Deck 9: Acid-Base Imbalances

Question 1

The nurse is caring for a client with acute respiratory acidosis and notes the client's rate and depth of breathing are increased. What is the nurse's understanding of the cause of this finding?

A) Respiratory muscles increase the force of contraction with excess hydrogen levels in the blood.
B) The diaphragm weakens with excess hydrogen levels in the blood.
C) As the pH increases, the respiratory rate increases.
D) As the carbon dioxide level decreases, the respiratory rate increases.

Answer 1

Respiratory muscles increase the force of contraction with excess hydrogen levels in the blood.

Question 2

The nurse reviews arterial blood gas results and notes the client has a metabolic acidosis. Which organ does the nurse expect will compensate for the client's acid-base imbalance?

A) Kidneys
B) Lungs
C) Liver
D) Brain

Answer 2

Lungs

Question 3

A client with renal impairment presents with an acid-base imbalance. Which mechanisms does the nurse recognize may be impaired? Select all that apply.

A) Resorption of bicarbonate from the renal tubule into the blood.
B) Secretion of bicarbonate into the urine.
C) Resorption of hydrogen from the nephron into the blood.
D) Excretion of hydrogen buffered by ammonia.
E) Secretion of hydrogen into the urine.

Answer 3

Resorption of bicarbonate from the renal tubule into the blood.
Excretion of hydrogen buffered by ammonia.
Secretion of hydrogen into the urine.

Question 4

The nurse cares for a client with acute respiratory acidosis. Which central nervous system (CNS) manifestation will the nurse likely find?

A) Parasthesias
B) Dizziness
C) Anxiety
D) Papilledema

Question 5

The nurse cares for a client with metabolic acidosis and hyperphosphatemia. What pathophysiological process does the nurse recognize is the reason for the client's phosphate abnormality?

A) Depression of glycolysis
B) Ionized calcium is decreased
C) Hydrogen ions move out of the cells
D) Positive and negative ions enter the cells

Question 6

The nurse cares for a client experiencing prolonged vomiting resulting in metabolic alkalosis. Which physiologic effect of alkalosis does the nurse recognize?

A) Movement of potassium out of the cells in exchange for hydrogen into the cells.
B) Increased level of free calcium blocking sodium channels.
C) Increased glycolysis and utilization of phosphate.
D) Decreased cardiac contractility.

Question 7

The nurse cares for a critically ill client with a severe acid-base imbalance. When reviewing the client's anion gap, which additional laboratory value does the nurse recognize may skew the anion gap results?

A) Hemoglobin
B) Albumin
C) PaO₂
D) PaCO₂

Question 8

The nurse cares for a client with an acid-base imbalance. Which electrolyte imbalance will most likely cause respiratory acidosis?

A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypernatremia

Question 9

A nurse cares for a client with hyperpyrexia due to pyelonephritis. Which acid-base imbalance is most likely with this client?

A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Respiratory acidosis

Question 10

An older adult client presents to the emergency room with a severe acid-base imbalance after taking "cold medicine" for a week. The client has a history of arthritis and reports daily use of aspirin. Which late effect acid-base imbalance does the nurse suspect the client is experiencing?

A) Respiratory alkalosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Metabolic acidosis

Question 11

The nurse cares for four clients with acid-base imbalances. Which client is most likely experiencing metabolic alkalosis?

A) Adult who has had lactated Ringer's solution infusing for 72 hours.
B) Adolescent with a diagnosis of diabetic ketoacidosis.
C) Older adult with a diagnosis of salicylate poisoning.
D) Child with severe diarrhea.

Question 12

A client with congestive heart failure is voiding large amounts of urine via indwelling urinary catheter. Which acid-base balance does the nurse recognize the client is at greatest risk for developing?

A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis

Question 13

The nurse is reviewing the arterial blood gas results of a client. When comparing various components of the ABG, which statement does the nurse recognize is true?

A) The higher the pH, the higher the H+ concentration.
B) The higher the HCO₃, the lower the pH.
C) The lower the pH, the higher the H+ concentration.
D) The lower the PaCO₂, the lower the pH.

Question 14

The nurse is caring for a client with respiratory acidosis. Which compensatory mechanism does the nurse understand will act to normalize the client's acid-base balance?

A) Kidneys excrete bicarbonate.
B) Hypoventilation retains carbon dioxide.
C) Hyperventilation releases carbon dioxide.
D) Kidneys reabsorb bicarbonate.

Question 15

A client with liver failure is diagnosed with metabolic acidosis. What pathophysiological mechanism does the nurse recognize is the cause of the client's acid-base imbalance?

A) Volume deficit and loss of gastric acid.
B) Impaired clearance of hydrogen ions.
C) Poor tissue perfusion and anaerobic metabolism.
D) Impaired clearance of lactate.

Question 16

A nurse cares for a client with chronic respiratory acidosis who is placed on mechanical ventilation for an acute exacerbation of emphysema. Which acid-base abnormality will the nurse expect if the client's PaCO₂ is corrected too quickly?

A) pH 7.52
B) pH 7.35
C) HCO₃ 18 mmoL/L
D) HCO₃ 24 mmoL/L

Question 17

The nurse cares for a pediatric client who has accidentally taken an overdose of antacids. Which acid-base abnormality does the nurse anticipate the client will manifest?

A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis

Question 18

The nurse is caring for a client with metabolic alkalosis. The health care provider prescribes acetazolamide for the treatment of the client's condition. What is the nurse's understanding of the purpose of this treatment?

A) It increases renal resorption of bicarbonate.
B) It decreases carbonic acid levels in the blood.
C) It decreases urinary output and hydrogen loss.
D) It increases renal excretion of bicarbonate.

Question 19

The nurse is caring for a client with uncompensated respiratory acidosis. Which acid-base findings will the nurse anticipate? Select all that apply.

A) pH 7.29
B) HCO₃ 23 mmoL/L
C) HCO₃ 18 mmoL/L
D) pH 7.48
E) PaCO₂ 50 mmHg

Question 20

The nurse is caring for a client with an acid-base imbalance. The nurse recognizes that the client has an alteration in protein function due to the imbalance. Proteins are components of which pathophysiological concept or process? Select all that apply.

A) Receptors
B) Ion channels
C) Ion pumps
D) Metabolic reaction catalysts
E) Production of cellular energy