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The most appropriate immediate treatment for a patient exhibiting signs of respiratory alkalosis with hyperventilation is to have them breathe into a rebreather mask. This technique is effective in increasing carbon dioxide (CO2) retention, which counteracts the excessive loss of CO2 that occurs during hyperventilation, thereby helping to restore the acid-base balance in the body.

When a patient hyperventilates, they rapidly exhale CO2, leading to respiratory alkalosis, characterized by an increase in blood pH and a decrease in arterial CO2 levels. By using a rebreather mask, the patient inhales a mixture of ambient air and exhaled air, which contains higher levels of CO2. This method effectively decreases the pH level towards normal by increasing CO2 levels in the blood, alleviating symptoms such as lightheadedness, tingling, and confusion that typically accompany respiratory alkalosis.

Other considerations, such as the use of bronchodilators, may be relevant in patients with obstructive airway diseases but are not indicated for managing respiratory alkalosis directly. Paced breathing exercises may help in long-term management or to reduce anxiety that leads to hyperventilation but are not an immediate intervention to address the acute acid-base imbalance. Mechanical