Upon entering a room, the nurse quickly scans the environment and ...

[notis]

Upon entering a room, the nurse quickly scans the environment and then immediately assesses the client for manifestations of metabolic acidosis. Which did the nurse observe to precipitate this client assessment?
 
  A) Client sleeping with the head of the bed flat
  B) Half of the client's lunch tray uneaten
  C) One formed stool in the bedside commode
  D) 1000 mL of intravenous 0.9 normal saline infused in 2 hours

Question 2

A client complaining of mouth soreness had gastric bypass surgery 1 year ago. During the assessment, the nurse notes the client's tongue is beefy, red, and smooth and the client's skin appears yellowish.
 
  Which additional information is most likely needed before diagnosing this client?
  A) Vitamin B6 levels
  B) Vitamin B12 levels
  C) Potassium levels
  D) Iron levels

[cassie_ragen]

Answer to Question 1

Answer: D

Excessive infusions of chloride-containing intravenous fluids can precipitate metabolic acidosis. The head of the bed's being flat might influence a client's oxygenation status; however, the client was not demonstrating a change in respiratory depth or rate. A reduction in oral intake does not cause metabolic acidosis. Eating half of a meal tray is not the same as starvation. Diarrhea can lead to the development of metabolic acidosis. One formed stool would not cause the nurse alarm.

Answer to Question 2

Answer: B

Vitamin B12 deficiency is associated with gastric bypass surgery. A deficiency of vitamin B12 levels will result in pernicious anemia. This deficiency will manifest as pallor, jaundice, and weakness, and a beefy, smooth red tongue. Iron deficiency anemia will manifest with weakness and fatigue. Vitamin B6 deficiencies are not typically seen with gastric bypass surgeries and are not manifested with a beefy, red, smooth tongue. The client's reports are not consistent with a potassium deficiency.

[notis]

TYSM

[tkempin]

Excellent