The arterial blood gas (ABG) results for a patient who overdosed on barbiturates are pH = 7.32, PaCO2 = 52, and HCO3 = 23. Which interpretation would the nurse rely on when planning the patient's care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: The given ABG results indicate a low pH (acidosis), an elevated PaCO2 (respiratory component), and a normal HCO3 (metabolic component). The low pH and increased PaCO2 suggest respiratory acidosis.
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A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: B
Rationale: Metabolic alkalosis is indicated by a high pH (7.48) and elevated HCO3- (30 mEq/L), with normal PaCO2, suggesting no respiratory involvement.
Which role is attributed to the base in the acid-base balance?
- A. Does not interact with acids.
- B. Promotes the excretion of acid.
- C. Activates the system of acid-base balance.
- D. Increases the action of the hydrogen ions.
Correct Answer: B
Rationale: Bases, like bicarbonate, promote acid excretion by neutralizing hydrogen ions, aiding in maintaining acid-base balance.
Which change occurs first, making patients susceptible to coronary artery disease?
- A. Formation of thrombus in the coronary artery.
- B. Formation of fibrous plaque in the endothelium.
- C. Reduction of blood flow through the coronary arteries.
- D. Development of fatty streaks in the smooth muscles of the endothelium.
Correct Answer: D
Rationale: Development of fatty streaks in the endothelium is the initial change in atherosclerosis, predisposing patients to coronary artery disease.
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 is teaching a patient about the administration of liquid iron supplements. Which response by the patient indicates the need for additional teaching?
- A. I will take my iron supplement with a straw.
- B. I will take my iron supplement at bedtime.
- C. I will take my iron supplement along with meals.
- D. I will take my iron supplement along with orange juice.
Correct Answer: C
Rationale: Taking iron supplements with meals decreases absorption, indicating a need for further teaching; iron should be taken on an empty stomach or with vitamin C.
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