Question

TEST I. Part I.

1. A client was admitted due to blunt trauma to the chest. On x-ray, multiple rib fractures were seen and the client complains of pain on breathing. Which of the following acid-base imbalances should the nurse anticipate the client may experience?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

2. Which of the following statements by the client indicates that the discharge teaching for respiratory alkalosis is understood?
A. "I will not take so many antacids anymore."
B. "I will take a stress management class."
C. "I will not take my Lasix without taking my potassium supplement."
D. "I will tell the doctor the next time i have diarrhea for so long."

3. Your unit is admitting a client with metabolic alkalosis due to overdosing of bicarbonate-containing antacid. Which of the following should the nurse implement? Select all that apply.
A. Restrict the use of potassium-containing IV fluids
B. Administer the diuretic acetazolamide
C. Pad the side rails and put the bed at the lowest level
D. Administer sodium-potassium exchange resin enema

4. A non-compliant client with diabetes type I was rushed in the hospital for sudden loss of consciousness. Upon assessment the capillary blood sugar of the client was high at 560mg/dL, noted with ketone bodies in both her blood and urine. Which of the following assessment parameters would indicate to the nurse that client is having diabetic ketoacidosis?
A. Elevated blood pressure
B. Warm, dry skin
C. Deep, rapid respirations
D. Fever

5. A client's blood gas results are pH 7.36, PaCO2 50, HCO3 28. What do these results indicate to the nurse?
A. Respiratory acidosis, compensated
B. Metabolic acidosis, compensated
C. Metabolic acidosis, uncompensated
D. Respiratory acidosis, uncompensated

6. You are caring an unconscious patient who has been bed-bound for a long time. An ABG was done the result are as follow: pH 7.34 PaCO2 52 HCO3 23. Which of the following should the nurse implement to help correct the acid-base imbalance? Select all that apply.
A. Administer oxygen at 3-5 liters via non-rebreather face mask
B. Administer acetylcysteine
C. Humidify the client's room using a hospital-approved room humidifier
D. Restrict the client's intake of water to 1.5 liters a day
E. Turn the client every 2 hours and tap his back every 4 hours

7. You are caring for a client who is on enteral feeding via NGT. You are about to administer his 10am scheduled feeding. Having in mind that the client is prone to metabolic alkalosis due to enteral feeding, which of the following should the nurse do prior to the administration of the feed?
A. Administer 30ml of NSS prior to feeding
B. Reintroduce to the aspirated residual
C. Administer acidifying agents such as citric acid or tartaric acid supplement
D. Administer H2- receptor antagonist as prescribed

Answer 1

Question no 1

pH: 7.35-7.45.is the normal ph of our human body , but incase of rib fracture the patient will breath in a restricted manner . So it will result in the patient accumulation of co2 inthe respiratory system . As the depth of the breath is reduced this happens . The ph will reduce less than the normal and so will cause acidosis in the patient .

So the Partial pressure of co2 will increase from the normal range that is 35-45 mmHg . It will be more than 45 mmHg and will result in respiratiory acidosis in the patient

Question no 2

Option b is the correct answer as the patient stressed on stress management .

When stress patient respiratory rate increase and will result in increased in the pH of the patient . This is because the patient will exhale in increased rate and will result in respiratiory alkalosis . This alkalosis can be controlled by stress management exercise . So this is the question that show the understanding of patient

So option a, c and d are wrong