Question 1

What is the kidneys' most important function?

Accepted Answer

A)  Acid-base balance 
B)  Chloride maintenance 
C)  HCO3- maintenance 
D)  Sodium maintenance 
A)  Acid-base balance 
B)  Chloride maintenance 
C)  HCO3- maintenance 
D)  Sodium maintenance D

Question 2

What is the primary chemical event in respiratory acidosis?

Accepted Answer

A)  Decrease in blood CO2 levels 
B)  Decrease in blood HCO3- levels 
C)  Increase in blood CO2 levels 
D)  Increase in blood HCO3- levels 
A)  Decrease in blood CO2 levels 
B)  Decrease in blood HCO3- levels 
C)  Increase in blood CO2 levels 
D)  Increase in blood HCO3- levels C

Question 3

In order to eliminate the influence of PCO2 changes on plasma HCO3- concentrations, what additional measures of the metabolic component of acid-base balance can be used?

Accepted Answer

A)  HCO3- 
B)  Hemoglobin content 
C)  Henderson-Hasselbalch equation 
D)  Standard bicarbonate 
A)  HCO3- 
B)  Hemoglobin content 
C)  Henderson-Hasselbalch equation 
D)  Standard bicarbonate D

Question 4

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.43, PCO2 = 39 mm Hg, HCO3- = 25.1 mEq/L

Accepted Answer

A)  Acid-base status within normal limits 
B)  Fully compensated metabolic acidosis 
C)  Fully compensated respiratory alkalosis 
D)  Partially compensated metabolic acidosis 
A)  Acid-base status within normal limits 
B)  Fully compensated metabolic acidosis 
C)  Fully compensated respiratory alkalosis 
D)  Partially compensated metabolic acidosis

Question 5

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 6

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

Accepted Answer

A) 2 and 3 only 
B) 1, 2, and 3 
C) 3 only 
D) 1 and 2 only 
A) 2 and 3 only 
B) 1, 2, and 3 
C) 3 only 
D) 1 and 2 only

Question 7

A 21-year-old woman in the emergency room is displaying rapid and deep, labored breathing. Her room ABG reveals a pH of 7.25, PaCO2 of 28, HCO3- of 14 mEq/L, and a base excess of -14 mEq/L. How would the respiratory therapist assess her acid-base condition?
1) Severe hyperventilation
2) Partially compensated metabolic acidosis
3) Compensatory response to the metabolic acidosis
4) Severe hypoventilation

Accepted Answer

A) 1, 2, and 3 only 
B) 1 and 3 only 
C) 3 only 
D) 2, 3, and 4 only 
A) 1, 2, and 3 only 
B) 1 and 3 only 
C) 3 only 
D) 2, 3, and 4 only

Question 8

A decrease in the H+ ion concentration [H+] of the blood caused by a low PaCO2 best describes which of the following?

Accepted Answer

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

Question 9

What is the main compensatory mechanism for metabolic acidosis?

Accepted Answer

A)  Excretion of HCO3- 
B)  Hyperventilation 
C)  Hypoventilation 
D)  Retention of CO2 
A)  Excretion of HCO3- 
B)  Hyperventilation 
C)  Hypoventilation 
D)  Retention of CO2

Question 10

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

Accepted Answer

A)  Ammonia 
B)  HCO3- 
C)  Hb 
D)  Phosphate 
A)  Ammonia 
B)  HCO3- 
C)  Hb 
D)  Phosphate

Question 11

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.35, PCO2 = 68 mm Hg, HCO3- = 34.3 mEq/L

Accepted Answer

A)  Acute respiratory acidosis 
B)  Combined metabolic and respiratory acidosis 
C)  Fully compensated respiratory acidosis 
D)  Fully compensated metabolic alkalosis 
A)  Acute respiratory acidosis 
B)  Combined metabolic and respiratory acidosis 
C)  Fully compensated respiratory acidosis 
D)  Fully compensated metabolic alkalosis

Question 12

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 13

What is the most common cause of respiratory alkalosis?

Accepted Answer

A)  Anxiety 
B)  Central nervous system depression 
C)  Hypoxemia 
D)  Pain 
A)  Anxiety 
B)  Central nervous system depression 
C)  Hypoxemia 
D)  Pain

Question 14

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 15

What effect does hyperventilation have on the closed buffer systems?

Accepted Answer

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

Question 16

A patient has a PCO2 of 80 mm Hg. What is the concentration of dissolved CO2 (in mmol/L) in the blood?

Accepted Answer

A)  1.2 mmol/L 
B)  2.4 mmol/L 
C)  24 mmol/L 
D)  40 mmol/L 
A)  1.2 mmol/L 
B)  2.4 mmol/L 
C)  24 mmol/L 
D)  40 mmol/L

Question 17

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.01, PCO2 = 71 mm Hg, HCO3- = 16.3 mEq/L

Accepted Answer

A)  Acute metabolic acidosis 
B)  Acute respiratory acidosis 
C)  Combined respiratory and metabolic acidosis 
D)  Partially compensated respiratory acidosis 
A)  Acute metabolic acidosis 
B)  Acute respiratory acidosis 
C)  Combined respiratory and metabolic acidosis 
D)  Partially compensated respiratory acidosis

Question 18

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO2 = 41 mm Hg, HCO3- = 40.9 mEq/L

Accepted Answer

A)  Acute (uncompensated) metabolic alkalosis 
B)  Acute (uncompensated) respiratory alkalosis 
C)  Fully compensated metabolic alkalosis 
D)  Partially compensated metabolic alkalosis 
A)  Acute (uncompensated) metabolic alkalosis 
B)  Acute (uncompensated) respiratory alkalosis 
C)  Fully compensated metabolic alkalosis 
D)  Partially compensated metabolic alkalosis

Question 19

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

Accepted Answer

A) 2 only 
B) 1 and 2 only 
C) 1 and 3 only 
D) 3 only 
A) 2 only 
B) 1 and 2 only 
C) 1 and 3 only 
D) 3 only

Question 20

What would be an example of an iatrogenic cause of metabolic alkalosis?

Accepted Answer

A)  Gastric suction 
B)  High-salt diet 
C)  Discontinuing the patient's diuretics 
D)  Vomiting 
A)  Gastric suction 
B)  High-salt diet 
C)  Discontinuing the patient's diuretics 
D)  Vomiting

Exam 14: Acid-Base Balance

What is the kidneys' most important function?

What is the primary chemical event in respiratory acidosis?

In order to eliminate the influence of PCO2 changes on plasma HCO3- concentrations, what additional measures of the metabolic component of acid-base balance can be used?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.43, PCO2 = 39 mm Hg, HCO3- = 25.1 mEq/L

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

When does a state of alkalemia exist? 1) The HCO3-/CO2 ratio exceeds 20:1. 2) The blood pH exceeds 7.45. 3) The blood PCO2 exceeds 54 mm Hg.

A decrease in the H+ ion concentration [H+] of the blood caused by a low PaCO2 best describes which of the following?

What is the main compensatory mechanism for metabolic acidosis?

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

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.35, PCO2 = 68 mm Hg, HCO3- = 34.3 mEq/L

Which buffer system has the greatest capacity?

What is the most common cause of respiratory alkalosis?

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

What effect does hyperventilation have on the closed buffer systems?

A patient has a PCO2 of 80 mm Hg. What is the concentration of dissolved CO2 (in mmol/L) in the blood?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.01, PCO2 = 71 mm Hg, HCO3- = 16.3 mEq/L

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO2 = 41 mm Hg, HCO3- = 40.9 mEq/L

A patient has an anion gap of 21 mEq/L. Based on this information, what can you conclude? 1) There is an abnormal excess of unmeasured anions in the plasma. 2) The patient probably has metabolic acidosis. 3) The concentration of fixed acids is decreased.

What would be an example of an iatrogenic cause of metabolic alkalosis?

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Regulation of Breathing

Bedside Assessment of the Patient

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

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Flexible Bronchoscopy and the Respiratory Therapist

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Respiratory Failure and the Need for Ventilatory Support

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Physiology of Ventilatory Support

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Monitoring the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

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Filters

In order to eliminate the influence of PCO₂ changes on plasma HCO₃^- concentrations, what additional measures of the metabolic component of acid-base balance can be used?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.43, PCO₂ = 39 mm Hg, HCO₃^- = 25.1 mEq/L

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

When does a state of alkalemia exist? 1) The HCO₃^-/CO₂ ratio exceeds 20:1. 2) The blood pH exceeds 7.45. 3) The blood PCO₂ exceeds 54 mm Hg.

A decrease in the H⁺ ion concentration [H⁺] of the blood caused by a low PaCO₂ best describes which of the following?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.35, PCO₂ = 68 mm Hg, HCO₃^- = 34.3 mEq/L

A patient has a PCO₂ of 80 mm Hg. What is the concentration of dissolved CO₂ (in mmol/L) in the blood?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.01, PCO₂ = 71 mm Hg, HCO₃^- = 16.3 mEq/L

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO₂ = 41 mm Hg, HCO₃^- = 40.9 mEq/L