Nursing Elites

1. You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these results?

• A. Respiratory acidosis with no compensation
• B. Metabolic alkalosis with a compensatory alkalosis
• C. Metabolic acidosis with no compensation
• D. Metabolic acidosis with a compensatory respiratory alkalosis

Correct answer: D

Rationale: A low pH indicates acidosis (normal pH is 7.35 to 7.45). The PaCO2 is also low, which causes alkalosis. The bicarbonate is low, which causes acidosis. The pH bicarbonate more closely corresponds with a decrease in pH, making the metabolic component the primary problem. Therefore, the correct interpretation of the arterial blood gas results is metabolic acidosis with a compensatory respiratory alkalosis. Choices A, B, and C are incorrect because they do not accurately reflect the primary acid-base disturbance and the compensatory response seen in the given results.

2. A nurse is caring for clients with electrolyte imbalances on a medical-surgical unit. Which clinical manifestations are correctly paired with the contributing electrolyte imbalance? (Select all that do not apply.)

• A. Hypokalemia Flaccid paralysis with respiratory depression
• B. Hyperphosphatemia Paresthesia with sensations of tingling and numbness
• C. . Hyponatremia Decreased level of consciousness
• D.

Correct answer: B

Rationale:

3. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would the nurse interpret the results?

• A. Respiratory acidosis with no compensation
• B. Metabolic alkalosis with a compensatory alkalosis
• C. Metabolic acidosis with no compensation
• D. Metabolic acidosis with a compensatory respiratory alkalosis

Correct answer: D

Rationale: The given arterial blood gas results show a low pH, indicating acidosis, with normal pH range being 7.35 to 7.45. The low PaCO2 suggests alkalosis, while the low bicarb level indicates acidosis. In this scenario, the primary issue is the metabolic acidosis, as the pH bicarb relationship supports this. The compensatory response to metabolic acidosis is a decrease in PaCO2, leading to a respiratory alkalosis. Therefore, the correct interpretation is 'Metabolic acidosis with a compensatory respiratory alkalosis.' Choices A, B, and C are incorrect as they do not accurately reflect the relationship between the pH, PaCO2, and HCO3 levels in the arterial blood gas results provided.

4. After teaching a client who was malnourished and is being discharged, a nurse assesses the clients understanding. Which statement indicates the client correctly understood teaching to decrease risk for the development of metabolic acidosis?

• A. I will drink at least three glasses of milk each day.
• B. . I will eat three well-balanced meals and a snack daily.
• C. . I will not take pain medication and antihistamines together.
• D. I will avoid salting my food when cooking or during meals.

Correct answer: A

Rationale:

5. A patient who is hospitalized with a possible electrolyte imbalance is disoriented and weak, has an irregular pulse, and takes hydrochlorothiazide. He most likely suffers from:

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: D

Rationale: The patient is displaying symptoms of hypokalemia, including weakness, disorientation, irregular pulse, which can lead to cardiac disturbances. Hydrochlorothiazide is a potassium-wasting diuretic that can cause hypokalemia if not accompanied by potassium replacement therapy. Hypernatremia (choice A) is characterized by high sodium levels, not potassium. Hyponatremia (choice B) is low sodium levels. Hyperkalemia (choice C) is high potassium levels, which is not consistent with the symptoms described in the question.

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