Acid-Base Imbalances Practice Q's

The nurse expects which client to be in respiratory acidosis? A. Morphine overdose B. Panic attack C. Sleep apnea D. COPD E. Asthma attack F. Alcohol intoxication

A, C, D, E, F

The nurse notes that a clients arterial blood gas results reveal a pH of 7.50 and a PCO2 of 30 mmHg. The nurse monitors the client for which clinical manifestations associated with these arterial blood gas results? Select all that apply. A. Nausea B. Confusion C. Bradypnea D. Tachycardia E. Hyperkalemia F. Lightheadedness

A, B, D, F Clinical manifestations of respiratory alkalosis include lethargic, lightheadedness, confusion, tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, epigastric pain, and numbness and tingling of the extremities.

Best diagnostic test to evaluate a patient's oxygenation & ventilation after a traumatic brain injury?

Arterial blood gases (ABGs)

In respiratory acidosis the lungs retain ______?

CO2

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 HCO3 is 22 mEq/L The nurse interprets the results as indicating which condition? A. Metabolic acidosis with compensation B. Respiratory acidosis with compensation C. Metabolic acidosis without compensation D. Respiratory acidosis without compensation

D. Respiratory acidosis without compensation

A patient ABG level is pH 7.34, PaCO2 60, HCO3 37. A. Metabolic alkalosis, total compensation B. Metabolic alkalosis, partial compensation C. Respiratory acidosis, total compensation D. Respiratory acidosis, partial compensation

D. Respiratory acidosis, partial compensation.

A charge nurse is teaching a group of nurses about conditions related to metabolic acidosis. Which of the following statements by unit nurse indicates the teaching has been effective? A. "metabolic acidosis can occur due to diabetic ketoacidosis." B. " metabolic acidosis can occur in a client who has myasthenia gravis." C. "metabolic acidosis can occur in a client who has asthma." D. "metabolic acidosis can occur due to cancer."

A. "metabolic acidosis can occur due to diabetic ketoacidosis." Metabolic acidosis results from an excess production of hydrogen ions, which occurs in diabetic ketoacidosis.

A nurse is caring for a client who was in a motor vehicle accident. The client reports chest pain and difficulty breathing. A chest x-ray reveals the client has a pneumothorax. Which of the following arterial blood gas findings should the nurse expect? A. pH 7.06 PaO2 86 mmHg PaCO2 52 mmHg HCO3 -24 mEq/L B. pH 7.42 PaO2 100 mmHg PaCO2 38 mmHg HCO3 -23 mEq/L C. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 -18 mEq/L D. pH 7.58 PaO2 96 mmHg PaCO2 38 mmHg HCO3 -29 mEq/L

A. pH 7.06 PaO2 86 mmHg PaCO2 52 mmHg HCO3 -24 mEq/L A pneumothorax can cause alveolar hypoventilation and increased carbon dioxide levels resulting in a state of respiratory acidosis.

Nurse caring for a client with an ileostomy understands that the client is most at risk for developing which acid-based disorder? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A. Metabolic acidosis Intestinal secretions are high in bicarbonate and may be lost through enteric drainage tubes, an ileostomy, or diarrhea. These conditions result in metabolic acidosis.

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 nurses findings? A. pH 7.25, PCO3 50 mmHg B. pH 7.35, PCO3 40 mmHg C. pH 7.50, PCO3 52 mmHg D. pH 7.52, PCO3 28 mmHg

A. pH 7.25, PCO3 50 mmHg In respiratory acidosis, the pH is decreased and the PCO2 is elevated.

What is the most important objective data when determining if a client is hypoxic?

Abnormal blood gases (ABGs)

What is the essential action after ABGs are drawn?

Apply pressure to puncture site

How does the nurse expect the client to show compensation for the following ABG values? (Metabolic acidosis) pH 7.20, PaO2 82mmHg, PaCO2 37mmHg, HCO 15mEq/L A. Decreased respiratory rate B. Increased respiratory rate C. Increased renal retention of H+ D. Decreased renal excretion of HCO3

B. Increased respiratory rate to blow off all the acid.

The nurse is caring for a client with the nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-based disorder? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

B. Metabolic alkalosis Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid.

The nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a PCO2 of 30 mmHg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition? A. Sodium level of 145 mEq/L B. Potassium level of 3.0 mEq/L C. Magnesium level of 2.0 mg/dL D. Phosphorus level of 4.0 mg/dL

B. Potassium level of 3.0 mEq/L All three incorrect options identify normal laboratory values. The correct option identifies the presence of hypokalemia.

The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, PCO2 30 mmHg, HCO3 20 mEq/L The nurse analyzes these results as indicating which condition? A. Metabolic acidosis, compensated B. Respiratory alkalosis, compensated C. Metabolic alkalosis, uncompensated D. Respiratory acidosis, uncompensated

B. Respiratory alkalosis, compensated In an alkalotic condition, the pH is elevated. Because the pH has returned to a normal value, compensation has occurred.

A patient with a history of myasthenia gravis is admitted to the ED with complaints of respiratory distress. The clients condition worsens and arterial blood gases are drawn. Which condition is expected? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis

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 base imbalance? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis Respiratory acidosis is most often caused by hypoventilation in a client with COPD. COPD is a respiratory condition, not a metabolic one.

A nurse is caring for a client admitted with confusion and lethargy. The client was found at home unresponsive with an empty bottle of aspirin lying next to the bed. Vital signs reveal blood pressure 104/72 mmHg, heart rate 116/min with regular rhythm, and respiratory rate 42/min and deep. Which of the following arterial blood gas findings should the nurse expect? A. pH 7.68 PaO2 96 mmHg PaCO2 38 mmHg HCO3 -28 mEq/L B. pH 7.48 PaO2 100 mmHg PaCO2 28 mmHg HCO3 -23 mEq/L C. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 -29 mEq/L D. pH 7.58 PaO2 96 mmHg PaCO2 38 mmHg HCO3 -29 mEq/L

C. pH 6.98 PaO2 100 mmHg PaCO2 30 mmHg HCO3 -29 mEq/L An aspirin toxicity would result in arterial blood gas findings of metabolic acidosis

Which ABG result would you expect to see in a patient with PNA, who has respiratory distress? A. pH 7.40 PaCO2 46mmHg HCO3 -23mEq/L B. pH 7.37 PaCO2 40mmHg HCO3 -25mEq/L C. pH 7.30 PaCO2 60mmHg HCO3 -24mEq/L D. pH 7.48 PaCO2 32mmHg HCO3 -26mEq/L

C. pH 7.30 PaCO2 60mmHg HCO3 -24mEq/L Because the pH dropped.

When CO2 concentration in the blood increases breathing becomes... A. Shallow and slow B. No effect on breathing C. Slow and deep D. Faster and deeper

D. Faster and deeper

A client with a three day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram monitor displays tachycardia with a heart rate of 120 bpm. Arterial blood gases are drawn and the nurse reviews the results, expecting to know which finding? A. Decreased pH and increased CO2 B. Increased pH and decreased CO2 C. Decreased pH and decreased HCO3 D. Increased pH and increased HCO3

D. Increased pH and increased HCO3 Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and HCO3 to increase.

A nurse is obtaining arterial blood gases for a client who has vomited for 24 hours. The nurse should expect which of the following acid base in balance is to result from vomiting for 24 hours? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

D. Metabolic alkalosis Excessive vomiting causes a loss of gastric acid and an accumulation of bicarbonate in the blood resulting in metabolic alkalosis.

The nurse is caring for a client with diabetic keto acidosis and documents that the client is experiencing Kussmaul's respirations. On the basis of this documentation, which pattern did the nurse observe? A. Respirations that cease for several seconds B. Respirations that are regular but abnormally slow C. Respirations that are labored and increased in depth and rate D. Respirations that are abnormally deep, regular, and increased in rate

D. Respirations that are abnormally deep, regular, and increased in rate

The nurse is assessing a client who has pancreatitis. The clients arterial blood gas is revealed metabolic acidosis. Which of the following are expected findings? (Select all that apply.) A. Tachycardia B. Hypertension C. Bounding pulses D. Hyperreflexia E. Dysrhythmia F. Tachypnea

E. Dysrhythmia F. Tachypnea Dysrhythmia and Tachypnea are expected findings in a client who has pancreatitis and metabolic acidosis.