ESTUDYR
TEST BANK FOR NURSING A CONCEPT-BASED APPROACH, 4TH
EDITION MOST TESTED QUESTIONS AND ANSWERS GRADED
A+ WITH RATIONALES
1. A nurse is reviewing a client’s laboratory values. Which finding is most consistent with
metabolic acidosis?
A. pH 7.48, PaCO₂ 38 mmHg, HCO₃⁻ 30 mEq/L
B. pH 7.30, PaCO₂ 40 mmHg, HCO₃⁻ 18 mEq/L
C. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
D. pH 7.36, PaCO₂ 48 mmHg, HCO₃⁻ 26 mEq/L
Correct Answer: B
Rationale:
Metabolic acidosis is characterized by:
pH < 7.35
Decreased HCO₃⁻ (<22 mEq/L)
Normal or compensatory PaCO₂
Option B shows decreased pH (7.30) and low bicarbonate (18 mEq/L), confirming metabolic
acidosis.
2. A client with diabetic ketoacidosis is expected to demonstrate which compensatory
mechanism?
A. Bradypnea
B. Shallow respirations
C. Kussmaul respirations
D. Irregular apnea
Correct Answer: C
Rationale:
In metabolic acidosis (such as DKA), the body compensates through hyperventilation to reduce
CO₂ (carbonic acid). This results in deep, rapid respirations known as Kussmaul respirations.
,ESTUDYR
3. Which condition most commonly causes respiratory acidosis?
A. Severe vomiting
B. Diarrhea
C. Hyperventilation
D. Chronic Obstructive Pulmonary Disease (COPD)
Correct Answer: D
Rationale:
Chronic Obstructive Pulmonary Disease leads to hypoventilation and CO₂ retention, increasing
carbonic acid and lowering blood pH, resulting in respiratory acidosis.
4. A client experiencing panic-induced hyperventilation is at risk for which imbalance?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B
Rationale:
Hyperventilation decreases PaCO₂, causing increased pH (>7.45). This defines respiratory
alkalosis.
5. Which ABG result indicates metabolic alkalosis?
A. pH 7.32, HCO₃⁻ 18
B. pH 7.28, PaCO₂ 50
C. pH 7.50, HCO₃⁻ 32
D. pH 7.38, PaCO₂ 45
Correct Answer: C
Rationale:
Metabolic alkalosis =
pH > 7.45
Elevated HCO₃⁻ (>26 mEq/L)
Option C meets both criteria.
,ESTUDYR
6. Which assessment finding is most associated with metabolic acidosis?
A. Muscle twitching
B. Lethargy and CNS depression
C. Hyperreflexia
D. Tetany
Correct Answer: B
Rationale:
Acidosis depresses the central nervous system, causing lethargy, confusion, and decreased
responsiveness.
7. Which condition can result in lactic acidosis?
A. Hypertension
B. Hypovolemic shock
C. Asthma
D. Hyperthyroidism
Correct Answer: B
Rationale:
Hypovolemic shock reduces tissue perfusion, leading to anaerobic metabolism and lactic acid
accumulation.
8. Which laboratory value is the primary indicator of respiratory function in acid-base
balance?
A. HCO₃⁻
B. pH
C. PaCO₂
D. Serum potassium
Correct Answer: C
Rationale:
PaCO₂ reflects ventilation status and is regulated by the lungs. Normal range: 35–45 mmHg.
, ESTUDYR
9. A client has prolonged vomiting. Which acid-base imbalance is most likely?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Correct Answer: C
Rationale:
Vomiting causes loss of gastric acid (HCl), increasing bicarbonate retention and raising pH.
10. A client presents with pH 7.29 and PaCO₂ 52 mmHg. What is the interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Compensated alkalosis
Correct Answer: B
Rationale:
Low pH (<7.35)
Elevated PaCO₂ (>45 mmHg)
This indicates respiratory acidosis due to CO₂ retention.
11. Which medication can worsen metabolic alkalosis if overused?
A. Sodium chloride
B. Furosemide
C. Calcium carbonate antacids
D. Insulin
Correct Answer: C
Rationale:
Calcium carbonate increases bicarbonate levels when overused, leading to metabolic alkalosis.
TEST BANK FOR NURSING A CONCEPT-BASED APPROACH, 4TH
EDITION MOST TESTED QUESTIONS AND ANSWERS GRADED
A+ WITH RATIONALES
1. A nurse is reviewing a client’s laboratory values. Which finding is most consistent with
metabolic acidosis?
A. pH 7.48, PaCO₂ 38 mmHg, HCO₃⁻ 30 mEq/L
B. pH 7.30, PaCO₂ 40 mmHg, HCO₃⁻ 18 mEq/L
C. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
D. pH 7.36, PaCO₂ 48 mmHg, HCO₃⁻ 26 mEq/L
Correct Answer: B
Rationale:
Metabolic acidosis is characterized by:
pH < 7.35
Decreased HCO₃⁻ (<22 mEq/L)
Normal or compensatory PaCO₂
Option B shows decreased pH (7.30) and low bicarbonate (18 mEq/L), confirming metabolic
acidosis.
2. A client with diabetic ketoacidosis is expected to demonstrate which compensatory
mechanism?
A. Bradypnea
B. Shallow respirations
C. Kussmaul respirations
D. Irregular apnea
Correct Answer: C
Rationale:
In metabolic acidosis (such as DKA), the body compensates through hyperventilation to reduce
CO₂ (carbonic acid). This results in deep, rapid respirations known as Kussmaul respirations.
,ESTUDYR
3. Which condition most commonly causes respiratory acidosis?
A. Severe vomiting
B. Diarrhea
C. Hyperventilation
D. Chronic Obstructive Pulmonary Disease (COPD)
Correct Answer: D
Rationale:
Chronic Obstructive Pulmonary Disease leads to hypoventilation and CO₂ retention, increasing
carbonic acid and lowering blood pH, resulting in respiratory acidosis.
4. A client experiencing panic-induced hyperventilation is at risk for which imbalance?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B
Rationale:
Hyperventilation decreases PaCO₂, causing increased pH (>7.45). This defines respiratory
alkalosis.
5. Which ABG result indicates metabolic alkalosis?
A. pH 7.32, HCO₃⁻ 18
B. pH 7.28, PaCO₂ 50
C. pH 7.50, HCO₃⁻ 32
D. pH 7.38, PaCO₂ 45
Correct Answer: C
Rationale:
Metabolic alkalosis =
pH > 7.45
Elevated HCO₃⁻ (>26 mEq/L)
Option C meets both criteria.
,ESTUDYR
6. Which assessment finding is most associated with metabolic acidosis?
A. Muscle twitching
B. Lethargy and CNS depression
C. Hyperreflexia
D. Tetany
Correct Answer: B
Rationale:
Acidosis depresses the central nervous system, causing lethargy, confusion, and decreased
responsiveness.
7. Which condition can result in lactic acidosis?
A. Hypertension
B. Hypovolemic shock
C. Asthma
D. Hyperthyroidism
Correct Answer: B
Rationale:
Hypovolemic shock reduces tissue perfusion, leading to anaerobic metabolism and lactic acid
accumulation.
8. Which laboratory value is the primary indicator of respiratory function in acid-base
balance?
A. HCO₃⁻
B. pH
C. PaCO₂
D. Serum potassium
Correct Answer: C
Rationale:
PaCO₂ reflects ventilation status and is regulated by the lungs. Normal range: 35–45 mmHg.
, ESTUDYR
9. A client has prolonged vomiting. Which acid-base imbalance is most likely?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Correct Answer: C
Rationale:
Vomiting causes loss of gastric acid (HCl), increasing bicarbonate retention and raising pH.
10. A client presents with pH 7.29 and PaCO₂ 52 mmHg. What is the interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Compensated alkalosis
Correct Answer: B
Rationale:
Low pH (<7.35)
Elevated PaCO₂ (>45 mmHg)
This indicates respiratory acidosis due to CO₂ retention.
11. Which medication can worsen metabolic alkalosis if overused?
A. Sodium chloride
B. Furosemide
C. Calcium carbonate antacids
D. Insulin
Correct Answer: C
Rationale:
Calcium carbonate increases bicarbonate levels when overused, leading to metabolic alkalosis.
