Hogan Chapter 54 - Comprehensive Review NCLEX-RN

3. pH 7.31; PaCO2 50; HCO3 234. pH 7.43; PaCO2 48; HCO3 30Rationale: Clients with renal failure have difficulty synthesizing HCO3 - in the renal tubules secondary to the renal failure. These clients also retain K+ and subsequently develop metabolic acidosis. The ABG with the pH of 7.30 reflects uncompensated metabolic acidosis. The ABG with thepH of 7.49 is incorrect because it reflects metabolic alkalosis (increased pH and HCO3 -) and normal PaCO2. The ABG with the pH of 7.31 is incorrect because it reflects respiratory acidosis (decreased pH, increased PaCO2) and normal HCO3 -. The ABG with the pH of 7.43 is incorrect because it reflects a mixed acid–base imbalance metabolic alkalosis with a respiratory acidosis (normal pH andincreased PaCO2 and HCO3 -).5. A client is admitted to the hospital with atelectasis and reports of chest pain. For which acid-base imbalance should the nurse assess this client?1. Respiratory alkalosis2. Metabolic acidosis3. Metabolic alkalosis4. Respiratory acidosisRationale: A client with atelectasis has collapsed alveoli that retain CO2, which can lead to respiratory acidosis. The client most likely would have hypoventilation as a respiratory pattern, which would further contribute to the development of respiratory acidosis. Respiratory and metabolic alkalosis are incorrect because the client would not be in an alkalotic state. Metabolic acidosis is incorrect because the primary disturbance is respiratory.6. A client is admitted to the hospital with respiratory acidosis. The nurse considers that which condition could be an etiology for this state? Select All That Apply.1. Severe diarrhea for several days2. Diabetic Ketoacidosis3. Obesity4. Diuretics5. Sedative OverdoseRationale: Obesity can lead to chest wall abnormalities and hypoventilation, which can lead to respiratory acidosis. Sedative overdose depresses the central nervous system, which leads to hypoventilation and respiratory acidosis. Prolonged diarrhea can lead to the development of metabolic acidosis. DKA leads to the development of metabolic acidosis. Diuretic administration leads to the development of metabolic alkalosis.7. The nurse should assess for which signs and symptoms in a client who has metabolic acidosis? Select All That Apply.1. Weight Gain2. Rapid, Deep Respirations3. Drowsiness4. Decreased Respiratory rate and Depth5. MelenaRationale: Clients who have metabolic acidosis develop Kussmaul’s breathing (rapid and deep respirations). Drowsiness occurs because of the CNS depressant effect of acidosis. Weight gain is not an associated finding with metabolic acidosis. Shallow breathing is associated with the