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Tumor Lysis Syndrome
1 / 10
What is a common symptom of hyperphosphatemia in a patient with TLS?
Hyperphosphatemia can lead to muscle cramps and tetany due to its effect on calcium levels.
2 / 10
Which of the following is a key nursing intervention for a patient at risk of TLS?
Close monitoring of electrolyte levels is crucial for detecting and managing the imbalances associated with TLS.
3 / 10
Which medication is used to treat hyperkalemia by shifting potassium into cells?
Insulin with dextrose is used to shift potassium from the bloodstream into the cells, temporarily reducing serum potassium levels.
4 / 10
What is the primary purpose of administering IV fluids to a patient with TLS?
IV fluids help flush out the released intracellular contents, such as uric acid and electrolytes, through the kidneys, reducing the risk of renal damage.
5 / 10
The presence of which symptom suggests that a patient with TLS might be experiencing hypocalcemia?
Trousseau's sign is a clinical indication of hypocalcemia, which is a common electrolyte disturbance in TLS.
6 / 10
Which laboratory test result is most indicative of TLS?
Elevated serum creatinine indicates renal impairment, which is a common complication of TLS due to the precipitation of uric acid in the kidneys.
7 / 10
What is the first-line treatment for hyperuricemia in TLS?
Allopurinol is commonly used to prevent and treat hyperuricemia in patients with TLS by inhibiting the formation of uric acid.
8 / 10
A patient with TLS is at risk for which of the following cardiac complications?
Hyperkalemia and other electrolyte imbalances in TLS can lead to dangerous cardiac arrhythmias.
9 / 10
Which electrolyte imbalance is most commonly associated with Tumor Lysis Syndrome?
TLS often leads to hyperkalemia due to the release of potassium from lysed tumor cells.
10 / 10
What is the primary cause of Tumor Lysis Syndrome?
TLS occurs when a large number of tumor cells are rapidly destroyed by chemotherapy, releasing their intracellular contents into the bloodstream.
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ABG Analysis
Mastering ABG analysis is essential for nursing practice and success on the NCLEX. Each question in this set emphasizes key concepts, including the identification of acid-base imbalances, physiological responses, and their implications for patient care. A strong grasp of these principles will enhance your ability to assess and respond effectively to patients' needs in various clinical situations.
The number of attempts remaining is 5
1 / 50
A nurse notices a patient has rapid, shallow breathing. The patient’s ABG shows: pH 7.45, PaCO2 30 mmHg, HCO3- 22 mEq/L. What is the likely diagnosis?
The elevated pH and low PaCO2 indicate respiratory alkalosis, likely due to hyperventilation.
2 / 50
A patient has a pH of 7.39, PaCO2 of 52 mmHg, and HCO3- of 28 mEq/L. This patient is likely experiencing:
The low pH and elevated PaCO2 suggest respiratory acidosis, with the HCO3- slightly elevated indicating some compensation.
3 / 50
If a patient is experiencing metabolic alkalosis, which ABG result might be expected?
The elevated pH and HCO3- suggest metabolic alkalosis.
4 / 50
A patient with chronic respiratory acidosis may develop:
The kidneys retain bicarbonate to compensate for the chronic respiratory acidosis.
5 / 50
A patient presents with confusion and lethargy. ABG analysis reveals pH 7.34, PaCO2 55 mmHg, HCO3- 26 mEq/L. Which of the following interventions is the priority?
The elevated PaCO2 suggests respiratory acidosis, and encouraging deep breathing can help increase ventilation.
6 / 50
A patient presents with confusion and fatigue. Their ABG results show: pH 7.28, PaCO2 58 mmHg, HCO3- 22 mEq/L. What condition do these findings suggest?
The low pH and high PaCO2 indicate acute respiratory acidosis.
7 / 50
A nurse reviews an ABG report: pH 7.35, PaCO2 55 mmHg, HCO3- 22 mEq/L. Which nursing diagnosis is appropriate?
The elevated PaCO2 and low pH suggest respiratory failure, likely due to inadequate ventilation.
8 / 50
In a patient with respiratory acidosis, what is the expected change in the kidneys?
The kidneys retain bicarbonate to help compensate for the acidosis.
9 / 50
Which of the following scenarios would likely lead to respiratory alkalosis?
Hyperventilation during an anxiety attack leads to respiratory alkalosis.
10 / 50
A patient with diabetic ketoacidosis has the following ABG results: pH 7.25, PaCO2 30 mmHg, HCO3- 15 mEq/L. What is the primary acid-base imbalance?
The low pH and HCO3- indicate a primary metabolic acidosis due to the accumulation of keto acids.
11 / 50
The nurse is caring for a patient with COPD. Which ABG result would indicate respiratory acidosis?
The low pH and high PaCO2 indicate respiratory acidosis, commonly seen in COPD patients.
12 / 50
A patient with renal failure presents with ABG results: pH 7.32, PaCO2 42 mmHg, HCO3- 16 mEq/L. What does this indicate?
The low pH and HCO3- indicate metabolic acidosis without respiratory compensation.
13 / 50
A nurse is reviewing ABG results: pH 7.35, PaCO2 50 mmHg, HCO3- 25 mEq/L. Which condition is most likely?
The low pH and elevated PaCO2 without a change in HCO3- indicate uncompensated respiratory acidosis.
14 / 50
A patient with renal failure shows ABG results of pH 7.25, PaCO2 40 mmHg, HCO3- 16 mEq/L. This indicates:
The low pH and HCO3- indicate uncompensated metabolic acidosis.
15 / 50
If a patient’s ABG shows a pH of 7.28, what should the nurse suspect?
A pH below 7.35 indicates acidosis.
16 / 50
A patient has the following ABG results: pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L. What is the primary acid-base disturbance?
The low pH and elevated PaCO2 indicate an accumulation of carbon dioxide due to hypoventilation, which leads to respiratory acidosis.
17 / 50
A patient is hyperventilating due to anxiety. What would you expect their ABG results to show?
Hyperventilation causes increased elimination of CO2, leading to respiratory alkalosis.
18 / 50
In which condition would you expect to see a decreased HCO3- level?
In metabolic acidosis, there is a loss of bicarbonate or an accumulation of acid, leading to decreased HCO3- levels.
19 / 50
Which of the following can lead to metabolic alkalosis?
Vomiting causes a loss of gastric acid, leading to a rise in HCO3- and thus metabolic alkalosis.
20 / 50
ABG results show: pH 7.45, PaCO2 35 mmHg, HCO3- 21 mEq/L. What is the interpretation?
The pH is normal due to compensation; the low HCO3- indicates a prior metabolic disturbance.
21 / 50
A patient with a history of excessive alcohol consumption presents with ABG results: pH 7.30, PaCO2 40 mmHg, HCO3- 15 mEq/L. What is the likely diagnosis?
The low pH and HCO3- suggest metabolic acidosis, possibly due to alcoholic ketoacidosis.
22 / 50
ABG results show: pH 7.48, PaCO2 42 mmHg, HCO3- 30 mEq/L. What does this indicate?
The elevated pH and HCO3- indicate metabolic alkalosis, possibly from vomiting or diuretic use.
23 / 50
ABG results show: pH 7.40, PaCO2 32 mmHg, HCO3- 19 mEq/L. Which acid-base balance does this indicate?
The low PaCO2 and normal pH suggest that the respiratory system has compensated for metabolic acidosis.
24 / 50
A patient with diabetes presents with a fruity odor on their breath. ABG results show: pH 7.25, PaCO2 40 mmHg, HCO3- 15 mEq/L. What condition is this indicative of?
The low pH and HCO3- indicate metabolic acidosis due to ketoacidosis.
25 / 50
The nurse is interpreting ABG results: pH 7.50, PaCO2 30 mmHg, HCO3- 24 mEq/L. What condition is indicated?
The high pH and low PaCO2 suggest hyperventilation, leading to respiratory alkalosis.
26 / 50
A patient with chronic kidney disease shows signs of acidosis. What ABG change would be expected?
Chronic kidney disease impairs acid excretion, leading to decreased HCO3- and metabolic acidosis.
27 / 50
A patient is hypoventilating after a drug overdose. What would their ABG likely show?
Hypoventilation results in CO2 retention, leading to respiratory acidosis.
28 / 50
Which patient condition would most likely cause metabolic alkalosis?
Vomiting causes a loss of gastric acid and leads to metabolic alkalosis.
29 / 50
A patient presents with tachypnea and lightheadedness. Which ABG finding would be expected?
Tachypnea may lead to hyperventilation, causing a decrease in PaCO2 and an increase in pH (respiratory alkalosis).
30 / 50
ABG results show: pH 7.38, PaCO2 48 mmHg, HCO3- 26 mEq/L. This indicates which type of compensation?
The pH is slightly acidic with an elevated PaCO2, indicating the body is attempting to compensate but hasn't fully corrected the acidosis.
31 / 50
ABG results show: pH 7.47, PaCO2 38 mmHg, HCO3- 29 mEq/L. The nurse should assess for which of the following?
The elevated HCO3- and pH suggest metabolic alkalosis, commonly caused by vomiting.
32 / 50
If a patient is experiencing metabolic acidosis, what would you expect the respiratory compensation to be?
The body compensates for metabolic acidosis by increasing the respiratory rate to blow off CO2.
33 / 50
A patient presents with a high HCO3- level and a pH of 7.50. What could this indicate?
An elevated HCO3- and high pH suggest metabolic alkalosis.
34 / 50
A patient presents with tachycardia and muscle cramps. ABG analysis shows: pH 7.50, PaCO2 38 mmHg, HCO3- 30 mEq/L. What should the nurse assess for?
The elevated pH and HCO3- indicate metabolic alkalosis, which can cause symptoms like muscle cramps.
35 / 50
A patient with a history of COPD is experiencing respiratory acidosis. Which intervention is most appropriate?
Oxygen therapy can help improve oxygenation and reduce hypoxia associated with respiratory acidosis.
36 / 50
A patient with an acute asthma attack is likely to have which of the following ABG results?
During an acute asthma attack, hypoventilation occurs, leading to increased CO2 and respiratory acidosis
37 / 50
A patient with chronic kidney disease has a pH of 7.35 and HCO3- of 18 mEq/L. What is the likely diagnosis?
The low pH and HCO3- indicate metabolic acidosis, often seen in chronic kidney disease due to the accumulation of acids.
38 / 50
A patient’s ABG indicates a pH of 7.50, what should the nurse suspect?
A pH above 7.45 indicates alkalosis, whether metabolic or respiratory.
39 / 50
A nurse is assessing a patient with potential metabolic acidosis. Which sign would be most indicative?
Kussmaul respirations are deep, labored breathing patterns often seen in metabolic acidosis as the body attempts to compensate.
40 / 50
A patient is experiencing respiratory distress and has an ABG result of pH 7.32, PaCO2 52 mmHg, HCO3- 24 mEq/L. What does this indicate?
The low pH and high PaCO2 without a change in HCO3- suggest uncompensated respiratory acidosis.
41 / 50
Which of the following ABG values would indicate respiratory alkalosis?
High pH and low PaCO2 indicate respiratory alkalosis due to hyperventilation.
42 / 50
A patient has a pH of 7.30, PaCO2 30 mmHg, HCO3- 18 mEq/L. What is the most likely diagnosis?
The low pH and HCO3- suggest metabolic acidosis, while the low PaCO2 indicates compensation through hyperventilation.
43 / 50
A patient with severe dehydration would likely exhibit which of the following ABG results?
Severe dehydration can lead to metabolic alkalosis due to electrolyte imbalances and hypovolemia.
44 / 50
What is a common cause of metabolic acidosis?
Renal failure impairs the excretion of acids, leading to metabolic acidosis.
45 / 50
A patient in renal failure presents with pH 7.30 and HCO3- 15 mEq/L. What is the expected respiratory response?
The body will attempt to compensate for the metabolic acidosis by hyperventilating to lower CO2 levels.
46 / 50
What is the normal range for arterial blood pH?
The normal pH range for arterial blood is between 7.35 and 7.45
47 / 50
A patient’s ABG shows: pH 7.45, PaCO2 48 mmHg, HCO3- 36 mEq/L. What condition does this most likely indicate?
The elevated HCO3- and pH with an increased PaCO2 suggest compensation for chronic respiratory acidosis
48 / 50
Which of the following ABG results would indicate metabolic acidosis?
The low pH and HCO3- indicate metabolic acidosis, commonly seen in conditions like renal failure or severe diarrhea.
49 / 50
In a patient with a suspected pulmonary embolism, what ABG changes might you expect?
Hyperventilation can occur due to hypoxia from the embolism, leading to respiratory alkalosis.
50 / 50
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