Nokea
Which acid-base mechanism would the kidney use to buffer a patient's acidosis (serum pH <7.35)? Select all that apply.
- A. Eliminating excess H+.
- B. Excreting excess water.
- C. Eliminating excess CO2.
- D. Reabsorbing additional HCO3-.
- E. Reabsorbing additional sodium ions.
Correct Answer: A,D
Rationale: The kidneys buffer acidosis by eliminating excess hydrogen ions (H+) and reabsorbing additional bicarbonate ions (HCO3-) to neutralize acid and raise pH.
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The nurse receives information about the assigned patients during shift report. Which patient would the nurse assess first?
- A. A patient who reports dizziness with a blood pressure (BP) of 150/92 mm Hg.
- B. A patient who reports a severe headache and has begun vomiting.
- C. A patient with a hip fracture who reports a pain level of 2 on a 1-to-10 scale.
- D. A patient who received an angiotensin-converting enzyme (ACE) inhibitor 30 minutes previously and reports fatigue.
Correct Answer: B
Rationale: A severe headache and vomiting could be indicative of a serious neurological condition such as a stroke, intracranial bleeding, or increased intracranial pressure. This patient needs urgent assessment and intervention to prevent potential complications.
Which goal is a primary objective for a patient who has chronic heart failure (HF)?
- A. Maximizing cardiac output.
- B. Maintaining ideal body weight.
- C. Performing daily aerobic exercises.
- D. Maintaining a steady pulse oximetry reading.
Correct Answer: A
Rationale: Maximizing cardiac output is a primary goal for patients with chronic heart failure (HF) because it helps improve tissue perfusion and oxygen delivery to meet the body's demands. It is a crucial aspect of managing heart failure and preventing further complications.
Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?
- A. pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.
- B. pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.
- C. pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.
- D. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Correct Answer: D
Rationale: Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The data in option D (pH = 7.52, PaCO2 = 24 mm Hg) indicates respiratory alkalosis.
Which information will the nurse include when teaching a patient who is receiving chemotherapy for leukemia?
- A. The treatment has severe side effects, some of which will be permanent.
- B. You need to use your call light to ask for help every time you get out of bed.
- C. Prevention and early detection of infection are important during leukemia treatment.
- D. Feeling isolated is a common and unavoidable consequence of leukemia treatment.
Correct Answer: C
Rationale: Prevention and early detection of infection are critical during leukemia chemotherapy due to immune suppression, a key patient education point.
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.