Correct Answer: D

Rationale: The correct answer is D: Mixed acid-base disorder. The ABG results show a pH within the acidic range (7.28), indicating acidosis. The PaCO2 is elevated (50 mm Hg), suggesting respiratory acidosis as the primary disorder. However, the HCO3 level is within normal range (23 mEq/L), which is not consistent with compensatory metabolic alkalosis. Therefore, the presence of both respiratory acidosis and normal HCO3 levels indicates a mixed acid-base disorder. Choice A (Respiratory acidosis) is incorrect because although the patient has an elevated PaCO2, the normal HCO3 level rules out a pure respiratory acidosis. Choice B (Metabolic alkalosis) and C (Respiratory alkalosis) are incorrect as the ABG results do not support these diagnoses.

Correct Answer: D

Rationale: To interpret the given ABG results: 1. pH <7.35 indicates acidosis. 2. PaCO2 <35 indicates respiratory alkalosis. 3. HCO3 <22 indicates metabolic acidosis. Therefore, the ABG results show metabolic acidosis (low pH, low HCO3) with compensatory respiratory alkalosis (low PaCO2). This means the body is trying to compensate for the metabolic acidosis by decreasing PaCO2 through hyperventilation. Option D is correct. Options A, B, and C are incorrect as they do not align with the ABG results and the principles of acid-base balance.

Correct Answer: A

Rationale: The correct answer is A: "Avoid carrying your grandchild with the arm that has the central catheter." This is important because carrying a child can put strain on the arm where the catheter is inserted, increasing the risk of dislodging or damaging the catheter. It is crucial to protect the integrity of the catheter site to prevent complications such as infection or bleeding. Choice B is incorrect because placing the arm with the central catheter in a sling during the day is unnecessary and could restrict the client's mobility and lead to discomfort. Choice C is incorrect because flushing the PICC line with normal saline should be done by a healthcare professional and not the client themselves. Choice D is incorrect because using the arm with the central catheter for most activities of daily living can increase the risk of accidental dislodgment or damage to the catheter. It is important to be cautious and limit certain activities to protect the catheter and maintain its function.

Correct Answer: A

Rationale: The correct answer is A: Encourage oral fluid intake. When a client has hypercalcemia (serum calcium level of 14 mg/dL), the priority is to increase fluid intake to promote renal calcium excretion. This helps prevent complications such as renal calculi. The first step is to dilute the serum calcium by increasing fluid intake, which can help lower the serum calcium level. Connecting the client to a cardiac monitor (B) is not the priority as hypercalcemia affects the kidneys more than the heart. Assessing urinary output (C) is important but encouraging fluid intake is more immediate. Administering oral calcitonin (Calcimar) (D) is not the first action as it is a medication used for long-term management of hypercalcemia, not the immediate priority.

Correct Answer: D

Rationale: The correct answer is D: Fluid volume status. Assessment of specific gravity helps to determine the concentration of solutes in the urine, indicating the degree of hydration or dehydration. In SIADH, there is water retention leading to diluted urine, resulting in low specific gravity. Monitoring specific gravity every 4 hours is crucial in assessing the patient's fluid volume status and response to treatment. A: Nutritional status is not directly assessed by specific gravity. B: Potassium balance is not directly assessed by specific gravity. C: Calcium balance is not directly assessed by specific gravity.