ACID-BASE BALANCE, NCLEX FLUIDS AND
ELECTROLYTES: CHAPTER 9, FUNDAMENTALS
CHAPTER 42: FLUID, ELECTROLYTE AND ACID-
BASE BALANCE EXAM Q&A WITH RATIONALES
The results of a patient's arterial blood gas sample indicate an oxygen level of
72 mmHg. Which should the nurse closely assess when providing care to this
patient?
1) Perfusion
2) Cognition
3) Communication
4) Fluid and electrolytes --ANSWER--2) Cognition
An oxygen level of less than 75 mmHg can be due to hypoventilation. This drop
in oxygen will change the patient's level of responsiveness
The nurse is caring for a comatose patient with respiratory acidosis. For which
intervention will the nurse need to collaborate when caring for this patient?
1) Monitoring vital signs
2) Measuring intake and output
3) Determining recent eating behaviors
4) Identifying current oxygen saturation level --ANSWER--3) Determining
recent eating behaviors
Page | 1
,For patients in severe distress, family members may need to be consulted for
critical information such as recent eating habits and history of vomiting.
The nurse is analyzing the patient's arterial blood gas report, which reveals a pH
of 7.15. The patient has just suffered a cardiac arrest. Which consequences of
this pH value does the nurse consider for this patient?
1) Decreased cardiac output
2) Decreased potassium levels
3) Increased magnesium levels
4) Decreased free calcium in the ECF --ANSWER--1) Decreased cardiac output
The nurse knows that severe acidosis depresses myocardial contractility, which
leads to decreased cardiac output.
The nurse is caring for a patient admitted with renal failure and metabolic
acidosis. Which clinical manifestation would indicate to the nurse that planned
interventions to relieve the metabolic acidosis have been effective?
1) Tachypnea
2) Palpitations
3) Increased deep tendon reflexes
4) Decreased depth of respirations --ANSWER--4) Decreased depth of
respirations
The patient with metabolic acidosis will have an increased respiratory rate and
depth. Signs that care has been effective would include a decrease in the rate
and depth of respirations.
Page | 2
,A patient with metabolic acidosis has been admitted to the unit from the
emergency department (ED). The patient is experiencing confusion and
weakness. Which independent nursing intervention is the priority?
1) Protecting the patient from injury
2) Placing the patient in a high-Fowler's position
3) Administering sodium bicarbonate to the patient
4) Providing the patient with appropriate skin care --ANSWER--1) Protecting
the patient from injury
The patient with metabolic acidosis may have symptoms of drowsiness,
lethargy, confusion, and weakness. A priority of care would be preventing
injury.
The nurse is providing care for an adult patient who is admitted to the
emergency department (ED) after passing out. The patient has been fasting and
currently has ketones in the urine. Which acid-based imbalance should the nurse
monitor the patient for based on the current data?
1) Metabolic acidosis
2) Metabolic alkalosis
3) Respiratory acidosis
4) Respiratory alkalosis --ANSWER--1) Metabolic acidosis
Page | 3
, The patient who is fasting is at risk for metabolic acidosis. The body recognized
fasting as starvation and begins to metabolize its own proteins into ketones,
which are metabolic acid.
The nurse is providing care to patient with the following laboratory values: pH -
7.31; PaCO2 - 48 mmHg; and a normal HCO3. Which condition should the
nurse plan care for based on the current data?
1) Metabolic acidosis
2) Metabolic alkalosis
3) Respiratory acidosis
4) Respiratory alkalosis --ANSWER--3) Respiratory acidosis
If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
uncompensated respiratory acidosis
The nurse is reviewing the latest arterial blood gas results for a patient with
metabolic alkalosis. Which result indicates that the metabolic alkalosis is
compensated?
1) pH 7.32
2) HCO3 8 mEq/L
3) PaCO2 48 mmHg
4) PaCO2 18 mmHg --ANSWER--3) PaCO2 48 mmHg
To compensate for this imbalance, the rate and depth of respirations decrease,
leading to retention of carbon dioxide. The PaCO2 will be elevated
Page | 4
ELECTROLYTES: CHAPTER 9, FUNDAMENTALS
CHAPTER 42: FLUID, ELECTROLYTE AND ACID-
BASE BALANCE EXAM Q&A WITH RATIONALES
The results of a patient's arterial blood gas sample indicate an oxygen level of
72 mmHg. Which should the nurse closely assess when providing care to this
patient?
1) Perfusion
2) Cognition
3) Communication
4) Fluid and electrolytes --ANSWER--2) Cognition
An oxygen level of less than 75 mmHg can be due to hypoventilation. This drop
in oxygen will change the patient's level of responsiveness
The nurse is caring for a comatose patient with respiratory acidosis. For which
intervention will the nurse need to collaborate when caring for this patient?
1) Monitoring vital signs
2) Measuring intake and output
3) Determining recent eating behaviors
4) Identifying current oxygen saturation level --ANSWER--3) Determining
recent eating behaviors
Page | 1
,For patients in severe distress, family members may need to be consulted for
critical information such as recent eating habits and history of vomiting.
The nurse is analyzing the patient's arterial blood gas report, which reveals a pH
of 7.15. The patient has just suffered a cardiac arrest. Which consequences of
this pH value does the nurse consider for this patient?
1) Decreased cardiac output
2) Decreased potassium levels
3) Increased magnesium levels
4) Decreased free calcium in the ECF --ANSWER--1) Decreased cardiac output
The nurse knows that severe acidosis depresses myocardial contractility, which
leads to decreased cardiac output.
The nurse is caring for a patient admitted with renal failure and metabolic
acidosis. Which clinical manifestation would indicate to the nurse that planned
interventions to relieve the metabolic acidosis have been effective?
1) Tachypnea
2) Palpitations
3) Increased deep tendon reflexes
4) Decreased depth of respirations --ANSWER--4) Decreased depth of
respirations
The patient with metabolic acidosis will have an increased respiratory rate and
depth. Signs that care has been effective would include a decrease in the rate
and depth of respirations.
Page | 2
,A patient with metabolic acidosis has been admitted to the unit from the
emergency department (ED). The patient is experiencing confusion and
weakness. Which independent nursing intervention is the priority?
1) Protecting the patient from injury
2) Placing the patient in a high-Fowler's position
3) Administering sodium bicarbonate to the patient
4) Providing the patient with appropriate skin care --ANSWER--1) Protecting
the patient from injury
The patient with metabolic acidosis may have symptoms of drowsiness,
lethargy, confusion, and weakness. A priority of care would be preventing
injury.
The nurse is providing care for an adult patient who is admitted to the
emergency department (ED) after passing out. The patient has been fasting and
currently has ketones in the urine. Which acid-based imbalance should the nurse
monitor the patient for based on the current data?
1) Metabolic acidosis
2) Metabolic alkalosis
3) Respiratory acidosis
4) Respiratory alkalosis --ANSWER--1) Metabolic acidosis
Page | 3
, The patient who is fasting is at risk for metabolic acidosis. The body recognized
fasting as starvation and begins to metabolize its own proteins into ketones,
which are metabolic acid.
The nurse is providing care to patient with the following laboratory values: pH -
7.31; PaCO2 - 48 mmHg; and a normal HCO3. Which condition should the
nurse plan care for based on the current data?
1) Metabolic acidosis
2) Metabolic alkalosis
3) Respiratory acidosis
4) Respiratory alkalosis --ANSWER--3) Respiratory acidosis
If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
uncompensated respiratory acidosis
The nurse is reviewing the latest arterial blood gas results for a patient with
metabolic alkalosis. Which result indicates that the metabolic alkalosis is
compensated?
1) pH 7.32
2) HCO3 8 mEq/L
3) PaCO2 48 mmHg
4) PaCO2 18 mmHg --ANSWER--3) PaCO2 48 mmHg
To compensate for this imbalance, the rate and depth of respirations decrease,
leading to retention of carbon dioxide. The PaCO2 will be elevated
Page | 4
