ATI Detailed Answer Key Student Success. N4581Resp Practice Questions

ATI Detailed Answer Key Student Success. N4581Resp Practice Questions QUESTIONS AND RATIONALE 1. A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 48 mm Hg and the HCO3 is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances? A. Respiratory acidosis Rationale: A number of conditions can lead to respiratory acidosis, including COPD and pneumonia. In the presence of respiratory acidosis, the client's blood gas values meet the following criteria: a pH less than 7.35, a PaCO2 greater than greater 45 mg/Hg, and a HCO3 that is normal or slightly elevated (22 to 26 mEq/mL). B. Respiratory alkalosis Rationale: Hyperventilation, from acute pain or anxiety, can causes respiratory alkalosis. In the presence of respiratory alkalosis, the client's blood gas values meet the following criteria: a pH greater than 7.45, a PaCO2 less than 35 mm Hg, and a HCO3 of 22 to 26 mEq/mL. C. Metabolic acidosis Rationale: Ketoacidosis can cause metabolic acidosis. In the presence of metabolic acidosis, the client's blood gas values meet the following criteria: a pH less than 7.35, a PaCO2 that is normal if uncompensated (35 to 45 mm/Hg), and a HCO3 less than 22 mEq/mL. D. Metabolic alkalosis Rationale: Persistent vomiting can cause metabolic alkalosis. In the presence of metabolic acidosis, the client's blood gas values meet the following criteria: a pH greater than 7.45, a PaCO2 that is normal if uncompensated (35 to 45 mm/Hg), and a HCO3 that is greater than 26 mEq/mL. 2. A nurse is providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort. Aside from managing pain, which of the following desired effects of medications should the nurse identify as most important for the client’s recovery? A. It decreases the client's level of anxiety. Rationale: The nurse should assess for and manage the client’s anxiety, as this can result in postoperative delirium. Following the administration of an opioid medication, the nurse should assess the client for relief of pain and apprehension. Even though opioid analgesics may decrease the client's level of anxiety (partially from pain reduction alone), there is another effect that is more important. B. It facilitates the client's deep breathing. Rationale: When using the airway, breathing, circulation approach to client care, the nurse should identify facilitation of deep breathing as the most important desired effect of opioids aside from pain relief. Following thoracic type surgeries, the client’s has increased pain with moving, deep breathing and coughing. Opioid medications help minimize the discomfort experienced with deep breathing and coughing which prevents the development of postoperative pneumonia. The nurse should also encourage the client to splint his incision to help minimize pain. C. It enhances the client's ability to sleep. Rationale: The nurse should take measures to facilitate sleep in the postoperative client such as providing quiet time that is undisturbed, dimming lights, and ensuring the client is comfortable and not in pain. Even though opioid analgesics may increase the client’s ability to relax and sleep, another effect is more important. D. It reduces the client's blood pressure. Rationale: The nurse should closely monitor the cardiac status of the client who is postoperative. The client who is experiencing pain releases catecholamines which produce vasoconstriction and increase blood pressure. Even though opioid analgesics may assist in reducing a client’s blood pressure, another effect is more important. 3. A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L A. Respiratory acidosis Rationale: Respiratory acidosis occurs when there is retention of CO2 due to an impairment of respiratory function. It can be the result of respiratory depression, seen with anesthesia or opioid administration; inadequate chest expansion, due to a weakness of the respiratory muscles or constriction to the thorax; an obstruction of the airway, seen in aspiration, bronchoconstriction, or laryngeal edema; or from an inability of the lungs to adequately diffuse gases (O2 and CO2), resulting from conditions such as pneumonia, COPD, chest trauma, or pulmonary emboli. Arterial blood gases will reveal a pH that is lower than the normal reference range (7.35 – 7.45) and a CO2 level that is higher than the normal reference range (35 – 45 mm Hg). B. Metabolic acidosis Rationale: Metabolic acidosis occurs when there is an alteration in the level of hydrogen ions or a reduction in the amount of bicarbonate available. It can be the result of diabetic ketoacidosis, starvation, hypoxia, renal or liver failure, dehydration, or diarrhea. Arterial blood gases will reveal a pH that is lower than the normal reference range (7.35 – 7.45) and a bicarbonate (HCO3) level that is lower than the normal reference range (21 – 28 mEq/mL). C. Metabolic alkalosis Rationale: Metabolic alkalosis occurs when there is an alteration in the level of HCO3 along with an increase in the pH of the blood. It can be the result when a client ingests too much antacid from blood transfusions or total parenteral nutrition. It can also occur if the client has prolonged vomiting or NG suction, takes thiazide diuretics, or has a metabolic disorder such as hypercortisolism or hyper aldosteronism. Arterial blood gases will reveal a pH that is higher than the normal reference range (7.35 – 7.45) and an HCO3 level that is higher than the normal reference range (35 – 45 mm Hg). D. Respiratory alkalosis Rationale: Respiratory alkalosis occurs when there is an excessive loss of CO2 through hyperventilation, mechanical ventilation, fever, overdose of salicylates, or lesions to the central nervous system. Arterial blood gases will reveal a pH that is higher than the normal reference range (7.35 – 7.45) and a CO2 level that is lower than the normal reference range (35 – 45 mm Hg). 4. A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see? A. pH below 7.35 Rationale: With acidosis, the pH is below 7.35. However, the pH alone does not indicate whether the problem is metabolic or respiratory. A pH above 7.45 indicates alkalosis. B. HCO3 above 26 mEq/L Rationale: With metabolic acidosis, the HCO3 is below 21 mEq/L. C. PaO2 below 70 mm Hg Rationale: With metabolic acidosis, the PaO2 is likely to be within the expected reference range of 80 to 100 mm Hg, unless the client has other complications that are causing hypoxia. D. PaCO2 above 45 mm Hg Rationale: With metabolic acidosis, the PaCO2 is within the expected reference range of 35 to 45 mm Hg or below 35 mm Hg with respiratory compensation. An elevated PaCO2 indicates respiratory acidosis. 5. A nurse is caring for a female client in the emergency department who reports shortness of breath and pain in the lung area. She states that she started taking birth control pills 3 weeks ago and that she smokes. Her heart rate is 110/min, respiratory rate 40/min, and blood pressure 140/80 mm Hg. Her arterial blood gases are pH 7.50, PaCO2 29 mm Hg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. Which of the following is the priority nursing intervention? A. Prepare for mechanical ventilation. Rationale: If the client cannot compensate for this acid-base imbalance and conservative treatment does not help, mechanical ventilation might become necessary; however, it is not the first step in managing this client’s imbalance. B. Administer oxygen via face mask. Rationale: The pH reflects alkalosis, and the low PaCO2 indicates that the lungs are involved, so the client has respiratory alkalosis. The client’s oxygen saturation is low, so one priority is to administer oxygen via mask attempting to achieve an oxygen saturation of at least 95%. The greatest risk to this client is hypoxia, thus the priority is to restore oxygenation. C. Prepare to administer a sedative. Rationale: In many cases, the cause of this acid-base disorder is extreme anxiety with hyperventilation and loss of CO2, as evidenced by the client’s respiratory rate of 40/min and her PaCO2 of 29. A sedative will help relieve anxiety and slow her breathing enough to correct the acid-base imbalance. However, the greatest risk to the client is hypoxia, so administering a sedative is not the priority action. D. Assess for indications of pulmonary embolism. Rationale: Pulmonary embolism is a possible cause of this type of acid-base imbalance, particularly with the client’s history of birth control pills and smoking, so the nurse should be alert for manifestations of this disorder. However, this is part of ongoing client monitoring and not the first step in managing the imbalance. 6. A nurse is caring for a client who is postoperative and whose respirations are shallow and 9/min. Which of the following acid-based imbalances should the nurse identify the client as being at risk for developing initially? A. Respiratory acidosis Rationale: Respiratory acidosis represents an increase in the acid component, carbon dioxide, due to inadequate excretion of it, and an increase in the hydrogen ion concentration (decreased pH) of the arterial blood. A major cause of this imbalance is hypoventilation from anesthetics or opioids. B. Respiratory alkalosis Rationale: Alkalosis occurs when there is an imbalance in the amount or strength of the bases. In cases of respiratory alkalosis, this occurs because of an excessive loss of carbon dioxide through hyperventilation. It can occur in clients as a response to fear, anxiety or pain, from a fever or salicylate (aspirin) overdose. C. Metabolic acidosis Rationale: Metabolic acidosis results due to an increase in the amount of acid or a decrease in the amount of base available. It is seen in starvation, diabetic ketoacidosis, renal failure, dehydration, and diarrhea. D. Metabolic alkalosis Rationale: Metabolic alkalosis results from an increase in the amount of bases seen in massive blood transfusion, or the administration of sodium bicarbonate, or a bicarbonate containing antacid. It can also occur related to an acid deficit, seen with prolonged vomiting, the use of thiazide diuretics, or prolonged gastric suctioning. 7. A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect? A. Widened QRS complexes Rationale: A client who has respiratory acidosis is likely to cardiac changes from delayed electrical conduction through the heart, such as widened QRS complexes, tall T waves, prolonged PR intervals, and a heart rate that ranges from bradycardia to heart block. B. Hyperactive deep tendon reflexes Rationale: A client who has respiratory acidosis is more likely to have reduced muscle tone and hypoactive deep tendon reflexes due to hyperkalemia. C. Bounding peripheral pulses Rationale: A client who has respiratory acidosis is more likely to have thready peripheral pulses which are difficult to palpate. D. Warm, flushed skin Rationale: A client who has respiratory acidosis is more likely to have pale to cyanotic, dry skin. A client who has metabolic acidosis is likely to have warm, flushed dry skin. 8. A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect? A. HCO3- 30 mEq/L Rationale: This laboratory value is expected for a client who has metabolic alkalosis. B. PaCO2 50 mm Hg Rationale: This laboratory value is an expected finding for a client who has respiratory acidosis. C. pH 7.45 Rationale: This laboratory value is within the expected reference range. D. Potassium 3.3 mEq/L Rationale: This laboratory value is expected for a client who has metabolic alkalosis. 9. A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis? A. A client who has diarrhea Rationale: Diarrhea can cause metabolic acidosis due to the loss of bicarbonate. B. A client who is vomiting Rationale: Vomiting can cause metabolic alkalosis due to acid loss. C. A client who is taking a thiazide diuretic Rationale: Thiazide diuretics can cause metabolic alkalosis due to excretion of acid. D. A client who has salicylate intoxication Rationale: Salicylate intoxication can cause respiratory alkalosis due to carbon dioxide loss from tachypnea. 10. A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a PaCO2 of 50 mm Hg. The nurse should identify that the client is experiencing which of the following acid-base imbalances? A. Metabolic acidosis Rationale: With uncompensated metabolic acidosis, the pH is less than 7.35 and the PaCO2 is less than 35 mm Hg or within the expected reference range. B. Metabolic alkalosis Rationale: With uncompensated metabolic alkalosis, the pH is greater than 7.45 and the PaCO2 is greater than 45 mm Hg or within the expected reference range. C. Respiratory acidosis Rationale: With uncompensated respiratory acidosis, the pH is less than 7.35 and the PaCO2 is greater than 45 mm Hg. D. Respiratory alkalosis Rationale: With uncompensated respiratory alkalosis, the pH is greater than 7.45 and the PaCO2 is less than 45 mm Hg. 11. A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect? A. pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg Rationale: The nurse should expect a client who has renal failure to have metabolic acidosis, which is characterized by a low HCO3-, a low pH, and a low or normal PaCO2. Expected reference ranges for these laboratory values are as follows: pH 7.35 to 7.45, HCO3- 21 to 28 mEq/L, and PaCO2 35 to 45 mm Hg. B. pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg Rationale: These values indicate respiratory acidosis, which is associated with respiratory disorders, such as pulmonary edema and pneumonia. C. pH 7.50, HCO3- 20 mEq/L, PaCO2 32 mm Hg Rationale: These values indicate respiratory alkalosis, which is associated with hyperventilation. D. pH 7.55, HCO3- 30 mEq/L, PaCO2 31 mm Hg Rationale: These values indicate metabolic alkalosis, which is associated with severe emesis or gastric suctioning. 12.A A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client's heart rate increases from 86/min to 110/min and becomes irregular. Which of the following actions should the nurse take? A. Obtain a cardiology consult. Rationale: These manifestations are not related to a cardiac condition in this situation. B. Suction the client less frequently. Rationale: These manifestations are not the result of suctioning too frequently. C. Administer an antidysrhythmic medication. Rationale: These manifestations cannot be corrected with the use of an antidysrhythmic medication. D. Perform pre-oxygenation prior to suctioning. Rationale: Suctioning should be performed on the endotracheal tube of a client who is mechanically ventilated to remove accumulated secretions from the airways. Possible complications of the procedure include hypoxemia, manifested by tachycardia and arrhythmia, and tissue injury. . In preparation for suctioning, and to prevent hypoxemia, the client should be pre-oxygenated using a manual resuscitator bag set at 100% oxygen. 13. A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which of the following changes in assessment should indicate to the nurse that the client could be developing a serious complication? A. Increased respiratory rate from 18 to 44/min. Rationale: This change in respiratory rate is significant, as the first value is within the expected reference range, but the second value is very elevated for an adult client. Increased respiratory rate could be a manifestation of a possible fat embolism, a serious complication that may follow the type of fracture sustained by the client. Fat emboli can be trapped in lung tissue, leading to respiratory symptoms and mental disturbances. B. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F). Rationale: This change in temperature is not significant, as both values are within the expected reference range. A client who has a fat embolism may develop a high temperature, usually 39.5º C (103 Fº). C. Increased blood pressure from 112/68 to 120/72 mm Hg. Rationale: This change in blood pressure is not significant, as both values are within the expected reference range. D. Increased heart rate from 68 to 72/min. Rationale: This change in heart rate is not significant, as both values are within the expected reference range. 14.A A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect? A. Nausea Rationale: The nurse would not expect the client to be nauseated during an asthma attack. B. Dysphagia Rationale: The nurse should expect the client to display dyspnea, not dysphagia, during an asthma attack. C. Agitation Rationale: The nurse should expect agitation due to neurological changes from poor oxygen exchange. D. Hypotension Rationale: The nurse should expect hypertension due to increased work load of the heart from decreased oxygenation. 15.A A nurse is prioritizing client care after receiving change-of-shift report. Which of the following clients should the nurse plan to see first? A. A client who is scheduled for an abdominal x-ray and is awaiting transport Rationale: A client who is scheduled for an abdominal x-ray and is awaiting transport is stable. The nurse should see the client before allowing her to leave the unit; however, there is another client the nurse should see first. B. A client who has a prescription for discharge Rationale: A client who has a prescription for discharge is stable; therefore, there is another client the nurse should see first. C. A client who received oral pain medication 30 min ago Rationale: A client who received oral pain medication 30 minutes ago is stable; therefore, there is another client the nurse should see first. The nurse should expect oral analgesia to reach peak effect after 1 hr. D. A client who told an assistive personnel he is short of breath Rationale: A client who has shortness of breath is unstable; therefore, this is the client the nurse should plan to see first. 16.A A nurse is planning care for a client who has acute respiratory distress syndrome (ARDS). Which of the following interventions should the nurse include in the plan? A. Administer low-flow oxygen continuously via nasal cannula. Rationale: ARDS is an acute respiratory failure in which the client remains hypoxic despite the administration of 100% oxygen. Clients who have ARDS require high concentrations of oxygen, usually by mask or ventilator. B. Encourage oral intake of at least 3,000 mL of fluids per day. Rationale: Diuretics and fluid restrictions help minimize pulmonary edema, which is part of ARDS. C. Offer high-protein and high-carbohydrate foods frequently. Rationale: Clients who have ARDS are at high risk for malnutrition. The client is often sedated and paralyzed to provide mechanical ventilation and decrease oxygen needs. The nutritional needs of the client will be met through enteral or parenteral means. D. Place in a prone position. Rationale: Oxygenation in clients who have ARDS is improved when placed in the prone position. Frequent and consistent turning of the client is also beneficial and can be accomplished by the use of specialty beds. 17.A A nurse is assessing a client who has developed atelectasis postoperatively. Which of the following findings should the nurse expect? A. Facial flushing Rationale: Atelectasis refers to the closure or collapse of the alveoli resulting in hypoxia. A client may develop cyanosis as a result. B. Increasing dyspnea Rationale: The postoperative client is at increased risk for developing atelectasis because of a blunted cough reflex or shallow breathing due to anesthesia, opioids or pain medication. Common manifestations include shortness of breath and pleural pain. C. Decreasing respiratory rate Rationale: Because of the decreased oxygen exchange caused by the atelectasis, the client will be tachypneic in an effort to meet the body's oxygen needs. D. Friction rub Rationale: A friction rub is a grating or creaking sound heard when a client has inflammation of the pleura. For the client who has atelectasis, auscultation may reveal decreased breath sounds and crackles. 18. A nurse is assessing a client immediately after the provider removed the client's endotracheal tube. Which of the following findings should the nurse report to the provider? A. Stridor Rationale: Stridor, or a high-pitched crowing sound heard during inspiration, is a result of laryngeal edema. This finding indicates possible obstruction of the client's airway. Therefore, the nurse should report it to the provider immediately. B. Copious oral secretions Rationale: Copious oral secretions following extubation is an expected finding. The nurse should remind the client to cough to facilitate removal of secretions in the throat. C. Hoarseness Rationale: Hoarseness is an expected finding following extubation. D. Sore throat Rationale: Sore throat is an expected finding following extubation. 19.A A nurse in the emergency department is assessing an older adult client who has community- acquired pneumonia. Which of the following findings should the nurse expect? A. Unequal pupils Rationale: Unequal pupils are an expected finding for a client who has increased intracranial pressure. B. Hypertension Rationale: Hypotension is an expected finding for a client who has pneumonia. C. Tympany upon chest percussion Rationale: Dull sounds upon chest percussion is an expected finding for a client who has pneumonia. D. Confusion Rationale: Confusion due to hypoxemia is an expected finding for an older-adult who has pneumonia. 20. A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.) A. Severe dyspnea B. Nausea C. Decreased level of consciousness D. Headache E. Hypotension Rationale: Severe dyspnea is correct. Severe dyspnea is a manifestation of ARF that occurs as a result of hypoxemia. Nausea is incorrect. Gastrointestinal manifestations are not manifestations of ARF. Decreased level of consciousness is correct. Decreased level of consciousness is a manifestation of ARF that occurs due to hypercapnia. Headache is correct. Headache is a manifestation of ARF that occurs due to hypercapnia. Hypotension is correct. Hypotension is a manifestation of ARF that occurs due to acidosis. 21. A nurse is caring for a client who is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select all that apply.) A. Elevate the head of the bed to at least 30&deg. B. Verify the prescribed ventilator settings daily. C. Apply restraints if the client becomes agitated. D. Administer pantoprazole as prescribed. E. Reposition the endotracheal tube to the opposite side of the mouth daily. Rationale: Elevate the head of the bed to at least 30&deg is correct. A client who is intubated is at risk for aspiration and ventilator-associated pneumonia. To minimize these risks, the nurse should maintain the head of the bed at 30&deg or higher.Verify the prescribed ventilator settings daily is incorrect. The nurse should perform and document ventilator checks at least every 8 hr to ensure the ventilator settings are as prescribed.Apply restraints if the client becomes agitated is incorrect. A client who becomes agitated or restless might be experiencing air hunger. The nurse should assess the flow settings. If the client continues to be restless or agitated, a chemical restraint, such as midazolam, may be administered. Physical restraints are a last resort and only applied to prevent accidental dislodgement of the endotracheal tube.Administer pantoprazole as prescribed is correct. Stress ulcers occur in many patients receiving mechanical ventilation. Antacids, histamine blockers, or proton-pump inhibitors are often prescribed as soon as a client is intubated.Reposition the endotracheal tube to the opposite side of the mouth daily is correct. The nurse should assess the area around the endotracheal tube frequently for color, tenderness, skin irritation, and drainage. The nurse should perform oral care every 2 hr. To prevent skin breakdown, the oral endotracheal tube should be moved to the opposite side on the mouth once daily. 22.A A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. Which of the following interventions should the nurse take to reduce the risk for ventilator-associated pneumonia? A. Position the head of the client's bed in the flat position. Rationale: The nurse should elevate the head of the client’s bed 30&deg to reduce the risk for aspiration and pneumonia. B. Turn the client every 4 hr. Rationale: The nurse should turn the client every 2 hr to promote lung expansion and reduce the risk for pneumonia. C. Rinse the client's mouth with an antimicrobial solution every 4 hr. Rationale: The nurse should brush the client’s teeth every 8 hr and rinse the client’s mouth with an antimicrobial rinse every 2 hr to reduce the growth of bacteria. D. Perform hand hygiene prior to suctioning the client's endotracheal tube. Rationale: The nurse should perform hand hygiene prior to suctioning the client’s endotracheal tube to reduce the risk of introducing bacteria. 23. A nurse is reviewing a client’s laboratory report of blood gas findings: HCO3- 18 mEq/L and PaCO2 28 mm Hg. Which of the following pH values and conditions should the nurse expect when interpreting these findings? A. Decreased pH and metabolic acidosis Rationale: This client would have a decreased pH and be in metabolic acidosis. Other findings would include diarrhea, circulatory shock, decreased level of consciousness, abdominal pain, cardiac dysrhythmia, and increased depth and rate of respirations. B. Decreased pH and respiratory acidosis Rationale: The client would have a decreased pH, but would not be in respiratory acidosis. C. Elevated pH and metabolic alkalosis Rationale: The client would not have an increased pH, but would be in metabolic alkalosis. D. Elevated pH and respiratory alkalosis Rationale: The client would not have an increased pH, and would not be in respiratory alkalosis. 24. A nurse is caring for a client who has the following arterial blood gas results: HCO3 18 mEq, PaCO2 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances? A. Metabolic acidosis Rationale: A client experiencing metabolic acidosis would have a decreased pH, a decreased HCO3 and a decreased PaCO2. B. Respiratory acidosis Rationale: A client experiencing respiratory acidosis would have a decreased pH, a normal (or slightly elevated if acute) HCO3 and an increased PaCO2. C. Metabolic alkalosis Rationale: A client experiencing metabolic alkalosis would an increased pH, and increased HCO3 and an increased PaCO2. D. Respiratory alkalosis Rationale: A client experiencing respiratory alkalosis would an increased pH, a normal (or slightly decreased if compensated) HCO3 and a decreased PaCO2. 25. A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have? A. pH 7.49, HCO3 24, PaCO2 30 Rationale: These values suggest uncompensated respiratory alkalosis, which is unlikely to result solely from AKI. B. pH 7.49, HCO3 30, PaCO2 40 Rationale: These values suggest uncompensated metabolic alkalosis, which is unlikely to result solely from AKI. C. pH 7.26, HCO3 24, PaCO2 46 Rationale: These values suggest uncompensated respiratory acidosis, which is unlikely to result solely from AKI. D. pH 7.26, HCO3 14, PaCO2 30 Rationale: AKI causes metabolic acidosis because the kidneys cannot adequately process and excrete the acidic substances the usual bodily functions produce every day. With metabolic acidosis, the pH is low, the bicarbonate is low, and the PaCO2 is low or in the expected range, as in these results.