Question 1

The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis.Which result indicates that the metabolic alkalosis is compensated?

Accepted Answer

The PaCO2 of 48 mmHg indicates respiratory compensation, which is appropriate for metabolic alkalosis. The other options do not indicate compensation for metabolic alkalosis. pH of 7.32 indicates acidosis, HCO3- of 8 mEq/L indicates metabolic alkalosis, and PaO2 of 18 mmHg indicates hypoxia.

Question 2

Why should a nurse take daily weights of a client with acid-base balance?

Accepted Answer

Daily weights of the client help the nurse monitor fluid balance. Acid-base balance is closely related to fluid balance, so monitoring fluid intake and output is essential to maintain a healthy acid-base balance. A sudden weight gain may indicate fluid retention, while a sudden weight loss may indicate fluid loss, so daily weighing helps the nurse detect any changes in fluid balance and take appropriate interventions to correct imbalances. Monitoring renal function is also important for maintaining acid-base balance, but daily weighing is not directly related to this function. Similarly, monitoring oxygenation status and perfusion of organs is important in critical care settings but may not require daily weighing.

Question 3

When considering acid-base balance,health promotion should focus on

Accepted Answer

Maintaining fluid balance is crucial for proper acid-base balance in the body. Adequate hydration helps to regulate pH levels and ensures that waste products are properly eliminated through the kidneys. Conducting yearly health screenings, obtaining immunizations, and beginning an exercise regimen are important for overall health, but do not directly impact acid-base balance.

Question 4

The nurse is analyzing the client's arterial blood gas report,which reveals a pH of 6.58.The client has just suffered a cardiac arrest.Which consequences of this pH value does the nurse consider for this client?

Accepted Answer

A pH of 6.58 indicates severe acidosis, which can lead to decreased cardiac output. The other options are not related to acid-base balance and are not expected consequences of severe acidosis.

Question 5

The client is receiving sodium bicarbonate intravenously (IV)for correction of acidosis secondary to diabetic coma.The nurse assesses the client to be lethargic,confused,and breathing rapidly.Which is the nurse's priority response to the current situation?

Accepted Answer

A) The client receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The client's symptoms do not indicate alkalosis so infusion should not be stopped. The client continues to exhibit signs of acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid, and the physician should be notified. The infusion should not be increased or decreased without a practitioner order.
B) The client receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The client's symptoms do not indicate alkalosis so infusion should not be stopped. The client continues to exhibit signs of acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid, and the physician should be notified. The infusion should not be increased or decreased without a practitioner order.
C) The client receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The client's symptoms do not indicate alkalosis so infusion should not be stopped. The client continues to exhibit signs of acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid, and the physician should be notified. The infusion should not be increased or decreased without a practitioner order.
D) The client receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The client's symptoms do not indicate alkalosis so infusion should not be stopped. The client continues to exhibit signs of acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid, and the physician should be notified. The infusion should not be increased or decreased without a practitioner order.

Question 6

The nurse is identifying a diagram to use to explain a client's acid-base balance.Which imbalance does the following diagram suggest is occurring with the client?

Accepted Answer

The answer of The nurse is identifying a diagram to...

Question 7

The nurse is caring for a comatose client with metabolic acidosis.For which intervention will the nurse need to collaborate when caring for this client?

Accepted Answer

A)For clients in severe distress, family members may need to be consulted for critical information such as recent eating habits and history of vomiting. Measuring vital signs, measuring intake and output, and identifying current oxygen saturation level are independent nursing actions.
B)For clients in severe distress, family members may need to be consulted for critical information such as recent eating habits and history of vomiting. Measuring vital signs, measuring intake and output, and identifying current oxygen saturation level are independent nursing actions.
C)For clients in severe distress, family members may need to be consulted for critical information such as recent eating habits and history of vomiting. Measuring vital signs, measuring intake and output, and identifying current oxygen saturation level are independent nursing actions.
D)For clients in severe distress, family members may need to be consulted for critical information such as recent eating habits and history of vomiting. Measuring vital signs, measuring intake and output, and identifying current oxygen saturation level are independent nursing actions.

Question 8

A client with a suspected acid-base imbalance has arterial blood gases tested.The test reveals a serum bicarbonate level of 22 mEq/L.The nurse understands that this bicarbonate level is

Accepted Answer

A serum bicarbonate level of 22 mEq/L is slightly low, which may indicate a metabolic acidosis.

Question 9

A child with acute asthma has a PaCO₂ of 48 mmHg,a pH of 7.31,and a normal HCO₃ blood gas value.The nurse interprets these findings as indicative of which condition?

Accepted Answer

The low pH and high PaCO2 values indicate respiratory acidosis. The normal HC0^3- value indicates that compensation has not yet occurred. Asthma can lead to respiratory acidosis due to inadequate ventilation leading to CO2 retention.

Question 10

If a change in acid-base balance is due to hypoventilation or hyperventilation,the nurse will need to primarily focus on which concept related to acid-base balance?

Accepted Answer

Acid-base balance is directly related to the amount of carbon dioxide in the blood. Hypoventilation and hyperventilation directly affect the amount of carbon dioxide in the blood, which can then impact acid-base balance. Therefore, the nurse would primarily focus on the concept of oxygenation to address changes in acid-base balance due to hypoventilation or hyperventilation.

Question 11

The nurse is preparing to analyze a client's arterial blood gas results.List the steps in the order that the nurse should follow when analyzing this laboratory test. 1.Look at the PaCO₂. 2.Look at the pH. 3.Evaluate the relationship between pH and PaCO₂. 4.Look for compensation. 5.Evaluate the pH,HCO₃,and base excess for a possible metabolic problem. 6.Look at the bicarbonate. 7.Evaluate oxygenation

Accepted Answer

The answer of The nurse is preparing to analyze a...

Question 12

The nurse performing a blood draw for arterial blood gases first performs a modified Allen test for what purpose?

Accepted Answer

The purpose of the modified Allen test is to determine if arterial puncture can safely be performed. The test is used to assess collateral circulation in the hand to prevent ischemia if the artery is inadvertently occluded during the procedure.

Question 13

A client has been admitted with chronic obstructive pulmonary disease.Diagnostic tests have been ordered.Which of the tests will provide the most accurate indicator of the client's acid-base balance?

Accepted Answer

Arterial blood gases (ABGs) provide a direct measurement of the levels of oxygen, carbon dioxide, pH, and bicarbonate in the arterial blood. This information can be used to assess the client's acid-base balance and guide treatment decisions.

Question 14

The results of a client's arterial blood gas sample reveal an oxygen level of 72 mmHg.For which associated health problem should the nurse assess this client?

Accepted Answer

A)An oxygen level of less than 75 mmHg can be due to hypoventilation. This drop in oxygen will change the client's level of responsiveness. Perfusion is affected by a reduction in circulating fluids. With a fluid and electrolyte imbalance, there is another disorder affecting acid-base balance. This might not be affected by oxygen level. Stress and coping may need to be analyzed to determine how the client is coping with the anxiety related to low oxygen levels, but this is not directly a physiological health problem.
B)An oxygen level of less than 75 mmHg can be due to hypoventilation. This drop in oxygen will change the client's level of responsiveness. Perfusion is affected by a reduction in circulating fluids. With a fluid and electrolyte imbalance, there is another disorder affecting acid-base balance. This might not be affected by oxygen level. Stress and coping may need to be analyzed to determine how the client is coping with the anxiety related to low oxygen levels, but this is not directly a physiological health problem.
C)An oxygen level of less than 75 mmHg can be due to hypoventilation. This drop in oxygen will change the client's level of responsiveness. Perfusion is affected by a reduction in circulating fluids. With a fluid and electrolyte imbalance, there is another disorder affecting acid-base balance. This might not be affected by oxygen level. Stress and coping may need to be analyzed to determine how the client is coping with the anxiety related to low oxygen levels, but this is not directly a physiological health problem.
D)An oxygen level of less than 75 mmHg can be due to hypoventilation. This drop in oxygen will change the client's level of responsiveness. Perfusion is affected by a reduction in circulating fluids. With a fluid and electrolyte imbalance, there is another disorder affecting acid-base balance. This might not be affected by oxygen level. Stress and coping may need to be analyzed to determine how the client is coping with the anxiety related to low oxygen levels, but this is not directly a physiological health problem.

Question 15

The nurse is caring for a client who has been admitted with persistent diarrhea lasting 3 days.Which are appropriate nursing diagnoses for this client during the acute phase of the illness? Select all that apply.

Accepted Answer

A)Metabolic acidosis decreases cardiac output by decreasing contractility, slowing the heart rate, and increasing the risk for dysrhythmias. The client with metabolic acidosis is also at risk for injury due to altered mental status. Appropriate nursing diagnoses during the acute phase of illness are Risk for Injury and Decreased Cardiac Output. The client may have a knowledge deficit, but this is not an appropriate nursing diagnosis during the acute phase of the illness. The client with metabolic acidosis is not at risk for Ineffective Airway Clearance or Overflow Urinary Incontinence.
B)Metabolic acidosis decreases cardiac output by decreasing contractility, slowing the heart rate, and increasing the risk for dysrhythmias. The client with metabolic acidosis is also at risk for injury due to altered mental status. Appropriate nursing diagnoses during the acute phase of illness are Risk for Injury and Decreased Cardiac Output. The client may have a knowledge deficit but this is not an appropriate nursing diagnosis during the acute phase of the illness. The client with metabolic acidosis is not at risk for Ineffective Airway Clearance or Overflow Urinary Incontinence.
C)Metabolic acidosis decreases cardiac output by decreasing contractility, slowing the heart rate, and increasing the risk for dysrhythmias. The client with metabolic acidosis is also at risk for injury due to altered mental status. Appropriate nursing diagnoses during the acute phase of illness are Risk for Injury and Decreased Cardiac Output. The client may have a knowledge deficit but this is not an appropriate nursing diagnosis during the acute phase of the illness. The client with metabolic acidosis is not at risk for Ineffective Airway Clearance or Overflow Urinary Incontinence.
D)Metabolic acidosis decreases cardiac output by decreasing contractility, slowing the heart rate, and increasing the risk for dysrhythmias. The client with metabolic acidosis is also at risk for injury due to altered mental status. Appropriate nursing diagnoses during the acute phase of illness are Risk for Injury and Decreased Cardiac Output. The client may have a knowledge deficit but this is not an appropriate nursing diagnosis during the acute phase of the illness. The client with metabolic acidosis is not at risk for Ineffective Airway Clearance or Overflow Urinary Incontinence.
E)Metabolic acidosis decreases cardiac output by decreasing contractility, slowing the heart rate, and increasing the risk for dysrhythmias. The client with metabolic acidosis is also at risk for injury due to altered mental status. Appropriate nursing diagnoses during the acute phase of illness are Risk for Injury and Decreased Cardiac Output. The client may have a knowledge deficit but this is not an appropriate nursing diagnosis during the acute phase of the illness. The client with metabolic acidosis is not at risk for Ineffective Airway Clearance or Overflow Urinary Incontinence.

Question 16

A client is brought to the emergency department (ED)after passing out in a local department store.The client has been fasting and has ketones in the urine.Which acid-base imbalance would the nurse expect to assess in this client?

Accepted Answer

The presence of ketones in the urine suggests that the client is experiencing a state of increased metabolism of fats due to inadequate carbohydrate intake, resulting in metabolic acidosis.

Question 17

An intervention that can be implemented independently by the nurse caring for a client with an acid-base balance is

Accepted Answer

The nurse can monitor the client's intake and output to assess their fluid balance and potential acid-base imbalances. Drawing blood for ABGs and giving sodium bicarbonate infusions require medical orders and/or advanced nursing skills. Administering oxygen via nasal cannula may be beneficial in some situations but is not directly related to acid-base balance.

Question 18

Which risk factors exhibited by the client presenting in the emergency department (ED)would place the client at risk for metabolic acidosis? Select all that apply.

Accepted Answer

Abdominal fistulas can cause loss of bicarbonate through the gastrointestinal tract, leading to metabolic acidosis. Acute renal failure can result in the accumulation of metabolic waste products, which can cause metabolic acidosis. Hypovolemia can cause lactic acidosis due to tissue hypoxia. Chronic obstructive pulmonary disease and pneumonia are not typically associated with metabolic acidosis.

Question 19

Acid-base balance is critical to homeostasis and cellular function.One measurement of acid-base balance is the pH of the blood.Which ion is measured to determine the pH?

Accepted Answer

To determine the pH of the blood, the concentration of hydrogen ions (H+) is measured. The equation for pH is pH = -log[H+]. Option B contains the hydrogen ion (H+) in the form of a hydrogen sulfate ion (HSO4-).

Question 20

The nurse is instructing a client with a history of acidosis on the use of sodium bicarbonate.Which client statement indicates that additional teaching is needed?

Accepted Answer

The client statement "I should use the antacid for at least 2 months" indicates a misunderstanding of the proper use of sodium bicarbonate. Sodium bicarbonate should only be used as directed by a healthcare provider for the treatment of acidosis and should not be used for longer than prescribed. The other statements demonstrate appropriate understanding of the medication's use and potential side effects.

Quiz 1: Acid-Base Balance

The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis.Which result indicates that the metabolic alkalosis is compensated?

Why should a nurse take daily weights of a client with acid-base balance?

When considering acid-base balance,health promotion should focus on

The nurse is analyzing the client's arterial blood gas report,which reveals a pH of 6.58.The client has just suffered a cardiac arrest.Which consequences of this pH value does the nurse consider for this client?

The client is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma.The nurse assesses the client to be lethargic,confused,and breathing rapidly.Which is the nurse's priority response to the current situation?

The nurse is identifying a diagram to use to explain a client's acid-base balance.Which imbalance does the following diagram suggest is occurring with the client?

The nurse is caring for a comatose client with metabolic acidosis.For which intervention will the nurse need to collaborate when caring for this client?

A client with a suspected acid-base imbalance has arterial blood gases tested.The test reveals a serum bicarbonate level of 22 mEq/L.The nurse understands that this bicarbonate level is

A child with acute asthma has a PaCO₂ of 48 mmHg,a pH of 7.31,and a normal HCO₃ blood gas value.The nurse interprets these findings as indicative of which condition?

If a change in acid-base balance is due to hypoventilation or hyperventilation,the nurse will need to primarily focus on which concept related to acid-base balance?

The nurse performing a blood draw for arterial blood gases first performs a modified Allen test for what purpose?

A client has been admitted with chronic obstructive pulmonary disease.Diagnostic tests have been ordered.Which of the tests will provide the most accurate indicator of the client's acid-base balance?

The results of a client's arterial blood gas sample reveal an oxygen level of 72 mmHg.For which associated health problem should the nurse assess this client?

The nurse is caring for a client who has been admitted with persistent diarrhea lasting 3 days.Which are appropriate nursing diagnoses for this client during the acute phase of the illness? Select all that apply.

A client is brought to the emergency department (ED) after passing out in a local department store.The client has been fasting and has ketones in the urine.Which acid-base imbalance would the nurse expect to assess in this client?

An intervention that can be implemented independently by the nurse caring for a client with an acid-base balance is

Which risk factors exhibited by the client presenting in the emergency department (ED) would place the client at risk for metabolic acidosis? Select all that apply.

Acid-base balance is critical to homeostasis and cellular function.One measurement of acid-base balance is the pH of the blood.Which ion is measured to determine the pH?

The nurse is instructing a client with a history of acidosis on the use of sodium bicarbonate.Which client statement indicates that additional teaching is needed?

Quiz 1: Acid-Base Balance

The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis.Which result indicates that the metabolic alkalosis is compensated?

Why should a nurse take daily weights of a client with acid-base balance?

When considering acid-base balance,health promotion should focus on

The nurse is analyzing the client's arterial blood gas report,which reveals a pH of 6.58.The client has just suffered a cardiac arrest.Which consequences of this pH value does the nurse consider for this client?

The client is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma.The nurse assesses the client to be lethargic,confused,and breathing rapidly.Which is the nurse's priority response to the current situation?

The nurse is identifying a diagram to use to explain a client's acid-base balance.Which imbalance does the following diagram suggest is occurring with the client?

The nurse is caring for a comatose client with metabolic acidosis.For which intervention will the nurse need to collaborate when caring for this client?

A client with a suspected acid-base imbalance has arterial blood gases tested.The test reveals a serum bicarbonate level of 22 mEq/L.The nurse understands that this bicarbonate level is

A child with acute asthma has a PaCO2 of 48 mmHg,a pH of 7.31,and a normal HCO3 blood gas value.The nurse interprets these findings as indicative of which condition?

If a change in acid-base balance is due to hypoventilation or hyperventilation,the nurse will need to primarily focus on which concept related to acid-base balance?

The nurse performing a blood draw for arterial blood gases first performs a modified Allen test for what purpose?

A client has been admitted with chronic obstructive pulmonary disease.Diagnostic tests have been ordered.Which of the tests will provide the most accurate indicator of the client's acid-base balance?

The results of a client's arterial blood gas sample reveal an oxygen level of 72 mmHg.For which associated health problem should the nurse assess this client?

The nurse is caring for a client who has been admitted with persistent diarrhea lasting 3 days.Which are appropriate nursing diagnoses for this client during the acute phase of the illness? Select all that apply.

A client is brought to the emergency department (ED) after passing out in a local department store.The client has been fasting and has ketones in the urine.Which acid-base imbalance would the nurse expect to assess in this client?

An intervention that can be implemented independently by the nurse caring for a client with an acid-base balance is

Which risk factors exhibited by the client presenting in the emergency department (ED) would place the client at risk for metabolic acidosis? Select all that apply.

Acid-base balance is critical to homeostasis and cellular function.One measurement of acid-base balance is the pH of the blood.Which ion is measured to determine the pH?

The nurse is instructing a client with a history of acidosis on the use of sodium bicarbonate.Which client statement indicates that additional teaching is needed?

A child with acute asthma has a PaCO₂ of 48 mmHg,a pH of 7.31,and a normal HCO₃ blood gas value.The nurse interprets these findings as indicative of which condition?