Page 293 - Saunders Comprehensive Review For NCLEX-RN

occurs. Bradypnea describes respirations that are regular but abnormally slow.
Hyperkalemia is associated with acidosis.
Test-Taking Strategy: Focus on the subject, the interpretation of ABG values. Note
the data in the question to determine that the client is experiencing respiratory
alkalosis. Next, it is necessary to think about the pathophysiology that occurs in this
acid-base condition and recall the manifestations that occur.
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: Ignatavicius, Workman, Rebar (2018), pp. 196-197.

61. Answer: 1

Rationale: Atelectasis is a condition characterized by the collapse of alveoli,
preventing the respiratory exchange of oxygen and carbon dioxide in a part of the
lungs. The normal pH is 7.35 to 7.45. The normal Paco is 35 to 45 mm Hg (35 to
2
45 mm Hg). In respiratory acidosis, the pH is decreased and the Paco is elevated.
2
Option 2 identifies normal values. Option 3 identifies an alkalotic condition, and
option 4 identifies respiratory alkalosis.
Test-Taking Strategy: Focus on the subject, the arterial blood gas results in a client
with atelectasis. Remember that in a respiratory imbalance you will find an opposite
response between the pH and the Paco . Also, remember that the pH is decreased in
2
an acidotic condition. First eliminate option 2 because it reflects a normal blood gas
result. Options 3 and 4 identify an elevated pH, indicating an alkalotic condition.
The correct option is the only one that reflects an acidotic condition.
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.

62. Answer: 2

Rationale: Respiratory alkalosis is defined as a deficit of carbonic acid or a
decrease in hydrogen ion concentration 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 that cause overstimulation of the respiratory system. Some clinical
manifestations of respiratory alkalosis include lightheadedness, confusion,
tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, diarrhea,
epigastric pain, and numbness and tingling of the extremities. All three incorrect
options identify normal laboratory values. The correct option identifies the presence
of hypokalemia.

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