NCLEX RN Questions

[judbelete]

I am taking my NCLEX RN exam in July and I am using Saunders 6th Ed right now. I came up with this question that is really confusing to me. I was trying to figure out why the answer they provided in the answer but it is a bit conflicting on what I know. Here's the question:

A client with a 3-day history of nausea an vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/min. the ECG monitor displays tachycardia, with a HR of 120bpm. ABG gases are drawn and the nurse reviews the results, expecting to note which finding?

1. A decreased pH and an increased CO2

2. An increased pH and a decreased CO2

3. A decreased pH and a decreased HCO3

4. An increased pH with an increased HCO3

I answered #1 because of the nausea and vomiting because with vomiting and the hypoventilation.

Please give me your answer and the rationale and later I will provide the correct answer based on the book coz I am kinda confused.

Thanks

[Ackeem, BSN, MSN, RN, APRN]

Nausea, vomiting and hypoventilation are indictive of metabolic alkadosis. Answer B is describing respiratory alkadosis, so im almost certain answer D which is metabolic alkadosis is the answer. I stand corrected tho

[SWimbish, BSN, RN]

4/D

These are not respiratory issues so you can remove the CO2 ones. They threw those in there to deter you from the problem.

Vomiting= Metabolic (bicarb) ALKALOSIS related to loss of gastric acid

I always remember diarrhea as ASS.. Like your behind where diarrhea comes from lol..= Metabolic Acidosis (get it.... Ass acidosis?)

I hope that makes sense.. It works for me.

[Ackeem, BSN, MSN, RN, APRN]

Thanks SWimbish i always miss spell alkalosis. OP this is a very straight forward question, acid base balance is CORE content so be sure to thoroughly review this topic.

[akulahawkRN, ADN, RN, EMT-P]

I am taking my NCLEX RN exam in July and I am using Saunders 6th Ed right now. I came up with this question that is really confusing to me. I was trying to figure out why the answer they provided in the answer but it is a bit conflicting on what I know. Here's the question:

A client with a 3-day history of nausea an vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/min. the ECG monitor displays tachycardia, with a HR of 120bpm. ABG gases are drawn and the nurse reviews the results, expecting to note which finding?

1. A decreased pH and an increased CO2

2. An increased pH and a decreased CO2

3. A decreased pH and a decreased HCO3

4. An increased pH with an increased HCO3

I answered #1 because of the nausea and vomiting because with vomiting and the hypoventilation.

Please give me your answer and the rationale and later I will provide the correct answer based on the book coz I am kinda confused.

Thanks

You're focusing on the respiratory component. The hypoventilation is compensatory for the 3 days of nausea/vomiting. Unlike an acidosis, the body doesn't compensate all that well for metabolic alkalosis. Just looking at pH and CO2, in this scenario, I would expect to see an increased pH and an increased CO2 level. That's not a given option so you move on to the bicarb options. Given the history and that the patient is attempting to compensate using hypoventilation, I wouldn't expect to see a decreased pH. Therefore, even if I wasn't entirely certain that the body may not be able to excrete bicarb fast enough to balance the alkalosis (it doesn't, so bicarb increases apparently), the only viable answer is #4.