PrepU Quizzes F&E Med Surg
A nurse reviews the arterial blood gas (ABG) values of a client admitted with
pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L.
What do these values indicate?
Respiratory alkalosis - A client with pneumonia may hyperventilate in an effort to
increase oxygen intake. Hyperventilation leads to excess carbon dioxide (CO2) loss,
which causes alkalosis — indicated by this client's elevated pH value. With respiratory
alkalosis, the kidneys' bicarbonate (HCO3-) response is delayed, so the client's HCO3-
level remains normal. The below-normal value for the partial pressure of arterial carbon
dioxide (PaCO2) indicates CO2 loss and signals a respiratory component. Because the
HCO3- level is normal, this imbalance has no metabolic component. Therefore, the
client is experiencing respiratory alkalosis.
Which of the following arterial blood gas results would be consistent with
metabolic alkalosis?
Serum bicarbonate of 28 mEq/L - Evaluation of arterial blood gases reveals a pH
greater than 7.45 and a serum bicarbonate concentration greater than 26 mEq/L.
A group of nursing students are studying for a test over acid-base imbalance.
One student asks another what the major chemical regulator of plasma pH is.
What should the second student respond?
Bicarbonate-carbonic acid buffer system - The major chemical regulator of plasma pH is
the bicarbonate-carbonic acid buffer system.
A client hospitalized for treatment of a pulmonary embolism develops respiratory
alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
Light-headedness or paresthesia - The client with respiratory alkalosis may complain of
light-headedness or paresthesia (numbness and tingling in the arms and legs). Nausea,
vomiting, abdominal pain, and diarrhea may accompany respiratory acidosis.
Hallucinations and tinnitus rarely are associated with respiratory alkalosis or any other
acid-base imbalance.
Which intervention is most appropriate for a client with an arterial blood gas
(ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm
Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2
of 94 mm Hg?
Instruct the client to breathe into a paper bag. - The ABG results reveal respiratory
alkalosis. The best intervention to raise the PaCO2 level would be to have the client
breathe into a paper bag. Administering a decongestant, offering fluids frequently, and
administering supplemental oxygen wouldn't raise the lowered PaCO2 level.
A client comes to the emergency department with status asthmaticus. His
respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas
analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2)
of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What
disorder is indicated by these findings?
Respiratory alkalosis - Respiratory alkalosis results from alveolar hyperventilation. It's
marked by a decrease in PaCO2 to less than 35 mm Hg and an increase in blood pH
over 7.45. Metabolic acidosis is marked by a decrease in HCO3? to less than 22 mEq/L,
and a decrease in blood pH to less than 7.35. In respiratory acidosis, the pH is less than
, 7.35 and the PaCO2 is greater than 45 mm Hg. In metabolic alkalosis, the HCO3? is
greater than 26 mEq/L and the pH is greater than 7.45.
When evaluating arterial blood gases (ABGs), which value is consistent with
metabolic alkalosis?
pH 7.48 - Metabolic alkalosis is a clinical disturbance characterized by a high pH and
high plasma bicarbonate concentration. The HCO value is below normal. The PaCO
value and the oxygen saturation level are within a normal range.
A client has the following arterial blood gas (ABG) values: pH, 7.12; partial
pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-),
15 mEq/L. These ABG values suggest which disorder?
Metabolic Acidosis - This client's pH value is below normal, indicating acidosis. The
HCO3- value also is below normal, reflecting an overwhelming accumulation of acids or
excessive loss of base, which suggests metabolic acidosis. The PaCO2 value is normal,
indicating absence of respiratory compensation. These ABG values eliminate
respiratory alkalosis, respiratory acidosis, and metabolic alkalosis.
A client with a suspected overdose of an unknown drug is admitted to the
emergency department. Arterial blood gas values indicate respiratory acidosis.
What should the nurse do first?
Prepare to assist with ventilation. - Respiratory acidosis is associated with
hypoventilation; in this client, hypoventilation suggests intake of a drug that has
suppressed the brain's respiratory center. Therefore, the nurse should assume the client
has respiratory depression and should prepare to assist with ventilation. After the
client's respiratory function has been stabilized, the nurse can safely monitor the heart
rhythm, prepare for gastric lavage, and obtain a urine specimen for drug screening.
A client admitted with acute anxiety has the following arterial blood gas (ABG)
values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial
pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-),
24 mEq/L. Based on these values, the nurse suspects:
respiratory alkalosis. - This client's above-normal pH value indicates alkalosis. The
below-normal PaCO2 value indicates acid loss via hyperventilation; this type of acid
loss occurs only in respiratory alkalosis. These ABG values wouldn't occur in metabolic
acidosis, respiratory acidosis, or metabolic alkalosis.
A client with Guillain-Barré syndrome develops respiratory acidosis as a result of
reduced alveolar ventilation. Which combination of arterial blood gas (ABG)
values confirms respiratory acidosis?
pH, 7.25; PaCO2 50 mm Hg - In respiratory acidosis, ABG analysis reveals an arterial
pH below 7.35 and partial pressure of arterial carbon dioxide (PaCO2) above 45 mm
Hg. Therefore, the combination of a pH value of 7.25 and a PaCO2 value of 50 mm Hg
confirms respiratory acidosis. A pH value of 7.5 with a PaCO2 value of 30 mm Hg
indicates respiratory alkalosis. A ph value of 7.40 with a PaCO2 value of 35 mm Hg and
a pH value of 7.35 with a PaCO2 value of 40 mm Hg represent normal ABG values,
reflecting normal gas exchange in the lungs.
To evaluate a client for hypoxia, the physician is most likely to order which
laboratory test?
Arterial blood gas (ABG) analysis - Red blood cell count, sputum culture, total
hemoglobin, and ABG analysis all help evaluate a client with respiratory problems.
A nurse reviews the arterial blood gas (ABG) values of a client admitted with
pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L.
What do these values indicate?
Respiratory alkalosis - A client with pneumonia may hyperventilate in an effort to
increase oxygen intake. Hyperventilation leads to excess carbon dioxide (CO2) loss,
which causes alkalosis — indicated by this client's elevated pH value. With respiratory
alkalosis, the kidneys' bicarbonate (HCO3-) response is delayed, so the client's HCO3-
level remains normal. The below-normal value for the partial pressure of arterial carbon
dioxide (PaCO2) indicates CO2 loss and signals a respiratory component. Because the
HCO3- level is normal, this imbalance has no metabolic component. Therefore, the
client is experiencing respiratory alkalosis.
Which of the following arterial blood gas results would be consistent with
metabolic alkalosis?
Serum bicarbonate of 28 mEq/L - Evaluation of arterial blood gases reveals a pH
greater than 7.45 and a serum bicarbonate concentration greater than 26 mEq/L.
A group of nursing students are studying for a test over acid-base imbalance.
One student asks another what the major chemical regulator of plasma pH is.
What should the second student respond?
Bicarbonate-carbonic acid buffer system - The major chemical regulator of plasma pH is
the bicarbonate-carbonic acid buffer system.
A client hospitalized for treatment of a pulmonary embolism develops respiratory
alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
Light-headedness or paresthesia - The client with respiratory alkalosis may complain of
light-headedness or paresthesia (numbness and tingling in the arms and legs). Nausea,
vomiting, abdominal pain, and diarrhea may accompany respiratory acidosis.
Hallucinations and tinnitus rarely are associated with respiratory alkalosis or any other
acid-base imbalance.
Which intervention is most appropriate for a client with an arterial blood gas
(ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm
Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2
of 94 mm Hg?
Instruct the client to breathe into a paper bag. - The ABG results reveal respiratory
alkalosis. The best intervention to raise the PaCO2 level would be to have the client
breathe into a paper bag. Administering a decongestant, offering fluids frequently, and
administering supplemental oxygen wouldn't raise the lowered PaCO2 level.
A client comes to the emergency department with status asthmaticus. His
respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas
analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2)
of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What
disorder is indicated by these findings?
Respiratory alkalosis - Respiratory alkalosis results from alveolar hyperventilation. It's
marked by a decrease in PaCO2 to less than 35 mm Hg and an increase in blood pH
over 7.45. Metabolic acidosis is marked by a decrease in HCO3? to less than 22 mEq/L,
and a decrease in blood pH to less than 7.35. In respiratory acidosis, the pH is less than
, 7.35 and the PaCO2 is greater than 45 mm Hg. In metabolic alkalosis, the HCO3? is
greater than 26 mEq/L and the pH is greater than 7.45.
When evaluating arterial blood gases (ABGs), which value is consistent with
metabolic alkalosis?
pH 7.48 - Metabolic alkalosis is a clinical disturbance characterized by a high pH and
high plasma bicarbonate concentration. The HCO value is below normal. The PaCO
value and the oxygen saturation level are within a normal range.
A client has the following arterial blood gas (ABG) values: pH, 7.12; partial
pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-),
15 mEq/L. These ABG values suggest which disorder?
Metabolic Acidosis - This client's pH value is below normal, indicating acidosis. The
HCO3- value also is below normal, reflecting an overwhelming accumulation of acids or
excessive loss of base, which suggests metabolic acidosis. The PaCO2 value is normal,
indicating absence of respiratory compensation. These ABG values eliminate
respiratory alkalosis, respiratory acidosis, and metabolic alkalosis.
A client with a suspected overdose of an unknown drug is admitted to the
emergency department. Arterial blood gas values indicate respiratory acidosis.
What should the nurse do first?
Prepare to assist with ventilation. - Respiratory acidosis is associated with
hypoventilation; in this client, hypoventilation suggests intake of a drug that has
suppressed the brain's respiratory center. Therefore, the nurse should assume the client
has respiratory depression and should prepare to assist with ventilation. After the
client's respiratory function has been stabilized, the nurse can safely monitor the heart
rhythm, prepare for gastric lavage, and obtain a urine specimen for drug screening.
A client admitted with acute anxiety has the following arterial blood gas (ABG)
values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial
pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-),
24 mEq/L. Based on these values, the nurse suspects:
respiratory alkalosis. - This client's above-normal pH value indicates alkalosis. The
below-normal PaCO2 value indicates acid loss via hyperventilation; this type of acid
loss occurs only in respiratory alkalosis. These ABG values wouldn't occur in metabolic
acidosis, respiratory acidosis, or metabolic alkalosis.
A client with Guillain-Barré syndrome develops respiratory acidosis as a result of
reduced alveolar ventilation. Which combination of arterial blood gas (ABG)
values confirms respiratory acidosis?
pH, 7.25; PaCO2 50 mm Hg - In respiratory acidosis, ABG analysis reveals an arterial
pH below 7.35 and partial pressure of arterial carbon dioxide (PaCO2) above 45 mm
Hg. Therefore, the combination of a pH value of 7.25 and a PaCO2 value of 50 mm Hg
confirms respiratory acidosis. A pH value of 7.5 with a PaCO2 value of 30 mm Hg
indicates respiratory alkalosis. A ph value of 7.40 with a PaCO2 value of 35 mm Hg and
a pH value of 7.35 with a PaCO2 value of 40 mm Hg represent normal ABG values,
reflecting normal gas exchange in the lungs.
To evaluate a client for hypoxia, the physician is most likely to order which
laboratory test?
Arterial blood gas (ABG) analysis - Red blood cell count, sputum culture, total
hemoglobin, and ABG analysis all help evaluate a client with respiratory problems.
