Question

A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a PaCO₂ of 50 mm Hg. The nurse should identify that the client is experiencing which of the following acid-base imbalances?

Answer 1

Correct Answers:

Respiratory acidosis

Rationale :

🔹A pH of 7.30 (acidic) and a PaCO₂ of 50 mm Hg (elevated) indicate respiratory acidosis, which results from hypoventilation and CO₂ retention.

🔹 CO₂ is an acidic gas, and its accumulation lowers blood pH.

🔹 Common causes include respiratory depression, chronic obstructive pulmonary disease (COPD), or drug overdose.

🔹 This imbalance reflects impaired gas exchange or inadequate ventilation, requiring interventions to improve respiratory function.

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Answer 2

Correct Answers:

25 mg/dL

Rationale :

Normal BUN (blood urea nitrogen) levels range from 7 to 20 mg/dL.
A BUN of 25 mg/dL is elevated and may indicate dehydration, as decreased intravascular volume reduces renal perfusion, concentrating waste products.
In the context of dehydration, this value reflects reduced kidney clearance and warrants prompt provider notification for fluid replacement strategies.

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Answer 3

Correct Answers:

Extracellular fluid deficit

Rationale :

Severe burns cause significant loss of plasma and interstitial fluid due to increased capillary permeability and fluid shifts.
This leads to an extracellular fluid (ECF) deficit, manifesting as hypovolemia, hypotension, and decreased urine output.
Managing ECF loss with fluid resuscitation (e.g., lactated Ringer's) is the first priority in burn care.
The intracellular compartment remains initially unaffected.

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Answer 4

Correct Answers:

Respiratory acidosis

Rationale :

💎A respiratory rate of 7 breaths/min indicates hypoventilation, leading to CO₂ retention and a drop in pH.

💎This is classic for respiratory acidosis.

💎 It results from impaired respiratory drive or neuromuscular compromise, requiring interventions such as oxygen support or mechanical ventilation to correct gas exchange and restore acid-base balance.

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Answer 5

Correct Answers:

Other electrolyte disturbances

Rationale :

💎Hypocalcemia frequently occurs alongside other electrolyte imbalances, especially hypomagnesemia and hypokalemia, due to shared regulatory pathways.

💎 These coexisting deficiencies can worsen neuromuscular symptoms and complicate treatment.

💎Therefore, monitoring for multiple electrolyte abnormalities is essential to guide comprehensive correction and prevent complications such as arrhythmias and tetany.

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Answer 6

Correct Answers:

Warm, flushed skin

Rationale :

💎In respiratory acidosis, elevated CO₂ (hypercapnia) causes vasodilation, resulting in warm, flushed skin. CO₂ acts as a vasodilator in peripheral circulation.

💎Other findings like bradycardia, confusion, or drowsiness may occur due to CNS depression, but flushed skin is a direct vascular response.

💎 This symptom is typical in acute respiratory failure or CO₂ narcosis.

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Answer 7

Correct Answers:

Thiazide diuretic

Rationale :

💎Thiazide diuretics promote renal potassium excretion, leading to hypokalemia.

💎They are commonly used for hypertension and heart failure, but prolonged use without potassium-sparing agents or supplements can cause significant deficits.

💎Hypokalemia increases the risk of muscle weakness, arrhythmias, and fatigue.

💎The nurse should review diuretic use when potassium levels are low.

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Answer 8

Correct Answers:

Client has an NG tube to gastric suction.

Rationale :

💎Gastric suctioning removes hydrogen ions and potassium from the stomach, contributing to hypokalemia.

💎 Prolonged suction leads to electrolyte imbalances, especially when not adequately replaced.

💎While alcohol abuse can also lower potassium, NG suction is the most direct cause in this scenario and requires electrolyte monitoring and supplementation.

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Answer 9

Correct Answers:

sodium 155 mEq/L
Urine specific gravity 1.035

Rationale :

💎Sodium 155 mEq/L

In fluid volume deficit, water loss exceeds sodium loss, leading to hemoconcentration and hypernatremia (elevated serum sodium).
This occurs because the body retains sodium while losing water through vomiting, diarrhea, or inadequate intake.
A sodium level >145 mEq/L reflects this imbalance and is a key indicator of dehydration.

💎Urine Specific Gravity 1.035

The kidneys conserve water during dehydration, producing highly concentrated urine.
A specific gravity >1.030 indicates reduced water excretion and increased solute concentration, matching the body’s attempt to compensate for fluid loss.
This finding is particularly significant in early dehydration before other labs (e.g., hematocrit) rise.

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Answer 10

Correct Answers:

Seizures

Rationale :

Hypernatremia (serum sodium >145 mEq/L) causes cellular dehydration, as water shifts out of cells (including neurons) to balance the high extracellular sodium concentration.
This leads to brain shrinkage, which can rupture cerebral veins and cause neurological symptoms, progressing from confusion to seizures or coma if untreated.
While cerebral bleeding (from vein rupture) is possible, seizures are the more immediate and common neurological complication.
Pulmonary edema and cardiac arrhythmias are unlikely here, as they typically occur with fluid overload (e.g., hyponatremia) or electrolyte imbalances like hyperkalemia.

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QLexNursing

1 : A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a PaCO₂ of 50 mm Hg. The nurse should identify that the client is experiencing which of the following acid-base imbalances?

2 : A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider?

3 : The nurse is planning care for a patient with severe burns. What health problem should the nurse realize that this patient could develop?

4 : A client is admited to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs?

5 : The nurse is caring for a patient diagnosed with hypocalcemia. What additional assessments should the nurse include when caring for this patient?

6 : A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?

7 : A patient is diagnosed with hypokalemia. After reviewing the patient's current medications, which drug should the nurse consider that might have contributed to the patients health problem?

8 : A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L Which of the following findings should the nurse recognize as a potential causative factor?

9 : A nurse is reviewing the laboratory results of a client who has fluid volume deficit. The nurse would expect which of the following findings?

10 : A patient is admitted with hypernatremia caused by being stranded on a boat in the Atlantic Ocean for two days without water. What is the patient at risk for developing?