NUR 305 Acid Base Practice Questions

A nurse is planning care for a school-aged child experiencing respiratory acidosis. What is the sequence of events that occurs in the child's respiratory response to acidosis? Place the physiologic responses in the order in which they occur

1. hyperventilation 2. increased CO2 elimination 3. decreased blood H+ ions 4. increased pH

A client is in a state of uncompensated acidosis. What approximate arterial blood pH does the nurse expect the client to have? a. 7.20 b. 7.35 c. 7.45 d. 7.48

A. 7.20 Acidic

A client develops respiratory alkalosis. When the nurse is reviewing the laboratory results, which finding is consistent with respiratory alkalosis? a. an elevated pH, elevated PCO2 b. a decreased pH, elevated PCO2 c. an elevated pH, decreased PCO2 d. a decreased pH, decreased PCO2

C

A nurse on the pediatric unit is reviewing the arterial blood gas values of a 4-year-old child recovering from severe dehydration. Which results most accurately reflect the child's recovery? a. pH 7.50, Po2 85 mm Hg,Pco2 35 mm Hg b. pH 7.25, Po2 60 mm Hg, Pco2 50 mm Hg c. pH 7.40, Po2 85 mm Hg, Pco2 40 mm Hg d. pH 7.45, Po2 70 mm Hg, Pco2 25 mm Hg

C Because these gases are within normal limits 7.40 pH is normal 85 PO2 is normal CO2 40 is normal

What is a nursing priority to prevent complications in clients with respiratory acidosis? a. assessing nail beds b. listening to breath sounds c. monitoring breath status d. checking muscle contractions

C. monitoring breath status preventing complications when clients have respiratory acidosis - monitor breath status hourly and intervening changes, assessing the nail beds for cyanosis, which is usually a late finding in acidosis, is not a priority intervention. Listening to breath sounds and assessing how easily air is moving is a secondary priority

A patient is brought to the ED after being hit by a car while biking. He is unresponsive, has shallow breathing, and has an open femur fracture from which he has lost a significant amount of blood. The nurse anticipates which acid-base imbalance? a. metabolic alkalosis b. respiratory acidosis c. metabolic alkalosis and respiratory alkalosis d. metabolic acidosis and respiratory acidosis

D Shallow breathing = respiratory acidosis Loss of blood = metabolic acidosis

The nurse is evaluating the laboratory work of a patient who has uncontrolled metabolic acidosis. Which outcome would result from this condition? a. pH 7.30 b. bicarbonate 18 mEq/L c. Pao2 98 mm Hg d. serum potassium 5.7 mEq/L

D. serum potassium of 5.7 *Acidosis is most commonly associated with high potassium (hyperkalemia) !! Needs to have cardiac monitoring because of dysrhythmias

The nurse is caring for a client with the following arterial blood gas values PO2 89 mmHg PCO2 35 mmHg pH 7.37 These findings indicate that the client is experiencing which condition? a. acid-base balance b. fluid balance c. oxygen depletion d. metabolic acidosis

A. Acid-Base Balance

A patient has the following ABG results pH 7.48 PAO2 86 PACO2 44 HCO3 29 When assessing the patient, the nurse would expect the patient to have a. muscle cramping b. warm flushed skin c. respiratory rate of 36 d. blood pressure of 94/54

A. muscle cramping the patient is experiencing metabolic alkalosis

A patient with acid-base imbalance has an altered potassium level. The nurse recognizes that the potassium level is altered because:

Acidosis causes hydrogen ions in the blood to be exchanged for potassium from the cells

The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient has a history of chronic obstructive pulmonary disease (COPD), and his laboratory results and assessment reveal that he has mild respiratory acidosis. The nurse would question which order? a. encourage oral fluids b. oxygen therapy at 4 L/min PRN c. keep head of bed elevated d. bedrest with bathroom privileges

B Patient has COPD!!! if the oxygen is too high it can alter their breathing

To determine the presence of respiratory alkalosis in the laboring client, what should the nurse evaluate her for? a. A change in the respiratory rate b. A tingling sensation in the hands c. Periodic changes in the fetal heart rate d. pulse oximetry reading of less than 98%

B a tingling sensation in the hands indicates respiratory alkalosis due to a decrease in CO2

The nurse is caring for a 74 year old client scheduled for a cardiac catheterization with contrast dye. What nursing action is appropriate?

B. assess for co-existing conditions of diabetes, heart failure and kidney disease C. Collaborate with the provider about whether IV fluids should be infused before the test E. Alert the provider to a GFR of 60mL/min

A patient with acid-base imbalance has an altered potassium level. The nurse recognizes that the potassium level is altered because a. potassium is returned to extracellular fluid when metabolic acidosis is corrected b. hyperkalemia causes an alkalosis that results in potassium being shifted into cells c. acidosis causes hydrogen ions in the blood to be exchanged for potassium in the cells d. in alkalosis, potassium is shifted into extracellular fluid to bind excessive bicarbonate

C Changes in pH will affect potassium imbalance, and potassium shifts out of the cell to the extracellular fluid to maintain balance of cations across the cell membrane. ALKALOSIS: HYPOKALEMIA

A client is admitted with metabolic acidosis. The nurse considers that two body systems interact with the bicarbonate buffer system to preserve healthy body fluid pH. What two body systems should the nurse assess for compensatory changes? a. skeletal and nervous b. circulatory and urinary c. respiratory and urinary d. muscular and endocrine

C. respiratory and urinary Increased respirations blow off CO2, which decreases the hydrogen ion concentration and the pH increases. Decreased respirations result in CO2 buildup, which increases hydrogen ion concentration and the pH falls. Key words: Metabolic and pH

The nurse on a medical-surgical unit identifies that which patient has the highest risk for metabolic alkalosis? a. traumatic brain injury b. type 1 diabetes 3. acute respiratory failure 4. nasogastric tube suction

D. NG suction The patient is losing gastric acid which puts them at risk for metabolic alkalosis

A patient has the following ABG results: pH: 7.48 paO2: 86 CO2: 44 HCO3: 29 When assessing the patient, the nurse would expect the patient to experience? a. warm flushed skin b. respiratory rate of 36 c. blood pressure of 94/52 d. hypertonic muscles with cramping

D: hypertonic muscles with cramping because of hypokalemia - warm flushed skin is indicated with acidosis -respiratory rate of 36 would indicate hyperventilation -blood pressure of 94/52 - hyperkalemia is acidosis - hypokalemia is alkalosis

An arterial blood gas report indicates the client's pH 7.25 CO2 35 HCO3 20 Which disturbance should the nurse identify based on these results?

Metabolic acidosis