Question 1

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

Accepted Answer

A)In metabolic acidosis, the amount of bicarbonate decreases in relation to the amount of acid in the body. In metabolic alkalosis, there is an excess of bicarbonate in relation to the amount of hydrogen ions. Respiratory acidosis occurs when carbon dioxide is retained, increasing the amount of carbonic acid in the body. Respiratory alkalosis can occur when too much carbon dioxide is lost and carbonic acid levels fall.
B)In metabolic acidosis, the amount of bicarbonate decreases in relation to the amount of acid in the body. In metabolic alkalosis, there is an excess of bicarbonate in relation to the amount of hydrogen ions. Respiratory acidosis occurs when carbon dioxide is retained, increasing the amount of carbonic acid in the body. Respiratory alkalosis can occur when too much carbon dioxide is lost and carbonic acid levels fall.
C)In metabolic acidosis, the amount of bicarbonate decreases in relation to the amount of acid in the body. In metabolic alkalosis, there is an excess of bicarbonate in relation to the amount of hydrogen ions. Respiratory acidosis occurs when carbon dioxide is retained, increasing the amount of carbonic acid in the body. Respiratory alkalosis can occur when too much carbon dioxide is lost and carbonic acid levels fall.
D)In metabolic acidosis, the amount of bicarbonate decreases in relation to the amount of acid in the body. In metabolic alkalosis, there is an excess of bicarbonate in relation to the amount of hydrogen ions. Respiratory acidosis occurs when carbon dioxide is retained, increasing the amount of carbonic acid in the body. Respiratory alkalosis can occur when too much carbon dioxide is lost and carbonic acid levels fall.

Question 2

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

Accepted Answer

A)If the pH is decreased and the PaCO₂ is increased with a normal HCO₃, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO₂, and normal HCO₃. Uncompensated metabolic acidosis has a decreased pH, normal PaCO₂, and decreased HCO₃. Uncompensated metabolic alkalosis has an increased pH, normal PaCO₂, and increased HCO₃. B)If the pH is decreased and the PaCO₂ is increased with a normal HCO₃, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO₂, and normal HCO₃. Uncompensated metabolic acidosis has a decreased pH, normal PaCO₂, and decreased HCO₃. Uncompensated metabolic alkalosis has an increased pH, normal PaCO₂, and increased HCO₃. C)If the pH is decreased and the PaCO₂ is increased with a normal HCO₃, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO₂, and normal HCO₃. Uncompensated metabolic acidosis has a decreased pH, normal PaCO₂, and decreased HCO₃. Uncompensated metabolic alkalosis has an increased pH, normal PaCO₂, and increased HCO₃. D)If the pH is decreased and the PaCO₂ is increased with a normal HCO₃, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO₂, and normal HCO₃. Uncompensated metabolic acidosis has a decreased pH, normal PaCO₂, and decreased HCO₃. Uncompensated metabolic alkalosis has an increased pH, normal PaCO₂, and increased HCO₃.

Question 3

An intervention that can be implemented independently by the nurse caring for a client with an acid-base balance is
A)monitoring intake and output.
B)drawing blood for ABGs.
C)giving sodium bicarbonate infusions.
D)administering oxygen via nasal cannula.

Accepted Answer

A)Monitoring intake and output is an independent nursing intervention that does not require a provider's orders. Drawing blood for ABGs, giving sodium bicarbonate infusions, and administering oxygen via nasal cannula are all actions that can be performed by the nurse, but they must first be ordered by a provider.
B)Monitoring intake and output is an independent nursing intervention that does not require a provider's orders. Drawing blood for ABGs, giving sodium bicarbonate infusions, and administering oxygen via nasal cannula are all actions that can be performed by the nurse, but they must first be ordered by a provider.
C)Monitoring intake and output is an independent nursing intervention that does not require a provider's orders. Drawing blood for ABGs, giving sodium bicarbonate infusions, and administering oxygen via nasal cannula are all actions that can be performed by the nurse, but they must first be ordered by a provider.
D)Monitoring intake and output is an independent nursing intervention that does not require a provider's orders. Drawing blood for ABGs, giving sodium bicarbonate infusions, and administering oxygen via nasal cannula are all actions that can be performed by the nurse, but they must first be ordered by a provider.

Question 4

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)"I should contact the doctor if I have any gastric discomfort with chest pain."
B)"I need to purchase antacids without salt."
C)"I should use the antacid for at least 2 months."
D)"I should call the doctor if I get short of breath or start to sweat with this medication."

Accepted Answer

A)The client should be instructed to immediately contact the primary healthcare provider if gastric discomfort occurs with chest pain or if dyspnea or diaphoresis occurs. The client should be instructed to use non-sodium antacids to prevent the absorption of excess sodium or bicarbonate into systemic circulation and to not use any bicarbonate antacid for longer than 2 weeks.
B)The client should be instructed to immediately contact the primary healthcare provider if gastric discomfort occurs with chest pain or if dyspnea or diaphoresis occurs. The client should be instructed to use non-sodium antacids to prevent the absorption of excess sodium or bicarbonate into systemic circulation and to not use any bicarbonate antacid for longer than 2 weeks.
C)The client should be instructed to immediately contact the primary healthcare provider if gastric discomfort occurs with chest pain or if dyspnea or diaphoresis occurs. The client should be instructed to use non-sodium antacids to prevent the absorption of excess sodium or bicarbonate into systemic circulation and to not use any bicarbonate antacid for longer than 2 weeks.
D)The client should be instructed to immediately contact the primary healthcare provider if gastric discomfort occurs with chest pain or if dyspnea or diaphoresis occurs. The client should be instructed to use non-sodium antacids to prevent the absorption of excess sodium or bicarbonate into systemic circulation and to not use any bicarbonate antacid for longer than 2 weeks.

Question 5

Why should a nurse take daily weights of a client with acid-base balance?
A)It helps monitor oxygenation status.
B)It helps monitor perfusion of organs.
C)It helps monitor renal function.
D)It helps monitor fluid balance.

Accepted Answer

A)Fluid balance must be maintained to support acid-base balance. If a client rapidly gains weight, it is a sign of fluid overload. If a client rapidly loses weight, it is a sign of dehydration. Both of these conditions can alter the acid-base balance, so a client's weight should be monitored daily. A client's weight does not reflect oxygenation status or perfusion of organs. Daily weights can reflect renal function, but weight can fluctuate even if the kidneys are functioning properly.
B)Fluid balance must be maintained to support acid-base balance. If a client rapidly gains weight, it is a sign of fluid overload. If a client rapidly loses weight, it is a sign of dehydration. Both of these conditions can alter the acid-base balance, so a client's weight should be monitored daily. A client's weight does not reflect oxygenation status or perfusion of organs. Daily weights can reflect renal function, but weight can fluctuate even if the kidneys are functioning properly.
C)Fluid balance must be maintained to support acid-base balance. If a client rapidly gains weight, it is a sign of fluid overload. If a client rapidly loses weight, it is a sign of dehydration. Both of these conditions can alter the acid-base balance, so a client's weight should be monitored daily. A client's weight does not reflect oxygenation status or perfusion of organs. Daily weights can reflect renal function, but weight can fluctuate even if the kidneys are functioning properly.
D)Fluid balance must be maintained to support acid-base balance. If a client rapidly gains weight, it is a sign of fluid overload. If a client rapidly loses weight, it is a sign of dehydration. Both of these conditions can alter the acid-base balance, so a client's weight should be monitored daily. A client's weight does not reflect oxygenation status or perfusion of organs. Daily weights can reflect renal function, but weight can fluctuate even if the kidneys are functioning properly.

Question 6

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

Accepted Answer

A)A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
B)A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
C)A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
D)A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.

Question 7

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? A)Cl^- B)H⁺ C)Na⁺ D)HCO₃

Accepted Answer

A)The pH measures the concentration of hydrogen ions (H⁺)in the body. Sodium (Na⁺)and chloride (Cl^-)concentrations are not related to pH. Bicarbonate (HCO₂)is a weak base that is used as a buffer to help maintain the proper pH, but it is not used to measure pH. B)The pH measures the concentration of hydrogen ions (H+)in the body. Sodium (Na⁺)and chloride (Cl^-)concentrations are not related to pH. Bicarbonate (HCO₂)is a weak base that is used as a buffer to help maintain the proper pH, but it is not used to measure pH. C)The pH measures the concentration of hydrogen ions (H+)in the body. Sodium (Na⁺)and chloride (Cl^-)concentrations are not related to pH. Bicarbonate (HCO₂)is a weak base that is used as a buffer to help maintain the proper pH, but it is not used to measure pH. D)The pH measures the concentration of hydrogen ions (H+)in the body. Sodium (Na⁺)and chloride (Cl^-)concentrations are not related to pH. Bicarbonate (HCO₂)is a weak base that is used as a buffer to help maintain the proper pH, but it is not used to measure pH.

Question 8

The nurse performing a blood draw for arterial blood gases first performs a modified Allen test for what purpose?
A)To reduce the risk of bleeding or bruising of the arm
B)To determine if arterial puncture can safely be performed
C)To determine the oxygen saturation of the blood in the artery
D)To determine the pressure of the blood in the artery

Accepted Answer

A)A modified Allen test is a measure of ulnar patency. The patient elevates the hand and repeatedly makes a fist while the examiner places digital occlusive pressure over the radial and ulnar arteries of the wrist. The hand will lose its normal color. Digital pressure is released from one artery while the other remains compressed. The return of color indicates that the hand has good collateral supply of blood and that arterial puncture can safety be performed. The modified Allen test does not measure oxygen saturation or artery pressure, and it does not reduce the risk of bleeding or bruising.
B)A modified Allen test is a measure of ulnar patency. The patient elevates the hand and repeatedly makes a fist while the examiner places digital occlusive pressure over the radial and ulnar arteries of the wrist. The hand will lose its normal color. Digital pressure is released from one artery while the other remains compressed. The return of color indicates that the hand has good collateral supply of blood and that arterial puncture can safety be performed. The modified Allen test does not measure oxygen saturation or artery pressure, and it does not reduce the risk of bleeding or bruising.
C)A modified Allen test is a measure of ulnar patency. The patient elevates the hand and repeatedly makes a fist while the examiner places digital occlusive pressure over the radial and ulnar arteries of the wrist. The hand will lose its normal color. Digital pressure is released from one artery while the other remains compressed. The return of color indicates that the hand has good collateral supply of blood and that arterial puncture can safety be performed. The modified Allen test does not measure oxygen saturation or artery pressure, and it does not reduce the risk of bleeding or bruising.
D)A modified Allen test is a measure of ulnar patency. The patient elevates the hand and repeatedly makes a fist while the examiner places digital occlusive pressure over the radial and ulnar arteries of the wrist. The hand will lose its normal color. Digital pressure is released from one artery while the other remains compressed. The return of color indicates that the hand has good collateral supply of blood and that arterial puncture can safety be performed. The modified Allen test does not measure oxygen saturation or artery pressure, and it does not reduce the risk of bleeding or bruising.

Question 9

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 10

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?
A)Decreased cardiac output
B)Increase magnesium levels
C)Decreased free calcium in the ECT
D)Increased myocardial contractility

Accepted Answer

A)The nurse knows that severe acidosis (pH of 7.0 or less)depresses myocardial contractility, which leads to decreased cardiac output. Acid-base imbalances also affect electrolyte balance. In acidosis, calcium is released from its bonds with plasma proteins, increasing the amount of ionized (free)calcium in the blood. Magnesium levels may fall in acidosis.
B)The nurse knows that severe acidosis (pH of 7.0 or less)depresses myocardial contractility, which leads to decreased cardiac output. Acid-base imbalances also affect electrolyte balance. In acidosis, calcium is released from its bonds with plasma proteins, increasing the amount of ionized (free)calcium in the blood. Magnesium levels may fall in acidosis.
C)The nurse knows that severe acidosis (pH of 7.0 or less)depresses myocardial contractility, which leads to decreased cardiac output. Acid-base imbalances also affect electrolyte balance. In acidosis, calcium is released from its bonds with plasma proteins, increasing the amount of ionized (free)calcium in the blood. Magnesium levels may fall in acidosis.
D)The nurse knows that severe acidosis (pH of 7.0 or less)depresses myocardial contractility, which leads to decreased cardiac output. Acid-base imbalances also affect electrolyte balance. In acidosis, calcium is released from its bonds with plasma proteins, increasing the amount of ionized (free)calcium in the blood. Magnesium levels may fall in acidosis.

Question 11

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)Measuring vital signs
B)Measuring intake and output
C)The client's recent eating behaviors
D)Identifying current oxygen saturation level

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 12

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?
A)Stress and coping
B)Perfusion
C)Fluid and electrolyte imbalance
D)Cognition

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 13

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.
A)Abdominal fistulas
B)Chronic obstructive pulmonary disease
C)Pneumonia
D)Acute renal failure
E)Hypovolemic shock

Accepted Answer

A)Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
B)Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
C)Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
D)Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
E)Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.

Question 14

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? A)pH 7.32 B)PaCO₂ 18 mmHg C)HCO₃ 8 mEq/L D)PaCO₂ 48 mmHg

Accepted Answer

A)A normal pH level is 7.35-7.45. A pH of less than 7.35 is acidosis. A PaCO₂ level of 18 mmHg is low and is seen in respiratory alkalosis. A HCO₃ level of 8 mEq/L is low and is most likely associated with metabolic acidosis. In metabolic alkalosis, there is an excess of bicarbonate. To compensate for this imbalance, the rate and depth of respirations decrease, leading to retention of carbon dioxide. The PaCO₂ will be elevated. B)A normal pH level is 7.35-7.45. A pH of less than 7.35 is acidosis. A PaCO₂ level of 18 mmHg is low and is seen in respiratory alkalosis. A HCO₃ level of 8 mEq/L is low and is most likely associated with metabolic acidosis. In metabolic alkalosis, there is an excess of bicarbonate. To compensate for this imbalance, the rate and depth of respirations decrease, leading to retention of carbon dioxide. The PaCO₂ will be elevated. C)A normal pH level is 7.35-7.45. A pH of less than 7.35 is acidosis. A PaCO₂ level of 18 mmHg is low and is seen in respiratory alkalosis. A HCO₃ level of 8 mEq/L is low and is most likely associated with metabolic acidosis. In metabolic alkalosis, there is an excess of bicarbonate. To compensate for this imbalance, the rate and depth of respirations decrease, leading to retention of carbon dioxide. The PaCO₂ will be elevated. D)A normal pH level is 7.35-7.45. A pH of less than 7.35 is acidosis. A PaCO₂ level of 18 mmHg is low and is seen in respiratory alkalosis. A HCO₃ level of 8 mEq/L is low and is most likely associated with metabolic acidosis. In metabolic alkalosis, there is an excess of bicarbonate. To compensate for this imbalance, the rate and depth of respirations decrease, leading to retention of carbon dioxide. The PaCO₂will be elevated.

Question 15

When considering acid-base balance, health promotion should focus on
A)conducting yearly health screenings.
B)obtaining immunizations.
C)beginning an exercise regimen.
D)maintaining fluid balance.

Accepted Answer

A)Both overhydration and dehydration can result in acid-base imbalances. Therefore, health promotion should focus on maintaining fluid balance. Beginning an exercise regimen, obtaining immunizations, and conducting yearly health screenings are activities that can promote health in other areas.
B)Both overhydration and dehydration can result in acid-base imbalances. Therefore, health promotion should focus on maintaining fluid balance. Beginning an exercise regimen, obtaining immunizations, and conducting yearly health screenings are activities that can promote health in other areas.
C)Both overhydration and dehydration can result in acid-base imbalances. Therefore, health promotion should focus on maintaining fluid balance. Beginning an exercise regimen, obtaining immunizations, and conducting yearly health screenings are activities that can promote health in other areas.
D)Both overhydration and dehydration can result in acid-base imbalances. Therefore, health promotion should focus on maintaining fluid balance. Beginning an exercise regimen, obtaining immunizations, and conducting yearly health screenings are activities that can promote health in other areas.

Question 16

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?
A)Arterial blood gases (ABGs)
B)Pulse oximetry
C)Sputum studies
D)Bronchoscopy

Accepted Answer

A)ABGs are done to assess alterations in acid-base balance caused by respiratory disorders, metabolic disorders, or both. A bronchoscopy provides visualization of internal respiratory structures. Sputum studies can provide specific information about bacterial organisms. Pulse oximetry is a noninvasive test that evaluates the oxygen saturation level of blood.
B)ABGs are done to assess alterations in acid-base balance caused by respiratory disorders, metabolic disorders, or both. A bronchoscopy provides visualization of internal respiratory structures. Sputum studies can provide specific information about bacterial organisms. Pulse oximetry is a noninvasive test that evaluates the oxygen saturation level of blood.
C)ABGs are done to assess alterations in acid-base balance caused by respiratory disorders, metabolic disorders, or both. A bronchoscopy provides visualization of internal respiratory structures. Sputum studies can provide specific information about bacterial organisms. Pulse oximetry is a noninvasive test that evaluates the oxygen saturation level of blood.
D)ABGs are done to assess alterations in acid-base balance caused by respiratory disorders, metabolic disorders, or both. A bronchoscopy provides visualization of internal respiratory structures. Sputum studies can provide specific information about bacterial organisms. Pulse oximetry is a noninvasive test that evaluates the oxygen saturation level of blood.

Question 17

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)Decreased Cardiac Output
B)Ineffective Airway Clearance
C)Overflow Urinary Incontinence
D)Knowledge Deficit
E)Risk for Injury

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 18

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?
A)Stop the infusion and notify the physician because the client is in alkalosis.
B)Decrease the rate of the infusion and continue to assess the client for symptoms of alkalosis.
C)Continue the infusion, because the client is still in acidosis, and notify the healthcare provider.
D)Increase the rate of the infusion and continue to assess the client for symptoms of acidosis.

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 19

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)slightly high.
B)slightly low.
C)extremely high.
D)within normal range.

Accepted Answer

A)The normal serum bicarbonate level is 24-28 mEq/L. Therefore, the nurse would understand that the client's bicarbonate level is slightly low.
B)The normal serum bicarbonate level is 24-28 mEq/L. Therefore, the nurse would understand that the client's bicarbonate level is slightly low.
C)The normal serum bicarbonate level is 24-28 mEq/L. Therefore, the nurse would understand that the client's bicarbonate level is slightly low.
D)The normal serum bicarbonate level is 24-28 mEq/L. Therefore, the nurse would understand that the client's bicarbonate level is slightly low.

Question 20

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?
A)Oxygenation
B)Perfusion
C)Cognition
D)Stress and coping

Accepted Answer

A)Hypoventilation and hyperventilation are related to oxygenation. Respiratory rate helps regulate carbon dioxide pressures, which can contribute to acidosis or alkalosis. The nurse can help reverse respiratory acidosis or alkalosis by helping the client control their respiratory rate to restore normal oxygenation. Perfusion, cognition, and stress and coping do not directly relate to hypo- or hyperventilation.
B)Hypoventilation and hyperventilation are related to oxygenation. Respiratory rate helps regulate carbon dioxide pressures, which can contribute to acidosis or alkalosis. The nurse can help reverse respiratory acidosis or alkalosis by helping the client control their respiratory rate to restore normal oxygenation. Perfusion, cognition, and stress and coping do not directly relate to hypo- or hyperventilation.
C)Hypoventilation and hyperventilation are related to oxygenation. Respiratory rate helps regulate carbon dioxide pressures, which can contribute to acidosis or alkalosis. The nurse can help reverse respiratory acidosis or alkalosis by helping the client control their respiratory rate to restore normal oxygenation. Perfusion, cognition, and stress and coping do not directly relate to hypo- or hyperventilation.
D)Hypoventilation and hyperventilation are related to oxygenation. Respiratory rate helps regulate carbon dioxide pressures, which can contribute to acidosis or alkalosis. The nurse can help reverse respiratory acidosis or alkalosis by helping the client control their respiratory rate to restore normal oxygenation. Perfusion, cognition, and stress and coping do not directly relate to hypo- or hyperventilation.

Quiz 1: Acid-Base Balance

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?

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?

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

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?

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

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?

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

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

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?

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.

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?

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

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 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.

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?

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

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?