Respiratory Alkalosis NCLEX Style Questions
Which arterial blood gas result shows a resolution to respiratory alkalosis? pH 7.44, CO2 24 mmHg pH 7.42, CO2 39 mmHg pH 7.39, CO2 60 mmHg pH 7.35, CO2 55 mmHg
pH 7.42, CO2 39 mmHg
Which arterial blood gas results indicate compensated respiratory alkalosis? pH 7.45, CO2 44 mmHg, HCO3 24 mEq/L pH 7.32, CO2 64 mmHg, HCO3 32 mEq/L pH 7.48, CO2 22 mmHg, HCO3 20 mEq/L pH 7.43, CO2 25 mmHg, HCO3 20 mEq/L
pH 7.43, CO2 25 mmHg, HCO3 20 mEq/L
The nurse is monitoring a client for development of an acid-base imbalance. When interpreting the client's arterial blood gas (ABG) results, which data is most consistent with uncompensated respiratory alkalosis? pH 7.50, PaCO2 = 32 mmHg, HCO3 = 24 mEq/L pH 7.32, PaCO2 = 51 mmHg, HCO3 = 24 mEq/L pH 7.50, PaCO2 = 35 mmHg, HCO3 = 28 mEq/L pH 7.39, PaCO2 = 39 mmHg, HCO3 = 26 mEq/L
pH 7.50, PaCO2 = 32 mmHg, HCO3 = 24 mEq/L
Which statement indicates the nurse understands the effect of respiratory alkalosis on calcium? "Ionized calcium binds freely with skeletal muscle, and will not bind with albumin." "Decreased calcium increases hydrogen ions." "Ionized calcium binds with albumin, resulting in tetany or arrhythmias." "Increased serum calcium causes an increase in pH in the blood."
"Ionized calcium binds with albumin, resulting in tetany or arrhythmias."
The nurse is preparing a presentation to a group of students about the risk factors for respiratory alkalosis. Which topic will the nurse include in the presentation? (Select all that apply.) Anxiety Vomiting High fever Thyrotoxicosis Hypoventilation
Anxiety High fever Thyrotoxicosis
Which nursing diagnosis is indicated for a client with respiratory alkalosis? Injury, Risk for Fluid Volume, Deficient Breathing Pattern, Ineffective Airway Clearance, Ineffective
Breathing Pattern, Ineffective
Which action should a nurse take to reduce the likelihood of a client developing hyperventilation and respiratory alkalosis? Set a schedule of exercise and activity. Administer medications to prevent hyperventilation. Promote continuous interaction with visitors. Decrease lights and noise.
Decrease lights and noise.
A 6-year-old child is very frightened in a healthcare provider's office. The child begins to breathe rapidly, about 80 breaths per minute. What intervention should the nurse use to prevent respiratory alkalosis from developing? (Select all that apply.) Firmly tell the child to calm down. Ask the parent to leave the room. Give the child a balloon to blow up. Speak in a low, calm voice and try to soothe the child. Leave the room until the parents are able to calm the child.
Give the child a balloon to blow up. Speak in a low, calm voice and try to soothe the child.
A client has presented to the emergency department with hyperventilation. The client is anxious and breathing approximately 60 breaths per minute. What is the correct initial action the nurse should take? Notify the physician and order labs to determine whether the client is in respiratory alkalosis. Have the client lie flat. Give the client a paper bag and have her breathe into it. Apply oxygen.
Give the client a paper bag and have her breathe into it.
Which would the nurse recognize as the most common cause of respiratory alkalosis? Hypoventilation Diarrhea Diabetes Hyperventilation
Hyperventilation
Which instruction should the nurse provide as education about self-control of a hyperventilation reaction? If chest pain is present along with rapid breathing, seek medical attention. All hyperventilation is related to anxiety. Hyperventilation will eventually correct itself, so immediate treatment is not necessary. Breathing into a paper bag is always the best first reaction.
If chest pain is present along with rapid breathing, seek medical attention.
A client asks the nurse for ways of identifying and coping with a hyperventilation reaction. Which method would be appropriate for the nurse to recommend? (Select all that apply.) Increase exercise. Use guided imagery. Try not to react with anxiety. Completely avoid anything that induces anxiety. Recognize situations that can lead to increased anxiety.
Increase exercise. Use guided imagery. Recognize situations that can lead to increased anxiety.
A client has been stabilized in the emergency department after experiencing respiratory alkalosis secondary to hyperventilation. The client states this has occurred before, and she asks the nurse how to recognize a hyperventilation reaction to anxiety. Which clinical manifestation should the nurse instruct the client to watch for? (Select all that apply.) Increased anxiety Irritability and restlessness Chest tightness and heaviness Increased breathing rate the client cannot control A loss of interest in social activities and feeling withdrawn
Increased anxiety Chest tightness and heaviness Increased breathing rate the client cannot control
Which vital sign would the nurse assess to determine if a client is possibly in a state of respiratory alkalosis? (Select all that apply.) Increased pulse Irregular pulse rate Increased temperature Decreased blood pressure Increased respiratory rate
Increased pulse Increased temperature Increased respiratory rate
The nurse is caring for a client who is receiving oxygen by a partial nonrebreather mask for the treatment of respiratory alkalosis. What is the rationale for administering oxygen in this manner? It promotes relaxation. It is the treatment of choice for myocardial infarction. It allows the client to get rid of extraneous O2. It increases CO2 levels.
It increases CO2 levels.
What strategy should the nurse suggest to the client for reducing clinical manifestations of a hyperventilation reaction? (Select all that apply.) Meditation Guided imagery Removing themselves from the situation Telling the nurse immediately so medication can be given Maintaining a calm, pleasant environment and participating in enjoyable activities
Meditation Guided imagery Maintaining a calm, pleasant environment and participating in enjoyable activities
Which clinical manifestation would the nurse expect to observe in a client experiencing respiratory alkalosis? (Select all that apply.) Panic Tinnitus Dizziness Palpitations Hypoventilation
Panic Tinnitus Dizziness Palpitations
Which setting would the nurse caring for a client on a ventilator recognize as having the highest potential of contributing to respiratory alkalosis? Rate Pressure support PEEP FiO2
Rate
Which is an appropriate goal when caring for a client with respiratory alkalosis? (Select all that apply.) The client will not hyperventilate. The client will maintain a pH of 7.35-7.45 for daily lab draws. The client will utilize anxiety-reduction strategies to prevent hyperventilation. The nurse will provide education to the client about preventing hyperventilation. The client will implement relaxation techniques if a hyperventilation reaction occurs.
The client will maintain a pH of 7.35-7.45 for daily lab draws. The client will utilize anxiety-reduction strategies to prevent hyperventilation. The client will implement relaxation techniques if a hyperventilation reaction occurs.
Which key concern would the nurse have in administering an antianxiety medication to an older adult client to prevent hyperventilation? (Select all that apply.) There is a potential for problems with addiction. There is concern about interaction with other medications. Slowed metabolic function can lead to suppressed respiratory effort. Older adult clients may not fully understand how to correctly take medications. Use of antianxiety medications is not correcting the underlying cause of anxiety.
There is concern about interaction with other medications. Slowed metabolic function can lead to suppressed respiratory effort.