Acid-Base Questions

A client's most recent laboratory results suggest the presence of metabolic alkalosis. What action by the nurse best addresses a potential cause of this acid-base imbalance? a. Administering an antiemetic to treat the clients frequent vomiting b. Assessing the clients bowel sounds and administering scheduled stool softeners c. Assessing the clients level of consciousness using the Glasgow Coma Scale d. Repositioning the client frequently to reduce pressure on dependent skin surfaces

Administering an antiemetic to treat the clients frequent vomiting

A client has these arterial blood gas values: anion gap 20 mEq/L, pH 7.29, pCO2 37mm Hg, HCO3- 11 mEq/L, base excess -6 mEq/L. With what condition do these values correspond? a. Hyperkalemia b. Lithium toxicity c. Multiple myeloma d. Lactic acidosis

Lactic acidosis

The nurse recognizes the role of the lungs in acid-base balance is regulation of which of the following? a. CO2 b. H2O c. HCO3 d. Hydrogen

CO2

When interpreting the arterial blood gas, the nurse recognizes which of these reflects the value for bicarbonate? a. H2CO3 b. HCO3- c. HC d. H+

HCO3-

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma Pco2 levels. What is a common cause of respiratory alkalosis? a. Hyperventilation b. Kussmaul breathing c. Cluster breathing d. Hypoventilation

Hyperventilation

The nurse is reviewing laboratory data for the client with an anion gap of 17. The nurse recognizes which of these conditions are associated with an increased anion gap mEq/L? a. Lactic acidosis b. Hyperkalemia

Lactic acidosis

The nurse is caring for a client with worsening respiratory acidosis. Which of these interventions does the nurse anticipate if the client's condition continues to deteriorate? a. Reducing the amount of supplemental oxygen b. Mechanical ventilation c. Resolution of the underlying emotional cause d. Introduction of large muscle exercise

Mechanical ventilation

To calculate the H2CO3 content of the blood, the nurse needs to measure the Pco2 (partial pressure of CO2) by its solubility coefficient. What is the solubility coefficient of CO2? a. 0.03 b. 0.4 c. 0.04 d. 0.3

a. 0.03

The nurse is providing care for several clients on a medical unit. Which client likely has the highest risk for developing an acid-base imbalance? a. A client who is being treated for acute kidney injury and who requires dialysis b. A client who had an anaphylactic reaction to an insect sting and required resuscitation c. A client who has a rectovaginal fistula that will require surgery d. A client who is receiving intravenous penicillin for the treatment of primary syphillis

a. A client who is being treated for acute kidney injury and who requires dialysis

In which client would the nurse be most likely to assess the signs and symptoms of an acid-base imbalance? a. A client with chronic obstructive pulmonary disease whose most recent arterial blood gasses reveal a PCO2 of 51 mmHg b. A client with a fluid volume deficit who has been receiving intravenous 0.45% NaCl for over 48 hours c. A laboring client who is receiving an oxytocin infusion and who has been in the second stage of labor for seven hours d. A client who has been admitted with a traumatic head injury and whose intracranial pressure is 18 mmHg

a. A client with chronic obstructive pulmonary disease whose most recent arterial blood gasses reveal a PCO2 of 51 mmHg

How is hypoxia best treated? a. Administration of supplemental oxygen b. Rebreathing into a paper bag c. Alternating deep breathing with holding one's breath d. rapid, short, shallow breaths

a. Administration of supplemental oxygen

As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased: a. Bicarbonate/carbonic acid regulation b. Intracellular albumin c. Hydrogen/Potassium binding d. Sodium/phosphate anion absorption

a. Bicarbonate/carbonic acid regulation

The body regulates the pH of its fluids by what mechanism? a. Chemical buffer systems of the body fluids b. The lungs c. The cardiovascular system d. The liver e. The kidneys

a. Chemical buffer systems b. The lungs c. The kidneys

Which conditions can trigger ketoacidosis? Select all that apply. a. Excessive alcohol consumption b. A low-carbohydrate diet c. Starvation d. Uncontrolled diabetes mellitus e. Decreased cortisol levels

a. Excessive alcohol consumption b. A low-carbohydrate diet c. Starvation d. Uncontrolled diabetes mellitus

Which condition would result in an increased anion gap of greater than 14 mEq/L? a. Lactic acidosis b. Multiple myeloma c. Hypermagesemia d. Hyperkalemia

a. Lactic acidosis

The renal control mechanism of restoring the acid-base balance is accomplished through which process? a. Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms b. Reabsorption of hydrogen and excretion of carbonic acid c. Stimulation of the chemoreceptors in the brain stem d. Regulation of the production of carbonic acid

a. Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms

The nurse is caring for a client with acute primary respiratory acidosis. When determining the cause of the acidosis the nurse is aware that which of these is most common? a. Renal bicarbonate retention b. Impaired alveolar ventilation c. Increased metabolic acids d. Decreased CO2 retention

b. Impaired alvelolar ventilation

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications? a. Reduce dietary calcium b. Increase IV fluids c. Encourage ambulation d. Give aspirin for pain

b. Increase IV fluids

The nurse is reviewing the following lab results of a client diagnosed with renal failure: pH: 7.24 PCO2: 38 mm Hg HCO3:18 mEq/L The nurse would interpret this as: a. Metabolic alkalosis b. Metabolic acidosis c. Respiratory alkalosis d. Respiratory acidosis

b. Metabolic acidosis

What is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder? a. The client will compensate with the same system b. The client will compensate with the respiratory system c. The client will not be able to compensate d. The clients breathing will slow down

b. The client will compensate with the respiratory system

The nurse is caring for the following group of clients. Select the client most likely to be diagnosed with respiratory alkalosis. a. A 45-year-old male with pneumothorax after a car accident b. An 18-year-old female who has overdosed on narcotics c. A 26 year old female with anxiety who has been hyperventilating d. A 63 year old male with a 40 year history of smoking and chronic lung disease

c. A 26 year old female with anxiety who has been hyperventilating

The nurse is caring for a client with an acid base imbalance. Which of these does the nurse recognize is correct regarding compensation? a. A decreased pH is demonstrated b. An increased pH is demonstrated c. A pH moves toward the normal range d. There is no alteration the blood gas values

c. A pH moves toward the normal range

A client with a long history of alcohol abuse has been admitted to the emergency department after several of days of heavy drinking. The nurse can best promote the restoration of the client's acid-base balance by: a. positioning the client in an upright position when in bed and mobilizing the client frequently b. encouraging pursed lip breathing and deep breathing and coughing exercises c. administering intravenous sodium bicarbonate as prescribed d. administering intravenous magnesium sulfate as prescribed

c. Administering intravenous sodium bicarbonate as prescribed

The nurse is assessing a patient who is receiving mechanical ventilation. Which of the following assessment data obtained by the nurse may indicate that the patient is experiencing respiratory alkalosis? a. Hypotonia b. Negative Homan's sign c. Positive Chvostek sign d. Negative Trousseau sign

c. Positive Chvostek sign

The nurse caring for a client with metabolic acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's metabolic acidosis is improving? a. O2 has increased b. CO2 has increased c. pH has increased d. HCO3- has decreased

c. pH has increased

The nurse is caring for a client with diabetic ketoacidosis. Which breathing pattern does the nurse recognize is characteristic of metabolic acidosis? a. Shallow but rapid respirations b. Deep inspirations followed by shallow expirations c. Apnea followed by hyperpnea d. Deep and rapid respirations

d. Deep and rapid respirations

A client has been admitted to the hospital after losing 20 kg (44 lb) over the past 3 months, largely due to frequent induction of vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance? a. Mechanical ventilation and administration of supplementary oxygen b. Administration of intravenous sodium bicarbonate as prescribed c. Supplementary oxygen using a non-rebreather mask d. Fluid replacement with an intravenous solution containing KCl as prescribed

d. Fluid replacement with an intravenous solution containing KCl as prescribed

A client has these arterial blood gas values: anion gap 20 mEq/L, pH 7.29, pCO2 37mm Hg, HCO3- 11 mEq/L, base excess -6 mEq/L. With what condition do these values correspond? a. Multiple myeloma b. Hyperkalemia c. Lithium toxicity d. Lactic acidosis

d. Lactic acidosis

The nurse is caring for a client who has excessive diarrhea. Which of these acid base disturbances does the nurse anticipate uncovering during evaluation of the arterial blood gas? a. No change in values from normal b. An increase in bicarbonate c. Increased pH value d. Metabolic acidosis

d. Metabolic acidosis

Which acid-base disturbance is most likely to result in decreased respirations? a. Respiratory alkalosis b. Metabolic acidosis c. Respiratory acidosis d. Metabolic alkalosis

d. Metabolic alkalosis

The nurse is reviewing lab results of a client diagnosed with metabolic acidosis. The most important electrolyte for the nurse to assess would be: a. Calcium b. Magnesium c. Sodium d. Potassium

d. Potassium

The renal control mechanism of restoring the acid-base balance is accomplished through which process? a. Stimulation of the chemoreceptors in the brain stem b. Regulation of the production of carbonic acid c. Reabsorption of hydrogen and excretion of carbonic acid d. Reabsorption of carbonic acid and excretion of hydrogen

d. Reabsorption of carbonic acid and excretion of hydrogen

The condition of a client with metabolic acidosis from an intestinal fistula is not improving. The pulse is 125 beats/min and the BP 84/56mm Hg. ABG values are: pH 7.1, HCO3- 18 mEq/L, PCO2 57mm Hg. What IV medication should the nurse expect to provide next? a. Potassium chloride b. Epinephrine c. Antibiotics d. Sodium bicarbonate

d. Sodium bicarbonate

The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis? a. pH of 7.45 and HCO3 of 24 mEq/L b. pH of 7.25 and HCO3 of 18 mEq/L c. pH of 7.35 and HCO3 of 22 mEq/L d. pH of 7.50 and HCO3 of 45 mEq/L

d. pH of 7.50 and HCO3 of 45 mEq/L