Free BCEN Certified Emergency Nurse (CEN) Practice Question

The correct answer is metabolic alkalosis with hypokalemia and hyponatremia. The patient's history of vomiting and diarrhea has led to significant fluid and electrolyte losses. The low chloride (88 mEq/L) and elevated bicarbonate (32 mEq/L) indicate metabolic alkalosis, likely due to gastric acid loss from vomiting. The potassium is low at 2.8 mEq/L, indicating hypokalemia, which often accompanies metabolic alkalosis. The sodium is also low at 129 mEq/L, indicating hyponatremia. While the patient likely has some degree of dehydration, the lab values don't support hypernatremia or hypochloremic metabolic acidosis. The normal creatinine suggests that acute kidney injury is not present, ruling out uremic acidosis.