NCLEX: Acid-Base

A client is diagnosed with respiratory alkalosis induced by gram-negative sepsis. The nurse should plan to carry out which prescribed measure as the most effective means to treat the problem? 1. Administer prescribed antibiotics. 2. Have the client breathe into a paper bag. 3. Administer antipyretics as needed (on prn basis). 4. Request a prescription for a partial rebreather oxygen mask

1. Administer prescribed antibiotics.

The nurse is preparing to obtain an arterial blood gas specimen from a client and plans to perform the Allen test on the client. The nurse would perform the steps in which order to conduct an Allen test? Arrange the actions in the order that they should be performed. All options must be used.

1. Explain the procedure to the client. 2 Apply pressure over the ulnar and radial arteries. 3 Ask the client to open and close the hand repeatedly. 4 Release pressure from the ulnar artery. 5 Assess the color of the extremity distal to the pressure point. 6 Document the findings

The nurse is caring for a client who is retaining carbon dioxide (CO2) as a result of an obstructive respiratory disease. The nurse plans interventions knowing that as the client's CO2 level rises, what will occur with the blood pH? 1. Fall 2. Rise 3. Double 4. Remain unchanged

1. Fall

A client is determined by blood gas analysis to be in respiratory alkalosis. Which electrolyte disorder should the nurse monitor for that could accompany the acid-base imbalance? 1. Hypokalemia 2. Hypercalcemia 3. Hypochloremia 4. Hypernatremia

1. Hypokalemia

A client with diabetes mellitus has a blood glucose level of 644 mg/dL (35.7 mmol/L). The nurse plans care knowing that the client is at risk for the development of which type of acid-base imbalance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

1. Metabolic acidosis

A client with diabetes mellitus is most likely to experience which type of acid-base imbalance as a complication of the disorder? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

1. Metabolic acidosis

The nurse is caring for a client with hyperglycemia and diabetic ketoacidosis (DKA) who now has developed Kussmaul respirations. The nurse knows that the purpose of this type of breathing is to correct what imbalance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

1. Metabolic acidosis

The nurse notes that a client's arterial blood gas (ABG) results reveal a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm Hg). The nurse monitors the client for which clinical manifestations associated with these ABG results? Select all that apply. 1. Nausea 2. Confusion 3. Bradypnea 4. Tachycardia 5. Hyperkalemia 6. Lightheadedness

1. Nausea 2. Confusion 4. Tachycardia 6. Lightheadedness

An anxious preoperative client is at risk for developing respiratory alkalosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder? 1. Headache and tachypnea 2. Hyperactivity and dyspnea 3. Muscle twitches and cyanosis 4. Lightheadedness and paresthesias

4. Lightheadedness and paresthesias

The nurse is caring for a client with metabolic alkalosis. The nurse plans care knowing that most problems of metabolic alkalosis are related to increased stimulation of what systems? Select all that apply. 1. Buffer 2. Cardiac 3. Nervous 4. Chemical 5. Respiratory 6. Neuromuscular

2. Cardiac 3. Nervous 6. Neuromuscular

A client has been diagnosed with metabolic alkalosis as a result of excessive antacid use. The nurse monitoring this client should expect to note which signs/symptoms? 1. Disorientation and dyspnea 2. Decreased respiratory rate and depth 3. Drowsiness, headache, and tachypnea 4. Tachypnea, dizziness, and paresthesias

2. Decreased respiratory rate and depth

The nurse is caring for a client who overdosed on acetylsalicylic acid (aspirin) 24 hours ago. The nurse should expect to note which findings associated with an anticipated acid-base disturbance? 1. Disorientation and dyspnea 2. Drowsiness, headache, and tachypnea 3. Tachypnea, dizziness, and paresthesias 4. Decreased respiratory rate and depth, cardiac irregularities

2. Drowsiness, headache, and tachypnea

A client has a prescription for a set of arterial blood gas (ABG) samples to be drawn on room air. The client currently is receiving oxygen by nasal cannula at a delivery rate of 3 L/min. After reading the prescription, the nurse should take which action? 1. Remove the nasal cannula for 15 minutes; then have the ABG samples drawn. 2. Change the nasal cannula to a shovel face mask; then have the ABG samples drawn. 3. Leave the nasal cannula in place for 15 minutes; then have the ABG samples drawn. 4. Change the nasal cannula to a Venturi face mask; then have the ABG samples drawn.

1. Remove the nasal cannula for 15 minutes; then have the ABG samples drawn.

The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid-base imbalance? 1. Respiratory acidosis from inadequate ventilation 2. Respiratory alkalosis from anxiety and hyperventilation 3. Metabolic acidosis from calcium loss due to broken bones 4. Metabolic alkalosis from taking analgesics containing base products

1. Respiratory acidosis from inadequate ventilation

The nurse is caring for a client with respiratory failure related to Guillain-Barré syndrome. The nurse plans care knowing that what other extrapulmonary causes can lead to respiratory failure? Select all that apply. 1. Stroke 2. Pneumonia 3. Sleep apnea 4. Myasthenia gravis 5. Obstructive lung disease 6. Opioid analgesics, sedatives, anesthetics

1. Stroke 3. Sleep apnea 4. Myasthenia gravis 6. Opioid analgesics, sedatives, anesthetics

The nurse is caring for a client whose arterial blood gas results reveal alkalosis. What client reactions would the nurse expect to see? Select all that apply. 1. Tetany 2. Lethargy 3. Tingling 4. Confusion 5. Numbness 6. Restlessness

1. Tetany 3. Tingling 5. Numbness 6. Restlessness

The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurse's findings? 1. pH 7.25, Paco2 50 mm Hg (50 mm Hg) 2. pH 7.35, Paco2 40 mm Hg (40 mm Hg) 3. pH 7.50, Paco2 52 mm Hg (52 mm Hg) 4. pH 7.52, Paco2 28 mm Hg (28 mm Hg)

1. pH 7.25, Paco2 50 mm Hg (50 mm Hg)

The nurse is performing a change-of-shift assessment on a client. The client had an arterial blood gas specimen drawn during an admission workup on the previous day and has a hematoma at the puncture site. What is the priority nursing intervention? 1. Perform the Allen's test. 2. Apply a warm compress. 3. Administer the antidote for heparin. 4. Notify the hospital laboratory supervisor.

2. Apply a warm compress.

The nurse is caring for a client with diabetic ketoacidosis whose respirations are abnormally deep, regular, and increased in rate. What is the purpose of this type of respiration? Select all that apply. 1. Correct bradypnea 2. Blow off carbon dioxide 3. Correct metabolic acidosis 4. Correct an acid-base imbalance 5. Cause respiratory compensation 6. Stimulate Cheyne-Stokes respirations

2. Blow off carbon dioxide 3. Correct metabolic acidosis 4. Correct an acid-base imbalance 5. Cause respiratory compensation

The nurse is reviewing the arterial blood gas analysis results for a client in the respiratory care unit who is receiving nasal oxygen and notes a pH of 7.38 (7.38), Paco2 of 38 mm Hg (38 mm Hg), Pao2 of 86 mm Hg (86 mm Hg), and HCO3 of 23 mEq/L (23 mmol/L). What action should the nurse take in response to these results? 1. Discontinue the oxygen. 2. Continue monitoring the client. 3. Call 911 to have the client intubated immediately. 4. Have another set drawn because these results are not possible.

2. Continue monitoring the client.

A client is admitted to the hospital 24 hours following an aspirin (acetylsalicylic acid) overdose. The nurse assesses this client for which signs/symptoms indicating the acid-base disturbance that could occur in the client? 1. Bradypnea, dizziness, and paresthesias 2. Headache, nausea, vomiting, and diarrhea 3. Bradycardia, listlessness, and hyperactivity 4. Restlessness, confusion, and a positive Trousseau's sign

2. Headache, nausea, vomiting, and diarrhea

A client experiencing metabolic acidosis is to be admitted to the nursing unit. The nurse plans care knowing that what reaction is the most powerful regulator of acid-base balance? 1. Buffer 2. Kidney 3. Cations 4. Respiratory

2. Kidney

A client's blood gas results reveal acidosis. What are some signs and symptoms the nurse would expect to see? Select all that apply. 1. Seizures 2. Lethargy 3. Headache 4. Weakness 5. Confusion 6. Hyperactivity

2. Lethargy 3. Headache 4. Weakness 5. Confusion

The client tells the nurse that he ingests large amounts of oral antacids on a daily basis. The nurse plans care knowing that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2. Metabolic alkalosis

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2. Metabolic alkalosis

A client is being treated for metabolic acidosis with medication therapy and other measures. The nurse should plan to monitor the results of which electrolyte, which could dramatically decline with effective treatment of the acidosis? 1. Sodium 2. Potassium 3. Magnesium 4. Phosphorus

2. Potassium

The nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm Hg). The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition 1. Sodium level of 145 mEq/L (145 mmol/L) 2. Potassium level of 3.0 mEq/L (3.0 mmol/L) 3. Magnesium level of 1.3 mEq/L (0.65 mmol/L) 4. Phosphorus level of 3.0 mg/dL (0.97 mmol/L)

2. Potassium level of 3.0 mEq/L (3.0 mmol/L)

The nurse is caring for a client with chronic kidney disease. Arterial blood gas results indicate a pH of 7.30 (7.30), a Paco2 of 32 mm Hg (32 mm Hg), and a bicarbonate concentration of 20 mEq/L (20 mmol/L). Which laboratory value should the nurse expect to note? 1. Sodium level of 145 mEq/L (145 mmol/L) 2. Potassium level of 5.2 mEq/L (5.2 mmol/L) 3. Phosphorus level of 3.0 mg/dL (0.97 mmol/L) 4. Magnesium level of 1.3 mg/dL (0.53 mmol/L)

2. Potassium level of 5.2 mEq/L (5.2 mmol/L)

An anxious client is experiencing respiratory alkalosis from hyperventilation caused by anxiety. The nurse should take which action to help the client experiencing this acid-base disorder? 1. Put the client in a supine position. 2. Provide emotional support and reassurance. 3. Withhold all sedative or antianxiety medications. 4. Tell the client to breathe very deeply but more slowly.

2. Provide emotional support and reassurance

The nurse is caring for a client who is experiencing metabolic alkalosis. Knowing the risks of this imbalance, the nurse plans to protect the client's safety by carefully implementing which prescribed precaution? 1. Contact isolation 2. Seizure precautions 3. Bleeding precautions 4. Neutropenic precautions

2. Seizure precautions

The client with a history of lung disease is at risk for developing respiratory acidosis. The nurse asks this client about which symptoms that are characteristic of this disorder? 1. "Do you have shallow breathing?" 2. "Do you feel like you have a lot of energy?" 3. "Do you have a headache or become confused?" 4. "Do you feel dizzy or have tingling sensations?"

3. "Do you have a headache or become confused?"

A client is about to have arterial blood gases drawn, and the nurse explains what an Allen's test is. What comment shows that the client understands the nurse's explanation? 1. "Blood is drawn from the ulnar artery." 2. "I know I have to lie down while blood is drawn." 3. "This test is done to ensure adequate collateral circulation." 4. "Direct pressure has to be placed over the site for 15 minutes after blood is drawn."

3. "This test is done to ensure adequate collateral circulation."

The nurse is planning to obtain blood for arterial blood gas analysis from a client with chronic obstructive pulmonary disease. The nurse should plan time for which activity after the arterial blood specimen is drawn? 1. Holding a warm compress over the puncture site for 5 minutes 2. Encouraging the client to open and close the hand rapidly for 2 minutes 3. Applying pressure to the puncture site by applying a 2 × 2 gauze for 5 minutes 4. Having the client keep the radial pulse puncture site in a dependent position for 5 minutes

3. Applying pressure to the puncture site by applying a 2 × 2 gauze for 5 minutes

The nurse is providing care to a client with the following arterial blood gas results: pH of 7.50 (7.50), Pao2 of 90 mm Hg (90 mm Hg), Paco2 of 40 mm Hg (40 mm Hg), and bicarbonate of 35 mEq/L (35 mmol/L). When the nurse notifies the health care provider about these levels, the nurse should anticipate receiving from the HCP which prescription for this client? 1. Obtain a serum alcohol level. 2. Obtain a serum salicylate level. 3. Discontinue nasogastric suctioning. 4. Discontinue the client's fentanyl patch.

3. Discontinue nasogastric suctioning.

A client with a history of lung disease is at risk for developing respiratory acidosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder? 1. Bradycardia and hyperactivity 2. Decreased respiratory rate and depth 3. Headache, restlessness, and confusion 4. Bradypnea, dizziness, and paresthesias

3. Headache, restlessness, and confusion

The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul's respirations. Which patterns did the nurse observe? Select all that apply. 1. Respirations that are shallow 2. Respirations that are increased in rate 3. Respirations that are abnormally slow 4. Respirations that are abnormally deep 5. Respirations that cease for several seconds

3. Respirations that are increased in rate 4. Respirations that are abnormally deep

The nurse is admitting to the hospital a client with a diagnosis of Guillain-Barré syndrome. The nurse knows that if the disease is severe enough, the client will be at risk for which acid-base imbalance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

The nurse is reviewing the arterial blood gas values of a client and notes that the pH is 7.31 (7.31), Paco2 is 50 mm Hg (50 mm Hg), and the bicarbonate (HCO3) level is 26 mEq/L (26 mmol/L). The nurse concludes that which acid-base disturbance is present in this client? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

The nurse reviews the arterial blood gas results of an assigned client and notes that the laboratory report indicates a pH of 7.30 (7.30), a Paco2 of 58 mm Hg (58 mm Hg), a Pao2 of 80 mm Hg (80 mm Hg), and an HCO3 of 26 mEq/L (26 mmol/L). The nurse should interpret this to mean that the client has which acid-base disturbance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

The nurse reviews the arterial blood gas results of an assigned client and notes that the laboratory report indicates a pH of 7.30, Paco2 of 58 mm Hg, Pao2 of 80 mm Hg, and Hco3 of 27 mEq/L (27 mmol/L). The nurse interprets that the client has which acid-base disturbance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

The nurse reviews a client's arterial blood gas values and notes a pH of 7.50 (7.50), a Paco2 of 30 mm Hg (30 mm Hg), and an HCO3 of 25 mEq/L (25 mmol/L). The nurse should interpret these values as an indication of which condition? 1. Metabolic acidosis, uncompensated 2. Respiratory acidosis, uncompensated 3. Respiratory alkalosis, uncompensated 4. Metabolic acidosis, partially compensated

3. Respiratory alkalosis, uncompensated

A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding? 1. A decreased pH and an increased PaCO2 2. An increased pH and a decreased PaCO2 3. A decreased pH and a decreased HCO3- 4. An increased pH and an increased HCO3-

4. An increased pH and an increased HCO3-

A client with a chronic airflow limitation is experiencing respiratory acidosis as a complication. The nurse who is trying to enhance the client's respiratory status should avoid which action? 1. Keeping the head of the bed elevated 2. Monitoring the flow rate of supplemental oxygen 3. Assisting the client to turn, cough, and breathe deeply 4. Encouraging the client to breathe slowly and shallowly

4. Encouraging the client to breathe slowly and shallowly

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg (90 mm Hg), and HCO3- is 22 mEq/L (22 mmol/L). The nurse interprets the results as indicating which condition? 1. Metabolic acidosis with compensation 2. Respiratory acidosis with compensation 3. Metabolic acidosis without compensation 4. Respiratory acidosis without compensation

4. Respiratory acidosis without compensation

The nurse reviews a client's arterial blood gas results and notes that the pH is 7.30 (7.30), the Paco2 is 52 mm Hg (50 mm Hg), and the HCO3 is 22 mEq/L (22 mmol/L). The nurse interprets these results as indicating which condition? 1. Metabolic acidosis, compensated 2. Respiratory alkalosis, compensated 3. Metabolic alkalosis, uncompensated 4. Respiratory acidosis, uncompensated

4. Respiratory acidosis, uncompensated

Arterial blood gas analysis yields the following results: pH 7.48 (7.48), Paco2 32 mm Hg (32 mm Hg), Pao2 94 mm Hg (94 mm Hg), HCO3 level 24 mEq/L (24 mmol/L) for a client seen in the health care clinic. The nurse interprets that the client has which acid-base disturbance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

4. Respiratory alkalosis

The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas values are pH = 7.53, Pao2 = 72 mm Hg (72 mm Hg), Paco2 = 32 mmHg (32 mm Hg), and HCO3- = 28 mEq/L (28 mmol/L). Which conclusion about the client should the nurse make? 1. The client has acidotic blood. 2. The client is probably overreacting. 3. The client is fluid volume overloaded. 4. The client is probably hyperventilating.

4. The client is probably hyperventilating

The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg (30 mm Hg), and HCO3- of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition? 1. Metabolic acidosis, compensated 2. Respiratory alkalosis, compensated 3. Metabolic alkalosis, uncompensated 4. Respiratory acidosis, uncompensated

Respiratory alkalosis, compensated