Answer to Question 1
B
Compensated metabolic alkalosis should show alkalosis pH and HCO3 (metabolic) values, with a slightly acidic CO2 (compensatory respiratory acidosis). In this case, pH 7.52 is alkaline (normal = 7.35 to 7.45), PaCO2 is acidic (normal 35 to 45 mm Hg), and HCO3 is elevated (normal = 22 to 26 mEq/L). A result of pH 7.78, PaCO2 40 mm Hg, HCO3 30 mEq/L is uncompensated metabolic alkalosis. pH 7.35, PaCO2 35 mm Hg, HCO3 26 mEq/L is within normal limits. pH 7.25, PaCO2 47 mm Hg, HCO3 29 mEq/L is compensated respiratory acidosis.
Answer to Question 2
C
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A Although use of the Valsalva manoeuvre may contribute to hemorrhoids in pregnancy, this is not as serious as increasing the intraocular pressure of a patient with glaucoma.
B The Valsalva manoeuvre is not contraindicated in a patient with hypertrophied prostate disease.
C Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greatest risk of serious complications (such as cardiac irregularities and elevated blood pressure) with this manoeuvre, and need to avoid straining to pass the stool.
D The Valsalva manoeuvre is not contraindicated in a patient with stomach cancer.
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