought into the ED 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 has been no obvious urine output. Which problem would the nurse be concerned about? - Kidney failure - Mild dehydration - Metabolic acidosis - Respiratory alkalosis

Metabolic acidosis

Assessment findings of a client with smoke inhalation include a negative chest x-ray and arterial blood gasses that show a PO2 of 85 mmHg, a PCO2 of 45 mmHg, and a pH of 7.35. Which interventions would the nurse anticipate will be prescribed? (SATA) - Coughing - Deep breathing - Bronchodilators - Humidified Oxygen - Bronchia sunctioning

Coughing, deep breathing, humidified oxygen

Which priority nursing intervention would the nurse implement for a client on diuretic therapy who has developed metabolic alkalosis? - Fall prevention measures - Monitoring electrolytes - Administering anitemetics - Adjusting the diuretic therapy

Fall prevention measures

When ABG results for an alert client who is in the PACU after abdominal surgery are pH: 7.37, PaCO2: 42 mmHg, HCO3: 25 mEq/L, PaO2: 65 mmHg, and SaO2: 90%, which action would the nurse take? - Increase the oxygen flow rate - Insert an oropharyngeal airway - Suction the oropharynx and upper trachea - Prepare to transfer the client out of the PACU

Increase the oxygen flow rate

A client is hospitalized after 4 days of epigastric pain, nausea, and vomiting. The nurse reviews the laboratory tests results: plasma pH: 7.51, PCO2: 50 mmHg, HCO3: 58 mEq/L, chloride: 55 mEq/L, sodium: 132 mEq/L, and potassium: 3.8 mEq/L. Which condition does the nurse determine the results indicate? - Hypernatremia - Hyperchloremia - Metabolic alkalosis - Respiratory acidosis

Metabolic alkalosis

A client with COPD has a blood pH of 7.25 and a partial pressure of CO2 of 60 mmHg. Which complication would the nurse expect the client is experiencing? - Metabolic acidosis - Metabolic alkalosis - Respiratory acidosis - Respiratory alkalosis

Respiratory acidosis

The nurse is caring for a client with the following ABG values: PO2: 89 mmHg, PCO2: 35 mmHg, pH: 7.37. These findings indicate that the client is experiencing which condition? - Respiratory acidosis - Poor oxygen perfusion - Normal acid-base balance - Compensated metabolic acidosis

Normal acid-base balance

Which ABG result for a client receiving mechanical ventilation using the pressure support ventilation mode would indicate to the nurse that the client is hyperventilating? - pH 7.28 - HCO3: 24 ,Eq/L - PaO2: 60 mmHg - PaCO2: 30 mmHg

PaCO2: 30 mmHg

Which statement made by the nurse is accurate about the manifestations of alkalosis in the central nervous system (SATA) - "A client's Trousseau sign would be positive" - "A client would be suffering from paresthesias" - "A client would show signs of anxiety and irritability" - "A client's Chvostek sign would be negative" - "A client's central nervous system should have decreased activity"

"A client's Trousseau sign would be positive" "A client would be suffering from paresthesias" "A client would show signs of anxiety and irritability"

The nurse is caring for a client after abdominal surgery and encourages the client to engage in deep-breathing exercises and turn from side to side. Which complication is the nurse trying to prevent? - Metabolic acidosis - Metabolic alkalosis - Respiratory acidosis - Respiratory alkalosis

Respiratory acidosis

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

Respiratory acidosis caused by impaired reparations and increased formation of carbonic acid