Page 290 - Saunders Comprehensive Review For NCLEX-RN

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54. Answer: 2

Rationale: The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite
effect will be seen between the pH and the Paco . In this situation, the pH is at the
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high end of the normal value and the Pco is low. In an alkalotic condition, the pH is
2
elevated. Therefore, the values identified in the question indicate a respiratory
alkalosis that is compensated by the kidneys through the renal excretion of
bicarbonate. Because the pH has returned to a normal value, compensation has
occurred.
Test-Taking Strategy: Focus on the data in the question, noting the arterial blood
gas results. Remember that in a respiratory imbalance you will find an opposite
response between the pH and the Pco as indicated in the question. Therefore, you
2
can eliminate the options reflective of a primary metabolic problem. Also, remember
that the pH increases in an alkalotic condition and compensation can be evidenced
by a normal pH. The correct option reflects a respiratory alkalotic condition and
compensation and describes the blood gas values as indicated in the question.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Foundations of Care: Acid-Base
Health Problem: N/A
Priority Concepts: Acid-Base Balance; Clinical Judgment
Reference: Lewis et al. (2017), p. 288.

55. Answer: 2

Rationale:Metabolic alkalosis is defined as a deficit or loss of hydrogen ions or acids
or an excess of base (bicarbonate) that results from the accumulation of base or from
a loss of acid without a comparable loss of base in the body fluids. This occurs in
conditions resulting in hypovolemia, the loss of gastric fluid, excessive bicarbonate
intake, the massive transfusion of whole blood, and hyperaldosteronism. Loss of
gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result
of the loss of hydrochloric acid. The remaining options are incorrect interpretations.
Test-Taking Strategy: Focus on the data in the question, a client with a
nasogastric tube attached to suction. Remembering that a client receiving nasogastric
suction loses hydrochloric acid will direct you to the option identifying an alkalotic
condition. Because the question addresses a situation other than a respiratory one,
the acid-base disorder would be a metabolic condition.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Foundations of Care: Acid-Base

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