Question 1

For a patient with respiratory acidosis,chronic compensation by the body will include: A) Kidney excretion of H⁺ B) Kidney excretion of HCO₃ C) Prolonged exhalations to blow off CO₂ D) Protein buffering

Accepted Answer

The kidneys excrete H⁺ to compensate for respiratory acidosis. The kidneys do not excrete HCO₃ to compensate; this would increase acidosis. Prolonged exhalations would not be effective for compensation,especially in a chronic state. Protein buffering is intracellular and will not be effective enough to compensate for respiratory acidosis.

Question 2

A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor.Further testing indicates that the tumor secretes ADH.Which of the following assessment findings should the nurse expect? (Select all that apply.)
A) Confusion
B) Weakness
C) Nausea
D) Muscle twitching
E) Weight loss

Accepted Answer

Secretion of ADH leads to water intoxication with symptoms of cerebral edema,with confusion and convulsions; weakness; nausea; muscle twitching; headache; and weight gain,not loss.

Question 3

Which of the following conditions would cause the nurse to monitor for hyperkalemia?
A) Excess aldosterone
B) Acute acidosis
C) Insulin usage
D) Metabolic alkalosis

Accepted Answer

In acidosis,ECF hydrogen ions shift into the cells in exchange for ICF potassium and sodium; hyperkalemia and acidosis therefore often occur together.
Acidosis causes hyperkalemia,not excess aldosterone.
Insulin would help treat hyperkalemia,not cause it.
It is acidosis,not alkalosis,that leads to hyperkalemia.

Question 4

The nurse would anticipate the patient with syndrome of inappropriate ADH (SIADH)to demonstrate which of the following symptoms? (Select all that apply.)
A) Weakness
B) Nausea
C) Headache
D) Weight loss
E) Muscle twitching

Accepted Answer

Weakness,nausea,muscle twitching,headache,and weight gain,not loss,are common symptoms of chronic water accumulation.

Question 5

A 55-year-old female presents to her primary care provider and reports dizziness,confusion,and tingling in the extremities.Blood tests reveal an elevated pH,decreased PCO₂,and slightly decreased HCO₃.Which of the following is the most likely diagnosis? A) Respiratory alkalosis with renal compensation B) Respiratory acidosis with renal compensation C) Metabolic alkalosis with respiratory compensation D) Metabolic acidosis with respiratory compensation

Accepted Answer

With an elevated pH,the diagnosis must be alkalosis.Since the PCO₂ is low,it is likely respiratory with a slight decrease in HCO₃ indicating renal compensation. With an elevated pH,the diagnosis must be alkalosis,not acidosis. With an elevated pH,the diagnosis must be alkalosis.Since the PCO₂ is low,it is likely respiratory since the HCO₃ is decreased. With an elevated pH,the diagnosis must be alkalosis.

Question 6

A nurse recalls regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:
A) Buffer systems
B) Kidneys
C) Lungs
D) Liver

Accepted Answer

The volatile acid is carbonic acid (H?CO?),which readily dissociates into carbon dioxide (CO?)and water (H?O).The CO? is then eliminated by the lungs.
Buffer systems are throughout the body and operate in the extracellular and intracellular systems.
The kidneys release hydrogen ions,not volatile acids.
The liver does not regulate acid-base balance.

Question 7

A 54-year-old male with a long history of smoking complains of excessive tiredness,shortness of breath,and overall ill feelings.Lab results reveal decreased pH,increased CO₂,and normal bicarbonate ion.These findings help to confirm the diagnosis of: A) Respiratory alkalosis B) Metabolic acidosis C) Respiratory acidosis D) Metabolic alkalosis

Accepted Answer

A decreased pH indicates acidosis.With increased CO₂,it is respiratory acidosis. The decreased pH indicates acidosis,not alkalosis. It is acidosis,but the bicarbonate is normal,so it cannot be metabolic. The decreased pH indicates acidosis,not alkalosis.

Question 8

A 60-year-old female is diagnosed with hyperkalemia.Which assessment finding should the nurse expect to observe?
A) Weak pulse
B) Excessive thirst
C) Oliguria
D) Constipation

Accepted Answer

Hyperkalemia is manifested by oliguria.
Hypokalemia is manifested by a weak pulse; it is not caused by hyperkalemia.
Hypokalemia is manifested by excessive thirst.
Diarrhea,not constipation,is a manifestation of hyperkalemia.

Question 9

Which finding would support the diagnosis of respiratory acidosis?
A) Vomiting
B) Hyperventilation
C) Pneumonia
D) An increase in noncarbonic acids

Accepted Answer

Respiratory acidosis occurs with hypoventilation,and pneumonia leads to hypoventilation.
Vomiting leads to loss of acids and then to alkalosis.
Hyperventilation leads to respiratory alkalosis,not acidosis.
Metabolic acidosis is caused by an increase in noncarbonic acids.

Question 10

Which patient should the nurse assess for both hyperkalemia and metabolic acidosis? A patient diagnosed with:
A) Diabetes insipidus
B) Pulmonary disorders
C) Cushing syndrome
D) Renal failure

Accepted Answer

Renal failure is associated with hyperkalemia and metabolic acidosis.
Diabetes insipidus results in hypernatremia.
Pulmonary disorders are a cause of respiratory acidosis or alkalosis but do not affect hyperkalemia.
Cushing syndrome results in hypernatremia.

Question 11

A 19-year-old male presents to his primary care provider reporting restlessness,muscle cramping,and diarrhea.Lab tests reveal that he is hyperkalemic.Which of the following could have caused his condition?
A) Primary hyperaldosteronism
B) Acidosis
C) Insulin secretion
D) Diuretic use

Accepted Answer

During acute acidosis,hydrogen ions accumulate in the ICF and potassium shifts out of the cell to the ECF,causing hyperkalemia.
Primary hyperaldosteronism is associated with hypokalemia,not hyperkalemia.
Insulin secretion helps reduce potassium levels in the cell,not cause it.
Diuretics would cause hypokalemia,not hyperkalemia.

Question 12

For a patient experiencing metabolic acidosis,the body will compensate by: A) Excreting H⁺ through the kidneys B) Hyperventilating C) Retaining CO₂ in the lungs D) Secreting aldosterone

Accepted Answer

In an attempt to compensate for metabolic acidosis,the lungs hyperventilate to blow off CO₂. It is the lungs hyperventilating that would compensate for metabolic acidosis,not the kidneys. CO₂ retention would increase the acidotic state. Aldosterone would conserve water,but does not help compensate for acidosis.

Question 13

Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of:
A) 20:1
B) 1:20
C) 10:2
D) 2:10

Accepted Answer

Normal carbonic acid to bicarbonate ratio is 20:1.
Normal carbonic acid to bicarbonate ratio is 20:1.
Normal carbonic acid to bicarbonate ratio is 20:1.
Normal carbonic acid to bicarbonate ratio is 20:1.

Question 14

Which of the following buffer pairs is considered the major plasma buffering system?
A) Protein/fat
B) Carbonic acid/bicarbonate
C) Sodium/potassium
D) Amylase/albumin

Accepted Answer

The carbonic acid/bicarbonate buffer pair operates in both the lung and the kidney and is a major extracellular buffer.
Protein and fat are nutrients not related to the buffering system.
Sodium and potassium are electrolytes for fluid and electrolyte balance,not the major plasma buffering system for acid-base balance.
Amylase is a carbohydrate enzyme,and albumin is a protein; neither is a buffering system.

Question 15

Which patient is most prone to metabolic alkalosis? A patient with:
A) Retention of metabolic acids
B) Hypoaldosteronism
C) Excessive loss of chloride (Cl)
D) Hyperventilation

Accepted Answer

When acid loss is caused by vomiting,renal compensation is not very effective because loss of Cl stimulates renal retention of bicarbonate,leading to alkalosis.
Retention of metabolic acids would lead to acidosis,not alkalosis.
Hypoaldosteronism leads to hyponatremia and does not cause alkalosis.
Hyperventilation leads to respiratory alkalosis,not metabolic alkalosis.

Question 16

Which organ system should the nurse monitor when the patient has long-term potassium deficits?
A) Central nervous system (CNS)
B) Lungs
C) Kidneys
D) Gastrointestinal tract

Accepted Answer

Long-term potassium deficits lasting more than 1 month may damage renal tissue,with interstitial fibrosis and tubular atrophy.
Long-term potassium deficits damage the kidneys,not the CNS.
Long-term potassium deficits damage the kidneys,not the lungs.
Long-term potassium deficits damage the kidneys,not the gastrointestinal tract.

Question 17

A 42-year-old female presents to her primary care provider reporting muscle weakness and cardiac abnormalities.Laboratory tests indicate that she is hypokalemic.Which of the following could be the cause of her condition?
A) Respiratory acidosis
B) Constipation
C) Hypoglycemia
D) Primary hyperaldosteronism

Accepted Answer

Primary hyperaldosteronism,with excessive secretion of aldosterone from an adrenal adenoma (tumor)also causes potassium wasting.
Acidosis is related to hyperkalemia,not hypokalemia.
Constipation can occur with hypokalemia but does not cause it.
Hypoglycemia is not related to muscle weakness.

Question 18

Outcomes of laboratory tests include an elevated level of natriuretic peptides.Which organ is the priority assessment?
A) Lungs
B) Heart
C) Liver
D) Brain

Accepted Answer

Elevated natriuretic peptides indicate problems with the heart or the vasculature.
Elevated natriuretic peptides indicate problems with the heart or the vasculature,not the lungs.
Elevated natriuretic peptides indicate problems with the heart or the vasculature,not the liver.
Elevated natriuretic peptides indicate problems with the heart or the vasculature,not the brain.

Quiz 4: Fluids and Electrolytes, Acids and Bases

For a patient with respiratory acidosis,chronic compensation by the body will include:

A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor.Further testing indicates that the tumor secretes ADH.Which of the following assessment findings should the nurse expect? (Select all that apply.)

Which of the following conditions would cause the nurse to monitor for hyperkalemia?

The nurse would anticipate the patient with syndrome of inappropriate ADH (SIADH) to demonstrate which of the following symptoms? (Select all that apply.)

A 55-year-old female presents to her primary care provider and reports dizziness,confusion,and tingling in the extremities.Blood tests reveal an elevated pH,decreased PCO₂,and slightly decreased HCO₃.Which of the following is the most likely diagnosis?

A nurse recalls regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:

A 54-year-old male with a long history of smoking complains of excessive tiredness,shortness of breath,and overall ill feelings.Lab results reveal decreased pH,increased CO₂,and normal bicarbonate ion.These findings help to confirm the diagnosis of:

A 60-year-old female is diagnosed with hyperkalemia.Which assessment finding should the nurse expect to observe?

Which finding would support the diagnosis of respiratory acidosis?

Which patient should the nurse assess for both hyperkalemia and metabolic acidosis? A patient diagnosed with:

A 19-year-old male presents to his primary care provider reporting restlessness,muscle cramping,and diarrhea.Lab tests reveal that he is hyperkalemic.Which of the following could have caused his condition?

For a patient experiencing metabolic acidosis,the body will compensate by:

Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of:

Which of the following buffer pairs is considered the major plasma buffering system?

Which patient is most prone to metabolic alkalosis? A patient with:

Which organ system should the nurse monitor when the patient has long-term potassium deficits?

A 42-year-old female presents to her primary care provider reporting muscle weakness and cardiac abnormalities.Laboratory tests indicate that she is hypokalemic.Which of the following could be the cause of her condition?

Outcomes of laboratory tests include an elevated level of natriuretic peptides.Which organ is the priority assessment?