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WorksheetsAcid Base Balance & Electrolytes
Total questions: 20
Worksheet time: 12mins
A patient’s arterial blood gas (ABG) results are:
pH 7.31, PaCO₂ 58 mmHg, HCO₃⁻ 25 mEq/L.
Which acid–base disorder is present?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Which conditions can cause respiratory acidosis?
Select all that apply.
A. COPD
B. Anxiety-induced hyperventilation
C. Pneumothorax
D. Opioid overdose
E. Diabetic ketoacidosis
Which ABG finding best indicates metabolic alkalosis?
A. pH 7.30, HCO₃⁻ 18
B. pH 7.48, HCO₃⁻ 30
C. pH 7.32, PaCO₂ 55
D. pH 7.44, PaCO₂ 36
Which body system provides the fastest compensation for acid–base imbalances?
A. Kidneys
B. Endocrine system
C. Respiratory system
D. Gastrointestinal system
A patient with respiratory alkalosis may exhibit which clinical manifestations?
Select all that apply.
A. Light-headedness
B. Seizures
C. Bradycardia
D. Chest pain
E. Confusion
A patient receiving furosemide develops muscle weakness and ECG changes. Which potassium imbalance does the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hyponatremia
Which ECG changes are associated with hypokalemia?
Select all that apply.
A. Peaked T waves
B. U waves
C. Flat T waves
D. Widened QRS
E. Ventricular dysrhythmias
Which findings are expected in hyperkalemia?
Select all that apply.
A. Peaked T waves
B. Muscle weakness
C. Bradycardia
D. Laryngospasm
E. Risk for ventricular fibrillation
Which clinical manifestations suggest hypocalcemia?
Select all that apply.
A. Chvostek’s sign
B. Trousseau’s sign
C. Laryngospasm
D. Hypotension
E. Tetany
Which findings are consistent with fluid volume excess (FVE)?
Select all that apply.
A. Bounding pulses
B. Crackles in lungs
C. Decreased blood pressure
D. Weight gain
E. Jugular venous distention
Which statement best describes renal compensation?
A. Occurs within minutes
B. Adjusts CO₂ levels
C. Retains or excretes bicarbonate
D. Is ineffective during metabolic disorders
Which intervention is most appropriate for metabolic alkalosis caused by NG suction?
A. Sodium bicarbonate
B. Increase NG suction
C. Administer acetazolamide
D. Restrict fluids
A patient with severe diarrhea presents with deep, rapid respirations. Which acid–base imbalance does the nurse suspect?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Which IV fluids are appropriate for hypovolemia?
Select all that apply.
A. 0.9% Normal Saline
B. Lactated Ringer’s
C. 0.45% Normal Saline
D. 3% Normal Saline
E. D10W
A patient with hypocalcemia suddenly develops stridor. What is the priority nursing action?
A. Administer IV fluids
B. Prepare for intubation
C. Apply a non-rebreather mask
D. Administer potassium chloride
Which laboratory findings support dehydration with metabolic acidosis?
Select all that apply.
A. Elevated BUN
B. Elevated creatinine
C. Low HCO₃⁻
D. Dilute urine
E. Increased urine specific gravity
A patient with heart failure develops crackles, weight gain, and hypertension. Which hormone is most likely released in response?
A. Aldosterone
B. Antidiuretic hormone
C. Natriuretic peptides
D. Renin
Which findings are consistent with hypermagnesemia?
Select all that apply.
A. Hypotension
B. Bradycardia
C. Decreased deep tendon reflexes
D. Tremors
E. Respiratory depression
A patient with prolonged nasogastric suctioning presents with confusion and dysrhythmias. Which acid–base imbalance is most likely?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
A patient with severe diarrhea has the following labs:
BUN ↑, creatinine ↑, urine specific gravity 1.035, HCO₃⁻ 19 mEq/L.
Which nursing action is the priority?
A. Restrict fluids
B. Administer isotonic IV fluids
C. Administer sodium bicarbonate immediately
D. Encourage deep breathing exercises
