RNSG 2539 – EXAM 1, EXAM 2, & EXAM 3 2026 VERSIONS |
ALL IN ONE DOCUMENT QUESTIONS AND ANSWERS |
LATEST UPDATE
EXAM 1 (Questions 1–85)
1. A client has the following ABG values: pH 7.12, PaCO₂ 40 mm Hg, HCO₃⁻ 15
mEq/L. Which disorder do these values suggest?
---CORRECT ANSWER---- Metabolic acidosis
2. As status asthmaticus worsens, which acid-base imbalance does the nurse
expect?
---CORRECT ANSWER---- Respiratory acidosis
3. Which medication classification represents a proton (gastric acid) pump
inhibitor?
---CORRECT ANSWER---- Omeprazole
4. A nursing student asks: “What is the major chemical regulator of plasma pH?”
The correct response is:
---CORRECT ANSWER---- Bicarbonate-carbonic acid buffer system
5. Which factor is the most likely cause of diabetic ketoacidosis (DKA) in a client
with diabetes?
---CORRECT ANSWER---- The client has eaten and has not taken or received
insulin.
,6. A client is admitted with DKA. Which insulin does the nurse expect to
administer intravenously?
---CORRECT ANSWER---- Regular insulin
7. A client has a dull headache, dizziness, and increased pulse rate. ABG: pH 7.26,
PaCO₂ 50 mm Hg, HCO₃⁻ 24 mEq/L. What imbalance is present?
---CORRECT ANSWER---- Respiratory acidosis
8. A client with acute anxiety has ABG: pH 7.55, PaO₂ 90 mm Hg, PaCO₂ 27 mm
Hg, HCO₃⁻ 24 mEq/L. The nurse suspects:
---CORRECT ANSWER---- Respiratory alkalosis
9. A client admitted with intractable vomiting for 3 days. Which acid-base
imbalance is expected from loss of stomach acid?
---CORRECT ANSWER---- Metabolic alkalosis
10. Vomiting typically results in which acid-base imbalance?
---CORRECT ANSWER---- Metabolic alkalosis
11. Which enzyme is needed as a catalyst when carbon dioxide combines with
water to form carbonic acid?
---CORRECT ANSWER---- Carbonic anhydrase
12. A client reports nausea, vomiting, diarrhea for 5 days. Mucous membranes
pale/dry, sunken eyes, pulse 122 thready, BP 78/55, temp 101.8°F. Priority nursing
intervention?
---CORRECT ANSWER---- Request an order for IV rehydration therapy
13. The lungs regulate acid-base balance by controlling which substance?
---CORRECT ANSWER---- CO₂
, 14. For a client with worsening respiratory acidosis, which intervention does the
nurse anticipate if deterioration continues?
---CORRECT ANSWER---- Mechanical ventilation
15. The major role of the kidneys in acid-base balance is to increase production of:
---CORRECT ANSWER---- HCO₃⁻ (bicarbonate)
16. A client has taken Alka-Seltzer (bicarbonate antacid) 4×/day for 2 weeks.
Assessment: hyperactive reflexes, tetany, confusion. ABG: pH 7.55, HCO₃⁻ 37
mEq/L. The nurse suspects:
---CORRECT ANSWER---- Metabolic alkalosis
17. Which insulin is the only one that can be given intravenously?
---CORRECT ANSWER---- Regular insulin
18. A client in cardiogenic shock has lactic acidosis. Which manifestation is
anticipated before acid-base balance is restored?
---CORRECT ANSWER---- Dysrhythmias
19. A client with DKA has a serum glucose of 480 mg/dL. The nurse prepares to
administer IV fluids and insulin. Which solution is typically initiated first?
---CORRECT ANSWER---- 0.9% normal saline
20. When administering IV regular insulin for DKA, the nurse knows the goal for
decreasing serum glucose is:
---CORRECT ANSWER---- 50–70 mg/dL per hour
21. Which finding indicates that DKA treatment is effective?
---CORRECT ANSWER---- Anion gap narrowing
22. A client with DKA has a potassium level of 2.9 mEq/L. What is the nurse’s
priority action?
ALL IN ONE DOCUMENT QUESTIONS AND ANSWERS |
LATEST UPDATE
EXAM 1 (Questions 1–85)
1. A client has the following ABG values: pH 7.12, PaCO₂ 40 mm Hg, HCO₃⁻ 15
mEq/L. Which disorder do these values suggest?
---CORRECT ANSWER---- Metabolic acidosis
2. As status asthmaticus worsens, which acid-base imbalance does the nurse
expect?
---CORRECT ANSWER---- Respiratory acidosis
3. Which medication classification represents a proton (gastric acid) pump
inhibitor?
---CORRECT ANSWER---- Omeprazole
4. A nursing student asks: “What is the major chemical regulator of plasma pH?”
The correct response is:
---CORRECT ANSWER---- Bicarbonate-carbonic acid buffer system
5. Which factor is the most likely cause of diabetic ketoacidosis (DKA) in a client
with diabetes?
---CORRECT ANSWER---- The client has eaten and has not taken or received
insulin.
,6. A client is admitted with DKA. Which insulin does the nurse expect to
administer intravenously?
---CORRECT ANSWER---- Regular insulin
7. A client has a dull headache, dizziness, and increased pulse rate. ABG: pH 7.26,
PaCO₂ 50 mm Hg, HCO₃⁻ 24 mEq/L. What imbalance is present?
---CORRECT ANSWER---- Respiratory acidosis
8. A client with acute anxiety has ABG: pH 7.55, PaO₂ 90 mm Hg, PaCO₂ 27 mm
Hg, HCO₃⁻ 24 mEq/L. The nurse suspects:
---CORRECT ANSWER---- Respiratory alkalosis
9. A client admitted with intractable vomiting for 3 days. Which acid-base
imbalance is expected from loss of stomach acid?
---CORRECT ANSWER---- Metabolic alkalosis
10. Vomiting typically results in which acid-base imbalance?
---CORRECT ANSWER---- Metabolic alkalosis
11. Which enzyme is needed as a catalyst when carbon dioxide combines with
water to form carbonic acid?
---CORRECT ANSWER---- Carbonic anhydrase
12. A client reports nausea, vomiting, diarrhea for 5 days. Mucous membranes
pale/dry, sunken eyes, pulse 122 thready, BP 78/55, temp 101.8°F. Priority nursing
intervention?
---CORRECT ANSWER---- Request an order for IV rehydration therapy
13. The lungs regulate acid-base balance by controlling which substance?
---CORRECT ANSWER---- CO₂
, 14. For a client with worsening respiratory acidosis, which intervention does the
nurse anticipate if deterioration continues?
---CORRECT ANSWER---- Mechanical ventilation
15. The major role of the kidneys in acid-base balance is to increase production of:
---CORRECT ANSWER---- HCO₃⁻ (bicarbonate)
16. A client has taken Alka-Seltzer (bicarbonate antacid) 4×/day for 2 weeks.
Assessment: hyperactive reflexes, tetany, confusion. ABG: pH 7.55, HCO₃⁻ 37
mEq/L. The nurse suspects:
---CORRECT ANSWER---- Metabolic alkalosis
17. Which insulin is the only one that can be given intravenously?
---CORRECT ANSWER---- Regular insulin
18. A client in cardiogenic shock has lactic acidosis. Which manifestation is
anticipated before acid-base balance is restored?
---CORRECT ANSWER---- Dysrhythmias
19. A client with DKA has a serum glucose of 480 mg/dL. The nurse prepares to
administer IV fluids and insulin. Which solution is typically initiated first?
---CORRECT ANSWER---- 0.9% normal saline
20. When administering IV regular insulin for DKA, the nurse knows the goal for
decreasing serum glucose is:
---CORRECT ANSWER---- 50–70 mg/dL per hour
21. Which finding indicates that DKA treatment is effective?
---CORRECT ANSWER---- Anion gap narrowing
22. A client with DKA has a potassium level of 2.9 mEq/L. What is the nurse’s
priority action?
