Nokea
Which of the following abnormalities in the arterial blood gas (ABG) would be consistent with a client who has overdosed on clonazepam?
- A. metabolic acidosis
- B. metabolic alkalosis, fully compensated
- C. respiratory alkalosis
- D. respiratory acidosis
Correct Answer: D
Rationale: Clonazepam, a benzodiazepine, depresses the central nervous system, reducing respiratory drive and causing CO2 retention, leading to respiratory acidosis (D). Metabolic acidosis (A), metabolic alkalosis (B), and respiratory alkalosis (C) are not typical.
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Which of the following arterial blood gas (ABG) results would the nurse expect if the client's condition is left untreated?
- A. pH 7.50, PCO2 48, PaO2 70, HCO3 44, SaO2 88%
- B. pH 7.28, PCO2 53, PaO2 55, HCO3 28, SaO2 82%
- C. pH 7.36, PCO2 44, PaO2 66, HCO3 28, SaO2 84%
- D. pH 7.48, PCO2 48, PaO2 70, HCO3 24, SaO2 86%
Correct Answer: B
Rationale: Untreated ARDS causes severe hypoxemia and CO2 retention, leading to respiratory acidosis. Option B (pH 7.28, PaCO2 53, PaO2 55, SaO2 82%) reflects this.
The nurse should interpret these results to indicate that the client has Laboratory: pH 7.50 [7.35-7.45], PaCO2 28 mmHg [35-45 mm Hg], HCO3- 25 mEq/L [22-28 mEq/L]
- A. metabolic alkalosis
- B. respiratory acidosis
- C. respiratory alkalosis
- D. metabolic acidosis
Correct Answer: C
Rationale: High pH (7.50) and low PaCO2 (28 mm Hg) with normal HCO3- indicate respiratory alkalosis (C) due to hyperventilation.
The nurse caring for a client in the intensive care unit (ICU) is reviewing the arterial blood gas (ABG) results, which reveal a PaO2 = 70 mm Hg [80-100 mm Hg]. On assessment, the client has labored breathing, tachypnea, and an altered mental status. The nurse should anticipate the physician will order
- A. intubation via endotracheal tube (ETT)
- B. 12-lead electrocardiogram (ECG)
- C. capillary blood glucose
- D. the insertion of an additional peripheral vascular access device (PVAD)
Correct Answer: A
Rationale: Low PaO2 (70 mm Hg) with labored breathing, tachypnea, and altered mental status suggests severe hypoxemia, warranting intubation (A) for airway protection and ventilation. ECG (B), glucose (C), and PVAD (D) do not address hypoxemia.
The nurse is reviewing a client's arterial blood gas (ABG) results who has a nasogastric tube (NGT) attached to continuous suction. The ABG results reveal the following: pH 7.50 [7.35-7.45], PaCO2 42 mmHg [35-45 mm Hg], HCO3- 35 mEq/L [22-28 mEq/L]. The nurse should interpret these results to indicate that the client has
- A. respiratory acidosis
- B. respiratory alkalosis
- C. metabolic acidosis
- D. metabolic alkalosis
Correct Answer: D
Rationale: High pH (7.50) and elevated HCO3- (35 mEq/L) with normal PaCO2 indicate metabolic alkalosis (D), likely due to loss of gastric acid from NGT suction.
The emergency department (ED) nurse cares for a client who reports persistent nausea and vomiting for three days. Which acid-base imbalance would the nurse expect based on the client's manifestations?
- A. A decreased pH and an elevated CO2
- B. An elevated pH and a decreased CO2
- C. A decreased pH and a decreased HCO3-
- D. An increased pH with an increased HCO3-
Correct Answer: D
Rationale: Persistent vomiting causes loss of gastric acid, increasing HCO3- and pH, leading to metabolic alkalosis (D).