NUR 425 Critical Care Exam 2 Practice
Questions
Acidosis – answer Hypercapnia causes vasodilation increasing blood flow to the brian
PEEP - answer Increases thoracic pressure, prevents optimal jugular venous outflow
Restraints - answer Causes increased agitation
Fever - answer Causes cerebral hyper metabolism
Hyperextension, flexion of the neck - answer Prevents optimal jugular venous outflow
Low protein - answer Decreases serum oncotic pressure, fluid displaces from
vasculature into cells
Alkalosis – answer Hypomania causes vasoconstriction, decreases blood flow to the
brain
Hypotonic solution - answerFluid moves from the vasculature into the cells
T/F: Hyperventilation is an acceptable method used to decrease ICP for patients -
answerFalse
T/F: Hypotonic fluids such as 0.45% NS or D5W would be an appropriate treatment for
a patient with increased ICP - answerTrue
Which of the following are appropriate strategies to help lower ICP via decreasing blood
volume? SATA
1. positioning patient upright
2. mannitol
3. furosemide
4. place patient in trendelenburg
5. 3% saline
6. 0.45% NS
7. Place a ventriculostomy - answer1. positioning patient upright
2. mannitol
3. furosemide
5. 3% saline
,What of the following are LATE signs of increased ICP and impending herniation of the
brain? SATA
1. SBP <90mmHg
2. bradycardia
3. kussmaul's breathing
4. RR of 15
5. increased SBP with widened pulse pressure - answer2. bradycardia
3. kussmaul's breathing
5. increased SBP with widened pulse pressure
How will the lungs compensate if for a patient in metabolic alkalosis - answerThe lungs
will decrease breathing rate/depth to retain CO2 to decrease the pH
How will the kidneys compensate if for a patient in respiratory acidosis - answerThe
kidneys will retain HCO3 and/or excrete H+ to increase the pH
How will the lungs compensate if for a patient in metabolic acidosis - answerThe lungs
will increase breathing rate/depth to blow off more CO2 to increase the pH
How will the kidneys compensate if for a patient in respiratory alkalosis - answerThe
kidneys will excrete HCO3 and/or retain H+ to decrease the pH
Extreme Anxiety - answerRespiratory alkalosis
Shock (lactic acid) - answerMetabolic acidosis
Opioid overdose - answerRespiratory acidosis
Severe pain - answerRespiratory alkalosis
Constant NGT suction - answerMetabolic alkalosis
Vomiting - answerMetabolic alkalosis
Initial response to hypoxia - answerRespiratory alkalosis
Untreated CKD - answerMetabolic acidosis
DKA - answerMetabolic acidosis
Antacid overdose - answerMetabolic alkalosis
Oversedation - answerResp acidosis
Thiazide/Loop diuretics - answerMetabolic alkalosis
, Brainstem injury inhibiting respiratory drive - answerRespiratory acidosis
High altitude - answerResp alkalosis
Diarrhea - answerMetabolic acidosis
Interpret this ABG:
pH 7.24
PaCO2 50
HCO3 25 - answerUncompensated resp acidosis
When we see that a PaCO2 is high >45, what is happening in the body to cause this? -
answerThe patient is breathing slow and/or shallow
Interpret this ABG:
pH 7.49
PaCO2 30
HCO3 24 - answerUncompensated Respiratory Alkalosis
When we see that a PaCO2 is low <35, what is happening in the body to cause this? -
answerThe patient is breathing fast and/or deep.
Interpret this ABG:
pH 7.52
PaCO2 38
HCO3 30 - answerUncompensated Metabolic Alkalosis
When we see that a HCO3 is low <22, what is happening in the body to cause this? -
answerThe kidney's are excreting too much HCO3
Interpret this ABG:
pH 7.31
PaCO2 38
HCO3 20 - answerUncompensated Metabolic Acidosis
pH 7.60 PaCO2 30 HCO3 32 - answerMixed alkalosis
pH 7.28 PaCO2 53 HCO3 31 - answerPartially compensated rest acidosis
pH 7.18 PaCO2 28 HCO3 16 - answerPartially compensated metabolic acidosis
pH 7.13 PaCO2 57 HCO3 18 - answerMixed acidosis
pH 7.65 PaCO2 88 HCO3 41 - answerPartially compensated metabolic alkalosis
Questions
Acidosis – answer Hypercapnia causes vasodilation increasing blood flow to the brian
PEEP - answer Increases thoracic pressure, prevents optimal jugular venous outflow
Restraints - answer Causes increased agitation
Fever - answer Causes cerebral hyper metabolism
Hyperextension, flexion of the neck - answer Prevents optimal jugular venous outflow
Low protein - answer Decreases serum oncotic pressure, fluid displaces from
vasculature into cells
Alkalosis – answer Hypomania causes vasoconstriction, decreases blood flow to the
brain
Hypotonic solution - answerFluid moves from the vasculature into the cells
T/F: Hyperventilation is an acceptable method used to decrease ICP for patients -
answerFalse
T/F: Hypotonic fluids such as 0.45% NS or D5W would be an appropriate treatment for
a patient with increased ICP - answerTrue
Which of the following are appropriate strategies to help lower ICP via decreasing blood
volume? SATA
1. positioning patient upright
2. mannitol
3. furosemide
4. place patient in trendelenburg
5. 3% saline
6. 0.45% NS
7. Place a ventriculostomy - answer1. positioning patient upright
2. mannitol
3. furosemide
5. 3% saline
,What of the following are LATE signs of increased ICP and impending herniation of the
brain? SATA
1. SBP <90mmHg
2. bradycardia
3. kussmaul's breathing
4. RR of 15
5. increased SBP with widened pulse pressure - answer2. bradycardia
3. kussmaul's breathing
5. increased SBP with widened pulse pressure
How will the lungs compensate if for a patient in metabolic alkalosis - answerThe lungs
will decrease breathing rate/depth to retain CO2 to decrease the pH
How will the kidneys compensate if for a patient in respiratory acidosis - answerThe
kidneys will retain HCO3 and/or excrete H+ to increase the pH
How will the lungs compensate if for a patient in metabolic acidosis - answerThe lungs
will increase breathing rate/depth to blow off more CO2 to increase the pH
How will the kidneys compensate if for a patient in respiratory alkalosis - answerThe
kidneys will excrete HCO3 and/or retain H+ to decrease the pH
Extreme Anxiety - answerRespiratory alkalosis
Shock (lactic acid) - answerMetabolic acidosis
Opioid overdose - answerRespiratory acidosis
Severe pain - answerRespiratory alkalosis
Constant NGT suction - answerMetabolic alkalosis
Vomiting - answerMetabolic alkalosis
Initial response to hypoxia - answerRespiratory alkalosis
Untreated CKD - answerMetabolic acidosis
DKA - answerMetabolic acidosis
Antacid overdose - answerMetabolic alkalosis
Oversedation - answerResp acidosis
Thiazide/Loop diuretics - answerMetabolic alkalosis
, Brainstem injury inhibiting respiratory drive - answerRespiratory acidosis
High altitude - answerResp alkalosis
Diarrhea - answerMetabolic acidosis
Interpret this ABG:
pH 7.24
PaCO2 50
HCO3 25 - answerUncompensated resp acidosis
When we see that a PaCO2 is high >45, what is happening in the body to cause this? -
answerThe patient is breathing slow and/or shallow
Interpret this ABG:
pH 7.49
PaCO2 30
HCO3 24 - answerUncompensated Respiratory Alkalosis
When we see that a PaCO2 is low <35, what is happening in the body to cause this? -
answerThe patient is breathing fast and/or deep.
Interpret this ABG:
pH 7.52
PaCO2 38
HCO3 30 - answerUncompensated Metabolic Alkalosis
When we see that a HCO3 is low <22, what is happening in the body to cause this? -
answerThe kidney's are excreting too much HCO3
Interpret this ABG:
pH 7.31
PaCO2 38
HCO3 20 - answerUncompensated Metabolic Acidosis
pH 7.60 PaCO2 30 HCO3 32 - answerMixed alkalosis
pH 7.28 PaCO2 53 HCO3 31 - answerPartially compensated rest acidosis
pH 7.18 PaCO2 28 HCO3 16 - answerPartially compensated metabolic acidosis
pH 7.13 PaCO2 57 HCO3 18 - answerMixed acidosis
pH 7.65 PaCO2 88 HCO3 41 - answerPartially compensated metabolic alkalosis
