Deck 9: Acidbase Balance

Question 1

The results of a patient's arterial blood gas sample indicate an oxygen level of 72 mm Hg. Based on this result the nurse needs to closely assess which parameter when providing care to this patient?
1)Perfusion
2)Level of consciousness
3)Urine output
4)Fluid and electrolytes

Answer 1

2

Question 2

The nurse is planning care for an older adult patient with respiratory acidosis. Which intervention does the nurse include in this patient's plan of care?
1)Perform chest physiotherapy.
2)Reduce environmental stimuli.
3)Administer intravenous sodium bicarbonate.
4)Administer prescribed intravenous fluids carefully.

Answer 2

1

Question 3

The nurse provides care to a patient admitted for the treatment of vomiting. When assessing the patient, the nurse closely monitors the patient for which clinical manifestation(s)?
1)Paresthesia
2)Respiratory distress
3)Kussmaul's respirations
4)Muscle twitching and cramps

Answer 3

4

Question 4

The nurse is reviewing the healthcare provider's orders for a patient who is diagnosed with respiratory alkalosis. Which order is appropriate for this patient's care needs?
1)Monitor arterial blood gas results.
2)Administer oxygen via face mask.
3)Restrict fluids to 2 L per day.
4)Infuse 1 ampule of sodium bicarbonate.

Question 5

A patient is admitted to the emergency department for the treatment of a drug overdose causing acute respiratory acidosis. Which substance noted on the toxicology report is the most likely cause for the current diagnosis?
1)PCP
2)Cocaine
3)Marijuana
4)Oxycodone

Question 6

In caring for patients with acid-base disorders, it is important that the nurse understand what regarding the renal buffering system?
1)This is the fastest buffering system.
2)Levels of PaCO₂ are regulated by the renal buffers.
3)Hydrogen ions are excreted if the body is in alkalosis.
4)Bicarbonate is excreted if the body is in alkalosis.

Question 7

The nurse is providing care to a patient admitted for a traumatic brain injury who has developed respiratory acidosis. Which action by the nurse is the priority?
1)Monitoring peripheral vascular status
2)Reassuring the patient to decrease anxiety
3)Assessing respiratory rate and depth closely
4)Administering sodium bicarbonate as ordered

Question 8

The nurse is analyzing the patient's arterial blood gas report after a cardiac arrest. Based on a pH of 7.15, the nurse monitors for which clinical manifestation?
1)Dysrhythmias
2)Tetany
3)Convulsions
4)Muscle twitching

Question 9

The nurse is providing care to a patient who has been vomiting for several days. Which acid-base disorder does the nurse assess for in this patient?
1)Metabolic alkalosis
2)Respiratory alkalosis
3)Metabolic acidosis
4)Respiratory acidosis

Question 10

A patient with elevated serum potassium is being treated with intravenous insulin and dextrose. The patient states, "I do not have diabetes. Why am I receiving insulin? " Which statement by the nurse is most appropriate?
1)"You may have early diabetes, and you will need further tests to rule this out."
2)"The insulin is given to counteract the glucose we are giving you to help lower your potassium level."
3)"Because your potassium is so high, the insulin helps to decrease the levels by moving potassium into your cells."
4)"The insulin will help decrease your potassium by making your kidneys get rid of potassium."

Question 11

The nurse is providing care to a patient who is intubated and receiving mechanical ventilation after a motor vehicle accident. The patient is fighting the ventilator and attempting to remove the endotracheal tube. Which nursing action decreases the patient's risk for developing respiratory alkalosis?
1)Apply wrist restraints.
2)Administer a prescribed sedative.
3)Teach the patient to take slow, deep breaths.
4)Recommend to the healthcare provider to increase the tidal volume on the ventilator.

Question 12

The nurse assesses a patient admitted to the hospital for treatment of pneumonia. The patient's pulse oximetry reads 77%. After repositioning the patient and increasing oxygen per the healthcare provider's order, there is no change in the pulse oximeter reading. Which is the priority action for the nurse?
1)Reassessing the patient in 1 hour
2)Obtaining an arterial blood gas analysis
3)Consulting the unit respiratory therapist
4)Documenting the findings in the medical record

Question 13

The nurse is providing care for an adult patient who is admitted to the emergency department (ED) after losing consciousness. The patient has been fasting and currently has ketones in the urine. The nurse monitors for which acid-base imbalance?
1)Metabolic acidosis
2)Metabolic alkalosis
3)Respiratory acidosis
4)Respiratory alkalosis

Question 14

The nurse completes discharge teaching for a patient with an anxiety disorder. Which patient statement indicates correct understanding of information related to respiratory alkalosis?
1)"I will eat more bananas at breakfast."
2)"I will practice stress reduction."
3)"I will not take antacids when I have heartburn."
4)"I will breathe faster when I am feeling anxious."

Question 15

The nurse prepares the patient diagnosed with chronic obstructive pulmonary disease (COPD) for which diagnostic test to monitor acid-base balance?
1)Pulse oximetry
2)Bronchoscopy
3)Sputum studies
4)Arterial blood gases

Question 16

The nurse is providing care for a patient admitted to the unit with respiratory failure and respiratory acidosis. The nurse correlates which data from the patient's history as the probable cause for the current diagnosis?
1)Recent severe pulmonary infection
2)A recent trip to South America
3)Recent recovery from a cold virus
4)Use of ibuprofen for the control of pain

Question 17

The patient is admitted to the emergency department (ED) with symptoms of a panic attack. Based on this data, the nurse recognizes the patient is at risk for which acid-base disorder?
1)Metabolic alkalosis
2)Metabolic acidosis
3)Respiratory acidosis
4)Respiratory alkalosis

Question 18

The nurse assesses a patient who is admitted for the treatment of anorexia nervosa based on a 15-pound weight loss over the last month. When assessing the patient, the nurse monitors for which clinical manifestation?
1)Dyspnea
2)Dry mouth
3)Dysrhythmia
4)Disorientation

Question 19

A patient is admitted for evaluation of a bowel obstruction and has a nasogastric tube placed to low intermittent suction. The physician orders arterial blood gases, and the following results are reported: pH7.37
PaCO₂33 mm Hg
PaO₂94 mm Hg
HCO₃19 mm Hg
SaO₂98%
What is the nurse's interpretation of these results?
1)Fully compensated metabolic acidosis
2)Uncompensated metabolic acidosis
3)Uncompensated respiratory alkalosis
4)Partially compensated respiratory alkalosis

Question 20

The nurse is providing care to patient with the following laboratory values: pH 7.31; PaCO₂ 48 mm Hg; and HCO₃ 24 mEq/L. The nurse correlates these values to which acid-base disorder?
1)Metabolic acidosis
2)Metabolic alkalosis
3)Respiratory acidosis
4)Respiratory alkalosis

Question 21

Which risk factors exhibited by the patient presenting in the emergency department (ED) would place the patient at risk for metabolic acidosis? Select all that apply.
1)Pneumonia
2)Abdominal fistulas
3)Acute renal failure
4)Hypovolemic shock
5)Chronic obstructive pulmonary disease

Question 22

The nurse is reviewing the latest arterial blood gas results for a patient with metabolic alkalosis. Which result indicates that the metabolic alkalosis is compensated?
1)pH 7.32
2)HCO₃ 8 mEq/L
3)PaCO₂ 48 mm Hg
4)PaCO₂ 18 mm Hg

Question 23

The nurse provides care to a patient who is admitted to the hospital for an aspirin overdose. Which clinical manifestations does the nurse monitor for when assessing this patient? Select all that apply.
1)Confusion
2)Palpitations
3)Blurred vision
4)Respiratory distress
5)Decreased responsiveness

Question 24

Which nursing actions are appropriate when conducting an Allen test? Select all that apply.
1)Rest the patient's arm on the mattress.
2)Support the patient's wrist with a rolled towel.
3)Tell the patient to relax the hand and then clench a fist.
4)Ensure that a second nurse is available to assist with the procedure.
5)Press the patient's radial and ulnar arteries using the index and middle fingers.

Question 25

In analyzing an arterial blood gas, the nurse correlates which findings to an uncompensated respiratory acidosis? Select all that apply.
1)pH 7.30
2)PaO₂ 82 mm Hg
3)PaCO₂ 48 mm Hg
4)HCO₃ 28 mEq/L
5)SaO₂ 90%

Question 26

The nurse is providing care to a patient who is admitted with manifestations of metabolic alkalosis. Which diagnostic test results are consistent with this? Select all that apply.
1)Serum glucose level 142 mg/dL
2)Blood pH 7.47
3)Arterial HCO₃ 34 mEq/L
4)Bilateral lower lobe infiltrates noted on chest x-ray
5)Electrocardiogram changes consistent with hypokalemia

Question 27

The nurse monitors for clinical manifestation of metabolic alkalosis in the patient with which disorder?
1)Diarrhea
2)Prolonged vomiting
3)Renal failure
4)Salicylate intoxication

Question 28

The nurse is caring for the patient experiencing hypovolemic shock and metabolic acidosis. Which nursing actions are appropriate for this patient? Select all that apply.
1)Limiting the intake of fluids
2)Administering sodium bicarbonate
3)Monitoring electrocardiogram for conduction problems
4)Keeping the bed in the locked and low position
5)Monitoring weight on admission and discharge