Acid-Base Balance Practice Questions

Which value of blood pH indicates acidosis? 1) 7.25 2) 7.35 3) 7.45 4) 7.55

1) 7.25

Which condition does the nurse suspect in a patient with renal failure? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

1. Metabolic acidosis

A nurse reviews the laboratory results of a patient. The arterial blood gas (ABG) values are: pH 7.30, PaCO2 35 mm Hg, and bicarbonate (HCO3-) 16 mEq/L. What is the correct interpretation of the values given? 1) Respiratory acidosis 2) Metabolic acidosis 3) Metabolic alkalosis 4) Respiratory alkalosis

2) Metabolic acidosis

A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicated a pH of 7.50 and a Pco2 of 30. The nurse has determines that the client is experience respiratory alkalosis. Which laboratory value would most likely be noted in this condition? 1) Sodium level of 145 2) Potassium level of 3 3) Magnesium level of 2 4) Phosphorus level of 4

2) Potassium level of 3 Rational: Respiratory alkalosis is defined as a deficit of carbonic acid or a decrease in hydrogen ion concentrations that results from the accumulations of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Clinical manifestations of respiratory alkalosis include headache, tachypnea, paresthesias, tetany, vertigo, confusions, hypokalemia, and hypocalcemia. Options 1, 3, & 4 identify normal laboratory values. Option 2 identifies the presence of hypokalemia.

A client who is found unresponsive has arterial blood gases drawn and the results indicate dthe following: pH is 7.12, Pco2 is 90, and HCO3- is 22. the nurse interprets the results as indicating which condition? 1) Metabolic Acidosis 2) Respiratory Acidosis 3) Metabolic Alkalosis 4) Respiratory Alkalosis

2) Respiratory Acidosis

After reviewing the patient's arterial blood gas analysis report, the primary health care provider concludes that the patient has respiratory acidosis. Which findings made the primary health care provider reach this conclusion? 1) pH, 7.4, partial pressure of carbon dioxide (PaCO2), 44, bicarbonate ion (HCO3-), 26 2) pH, 7.2, partial pressure of carbon dioxide (PaCO2), 47, bicarbonate ion (HCO3-), 25 3) pH, 7.36, partial pressure of carbon dioxide (PaCO2), 41, bicarbonate ion (HCO3-), 23 4) pH, 7.42, partial pressure of carbon dioxide (PaCO2), 42, bicarbonate ion (HCO3-), 24

2) pH, 7.2, partial pressure of carbon dioxide (PaCO2), 47, bicarbonate ion (HCO3-), 25

A patient's arterial blood gas results are: pH 7.48, PaCO2 38, HCO3- 30. The patient is in: 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2. Metabolic alkalosis

What is the normal range of blood pH? 1) 7.05 to 7.15 2) 7.15 to 7.25 3) 7.25 to 7.35 4) 7.35 to 7.45

4) 7.35 to 7.45

The nurse is told that the blood gas results indicate a pH of 7.55 and a PCO2 of 30 mm Hg. The nurse determines that these results indicate: 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

4. Respiratory alkalosis

The nurse provides care for a patient with respiratory alkalosis. What arterial blood gas results correspond to this condition? 1. pH 7.46, pCO2 44 mm Hg, PO2 95 mm Hg, and HCO3- 36 mEq/L 2. pH 7.27, pCO2 70 mm Hg, PO2 80 mm Hg, and HCO3- 26 mEq/L 3. pH 7.30, pCO2 35 mm Hg, PO2 70 mm Hg, and HCO3- 20 mEq/L 4. pH 7.52, pCO2 24 mm Hg, PO2 85 mm Hg, and HCO3- 24 mEq/L

4. pH 7.52, pCO2 24 mmHg, PO2 85 mm Hg, and HCO3- 24 mEq/L

The nurse plans care for a client with chronic obstructive pulmonary disease (COPD), understanding that the client is most likely to experience what type of acid-bases imbalance: 1) Metabolic Acidosis 2) Metabolic Alkalosis 3) Respiratory Acidosis 4) Respiratory Alkalosis

3) Respiratory Acidosis

A patient has the following arterial blood gas results: pH 7.32; PaCO2 56 mm Hg; HCO3- 24 mEq/L. The nurse determines that these results indicate: 1) Metabolic acidosis 2) Metabolic alkalosis 3) Respiratory acidosis 4) Respiratory alkalosis

3) Respiratory acidosis

While caring for a patient with chronic obstructive pulmonary disease, the nurse finds that the patient's arterial blood gas results show a blood pH of 7.29, partial pressure of carbon dioxide (PaCO2) of 49 mm Hg, and a bicarbonate ion (HCO3) level of 25 mEq/L. Which condition does the nurse suspect? 1) Metabolic acidosis 2) Metabolic alkalosis 3) Respiratory acidosis 4) Respiratory alkalosis

3) Respiratory acidosis

A nurse is caring for a client with a diagnosis of COPD. The nurse monitors the client for which acid-base imbalance that most likely occurs in clients with this condition? 1. Metabolic acidosis 2.Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

A patient's arterial blood gas results are: pH 7.32; PaCO2 52; HCO3- 24. The patient is in: 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

The RN reviews the results of the ABG with the LPN and tells the LPN that the client is experiencing respiratory acidosis. The LPN would expect to note which of the following on the laboratory result form? 1. pH 7.50, PCO2 52 mm Hg 2. pH 7.35, PCO2 40 mm Hg 3. pH 7.25, PCO2 50 mm Hg 4. pH 7.50, PCO2 30 mm Hg

3. pH 7.25, PCO2 50 mm Hg

A client has the following lab values: a pH of 7.55, an HCO3- of 22 mm Hg, and a PCO2 of 30 mm Hg. What should the nurse do? 1. Perform Allen's test 2. Prepare the client for dialysis 3. Administer insulin as ordered 4. Encourage the client to slow down breathing

4. Encourage the client to slow down breathing

A client with hyperaldosteronism has been admitted to the unit. The nurse knows the client is at risk for impaired gas exchange. Which position should this client be placed to enhance gas exchange? A) Fowler's position B) Prone position C) Left side-lying position D) Right Sims position

A) Fowler's position

What is the normal range of carbon dioxide (CO2) in arterial blood? A. 35-45 B. 22-26 C. 7.35-7.45 D. Not listed

A. 35-45

If HCO3- caused the acidosis or the alkalosis, it is what? A. Metabolic B. Respiratory C. Combined D. None

A. Metabolic

A nurse reviews the arterial blood gas results of a client and notes the following: ph 7.45, Pco2 of 30 mmhg, and HCO3- of 22 mEq/L. The nurse analysis these results as indicating which condition? 1. Metabolic acidosis 2. Respiratory alkalosis 3. Metabolic alkalosis 4. Respiratory acidosis

Answer: 2 Respiratory Alkalosis

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Pco2 is 90 mmHg, and HCO3- is 22 mEq/L. The nurse interprets the results as indicating which condition? 1. Metabolic acidosis 2. Respiratory alkalosis 3. Metabolic alkalosis 4. Respiratory acidosis

Answer: 4 Respiratory Acidosis

pH 7.39, PaCO2 59, HCO35 A. Respiratory Acidosis B. Metabolic Alkalosis C. Respiratory Acidosis D. Metabolic Alkalosis

Answer: C. Respiratory Acidosis

The nurse is preparing to discharge a client with congestive heart failure on furosemide (Lasix). The nurse determines that teaching has been effective if the client makes which statement? A) "I will use only sodium bicarbonate as my antacid." B) "I will restrict my intake of fluids." C) "I will use potassium supplements while I am taking Lasix." D) "I will take antacids only for my gastric discomforts."

C) "I will use potassium supplements while I am taking Lasix."

The nurse is caring for a client who has been admitted to the unit with respiratory failure and respiratory acidosis. What data from the nursing history would the nurse suspect contributed to the client's current state of health? A) Use of ibuprofen for the control of pain B) A recent trip to South America C) Aspiration pneumonia D) Recent recovery from a cold virus

C) Aspiration pneumonia

During an assessment, the nurse becomes concerned that a client is at risk for developing metabolic alkalosis. What did the nurse assess that caused this concern? A) Daily ingestion of a banana with breakfast B) Daily weight consistent C) Daily use of sodium bicarbonate for gastric upset D) Daily use of prescribed NSAIDs for arthritic pain

C) Daily use of sodium bicarbonate for gastric upset

While reviewing laboratory results, the nurse notes that a client's potassium level is 2.8 mEq/L and chloride level is 100 mEq/L. How should the nurse plan to support this client's acid-base balance? A) Prepare to administer 0.9% sodium chloride infusion. B) Measure for nasogastric tube insertion. C) Discuss potassium chloride replace therapy with the healthcare provider. D) Review implications of transfusing with ammonia chloride.

C) Discuss potassium chloride replace therapy with the healthcare provider.

What is the normal range of pH in the body? A. 35-45 B. 22-26 C. 7.35-7.45 D. Not listed

C. 7.35-7.45

A 10-year-old boy has been admitted to the hospital with respiratory acidosis. The nurse suspects that which chronic lung disease most likely caused the child to develop this condition? A) Cystic fibrosis B) Aspiration C) Hyperthyroidism D) Pneumonia

A. Cystic Fibrosis Explanation: A) Chronic lung disease such as asthma and cystic fibrosis put the child at risk for respiratory acidosis. Pneumonia and aspiration are both acute lung conditions. Hyperthyroidism is a disorder that results in metabolic acidosis.

Ben has an anxiety attack. His ABGs results show he is in respiratory alkalosis. He has just had a car accident. What is your next nursing intervention? A. Have him breathe into a paper bag B. Give him O2 C. Check his temperature D. Ask him if he is alright

A. Have him breathe into a paper bag

PH 7.47, CO2 44 mmHg, HCO3 30 mEq/L A. Metabolic alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Respiratory alkalosis

A. Metabolic Alkalosis

PH 7.31, CO2 50mmHg, HCO3- 22mEq/L A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

A. Respiratory Acidosis

A nurse is caring for a client on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and Pco2 of 30 mmHg. 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

Answer: 4. Respiratory alkalosis

A nurse caring for a client with an ileostomy understands the the client is most at risk for developing which acid-base disorder? 1) Metabolic Acidosis 2) Metabolic Alkalosis 3) Respiratory Acidosis 4) Respiratory Alkalosis

Answer: 1) Metabolic Acidosis Rational: Metabolic Acidosis is defined as total concentration of buffer base that is lower than normal, with a relative increase in the hydrogen ion concentration. This results from loss of buffer bases or the retention of too many acids without sufficient bases, and occurs in conditions such as renal failure, diabetic ketoacidosis, from the production of lactic acid, from the ingestion of toxins (such as acetylsalicylic acid -aka- aspirin), malnutrition, or severe diarrhea. Intestinal secretions are high in bicarbonate and may e lost through enteric drainage tubes or an ileostomy, or with diarrhea. These conditions result in metabolic acidosis. Options 2, 3, & 4 are incorrect interpretations and do not occur in the client with an ileostomy.**(Base/Bicarbonate is lost through an ileostomy)

A nurse notes that a client's arterial blood gas reults reveal a pH of 7.50 and a Pco2 of 30. The nurse monitors the client for which clinical manifestations associated with these arterial blood gas results?Select all the apply: 1) Nausea 2) Confusion 3) Bradypnea 4) Tachycardia 5) Hyperkalemia 6) Lightheadedness

Answer: 1) Nausea, 2) Confusion, 4) Tachycardia, 6) Lightheadedness Rational: Respiratory alkalosis is defined as a deficit of carbonic acid or a decrease in hydrogen ion concentrations that results from the accumulations of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Clinical manifestations of repirtory alkalosis include lethargy, lightheadedness, confusion, tachycardia, dysrhythmias related to hypokalemai, nausea, vomiting, epigastric pain, and numbness and tingling of the extremities. Hyperventilation (tachypnea) occurs.

A 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 of the following validates the nurse's findings? 1) pH 7.25, Pco2 50, 2) pH 7.35, Pco2 40 3) pH 7.50, Pco2 52 4) pH 7.52, Pco2 28

Answer: 1) pH 7.25, Pco2 50, Rational: Atelectasis is a condition characterized by the collapse of alveoli, preventing the respiratory exchange of oxygen and carbon dioxide in a part of the lungs. The normal pH is 7.35-7.45. The normal Pco2 is 32-48. In respiratory acidosis, the pH is decreased and the Pco2 is elevated. Option 2 identifies normal values. Option 3 identifies an alkalotic condition. Option 4 identifies respiratory alkalosis.

A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder? 1 Metabolic Acidosis 2. Metabolic Alkalosis 3. Respiratory Acidosis Respiratory Alkalosis

Answer: 2. Metabolic Alkalosis Rational: Metabolic Alkalosis is defined as a deficit or loss of hydrogen ions or acids or an excess of base (bicarbonate) that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions resulting in hypovolemia, the loss of gastric fluid, excessive bicarbonate intake, the massive transfusion of whole blood, and hyperaldosteronism. Loss of gastric fluid via nasogastric suction or vomiting causes Metabolic Alkalosis as a result of the loss of hydrochloric acid. Options 1, 3, & 4 are incorrect interpretations.

What is the normal range of bicarbonate ion (HCO3-) in arterial blood? A. 35-45 B. 21-28 C. 7.35-7.45 D. Not listed

B 21.28

A client with severe metabolic alkalosis has been admitted to the unit and is being cared for by a nursing student along with the nurse. What should the nurse say is a priority for this client? A) Administering medication for metabolic alkalosis B) Monitoring oxygen saturation C) Teaching the client the risk factors for metabolic alkalosis D) Setting goals for the client with metabolic alkalosis

B) Monitoring oxygen saturation

The nurse has admitted a client who was brought to the hospital after a morphine overdose. What acid-base imbalance does the nurse expect to observe in this client? A) Respiratory alkalosis B) Respiratory acidosis C) Metabolic alkalosis D) Metabolic acidosis

B) Respiratory acidosis

If the CO2 caused the acidosis or alkalosis, it is what? A. Metabolic B. Respiratory C. Combined D. None

B. Respiratory

PH 7.46, CO2 32mmHg, HCO3- 23mEq/L A. Respiratory acidosis B. Combined C. Metabolic alkalosis D. Respiratory alkalosis

D. Respiratory Alkalosis