Question 1

Which of the following is/are cause(s) of metabolic alkalosis?
1) Diuretics
2) Hyperkalemia
3) Hypochloremia
4) Vomiting

Accepted Answer

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

Question 2

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

Accepted Answer

A)  Temperature rise of more than 3° C 
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 3° C 
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 3

A patient with a measured plasma HCO3- concentration of 24 mmol/L has an episode of acute hypoventilation, with the PCO2 rising from 40 to 70 mm Hg. What do you predict will happen acutely to the plasma HCO3- concentration?

Accepted Answer

A)  HCO3- will remain unchanged. 
B)  HCO3- will rise to approximately 27 to 28 mmol/L. 
C)  HCO3- will fall to approximately 20 to 21 mmol/L. 
D)  HCO3- will rise to approximately 54 to 55 mmol/L. 
A)  HCO3- will remain unchanged. 
B)  HCO3- will rise to approximately 27 to 28 mmol/L. 
C)  HCO3- will fall to approximately 20 to 21 mmol/L. 
D)  HCO3- will rise to approximately 54 to 55 mmol/L.

Question 4

Which of the following statements about the equilibrium constant of an acid is true?

Accepted Answer

A)  The equilibrium constant of a weak acid is large. 
B)  The equilibrium constant of a strong acid is small. 
C)  The equilibrium constant of a weak acid is small. 
D)  The more an acid ionizes, the smaller is the equilibrium constant. 
A)  The equilibrium constant of a weak acid is large. 
B)  The equilibrium constant of a strong acid is small. 
C)  The equilibrium constant of a weak acid is small. 
D)  The more an acid ionizes, the smaller is the equilibrium constant.

Question 5

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.38, PCO2 = 21 mm Hg, HCO3- = 11.7 mEq/L

Accepted Answer

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

Question 6

A patient has a pH of 7.49. How would you describe this?

Accepted Answer

A)  Acidemia 
B)  Alkalemia 
C)  Not sufficient information to determine 
D)  Normal acid-base status 
A)  Acidemia 
B)  Alkalemia 
C)  Not sufficient information to determine 
D)  Normal acid-base status

Question 7

An ABG result shows pH of 7.35, PaCO2 of 30 mm Hg, and HCO3- of 18 mEq/L. Which of the following is the patient's most likely primary disorder?

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 8

In a patient with partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter?
1) Decreased pH
2) Decreased HCO3-
3) Decreased PCO2
4) Increased pH

Accepted Answer

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

Question 9

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.08, PCO2 = 39 mm Hg, HCO3- = 11.8 mEq/L

Accepted Answer

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

Question 10

What is a normal response of the body to a failure in one component of the acid-base regulatory mechanism?

Accepted Answer

A)  Autoregulation 
B)  Compensation 
C)  Correction 
D)  Homeostasis 
A)  Autoregulation 
B)  Compensation 
C)  Correction 
D)  Homeostasis

Question 11

If the blood PCO2 is high, the kidneys will do which of the following?

Accepted Answer

A)  Excrete more H+ and reabsorb more HCO3-. 
B)  Excrete less H+ and reabsorb more HCO3-. 
C)  Excrete less H+ and reabsorb less HCO3-. 
D)  Excrete more H+ and reabsorb less HCO3-. 
A)  Excrete more H+ and reabsorb more HCO3-. 
B)  Excrete less H+ and reabsorb more HCO3-. 
C)  Excrete less H+ and reabsorb less HCO3-. 
D)  Excrete more H+ and reabsorb less HCO3-.

Question 12

A patient who has fully compensated respiratory acidosis becomes severely hypoxic. If her lungs are not too severely compromised, what might her gases now appear to be?

Accepted Answer

A)  Fully compensated metabolic acidosis 
B)  Fully compensated metabolic alkalosis 
C)  Fully compensated respiratory alkalosis 
D)  No change 
A)  Fully compensated metabolic acidosis 
B)  Fully compensated metabolic alkalosis 
C)  Fully compensated respiratory alkalosis 
D)  No change

Question 13

Metabolic acidosis may be caused by:
1) an increase in fixed (nonvolatile) acids.
2) an increase in blood carbon dioxide (CO2).
3) excessive loss of bicarbonate (HCO3-).

Accepted Answer

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

Question 14

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 15

Which of the following clinical findings would you expect in a fully compensated respiratory acidosis?
1) Elevated HCO3-
2) pH below 7.35
3) pH between 7.35 and 7.39
4) Elevated PO2

Accepted Answer

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

Question 16

Which of the following is a volatile acid of physiologic significance?

Accepted Answer

A)  Hydrochloric 
B)  Carbonic 
C)  Phosphoric 
D)  Lactic 
A)  Hydrochloric 
B)  Carbonic 
C)  Phosphoric 
D)  Lactic

Question 17

What effect does hyperventilation have on HCO3- recovery in the kidneys?

Accepted Answer

A)  Less H+ excretion, greater HCO3- loss 
B)  No effect as these involve two independent systems. 
C)  Vicious cycle of worsening alkalemia as hyperventilation stimulates increased HCO3- retention. 
D)  Escalating retention of other buffer bases along with HCO3-. 
A)  Less H+ excretion, greater HCO3- loss 
B)  No effect as these involve two independent systems. 
C)  Vicious cycle of worsening alkalemia as hyperventilation stimulates increased HCO3- retention. 
D)  Escalating retention of other buffer bases along with HCO3-.

Question 18

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

Accepted Answer

A)  Blood buffer system 
B)  GI tract 
C)  Renal system 
D)  Respiratory system 
A)  Blood buffer system 
B)  GI tract 
C)  Renal system 
D)  Respiratory system

Question 19

Using the Henderson-Hasselbalch equation, determine the accuracy of the gas below. To be considered accurate, it must be within 0.03 pH unit. pH = 7.35, PCO2 = 77 mm Hg, HCO3- = 41 mEq/L

Accepted Answer

A)  This gas is completely accurate. 
B)  This gas is accurate as the calculated pH is 7.32. 
C)  This gas is accurate as the calculated pH is 7.38. 
D)  This gas is inaccurate according to the H-H equation. 
A)  This gas is completely accurate. 
B)  This gas is accurate as the calculated pH is 7.32. 
C)  This gas is accurate as the calculated pH is 7.38. 
D)  This gas is inaccurate according to the H-H equation.

Question 20

A 31-year-old man suffering from food poisoning is having severe vomiting for the last 2 days. His blood gas and serum electrolyte analyses revealed the following: pH of 7.60, PaCO2 of 49 mm Hg, an HCO3- of 47 mEq/L, a base excess (BE) of +20 mEq/L, a serum K+ of 2.5 mEq/L, and a serum of Cl- of 92 mEq/L. How would the respiratory therapist assess his acid-base condition?
1) Severe hyperventilation
2) Metabolic alkalosis
3) Adequate compensatory response
4) Minimal hypoventilation

Accepted Answer

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

Exam 14: Acid-Base Balance

Which of the following is/are cause(s) of metabolic alkalosis? 1) Diuretics 2) Hyperkalemia 3) Hypochloremia 4) Vomiting

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

A patient with a measured plasma HCO3- concentration of 24 mmol/L has an episode of acute hypoventilation, with the PCO2 rising from 40 to 70 mm Hg. What do you predict will happen acutely to the plasma HCO3- concentration?

Which of the following statements about the equilibrium constant of an acid is true?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.38, PCO2 = 21 mm Hg, HCO3- = 11.7 mEq/L

A patient has a pH of 7.49. How would you describe this?

An ABG result shows pH of 7.35, PaCO2 of 30 mm Hg, and HCO3- of 18 mEq/L. Which of the following is the patient's most likely primary disorder?

In a patient with partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter? 1) Decreased pH 2) Decreased HCO3- 3) Decreased PCO2 4) Increased pH

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.08, PCO2 = 39 mm Hg, HCO3- = 11.8 mEq/L

What is a normal response of the body to a failure in one component of the acid-base regulatory mechanism?

If the blood PCO2 is high, the kidneys will do which of the following?

A patient who has fully compensated respiratory acidosis becomes severely hypoxic. If her lungs are not too severely compromised, what might her gases now appear to be?

Metabolic acidosis may be caused by: 1) an increase in fixed (nonvolatile) acids. 2) an increase in blood carbon dioxide (CO2). 3) excessive loss of bicarbonate (HCO3-).

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

Which of the following clinical findings would you expect in a fully compensated respiratory acidosis? 1) Elevated HCO3- 2) pH below 7.35 3) pH between 7.35 and 7.39 4) Elevated PO2

Which of the following is a volatile acid of physiologic significance?

What effect does hyperventilation have on HCO3- recovery in the kidneys?

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

Using the Henderson-Hasselbalch equation, determine the accuracy of the gas below. To be considered accurate, it must be within 0.03 pH unit. pH = 7.35, PCO2 = 77 mm Hg, HCO3- = 41 mEq/L

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

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Respiratory Distress Syndrome

Trauma, Burns and Near Drowning

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

Airway Clearance Therapy Act

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring 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

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

A patient with a measured plasma HCO₃^- concentration of 24 mmol/L has an episode of acute hypoventilation, with the PCO₂ rising from 40 to 70 mm Hg. What do you predict will happen acutely to the plasma HCO₃^- concentration?

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.38, PCO₂ = 21 mm Hg, HCO₃^- = 11.7 mEq/L

An ABG result shows pH of 7.35, PaCO₂ of 30 mm Hg, and HCO₃^- of 18 mEq/L. Which of the following is the patient's most likely primary disorder?

In a patient with partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter? 1) Decreased pH 2) Decreased HCO₃^- 3) Decreased PCO₂ 4) Increased pH

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.08, PCO₂ = 39 mm Hg, HCO₃^- = 11.8 mEq/L

If the blood PCO₂ is high, the kidneys will do which of the following?

Metabolic acidosis may be caused by: 1) an increase in fixed (nonvolatile) acids. 2) an increase in blood carbon dioxide (CO₂). 3) excessive loss of bicarbonate (HCO₃^-).

Which of the following clinical findings would you expect in a fully compensated respiratory acidosis? 1) Elevated HCO₃^- 2) pH below 7.35 3) pH between 7.35 and 7.39 4) Elevated PO₂

What effect does hyperventilation have on HCO₃^- recovery in the kidneys?

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

Using the Henderson-Hasselbalch equation, determine the accuracy of the gas below. To be considered accurate, it must be within 0.03 pH unit. pH = 7.35, PCO₂ = 77 mm Hg, HCO₃^- = 41 mEq/L