You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these results?
- A. Respiratory acidosis with no compensation
- B. Metabolic alkalosis with a compensatory alkalosis
- C. Metabolic acidosis with no compensation
- D. Metabolic acidosis with a compensatory respiratory alkalosis
Correct Answer: D
Rationale: A low pH indicates acidosis (normal pH is 7.35 to 7.45). The PaCO2 is also low, which causes alkalosis. The bicarbonate is low, which causes acidosis. The pH bicarbonate more closely corresponds with a decrease in pH, making the metabolic component the primary problem. Therefore, the correct interpretation of the arterial blood gas results is metabolic acidosis with a compensatory respiratory alkalosis. Choices A, B, and C are incorrect because they do not accurately reflect the primary acid-base disturbance and the compensatory response seen in the given results.
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Which substance dissociates into ions in a water solution?
- A. Intracellular fluid
- B. Interstitial fluid
- C. Plasma
- D. Electrolyte
Correct Answer: D
Rationale: The correct answer is 'Electrolyte.' Electrolytes are substances that dissociate into ions when dissolved in water. Intracellular fluid, interstitial fluid, and plasma are not substances that dissociate into ions in a water solution. Intracellular fluid is the fluid inside cells, interstitial fluid is the fluid between cells, and plasma is the liquid component of blood. These choices do not dissociate into ions in a water solution, unlike electrolytes.
The term used to describe a blood sodium level of more than 145 mEq/L is:
- A. hyponatremia.
- B. hyperkalemia.
- C. hypernatremia.
- D. hypercalcemia.
Correct Answer: C
Rationale: The correct answer is C: hypernatremia. Hypernatremia refers to an elevated level of sodium in the blood, specifically when it is more than 145 mEq/L. Choice A, hyponatremia, is incorrect as it refers to low sodium levels. Choice B, hyperkalemia, is incorrect as it refers to high potassium levels, not sodium. Choice D, hypercalcemia, is also incorrect as it relates to elevated calcium levels, not sodium.
Who would have the greatest percentage of body water?
- A. an obese male
- B. a nonobese male
- C. a nonobese female
- D. a newborn
Correct Answer: D
Rationale: Newborns have a higher percentage of body water compared to adults due to their higher body fluid content. Factors such as the higher ratio of body surface area to body volume and lower body fat content contribute to this. This is why a newborn would have the greatest percentage of body water. Choices A, B, and C are incorrect because obesity and gender do not determine the percentage of body water in individuals. Therefore, the correct answer is a newborn.
A nurse is caring for a patient who requires measurement of specific gravity every 4 hours. What does this test detect?
- A. Nutritional deficit
- B. Hyperkalemia
- C. Hypercalcemia
- D. Fluid volume status
Correct Answer: D
Rationale: Specific gravity is a test used to determine the concentration of solutes in the urine, reflecting the kidney's ability to concentrate urine. Changes in specific gravity can indicate fluid volume status, such as dehydration (fluid volume deficit) or overhydration (fluid volume excess). Options A, B, and C are incorrect as specific gravity does not directly detect nutritional deficits, hyperkalemia, or hypercalcemia.
You are working on a burns unit, and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance?
- A. Metabolic alkalosis
- B. Hypermagnesemia
- C. Hypercalcemia
- D. Hypovolemia
Correct Answer: D
Rationale: When a patient exhibits signs and symptoms of third-spacing, where fluid moves out of the intravascular space but not into the intracellular space, hypovolemia is expected. This leads to a decreased circulating blood volume. Increased calcium and magnesium levels are not typically associated with third-spacing fluid shift. Burns usually result in acidosis rather than alkalosis, making metabolic alkalosis an incorrect choice. Therefore, hypovolemia is the correct answer in this scenario.