Question 1

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)  Communication 
B)  Perfusion 
C)  Fluid and electrolyte imbalance 
D)  Cognition

Question 2

The nurse is caring for a client who is being mechanically ventilated.Arterial blood gas analysis reveals a pH of 7.20 and a PaCO2 of 49 mmHg.Which change in ventilator settings should the nurse anticipate?

Accepted Answer

A)  Increase in humidification of inspired air 
B)  Decrease of FiO2 from 30% to 25% 
C)  Increased respiratory rate to 30 breaths per minute 
D)  Decreased tidal volume of each breath

Question 3

A client with injuries from a motor vehicle crash is intubated for respiratory support.The nurse notes that the client is fighting the ventilator and attempting to pull out the endotracheal tube.What should the nurse do to reduce this client's risk of developing respiratory alkalosis?

Accepted Answer

A)  Administer a sedative as prescribed. 
B)  Apply wrist restraints. 
C)  Teach the client to take slow, deep breaths. 
D)  Discuss removing the endotracheal tube with the healthcare provider.

Question 4

During a home visit,the nurse evaluates teaching provided to a client recently hospitalized for metabolic alkalosis.Which observation indicates that additional teaching is required?

Accepted Answer

A)  Drinks 2 cups of black coffee each day. 
B)  Consumes one orange each day with breakfast. 
C)  Ingests bicarbonate of soda after each meal. 
D)  Monitors and tracks daily weights.

Question 5

The nurse is caring for a client admitted with renal failure and metabolic acidosis.Which clinical manifestation would indicate to the nurse that planned interventions to relieve the metabolic acidosis have been effective?

Accepted Answer

A)  Decreased respiratory depth 
B)  Palpitations 
C)  Increased deep tendon reflexes 
D)  Respiratory rate of 38

Question 6

A client is admitted to the unit with chronic obstructive pulmonary disease.Blood gas analysis indicates respiratory acidosis.Based on this data,the nurse plans care based on which priority diagnosis?

Accepted Answer

A)  Impaired Gas Exchange 
B)  Ineffective Airway Clearance 
C)  Impaired Mobility 
D)  Anxiety

Question 7

A client with pneumonia develops respiratory acidosis.Which medications should the nurse prepare to administer to this client? Select all that apply.

Accepted Answer

A)  Furosemide (Lasix) 20 mg by mouth twice a day 
B)  Amoxicillin 1 gram intravenous every 6 hours 
C)  Albuterol inhaler 2 puffs every 4 hours 
D)  Diazepam (Valium) 2 mg by mouth at bedtime for sleep 
E)  Potassium chloride 20 mEq in 100 mL 0.9% normal saline intravenous every day

Question 8

The nurse is caring for a client with metabolic acidosis.Which goals are appropriate for this client? Select all that apply.

Accepted Answer

A)  The client will maintain a respiratory rate of 30 or more. 
B)  The client will describe preventative measure for the underlying chronic illness. 
C)  The client will maintain baseline cardiac rhythm. 
D)  pH will range from 7.25 to 7.35. 
E)  The client will take potassium supplements to increase potassium levels.

Question 9

The nurse is providing care to a client recently extubated for treatment of aspiration pneumonia and respiratory acidosis.Which action by the nurse provides an optimum environment for this client?

Accepted Answer

A)  Allowing family members to remain with client as much as possible 
B)  Restraining the client 
C)  Placing the client in a side-lying position 
D)  Administering narcotics for pain

Question 10

The nurse is caring for the client experiencing hypovolemic shock and metabolic acidosis.Which therapies would the nurse question if planned for this client? Select all that apply.

Accepted Answer

A)  Monitor weight on admission and discharge. 
B)  Monitor ECG for conduction problems. 
C)  Limit the intake of fluids. 
D)  Administer sodium bicarbonate. 
E)  Keep the bed in the locked and low position.

Question 11

The nurse suspects a client with one functioning lung is developing chronic respiratory acidosis.Which manifestation did the nurse most likely assess in this client?

Accepted Answer

A)  Warm, flushed skin 
B)  Daytime sleepiness 
C)  Irritability 
D)  Blurred vision

Question 12

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

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

Question 13

The nurse is caring for the client with a history of anxiety who is experiencing chest pain,palpitations and dyspnea.Which intervention would be a priority for this client?

Accepted Answer

A)  Providing educational material for the client's medical diagnosis 
B)  Ordering a regular diet for the client 
C)  Reassuring the client that symptoms will resolve 
D)  Asking Respiratory Therapy to set up a mechanical ventilator

Question 14

A client with hyperaldosteronism is admitted to the unit and is at risk for impaired gas exchange.Which position should this client be placed to enhance gas exchange?

Accepted Answer

A)  Fowler's position 
B)  Prone position 
C)  Left side-lying position 
D)  Right Sims position

Question 15

The nurse is caring for a client who has been admitted to the hospital for congestive heart failure.Which data collected during the nursing assessment indicates that the client is at risk for metabolic alkalosis? Select all that apply.

Accepted Answer

A)  The client takes furosemide (Lasix) daily. 
B)  The client takes a baby aspirin once daily. 
C)  The client takes metformin daily. 
D)  The client frequently uses calcium carbonate (Tums) for acid indigestion. 
E)  The client takes acetaminophen as needed for pain.

Question 16

The nurse is planning care for an older client with respiratory acidosis.Which intervention should the nurse include in this client's plan of care?

Accepted Answer

A)  Administer prescribed intravenous fluids carefully. 
B)  Administer intravenous sodium bicarbonate. 
C)  Maintain adequate hydration. 
D)  Reduce environmental stimuli.

Question 17

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

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

Question 18

A client with severe metabolic alkalosis is admitted to the unit.Which is the priority for the client?

Accepted Answer

A)  Administering medication for metabolic alkalosis 
B)  Monitoring oxygen saturation 
C)  Teaching the client the risk factors for metabolic alkalosis 
D)  Setting goals for the client with metabolic alkalosis

Question 19

The nurse is evaluating care provided to a client with respiratory alkalosis.Which outcomes indicate that nursing care has been effective for this client? Select all that apply.

Accepted Answer

A)  Respiratory rate 18 and regular 
B)  Sleeping through the night 
C)  Gait steady 
D)  Consistent body weight 
E)  Using prescribed bronchodilators

Question 20

The nurse is providing care to an older adult Asian-American client diagnosed with respiratory alkalosis.The nurse states to the client,"look into my eyes and breathe with me so that we can slow down your breathing rate." The client continues to look down and refuses to make eye contact with the nurse.The client's daughter later asks you to teach her how to help her mother to control her breathing.When documenting this client's care,which statement is appropriate for the nurse to include?

Accepted Answer

A)  "The client is noncompliant with suggested treatment plan." 
B)  "The client does not understanding the English language." 
C)  "The client's culture does not allow for direct eye contact with the nurse during care." 
D)  "The client's daughter may be abusive."

Exam 1: Acidbase Balance