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A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: Respiratory acidosis is characterized by low pH (7.32) and high PaCO2 (56 mm Hg), with normal HCO3 indicating no metabolic compensation.
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Which rationale supports the nurse's assessment of a patient's magnesium level?
- A. The electrolyte is the most abundant intracellular cation present in the body.
- B. The electrolyte may cause extracellular fluid overload.
- C. Magnesium may affect neuromuscular excitability and contractility.
- D. The patient is at risk for hypotension when the levels of magnesium decrease.
Correct Answer: C
Rationale: Magnesium plays a crucial role in neuromuscular excitability and contractility. Abnormal magnesium levels can lead to neuromuscular symptoms such as muscle weakness, tremors, and spasms, and affect cardiac function.
Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?
- A. 0.459% saline.
- B. 0.9% NaCl.
- C. 5% dextrose in 0.45% saline.
- D. Dextran.
Correct Answer: B
Rationale: 0.9% NaCl (normal saline) is an isotonic solution ideal for hypovolemic shock, expanding intravascular volume without causing fluid shifts.
The nurse notes that a patient has a smooth and shiny tongue surface. The nurse would attribute these findings to which condition?
- A. The patient has neutropenia.
- B. The patient has polycythemia.
- C. The patient has pernicious anemia.
- D. The patient has elevated estrogen levels.
Correct Answer: C
Rationale: Pernicious anemia causes glossitis, leading to a smooth and shiny tongue surface due to vitamin B12 deficiency.
In which type of water would a submersion injury cause the patient's fluid to be drawn from the vascular space into the alveoli, impairing alveolar ventilation and resulting in hypoxia?
- A. Hypotonic saltwater.
- B. Hypertonic saltwater.
- C. Hypotonic freshwater.
- D. Hypertonic freshwater.
Correct Answer: B
Rationale: Hypertonic saltwater draws fluid into the alveoli due to its higher solute concentration, impairing ventilation and causing hypoxia.
The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
- A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.
- B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.
- C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.
- D. Sodium level of 144 mEq/L, potassium level of 3.7 PROTOCOL mEq/L.
Correct Answer: C
Rationale: Normal sodium (135 mEq/L) and potassium (3.6 mEq/L) levels support changing to a lower potassium IV (20 mEq KCl/L) to prevent hyperkalemia while maintaining hydration.