A client who is found unresponsive has arterial blood gases drawn, and the results indicate the following:
- pH is 7.12 (normal range: 7.35-7.45)
- PaCO2 is 90 mm Hg (normal range: 35-45)
- HCO3- is 22 mEq/L (normal range: 22-26)
The nurse interprets the results as indicating which condition?
Metabolic alkalosis
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
The Correct Answer is C
A. Metabolic alkalosis is characterized by a high pH and elevated bicarbonate levels, which is not present in these results.
B. Respiratory alkalosis would present with an increased pH and decreased PaCO2, which does not apply here.
C. The low pH (7.12) indicates acidemia, and the elevated PaCO2 (90 mm Hg) suggests hypoventilation and respiratory acidosis due to CO2 retention. The bicarbonate level is within normal limits, further supporting respiratory acidosis.
D. Metabolic acidosis would be indicated by a low pH and low bicarbonate levels; however, the bicarbonate is normal in this case, ruling out metabolic acidosis.
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Correct Answer is B
Explanation
A. Obesity is a modifiable risk factor, as it can be addressed through lifestyle changes such as diet and exercise.
B. Race is a nonmodifiable risk factor; certain races may have a higher risk of stroke due to genetic and environmental factors.
C. History of smoking is a modifiable risk factor because individuals can choose to quit smoking to reduce their risk of stroke.
D. History of hypertension is also a modifiable risk factor; while having high blood pressure increases the risk of stroke, it can be managed with lifestyle changes and medications.
Correct Answer is D
Explanation
A. Checking pupillary response to light assesses cranial nerve II (optic nerve).
B. Observing for facial symmetry primarily assesses cranial nerves VII (facial nerve) and possibly V (trigeminal nerve).
C. Testing for sense of smell assesses cranial nerve I (olfactory nerve).
D. Eliciting the gag reflex assesses cranial nerve IX (glossopharyngeal nerve) and also cranial nerve X (vagus nerve), making it the correct action to assess cranial nerve IX.