A nurse is assessing clients who are at risk for acid-base imbalance. Which acid-base imbalance is correctly paired with the client at risk?

A. Respiratory alkalosis: client with inadequate chest expansion due to muscle weakness: Inadequate chest expansion leads to hypoventilation, which causes carbon dioxide retention and respiratory acidosis, not alkalosis. Respiratory alkalosis is caused by hyperventilation, resulting in excessive CO₂ loss. B. Metabolic alkalosis: client who is mechanically ventilated: Mechanical ventilation primarily affects respiratory function and gas exchange. While ventilation settings can influence CO₂ levels, they do not directly cause metabolic alkalosis, which is usually due to excessive loss of acids (e.g., vomiting) or gain of bicarbonate. C. Respiratory acidosis: client with hyperventilation due to anxiety: Hyperventilation from anxiety causes excessive CO₂ exhalation, leading to respiratory alkalosis, not acidosis. Respiratory acidosis occurs when CO₂ accumulates, often from hypoventilation or impaired gas exchange. D. Metabolic acidosis: client who has Kussmaul respirations: Kussmaul respirations are a compensatory mechanism for metabolic acidosis, as the body attempts to blow off CO₂ to lower acid levels. This pairing correctly identifies the imbalance and the compensatory respiratory response.