NGN HESI EXIT MED SURG EXAM LATEST 2023 GRADED A+
1.A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The
... [Show More] client’s arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3– 18 mEq/L. Which manifestation should the nurse identify as an example of the client’s compensation mechanism?
a.Increased rate and depth of respirations
b.Increased urinary output
c.Increased thirst and hunger
d.Increased release of acids from the kidneys ANS: A
This client has metabolic acidosis. The respiratory system compensates by increasing its activity and blowing off excess carbon dioxide. Increased urinary output, thirst, and hunger are manifestations of hyperglycemia but are not compensatory mechanisms for acid-base imbalances. The kidneys do not release acids.
3.A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance should the nurse assess to prevent complications of this therapy?
a.Respiratory acidosis
b.Respiratory alkalosis
c.Metabolic acidosis
d.Metabolic alkalosis ANS: D
Many diuretics, especially loop diuretics, increase the excretion of hydrogen ions, leading to excess acid loss through the renal system. This situation is an acid deficit of metabolic origin.
5.A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?
a.Agitation
b.Kussmaul respirations
c.Seizures
d.Positive Chvostek’s sign ANS: B
The pancreas is a major site of bicarbonate production. Pancreatitis can cause a relative metabolic acidosis through underproduction of bicarbonate ions.
Manifestations of acidosis include lethargy and Kussmaul respirations. Agitation, seizures, and a positive Chvostek’s sign are manifestations of the electrolyte imbalances that accompany alkalosis.
9.After teaching a client who was malnourished and is being discharged, a nurse assesses the client’s understanding. Which statement indicates the client correctly understood teaching to decrease risk for the development of metabolic acidosis?
a.“I will drink at least three glasses of milk each day.”
b.“I will eat three well-balanced meals and a snack daily.”
c.“I will not take pain medication and antihistamines together.”
d.“I will avoid salting my food when cooking or during meals.”
ANS: B
Starvation or a diet with too few carbohydrates can lead to metabolic acidosis by forcing cells to switch to using fats for fuel and by creating ketoacids as a by-product of excessive fat metabolism. Eating sufficient calories from all food groups helps reduce this risk.
14. A nurse is planning care for a client who is hyperventilating. The client’s arterial blood gas values are pH 7.30, PaO2 94 mm Hg, PaCO2 31 mm Hg, and HCO3– 26 mEq/L. Which question should the nurse ask when developing this client’s plan of care?
a.“Do you take any over-the-counter medications?”
b.“You appear anxious. What is causing your distress?”
c.“Do you have a history of anxiety attacks?”
d.“You are breathing fast. Is this causing you to feel
light-headed? ANS: [Show Less]