Acid-Base Imbalances NCLEX Questions

Acid-Base Imbalances NCLEX Questions 5.0 (1 review) Students also studied Terms in this set (10) Science MedicineNursing Save

NCLEX: Acid-Base

48 terms XiuDonovanPreview Fluid and Electrolytes NCLEX Quest...33 terms Alex_Hassiepen Preview NCLEX book questions CH 55 acid-...19 terms medwards1975 Preview Fluid & 145 term ngr A nurse is caring for a client admitted with confusion and lethargy. The client was found at home unresponsive with an empty bottle of aspirin lying next to her bed. Vital signs reveal blood pressure 104/72 mm Hg, heart rate 116/min with regular rhythm, and respiratory rate 42/min and deep. Which of the following arterial blood gas findings should the nurse expect?

• pH 7.68, PaO2 96 mmHg, PaCO2 38 mmHg, HCO3 28

mEq/L

• pH 7.48, PaO2 100 mmHg, PaCO2 28 mmHg, HCO3 23

mEq/L

• pH 6.98, PaO2 100 mmHg, PaCO2 30mm Hg, НСО3 18

mEq/L

• pH 7.58, PaO2 96 mmHg, PaCO2 38 mmHg, HСО3 29

mEq/L C Aspirin overdose would result in ABG findings of metabolic acidosis.A nurse caring for a client who was in a motor vehicle accident. The client reports chest pain and difficulty breathing. A chest x ray reveals the client has a pneumothorax. Which of the following arterial blood gas findings should the nurse expect?

• pH 7.06, PaO2 86 mmHg, PaCO2 55 mmHg, HCO3 24

mEq/L

• pH 7.42, PaO2 100 mmHg, PaCO2 38 mmHg, HCO3 23

mEq/L

• pH 6.98, PaO2 100 mmHg, PaCO2 30 mmHg, HCO3 18

mEq/L

• pH 7.58, PaO2 96 mmHg, PaCO2 38 mmHg, HCO3 29

mEq/L A A pneumothorax can cause alveolar hyperventilation and increased carbon dioxide levels, resulting in respiratory acidosis.

A nurse is obtaining arterial blood gases for a client who has vomited for 24 hr. The nurse should expect which of the following acid-base imbalances to result from vomiting for 24 hr?

• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Metabolic alkalosis

D Excessive vomiting causes a loss of gastric acids and an accumulation of bicarbonate in the blood, resulting in metabolic alkalosis.A charge nurse is teaching a group of nurses about conditions related to metabolic acidosis.Which of the following statements by a unit nurse indicates the teaching has been effective?

• "Metabolic acidosis can occur due to diabetic

ketoacidosis."

• "Metabolic acidosis can occur in a client who has

myasthenia gravis."

• "Metabolic acidosis can occur in a client who has

asthma."

• "Metabolic acidosis can occur due to cancer."

A Metabolic acidosis results from an excess production of hydrogen ions, which occurs in diabetic ketoacidosis *REMEMBER metabolic ACIDOSIS = diabetic ketoACIDOSIS A nurse is assessing a client who has pancreatitis. The client's arterial blood gases reveal metabolic acidosis.Which of the following are expected findings?(Select all that apply.)

• Tachycardia
• Hypertension
• Bounding pulses
• Hyperreflexia
• Dysrhythmia
• Tachypnea

E, F Dysrhythmias and tachypnea are expected findings in a client who has pancreatitis and metabolic acidosis.

Rationale:

• Tachycardia is found in respiratory acidosis or metabolic alkalosis
• Hypertension is found in respiratory acidosis
• Bounding pulses are found in respiratory acidosis
• Hyperreflexia is found in metabolic alkalosis

Practice Scenario:

A nurse is caring for a client who has liver cancer. The clients ABGs reveal metabolic acidosis.What nursing actions should the nurse include in the plan of care?-If DKA, administer insulin -If GI loss, administer antidiarrheals and provide rehydration -If sodium bicarbonate is low, administer sodium bicarbonate 1 mEq/kg A nurse is reviewing ABG laboratory results of a client who is in respiratory distress. The results are pH 7.47, PaCO2 33 mmHg, HCO3 33 mmHg. The nurse should recognize that the client is experiencing which of the following acid-base imbalances?

• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Metabolic alkalosis

B A client who is experiencing respiratory alkalosis will have an increased pH and a decreased PaCO2. Possible causes of respiratory alkalosis include hyperventilation, fever, and respiratory infections.

The nurse reviews the ABG results of a client and notes

the following:

pH 7.45 PaCO2 30 mmHg HCO3 20 mEq/L The nurse analyzes these results as indicating which condition?

• Metabolic acidosis, compensated
• Respiratory alkalosis, compensated
• Metabolic alkalosis, uncompensated
• Respiratory acidosis, uncompensated

B The pH is within normal limits, but mostly on the basic side. PaCO2 is acidic. In respiratory, pH and PaCO2 have an inverse relationship.The nurse caring for a client with a nasogastric tube that is attached to a low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?

• Metabolic acidosis
• Metabolic alkalosis
• Respiratory acidosis
• Respiratory alkalosis

B Metabolic alkalosis is a deficit/loss of hydrogen ions or an excess of base.Nasogastric secretions are acidic. Removing that acidity will leave the client with base in the body.A client who is found unresponsive has arterial blood

gases drawn and the results indicate dthe following: pH is

7.12, PaCO2 is 90, and HCO3- is 22. the nurse interprets the results as indicating which condition?

• Metabolic Acidosis with compensation
• Respiratory Acidosis with compensation
• Metabolic Acidosis without compensation
• Respiratory Acidosis without compensation

D pH is not within normal limits = not compensating. pH 7.12 is acidic. PaCO2 90 is basic. In respiratory, pH and PaCO2 have an inverse relationship.