NCLEX ABGs Questions

NCLEX ABG's Questions ScienceMedicineNursing Olivia_Monarrez Save ABGs Practice Questions 17 terms Kennnnnnna11 Preview Fluid and Electrolytes NCLEX Quest...33 terms Alex_Hassiepen Preview Prioritization NCLEX questions 28 terms madisoncastello Preview ABG Pr 23 terms ann The nurse reviews the arterial blood gas results of a client with emphysema and notes that the laboratory report indicates a pH of 7.30, Paco2 of 58 mm Hg, Pao2 of 80 mm Hg, and Hco3 of 27 mEq/L. The nurse interprets that the client has which acid-base disturbance?

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

Rationale:

The normal pH is 7.35 to 7.45. Normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is low and Paco2 is elevated. Options 1, 2, and 4 are incorrect interpretations of the values identified in the question.A client with a history of lung disease is at risk for developing respiratory acidosis. The nurse would assess the client for which signs and symptoms characteristic of this disorder?

• Bradycardia and hyperactivity
• Decreased respiratory rate and depth
• Headache, restlessness, and confusion
• Bradypnea, dizziness, and paresthesias
• Headache, restlessness, and confusion

Rationale:

When a client is experiencing respiratory acidosis, the respiratory rate and depth increase in an attempt to compensate. The client also experiences headache; restlessness; mental status changes, such as drowsiness and confusion; visual disturbances; diaphoresis; cyanosis as the hypoxia becomes more acute; hyperkalemia; rapid, irregular pulse; and dysrhythmias. Options 1, 2, and 4 are not specifically associated with this disorder.

The nurse is caring for a hospitalized client with chronic obstructive pulmonary disease who is retaining carbon dioxide (CO2). The nurse anticipates which physical response will initially occur?

• The client will lose consciousness.
• The client's sodium and chloride levels will rise.
• The client will complain of facial numbness and tingling.
• The client's arterial blood gas results will reflect acidosis.
• The client's arterial blood gas results will reflect acidosis.

Rationale:

When the client with respiratory disease retains CO2, a rise in CO2 will occur. This results in a corresponding fall in pH, thus respiratory acidosis.This concept forms the basis for key aspects of acid-base balance. The other options are incorrect and are not associated with this initial physical response.The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg (30 mm Hg), and HCO3- of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition?

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

Rationale:

The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite effect will be seen between the pH and the Paco2. In this situation, the pH is at the high end of the normal value, and the Pco2 is low. In an alkalotic condition, the pH is elevated. Therefore, the values identified in the question indicate a respiratory alkalosis that is compensated by the kidneys through the renal excretion of bicarbonate. Because the pH has returned to a normal value, compensation has occurred.A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding?

• A decreased pH and an increased Paco2
• An increased pH and a decreased Paco2
• A decreased pH and a decreased HCO3-
• An increased pH and an increased HCO3-
• An increased pH and an increased HCO3–

Rationale:

Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and HCO3– to increase. Symptoms experienced by the client would include hypoventilation and tachycardia. Option 1 reflects a respiratory acidotic condition. Option 2 reflects a respiratory alkalotic condition, and option 3 reflects a metabolic acidotic condition.

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg, and HCO3- is 22 mEq/L. 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
• Respiratory acidosis without compensation

Rationale:

The acid-base disturbance is respiratory acidosis without compensation. The normal pH is 7.35 to 7.45. The normal Paco2 is 35 to 45 mm. In respiratory acidosis, the pH is decreased and the Paco2 is elevated. The normal bicarbonate (HCO3–) level is 21 to 28 mEq/L. Because the bicarbonate is still within normal limits, the kidneys have not had time to adjust for this acid-base disturbance. In addition, the pH is not within normal limits. Therefore, the condition is without compensation. The remaining options are incorrect interpretations.The nurse notes that a client's arterial blood gas (ABG) results reveal a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm Hg). The nurse monitors the client for which clinical manifestations associated with these ABG results? Select all that apply.

• Nausea
• Confusion
• Bradypnea
• Tachycardia
• Hyperkalemia
• Light-headedness
• Nausea
• Confusion
• Tachycardia
• Light-headedness

Rationale:

Respiratory alkalosis is defined as a deficit of carbonic acid or a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. This occurs in conditions that cause overstimulation of the respiratory system. Clinical manifestations of respiratory alkalosis include lethargy, light-headedness, confusion, tachycardia, dysrhythmias related to hypokalemia, nausea, vomiting, epigastric pain, and numbness and tingling of the extremities. Hyperventilation (tachypnea) occurs.Bradypnea describes respirations that are regular but abnormally slow. Hyperkalemia is associated with acidosis.

The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurse's findings?

• pH 7.25, Paco2 50 mm Hg
• pH 7.35, Paco2 40 mm Hg
• pH 7.50, Paco2 52 mm Hg
• pH 7.52, Paco2 28 mm Hg
• pH 7.25, Paco2 50 mm Hg

Rationale:

Atelectasis is a condition characterized by the collapse of alveoli, preventing the respiratory exchange of oxygen and carbon dioxide in a part of the lungs. The normal pH is 7.35 to 7.45. The normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is decreased and the Paco2 is elevated. Option 2 identifies normal values. Option 3 identifies an alkalotic condition, and option 4 identifies respiratory alkalosis.The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid-base imbalance?

• Respiratory acidosis from inadequate ventilation
• Respiratory alkalosis from anxiety and hyperventilation
• Metabolic acidosis from calcium loss due to broken bones
• Metabolic alkalosis from taking analgesics containing base products
• Respiratory acidosis from inadequate ventilation

Rationale:

Respiratory acidosis is most often caused by hypoventilation. The client with broken ribs will have difficulty with breathing adequately and is at risk for hypoventilation and resultant respiratory acidosis. The remaining options are incorrect. Respiratory alkalosis is associated with hyperventilation. There are no data in the question that indicate calcium loss or that the client is taking analgesics containing base products.The nurse is reviewing the arterial blood gas analysis results for a client in the respiratory care unit who is receiving nasal oxygen and notes a pH of 7.38, Paco2 of 38 mm Hg, Pao2 of 86 mm Hg, and HCO3 of 23 mEq/L. What action would the nurse take in response to these results?

• Discontinue the oxygen.
• Continue to monitor the client.
• Call 911 to have the client intubated immediately.
• Have another set drawn because these results are not possible.
• Continue to monitor the client.

Rationale:

The client's results fall in the normal range for pH (7.35 to 7.45), Paco2 (35 to 45 mm Hg), and bicarbonate level (21 to 28 mEq/L). With acidosis, the pH would be less than 7.35; with alkalosis, the pH would be greater than 7.45. Carbon dioxide levels would be high with respiratory acidosis, whereas bicarbonate levels would be low if metabolic acidosis were present.