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Acid Base Balance Nursing

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

Which acid / base imbalance do the following ABG's indicate?

pH - 7.49

pCO2 - 29

HCO3 - 23

paO2 - 78

a)

Respiratory Alkalosis

b)

Respiratory Acidosis

c)

Metabolic Acidosis

d)

Metabolic Alkalosis

2.

A patient with heart failure comes to the ER with complaints nausea and vomiting over the last 3-4 days. What acid / base imbalance do you suspect?

a)

respiratory alkalosis

b)

respiratory acidosis

c)

metabolic acidosis

d)

metabolic alkalosis

3.

A patient who was helping getting people out of a burning building comes to the ER with cough and shortness of breath. The SaO2 is 100%. If any, what acid / base imbalance do you suspect?

a)

No imbalance

b)

Respiratory Alkalosis

c)

Respiratory Acidosis

d)

Metabolic Acidosis

4.

When caring for a patient with chronic heart failure and chronic kidney failure, you receive the following lab results:

Na+ = 131

K+ = 6.2

Creatinine = 2.89

BUN = 66

What nursing action will the nurse take first?

a)

Start IV isotonic fluids.

b)

Increase Na+ in diet order.

c)

Begin monitoring of cardiac rhythm.

d)

Teach about the need for dialysis.

5.

Best interpretation of the following ABG's.

pH - 7.33

pCO2 - 32

pHCO3 - 18

PaO2 - 92

Sa O2 - 97%

a)

Fully compensated respiratory acidosis

b)

Partially compensated respiratory acidosis

c)

Fully compensated metabolic acidosis

d)

Partially compensated metabolic acidosis

6.

The nurse is caring for a patient with metabolic acidosis related to recent uncontrolled loose stools. Which of the following interventions will the nurse carry out first?

a)

Give the patient an antiemetic.

b)

Schedule the patient for dialysis.

c)

Check patients fluid balance and electrolytes.

d)

Investigate the patient's usual dietary plan.

7.

The nurse receives the following ABG's on a patient being admitted.

pH - 7.33

pCO2 - 52

pHCO3 - 29

paO2 - 75

saO2 - 88%

Which of the following is most likely the cause of this imbalance?

a)

pulmonary embolism

b)

chronic kidney disease

c)

chronic bronchitis

d)

hyperventilation

8.

The nurse caring for a patient with heart failure receives an oral report of a critical potassium level of 6.3 on the patient. What actions will the nurse take? Select all that apply.

a)

Prepare the patient to receive IV potassium.

b)

Place the patient on cardiac rhythm monitoring.

c)

Check the patient's kidney function.

d)

Place the patient on bleeding precautions.

e)

Hold the scheduled dose of furosemide.

9.

Interpret the following ABG's.

pH - 7.43

pCO2 - 49

pHCO3 - 30

(a)  

10.

A patient in the PACU after a partial thyroidectomy suddenly develops stridor and low oxygen saturation. The nurse suspects a laryngeal spasm. What action does the nurse take to correct this complication?

a)

Administer oxygen

b)

Prone the patient

c)

Intubate the patient

d)

Give IV calcium

11.

The nurse is caring for a patient with chronic kidney disease. Which of the following diagnostics would lead the nurse to believe the patient is in need of hemodialysis?

a)

BUN - 35

creatinine- 2.55

Na+ - 132

K+ - 3.9

b)

BUN - 28

creatinine- 4.56

Na+ - 144

K+ - 4.8

c)

BUN - 30

creatinine- 3.24

Na+ - 142

K+ - 7.2

d)

BUN - 25

creatinine- 1.66

Na+ - 139

K+ - 5.2

12.

Interpret the following ABG's.

pH - 7.33

pCO2 - 51

pHCO3 - 32

(a)  

13.

The nurse receives the following ABG's on a patient being admitted.

pH - 7.48

pCO2 - 50

pHCO3 - 33

paO2 - 85

saO2 - 93%

Which of the following is most likely the cause of this imbalance?

a)

chronic diarrhea

b)

acute kidney injury

c)

hyperventilation

d)

increased bicarbonate intake

14.

The nurse suspects a patient is suffering from hypermagnemesia. What assessment finding supports this suspicion?

a)

2+ peripheral edema

b)

hyperactive deep tendon reflexes

c)

ventricular tachycardia

d)

confusion and lethargy

15.

How would increasing the Respiratory Rate on a Ventilator affect a patient's Acid/Base Balance (ABG, pH, etc.)?

a)

Increase CO2 and lower pH

b)

Decrease CO2 and elevate pH

c)

Increase HCO3 and lower pH

d)

Decrease HCO3 and elevate pH