Nokea
What do the following ABG values indicate: pH 7.38, PO2 78 mmHg, PCO2 36 mmHg, and HCO3 24 mEq/L?
- A. metabolic alkalosis
- B. homeostasis
- C. respiratory acidosis
- D. respiratory alkalosis
Correct Answer: B
Rationale: These ABG values are within normal limits. Choices A, C, and D are incorrect because the ABG values indicate none of these acid-base disturbances.
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A client newly diagnosed with Diabetes Mellitus needs education. Which of the following statements should the nurse include in this education?
- A. You can eat anything you want, but no foods with sugar.'
- B. You need to lose weight, so your diet must be a restricted one.'
- C. You need a diet and exercise program.'
- D. You must eliminate all salt, fat, and sugar from your diet.'
Correct Answer: C
Rationale: A balanced diet and exercise program are essential for managing diabetes, promoting glycemic control and overall health without extreme restrictions.
Clients who take iron preparations should be warned of the possible side effects, which might include:
- A. dizziness and orthostatic hypotension
- B. nausea, vomiting, diarrhea or constipation, and stomach cramps
- C. drowsiness, lethargy, and fatigue
- D. neuropathy and tingling in the extremities
Correct Answer: B
Rationale: Iron supplements commonly cause gastrointestinal side effects like nausea, vomiting, diarrhea, constipation, and stomach cramps, requiring client education.
Assessment of the client with an arteriovenous fistula for hemodialysis should include:
- A. inspection for visible pulsation.
- B. palpation of thrill.
- C. percussion for dullness.
- D. auscultation of blood pressure.
Correct Answer: B
Rationale: Thrill should be present. The client should be taught to check this daily at home. Pulsation is not typically visible. Percussion gives no information about the patency of a fistula. Blood pressure is not auscultated in a limb with an AVF. Auscultation of the AVF, for a bruit, is part of an assessment for patency.
Laboratory tests reveal the following electrolyte values for Mr. Smith: Na 135 mEq/L, Ca 8.5 mg/dL, Cl 102 mEq/L, and K 2.0 mEq/L. Which of the following values should the nurse report to the physician because of its potential risk to the client?
- A. Ca
- B. K
- C. Na
- D. Cl
Correct Answer: B
Rationale: A potassium level of 2.0 mEq/L is critically low (normal 3.5-5.5 mEq/L), risking cardiac arrhythmias, and should be reported immediately.
Which of the following nursing diagnoses is most appropriate for the client experiencing acute pancreatitis?
- A. Confusion
- B. Latex Allergy
- C. Acute Pain
- D. Constipation
Correct Answer: C
Rationale: Acute Pain is most appropriate for the client experiencing acute pancreatitis, as pancreatitis causes severe abdominal pain due to inflammation and autodigestion of the pancreas.