Question 1

Which of the following systems is primarily responsible for the buffering of fixed acids?

Accepted Answer

A) ammonia 
B) HCO3- 
C) Hb 
D) phosphates 
A) ammonia 
B) HCO3- 
C) Hb 
D) phosphates

Question 2

Causes of respiratory acidosis in patients with normal lungs include which of the following?
I.neuromuscular disorders
II.spinal cord trauma
III.anesthesia
IV.central nervous system depression

Accepted Answer

A) I, II, III, and IV 
B) III 
C) II, III, and IV 
D) II and IV 
A) I, II, III, and IV 
B) III 
C) II, III, and IV 
D) II and IV

Question 3

What is the sum of all blood buffers in 1 L of blood?

Accepted Answer

A) buffer base 
B) base excess 
C) standard bicarbonate 
D) base deficit 
A) buffer base 
B) base excess 
C) standard bicarbonate 
D) base deficit

Question 4

When does a state of alkalemia exist?
I.The HCO3-/CO2 ratio exceeds 20:1
II.The blood pH exceeds 7.45.
III.The blood PCO2 exceeds 54 mm Hg.

Accepted Answer

A) II and III 
B) I, II, and III 
C) III only 
D) I and II 
A) II and III 
B) I, II, and III 
C) III only 
D) I and II

Question 5

What factor would limit the ability of the H2CO3/HCO3- buffer system to perform efficiently?

Accepted Answer

A) temperature rise of more than 3S1U1P1$\circ$S1S1P0C 
B) inadequate amount of 2,3-DPG in the blood 
C) increased production of nonvolatile acids 
D) lungs failing to excrete adequate levels of CO2 
A) temperature rise of more than 3S1U1P1$\circ$S1S1P0C 
B) inadequate amount of 2,3-DPG in the blood 
C) increased production of nonvolatile acids 
D) lungs failing to excrete adequate levels of CO2

Question 6

Which of the following acts as the "first-line" or immediate defense against the accumulation of H+ ions?

Accepted Answer

A) blood buffer systems 
B) GI tract 
C) renal system 
D) respiratory system 
A) blood buffer systems 
B) GI tract 
C) renal system 
D) respiratory system

Question 7

[H+] can be determined by the use of which factors?
I.HCO3-
II.H2CO3
III.inorganic phosphorus
IV.PaO2

Accepted Answer

A) I, II, and III 
B) II and III 
C) IV only 
D) I and II 
A) I, II, and III 
B) II and III 
C) IV only 
D) I and II

Question 8

What affect does hyperventilation have on the closed buffer systems?

Accepted Answer

A) causes them to bind with more H+ 
B) causes them to release more H+ 
C) has no affect on them at all 
D) increases the affinity of the closed buffer system 
A) causes them to bind with more H+ 
B) causes them to release more H+ 
C) has no affect on them at all 
D) increases the affinity of the closed buffer system

Question 9

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 6.89, PCO2 = 24 mm Hg, HCO3- = 4.7 mEq/L

Accepted Answer

A) acute (uncompensated) metabolic acidosis 
B) acute (uncompensated) respiratory acidosis 
C) partially compensated metabolic acidosis 
D) partially compensated respiratory acidosis 
A) acute (uncompensated) metabolic acidosis 
B) acute (uncompensated) respiratory acidosis 
C) partially compensated metabolic acidosis 
D) partially compensated respiratory acidosis

Question 10

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO2 = 32 mm Hg, HCO3- = 29 mEq/L

Accepted Answer

A) acute (uncompensated) metabolic alkalosis 
B) combined metabolic and respiratory alkalosis 
C) partially compensated metabolic alkalosis 
D) partially compensated respiratory acidosis 
A) acute (uncompensated) metabolic alkalosis 
B) combined metabolic and respiratory alkalosis 
C) partially compensated metabolic alkalosis 
D) partially compensated respiratory acidosis

Question 11

Which buffer system has the greatest capacity?

Accepted Answer

A) bicarbonate 
B) hemoglobin 
C) phosphates 
D) plasma proteins 
A) bicarbonate 
B) hemoglobin 
C) phosphates 
D) plasma proteins

Question 12

In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter?
I.decreased pH
II.increased HCO3-
III.increased PCO2
IV.increased pH

Accepted Answer

A) I, II, and IV 
B) I and III 
C) III only 
D) II, III, and IV 
A) I, II, and IV 
B) I and III 
C) III only 
D) II, III, and IV

Question 13

Of what use is the Henderson-Hasselbalch equation for a clinician?

Accepted Answer

A) It can guide therapeutic decision for critically ill patients. 
B) It establishes the baseline values for buffer enhancement treatments. 
C) Given H2CO3 and CO2 values, the pH can be computed. 
D) It allows validation of the reported values on a blood gas report. 
A) It can guide therapeutic decision for critically ill patients. 
B) It establishes the baseline values for buffer enhancement treatments. 
C) Given H2CO3 and CO2 values, the pH can be computed. 
D) It allows validation of the reported values on a blood gas report.

Question 14

A patient has a confirmed metabolic acidosis with a normal PCO2. What inference can you draw from these findings?

Accepted Answer

A) A ventilatory disorder must coexist. 
B) Compensation for the acidosis has begun. 
C) The patient is hyperventilating. 
D) The values obtained must be in error. 
A) A ventilatory disorder must coexist. 
B) Compensation for the acidosis has begun. 
C) The patient is hyperventilating. 
D) The values obtained must be in error.

Question 15

A patient has an anion gap of 21 mEq/L. Based on this information, what can you conclude?
I.There is an abnormal excess of unmeasured anions in the plasma.
II.The patient probably has metabolic acidosis.
III.The concentration of fixed acids is increased.

Accepted Answer

A) II and III 
B) I and II 
C) I and III 
D) I, II, and III 
A) II and III 
B) I and II 
C) I and III 
D) I, II, and III

Question 16

A patient has a bicarbonate concentration of 36 mEq and a PCO2 of 60 mm Hg. What is the approximate pH?

Accepted Answer

A) 7.2 
B) 7.3 
C) 7.4 
D) 7.5 
A) 7.2 
B) 7.3 
C) 7.4 
D) 7.5

Question 17

What is the primary buffer system for fixed acids?

Accepted Answer

A) Cl- 
B) HCO3- 
C) phosphate 
D) plasma proteins 
A) Cl- 
B) HCO3- 
C) phosphate 
D) plasma proteins

Exam 13: Acid-Base Balance

Which of the following systems is primarily responsible for the buffering of fixed acids?

Causes of respiratory acidosis in patients with normal lungs include which of the following? I.neuromuscular disorders II.spinal cord trauma III.anesthesia IV.central nervous system depression

What is the sum of all blood buffers in 1 L of blood?

When does a state of alkalemia exist? I.The HCO3-/CO2 ratio exceeds 20:1 II.The blood pH exceeds 7.45. III.The blood PCO2 exceeds 54 mm Hg.

What factor would limit the ability of the H2CO3/HCO3- buffer system to perform efficiently?

Which of the following acts as the "first-line" or immediate defense against the accumulation of H+ ions?

[H+] can be determined by the use of which factors? I.HCO3- II.H2CO3 III.inorganic phosphorus IV.PaO2

What affect does hyperventilation have on the closed buffer systems?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 6.89, PCO2 = 24 mm Hg, HCO3- = 4.7 mEq/L

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO2 = 32 mm Hg, HCO3- = 29 mEq/L

Which buffer system has the greatest capacity?

In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter? I.decreased pH II.increased HCO3- III.increased PCO2 IV.increased pH

Of what use is the Henderson-Hasselbalch equation for a clinician?

A patient has a confirmed metabolic acidosis with a normal PCO2. What inference can you draw from these findings?

A patient has an anion gap of 21 mEq/L. Based on this information, what can you conclude? I.There is an abnormal excess of unmeasured anions in the plasma. II.The patient probably has metabolic acidosis. III.The concentration of fixed acids is increased.

A patient has a bicarbonate concentration of 36 mEq and a PCO2 of 60 mm Hg. What is the approximate pH?

What is the primary buffer system for fixed acids?

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

When does a state of alkalemia exist? I.The HCO₃^-/CO₂ ratio exceeds 20:1 II.The blood pH exceeds 7.45. III.The blood PCO₂ exceeds 54 mm Hg.

What factor would limit the ability of the H₂CO₃/HCO₃^- buffer system to perform efficiently?

Which of the following acts as the "first-line" or immediate defense against the accumulation of H⁺ ions?

[H⁺] can be determined by the use of which factors? I.HCO₃^- II.H₂CO₃ III.inorganic phosphorus IV.PaO₂

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 6.89, PCO₂ = 24 mm Hg, HCO₃^- = 4.7 mEq/L

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO₂ = 32 mm Hg, HCO₃^- = 29 mEq/L

In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter? I.decreased pH II.increased HCO₃^- III.increased PCO₂ IV.increased pH

A patient has a confirmed metabolic acidosis with a normal PCO₂. What inference can you draw from these findings?

A patient has a bicarbonate concentration of 36 mEq and a PCO₂ of 60 mm Hg. What is the approximate pH?