1. A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal
the following values. Which of the following is an appropriate analysis of the ABGs?
pH 7.22
PaCO2 68 mm Hg
Base excess -2
PaO2 78 mm Hg
Saturation 80%
Bicarbonate 26 mEq/L
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
2. A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy.
The nurse should monitor the client for which of the following clinical manifestations?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
3. A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a PaCO2 of 50 mm Hg. The
nurse should identify that the client is experiencing which of the following acid-base imbalances?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
4. A nurse is admitting a client who reports flu-like symptoms with hyperactive reflexes and a new onset of
confusion. The nurse should recognize that the client is experiencing which of the following conditions?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
This question is very vague. The test will have much more information.
5. A nurse is reviewing a client’s laboratory report of blood gas findings: HCO3- 18 mEq/L and PaCO2 28 mm Hg.
Which of the following pH values and conditions should the nurse expect when interpreting these findings?
a. Decreased pH and respiratory acidosis
b. Decreased pH and metabolic acidosis
c. Increased pH and respiratory alkalosis
d. Increased pH and metabolic alkalosis
The pH was missing from this question.. Sorry! I pulled this from my deepest darkest archives 😊 This would be a
compensated blood gas- don’t worry about it
6. A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations
should the nurse monitor? (Select all that apply.)
a. Bicarbonate excess
b. Kussmaul respirations
c. Flushing
d. Circumoral paresthesia
e. Lethargy
This question is pretty hard too… the questions on the tests are much simpler
7. A nurse is admitting a client who has influenza and is reporting numbness and tingling of the toes and fingers.
The nurse should recognize the client is experiencing which of the following acid-base imbalances?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
8. A nurse is caring for a client who has the following arterial blood gas results: HCO3 18 mEq, PaCO2 28 mm Hg and
pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
This is a compensated blood gas.. The bicarb is low and pH is low indicating metabolic acidosis. The patient is likely
breathing faster in an effort to remove CO2 (acid)
9. A nurse is caring for a client who is postoperative and whose respirations are shallow and 9/min. Which of the
following acid-based imbalances should the nurse identify the client as being at risk for developing initially?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
This question is very similar to what you will see on the class
10. A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines
the client has respiratory acidosis. Which of the following findings should the nurse expect?
a. Peaked T waves
b. Hyperactive deep tendon reflexes
c. Bounding peripheral pulses
d. Warm, flushed skin
11. A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following
findings should the nurse expect?
a. HCO3 30 mEq/L
b. PaCO2 50mmHg
c. pH 7.45
d. Potassium 3.3 mEq/L
12. A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should
recognize that which of the following clients is at risk for metabolic acidosis?
a. A client who has diarrhea
b. A client who is vomiting
c. A client who is taking a thiazide diuretic
d. A client who has salicylate intoxication
13. pH- 7.25/PaCO2- 60/HCO3- 22
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
14. pH- 7.29/PaCO2- 45/HCO3- 18
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
15. pH- 7.5/PaCO2- 40/HCO3- 28
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
16. pH- 7.29/PaCO2- 50/HCO3- 26
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
17. pH- 7.40/PaCO2- 30/HCO3- 24
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
18. A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect?
(Select all that apply.)
a. Increased HR
b. Increased blood pressure
c. Increased respiratory rate
d. Increased hematocrit
e. Increased temperature
19. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities
on the client's EKG should the nurse interpret as a sign of hypokalemia?
a. Abnormally prominent U waves
b. Elevated ST segment
c. Wide QRS
d. Inverted P wave
20. A nurse in the emergency department is caring for a client who collapsed after playing football on a hot day.
After reviewing the admission laboratory findings, the nurse recognizes that these findings are consistent with
which of the following conditions?
Sodium
152 mEq/L
Glucose
102 mg/dL
Potassium
3.6 mEq/L
BUN
18 mg/dL
Chloride
105 mEq/L
Creatinine
0.7 mg/dL
a. Renal failure
b. Low protein diet
c. Dehydration
d. Syndrome of inappropriate antidiuretic hormone
21. A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at
risk for fluid volume deficit?
a. The client who has been NPO since midnight for endoscopy
b. The patient who has heart failure and a high BNP
c. The client who has end stage renal failure and is scheduled for dialysis today
d. The client who has gastroenteritis and is febrile
22. A nurse is reviewing a client’s lab results. Which of the following lab values should the nurse report to the
provider?
a. Sodium 126 mEq/L
b. Potassium 3.6 mEq/L
c. Magnesium 1.9 mEq/L
d. Calcium 9.2 mEq/L
23. A nurse is caring for a group of adolescents. Which of the following findings should be reported to the provider
immediately?
a. A client who is 1 day postoperative and has a temperature of 99.5 degrees Fahrenheit
b. A client who has a burn injury to an estimated 5% of his leg and is crying
c. A client’s blood pressure changes from 112/60 mmHg to 90/54 mmHg when standing
d. A client with an ankle fracture who reports a pain increase from 3 to 6 after ambulation
24. A nurse is caring for a client who is receiving IV fluids to correct dehydration. Which of the following laboratory
values should indicate to the nurse that the client is effectively responding to treatment?
a. Sodium 165 mEq/L
b. Potassium 5.2 mEq/L
c. Urine specific gravity 1.020
d. Hct 62%
Remember though.. best indicators of fluid status are daily weights, urine output, and blood pressure
25. A nurse is caring for four clients who have drainage tubes. Which of the following clients should the nurse
recognize as being at risk for hypokalemia?
a. The client who has a tracheostomy tube attached to humidified oxygen
b. The client who has an indwelling urinary catheter to gravity drainage
c. The client who has a chest tube to water seal
d. The client who has a nasogastric (NG) tube to suction