Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?
A. HCO3 above 26 mEq/L
B. PaCO2 above 45 mm Hg
C. PaO2 below 70 mm Hg
D. pH below 7.35
Metabolic acidosis is characterized by a low pH, indicating acidemia. The other ABG values typically associated with metabolic acidosis are: HCO3 (bicarbonate) below 22 mEq/L: Metabolic acidosis is often accompanied by a decreased bicarbonate level, as it indicates a loss or insufficient production of bicarbonate, leading to an acid-base imbalance. PaCO2 (partial pressure of carbon dioxide) can vary in metabolic acidosis. While it may be elevated in some cases due to compensatory mechanisms, it is not a defining characteristic of metabolic acidosis. Therefore, the PaCO2 value alone may not always be indicative of metabolic acidosis. PaO2 (partial pressure of oxygen) below 70 mm Hg is not specific to metabolic acidosis and is more related to oxygenation status rather than acid-base balance.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Med surg exam 1A Proctored Exam. Take the full exam now
Similar Questions
Client is admitted following cerebrovascular accident (CVA). Client is alert and oriented. Heart rate regular. Respirations rapid and non-labored. Wheezing auscultated in upper lobes of the lungs. Client is receiving 2 U/min of oxygen via nasal cannula. Right upper and lower extremities flaccid with decreased muscle tone and strength.
Client sitting up in a chair for lunch. Client states they are right-handed and are having difficulty feeding themselves.
For which of the following interprofessional team members should the nurse anticipate a provider's referral?
Select all that apply.
A. Case manager
B. Respiratory therapist
C. Diabetes nurse educator
D. Physical therapist
Based on the provided information, the nurse should anticipate a provider's referral to the following interprofessional team members: Physical therapist: The client is experiencing flaccid paralysis and decreased muscle tone and strength in the right upper and lower extremities. A physical therapist can assess the client's mobility, strength, and coordination and develop a plan to improve motor function and mobility. Occupational therapist: The client is having difficulty feeding themselves due to being right-handed. An occupational therapist can evaluate the client's self-care abilities, including feeding skills, and provide interventions to improve independence and functional abilities. The following interprofessional team members may not be directly related to the client's current presentation and needs based on the given information: Case manager: Although a case manager can assist with coordination of care, in this scenario, the immediate need is focused on rehabilitation and functional recovery. Respiratory therapist: While the client is receiving oxygen via nasal cannula and wheezing is auscultated, the primary respiratory issue is not the focus of the client's current difficulty with feeding. Diabetes nurse educator: The client's current presentation does not indicate a specific need related to diabetes management, so a referral to a diabetes nurse educator may not be necessary at this time. Enterostomal therapy nurse: There is no indication in the information provided that the client requires specialized care related to enterostomal therapy. Therefore, the nurse should anticipate a referral to a physical therapist and an occupational therapist for the client's rehabilitation needs and assistance with feeding difficulties.
E. Occupational therapist
A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 48 mm Hg and the HCO, is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Respiratory acidosis occurs when there is an excess of carbon dioxide (PaCO2) in the blood, leading to a decrease in pH. The ABG values that support this analysis are as follows: pH 7.32: A pH below the normal range of 7.35-7.45 indicates acidosis. PaCO2 48 mm Hg: An elevated PaCO2 level is consistent with respiratory acidosis. The normal range for PaCO2 is typically 35-45 mm Hg, so a value of 48 mm Hg indicates an excess of carbon dioxide. HCO3- (bicarbonate) 23 mEq/L: The bicarbonate level is within the normal range. In respiratory acidosis, the kidneys typically respond to compensate for the acidosis by retaining bicarbonate, but the bicarbonate level remains within the normal range.
A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicates fluid volume excess? (Select all that apply.)
A. Crackles upon auscultation
Explanation: Fluid volume excess can result in the accumulation of fluid in the lungs, leading to pulmonary congestion. This can manifest as crackles or rales heard upon auscultation of the lung fields. Increased fluid volume can lead to an increase in stroke volume, resulting in a bounding pulse. This can be felt as a forceful and strong pulse. Fluid volume excess can cause the accumulation of fluid in the interstitial spaces, leading to pitting edema. When pressure is applied to the edematous area, an indentation or "pit" remains after releasing the pressure. The following findings are not typically associated with fluid volume excess: Swelling at the IV site is more commonly associated with local inflammation or infiltration of the IV site rather than fluid volume excess. A urine-specific gravity greater than 1.030 typically indicates concentrated urine and is more indicative of fluid volume deficit or dehydration rather than fluid volume excess. In fluid volume excess, the urine-specific gravity is usually lower due to the dilution of urine caused by increased fluid intake. A nurse is caring for a client who is unconscious and
B. Bounding pulse
C. Pitting edema
D. Swelling at the IV site
E. Urine-specific gravity greater than 1.030