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81. The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Pco 2 of 30 mm Hg, and of 20 mEq/L. The nurse analyzes these results as indicating which condition?
a) Metabolic acidosis, compensated
b) Respiratory alkalosis, compensated
c) Metabolic alkalosis, uncompensated
d) Respiratory acidosis, uncompensated
82. The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
83. 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) A decreased pH and an increased CO 2
b) An increased pH and a decreased CO 2
c) A decreased pH and a decreased
d) An increased pH with an increased
84. The nurse caring for a client with an ileostomy understands that the client is most at risk for developing which acid-base disorder?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
85. The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s respirations. On the basis of this documentation, which pattern did the nurse observe?
a) Respirations that cease for several seconds
b) Respirations that are regular but abnormally slow
c) Respirations that are labored and increased in depth and rate
d) Respirations that are abnormally deep, regular, and increased in rate
Fluid and Electrolytes NCLEX Questions
Answers and Rationale
81) B
- The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite effect will be seen between the pH and the Pco 2 . In this situation, the pH is at the high end of the normal value and the Pco 2 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.
82) B
- Metabolic alkalosis is defined as a deficit or loss of hydrogen ions or acids or an excess of base (bicarbonate) 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 resulting in hypovolemia, the loss of gastric fluid, excessive bicarbonate intake, the massive transfusion of whole blood, and hyperaldosteronism. Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid. The remaining options are incorrect interpretations.
83) D
- Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and to increase. Symptoms experienced by the client would include hypoventilation and tachycardia. Option A reflects a respiratory acidotic condition. Option B reflects a respiratory alkalotic condition, and option C reflects a metabolic acidotic condition.
84) A
- Metabolic acidosis is defined as a total concentration of buffer base that is lower than normal, with a relative increase in the hydrogen ion concentration. This results from loss of buffer bases or retention of too many acids without sufficient bases, and occurs in conditions such as kidney disease; diabetic ketoacidosis; high fat diet; insufficient metabolism of carbohydrates; malnutrition; ingestion of toxins, such as acetylsalicylic acid (aspirin); malnutrition; or severe diarrhea. Intestinal secretions are high in bicarbonate and may be lost through enteric drainage tubes, an ileostomy, or diarrhea. These conditions result in metabolic acidosis. The remaining options are incorrect interpretations and are not associated with the client with an ileostomy.
85) D
- Kussmaul’s respirations are abnormally deep, regular, and increased in rate. Apnea is described as respirations that cease for several seconds. In bradypnea, respirations are regular but abnormally slow. In hyperpnea, respirations are labored and increased in depth and rate.
After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:
Fluid and Electrolytes NCLEX Questions (1-6)
Or proceed to the next set of questions:
Respiratory NCLEX Questions with Rationale 1-9
a) Respirations that cease for several seconds
b) Respirations that are regular but abnormally slow
c) Respirations that are labored and increased in depth and rate
d) Respirations that are abnormally deep, regular, and increased in rate
Fluid and Electrolytes NCLEX Questions
Answers and Rationale
81) B
- The normal pH is 7.35 to 7.45. In a respiratory condition, an opposite effect will be seen between the pH and the Pco 2 . In this situation, the pH is at the high end of the normal value and the Pco 2 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.
82) B
- Metabolic alkalosis is defined as a deficit or loss of hydrogen ions or acids or an excess of base (bicarbonate) 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 resulting in hypovolemia, the loss of gastric fluid, excessive bicarbonate intake, the massive transfusion of whole blood, and hyperaldosteronism. Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid. The remaining options are incorrect interpretations.
83) D
- Clients experiencing nausea and vomiting would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH and to increase. Symptoms experienced by the client would include hypoventilation and tachycardia. Option A reflects a respiratory acidotic condition. Option B reflects a respiratory alkalotic condition, and option C reflects a metabolic acidotic condition.
84) A
- Metabolic acidosis is defined as a total concentration of buffer base that is lower than normal, with a relative increase in the hydrogen ion concentration. This results from loss of buffer bases or retention of too many acids without sufficient bases, and occurs in conditions such as kidney disease; diabetic ketoacidosis; high fat diet; insufficient metabolism of carbohydrates; malnutrition; ingestion of toxins, such as acetylsalicylic acid (aspirin); malnutrition; or severe diarrhea. Intestinal secretions are high in bicarbonate and may be lost through enteric drainage tubes, an ileostomy, or diarrhea. These conditions result in metabolic acidosis. The remaining options are incorrect interpretations and are not associated with the client with an ileostomy.
85) D
- Kussmaul’s respirations are abnormally deep, regular, and increased in rate. Apnea is described as respirations that cease for several seconds. In bradypnea, respirations are regular but abnormally slow. In hyperpnea, respirations are labored and increased in depth and rate.
After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:
Fluid and Electrolytes NCLEX Questions (1-6)
Or proceed to the next set of questions:
Respiratory NCLEX Questions with Rationale 1-9
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