Rasmussen College MDC2 Exam 1 Questions
and Answers ACTUAL EXAM 2026/2027 |
Rasmussen MDC2 Exam 1 | Verified Q&A |
Pass Guaranteed - A+ Graded
Total Questions: 60 | Time Suggested: 90 minutes
SECTION 1: ACID-BASE BALANCE & ABG INTERPRETATION (Questions 1–12)
Q1. A client with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas
results: pH 7.31, PaCO₂ 68 mm Hg, HCO₃⁻ 32 mEq/L. Which interpretation is correct?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory acidosis
D. Partially compensated metabolic alkalosis
Correct Answer: B
Rationale: The pH is acidic (7.31), PaCO₂ is elevated (68) indicating a respiratory acidosis. The HCO₃⁻ is
elevated (32) showing metabolic compensation. Because the pH remains abnormal (not yet returned to
7.35–7.45), this is partially compensated respiratory acidosis. This is expected in advanced COPD where
chronic retention leads to renal compensation that is incomplete during acute exacerbation.
Q2. A client with diabetic ketoacidosis (DKA) has the following ABG: pH 7.22, PaCO₂ 28 mm Hg, HCO₃⁻ 12
mEq/L, PaO₂ 96 mm Hg. Which compensation mechanism is occurring?
A. Respiratory compensation via hyperventilation
B. Renal compensation via bicarbonate retention
C. No compensation is present
D. Metabolic compensation via increased PaCO₂
Correct Answer: A
Rationale: The primary disorder is metabolic acidosis (low pH, low HCO₃⁻). The decreased PaCO₂ (28)
indicates the lungs are compensating by blowing off carbon dioxide through Kussmaul respirations
,(deep, rapid breathing). This respiratory compensation occurs within minutes to hours and is the body's
rapid response to metabolic acidosis. Renal compensation takes days and would increase HCO₃⁻, which
is not seen here.
Q3. [LAB VALUE INTERPRETATION] A postoperative client has the following ABG: pH 7.48, PaCO₂ 32 mm
Hg, HCO₃⁻ 24 mEq/L. The nurse should identify which acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct Answer: A
Rationale: The elevated pH (7.48) indicates alkalosis. The decreased PaCO₂ (32) is the primary disorder,
indicating respiratory alkalosis. The HCO₃⁻ (24) is normal, showing no metabolic compensation has
occurred. This pattern is common in postoperative clients due to pain, anxiety, or mechanical ventilation
settings causing hyperventilation. The nurse should address the underlying cause (pain management,
anxiety reduction, ventilator adjustment) to correct the alkalosis.
Q4. A client with severe vomiting has the following ABG: pH 7.50, PaCO₂ 48 mm Hg, HCO₃⁻ 38 mEq/L.
Which clinical finding supports this interpretation?
A. Kussmaul respirations
B. Hypokalemia
C. Hyperactive reflexes
D. Decreased urinary chloride
Correct Answer: B
Rationale: The ABG reveals metabolic alkalosis (elevated pH and HCO₃⁻) with respiratory compensation
(elevated PaCO₂). Severe vomiting causes loss of gastric acid (HCl), leading to metabolic alkalosis and
hypokalemia due to renal potassium wasting in exchange for hydrogen ion retention. Hypokalemia is a
hallmark finding in vomiting-induced metabolic alkalosis and requires potassium replacement alongside
correction of the underlying cause. The nurse should monitor potassium levels and cardiac rhythm, as
hypokalemia increases risk of dysrhythmias.
Q5. [SELECT ALL THAT APPLY] A client is receiving mechanical ventilation. The ABG shows: pH 7.35,
PaCO₂ 50 mm Hg, HCO₃⁻ 28 mEq/L. Which statements about this client's acid-base status are correct?
(Select all that apply.)
, A. The pH is within normal limits
B. The primary disorder is metabolic alkalosis
C. Full compensation has occurred
D. The PaCO₂ indicates respiratory acidosis
E. The HCO₃⁻ indicates metabolic compensation
F. This is a mixed acid-base disorder
Correct Answers: A, C, D, E
Rationale: The pH 7.35 is at the lower limit of normal (7.35–7.45), indicating full compensation has
returned pH to normal range (C). The elevated PaCO₂ (50) indicates the primary disorder is respiratory
acidosis (D). The elevated HCO₃⁻ (28) shows metabolic compensation (E). This is fully compensated
respiratory acidosis, not a mixed disorder (F) or primary metabolic alkalosis (B). This pattern is common
in clients with chronic lung disease on mechanical ventilation where settings maintain adequate
oxygenation but allow mild hypercapnia with full renal compensation.
Q6. [ORDERED RESPONSE – PRIORITY] A client with asthma has the following ABG during an acute
exacerbation: pH 7.30, PaCO₂ 55 mm Hg, HCO₃⁻ 26 mEq/L, PaO₂ 58 mm Hg. Place the nursing
interventions in order of priority.
1. Apply supplemental oxygen to maintain SpO₂ >90%
2. Administer bronchodilator therapy per protocol
3. Prepare for possible intubation and mechanical ventilation
4. Position the client in high-Fowler's with arms supported
Correct Answer: 1, 4, 2, 3
Rationale: The ABG reveals respiratory acidosis with hypoxemia—a dangerous sign in asthma indicating
respiratory muscle fatigue and impending respiratory failure. First, apply supplemental oxygen (1) to
correct hypoxemia (PaO₂ 58). Position in high-Fowler's (4) to maximize diaphragmatic excursion and
reduce work of breathing. Administer bronchodilators (2) to reverse bronchospasm. Prepare for
intubation (3) because rising PaCO₂ in asthma signals fatigue and decompensation; the "silent chest" or
normalization of PaCO₂ after being low can precede respiratory arrest. This follows the ABC framework
with early preparation for mechanical ventilation.
Q7. A client with salicylate overdose has the following ABG: pH 7.45, PaCO₂ 18 mm Hg, HCO₃⁻ 12 mEq/L.
Which interpretation is correct?
A. Fully compensated metabolic acidosis
B. Partially compensated respiratory alkalosis
and Answers ACTUAL EXAM 2026/2027 |
Rasmussen MDC2 Exam 1 | Verified Q&A |
Pass Guaranteed - A+ Graded
Total Questions: 60 | Time Suggested: 90 minutes
SECTION 1: ACID-BASE BALANCE & ABG INTERPRETATION (Questions 1–12)
Q1. A client with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas
results: pH 7.31, PaCO₂ 68 mm Hg, HCO₃⁻ 32 mEq/L. Which interpretation is correct?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory acidosis
D. Partially compensated metabolic alkalosis
Correct Answer: B
Rationale: The pH is acidic (7.31), PaCO₂ is elevated (68) indicating a respiratory acidosis. The HCO₃⁻ is
elevated (32) showing metabolic compensation. Because the pH remains abnormal (not yet returned to
7.35–7.45), this is partially compensated respiratory acidosis. This is expected in advanced COPD where
chronic retention leads to renal compensation that is incomplete during acute exacerbation.
Q2. A client with diabetic ketoacidosis (DKA) has the following ABG: pH 7.22, PaCO₂ 28 mm Hg, HCO₃⁻ 12
mEq/L, PaO₂ 96 mm Hg. Which compensation mechanism is occurring?
A. Respiratory compensation via hyperventilation
B. Renal compensation via bicarbonate retention
C. No compensation is present
D. Metabolic compensation via increased PaCO₂
Correct Answer: A
Rationale: The primary disorder is metabolic acidosis (low pH, low HCO₃⁻). The decreased PaCO₂ (28)
indicates the lungs are compensating by blowing off carbon dioxide through Kussmaul respirations
,(deep, rapid breathing). This respiratory compensation occurs within minutes to hours and is the body's
rapid response to metabolic acidosis. Renal compensation takes days and would increase HCO₃⁻, which
is not seen here.
Q3. [LAB VALUE INTERPRETATION] A postoperative client has the following ABG: pH 7.48, PaCO₂ 32 mm
Hg, HCO₃⁻ 24 mEq/L. The nurse should identify which acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct Answer: A
Rationale: The elevated pH (7.48) indicates alkalosis. The decreased PaCO₂ (32) is the primary disorder,
indicating respiratory alkalosis. The HCO₃⁻ (24) is normal, showing no metabolic compensation has
occurred. This pattern is common in postoperative clients due to pain, anxiety, or mechanical ventilation
settings causing hyperventilation. The nurse should address the underlying cause (pain management,
anxiety reduction, ventilator adjustment) to correct the alkalosis.
Q4. A client with severe vomiting has the following ABG: pH 7.50, PaCO₂ 48 mm Hg, HCO₃⁻ 38 mEq/L.
Which clinical finding supports this interpretation?
A. Kussmaul respirations
B. Hypokalemia
C. Hyperactive reflexes
D. Decreased urinary chloride
Correct Answer: B
Rationale: The ABG reveals metabolic alkalosis (elevated pH and HCO₃⁻) with respiratory compensation
(elevated PaCO₂). Severe vomiting causes loss of gastric acid (HCl), leading to metabolic alkalosis and
hypokalemia due to renal potassium wasting in exchange for hydrogen ion retention. Hypokalemia is a
hallmark finding in vomiting-induced metabolic alkalosis and requires potassium replacement alongside
correction of the underlying cause. The nurse should monitor potassium levels and cardiac rhythm, as
hypokalemia increases risk of dysrhythmias.
Q5. [SELECT ALL THAT APPLY] A client is receiving mechanical ventilation. The ABG shows: pH 7.35,
PaCO₂ 50 mm Hg, HCO₃⁻ 28 mEq/L. Which statements about this client's acid-base status are correct?
(Select all that apply.)
, A. The pH is within normal limits
B. The primary disorder is metabolic alkalosis
C. Full compensation has occurred
D. The PaCO₂ indicates respiratory acidosis
E. The HCO₃⁻ indicates metabolic compensation
F. This is a mixed acid-base disorder
Correct Answers: A, C, D, E
Rationale: The pH 7.35 is at the lower limit of normal (7.35–7.45), indicating full compensation has
returned pH to normal range (C). The elevated PaCO₂ (50) indicates the primary disorder is respiratory
acidosis (D). The elevated HCO₃⁻ (28) shows metabolic compensation (E). This is fully compensated
respiratory acidosis, not a mixed disorder (F) or primary metabolic alkalosis (B). This pattern is common
in clients with chronic lung disease on mechanical ventilation where settings maintain adequate
oxygenation but allow mild hypercapnia with full renal compensation.
Q6. [ORDERED RESPONSE – PRIORITY] A client with asthma has the following ABG during an acute
exacerbation: pH 7.30, PaCO₂ 55 mm Hg, HCO₃⁻ 26 mEq/L, PaO₂ 58 mm Hg. Place the nursing
interventions in order of priority.
1. Apply supplemental oxygen to maintain SpO₂ >90%
2. Administer bronchodilator therapy per protocol
3. Prepare for possible intubation and mechanical ventilation
4. Position the client in high-Fowler's with arms supported
Correct Answer: 1, 4, 2, 3
Rationale: The ABG reveals respiratory acidosis with hypoxemia—a dangerous sign in asthma indicating
respiratory muscle fatigue and impending respiratory failure. First, apply supplemental oxygen (1) to
correct hypoxemia (PaO₂ 58). Position in high-Fowler's (4) to maximize diaphragmatic excursion and
reduce work of breathing. Administer bronchodilators (2) to reverse bronchospasm. Prepare for
intubation (3) because rising PaCO₂ in asthma signals fatigue and decompensation; the "silent chest" or
normalization of PaCO₂ after being low can precede respiratory arrest. This follows the ABC framework
with early preparation for mechanical ventilation.
Q7. A client with salicylate overdose has the following ABG: pH 7.45, PaCO₂ 18 mm Hg, HCO₃⁻ 12 mEq/L.
Which interpretation is correct?
A. Fully compensated metabolic acidosis
B. Partially compensated respiratory alkalosis
