NURS 327 FINAL EXAM ACTUAL EXAM 2026 | ALL QUESTIONS AND
CORRECT ANSWERS | VERIFIED ANSWERS | GRADED A+ | JUST
RELEASED
Question 1
Which component of an arterial blood gas (ABG) is the primary indicator of the respiratory
system's contribution to acid-base balance?
A) pH
B) PaO2
C) PaCO2
D) HCO3
E) Base Excess
Correct Answer: C) PaCO2
Rationale: PaCO2 (Partial Pressure of Carbon Dioxide) reflects how effectively the lungs are
ventilating and removing CO2, which acts as an acid in the body. Therefore, it is the
respiratory component of the ABG.
Question 2
A client's ABG results are: pH 7.30, PaCO2 30, HCO3 18. The nurse interprets this as:
A) Uncompensated Respiratory Acidosis
B) Fully Compensated Metabolic Acidosis
C) Partially Compensated Metabolic Acidosis
D) Uncompensated Metabolic Alkalosis
E) Partially Compensated Respiratory Alkalosis
Correct Answer: C) Partially Compensated Metabolic Acidosis
Rationale: The pH is low (acidosis). The HCO3 is low (metabolic cause). The PaCO2 is also low,
indicating the respiratory system is trying to compensate by blowing off CO2 (an acid).
Because the pH is still abnormal, the compensation is only partial.
Question 3
Which of the following is a common cause of respiratory alkalosis?
A) Opioid overdose
,B) Chronic Obstructive Pulmonary Disease (COPD)
C) Hyperventilation due to anxiety
D) Severe diarrhea
E) Renal failure
Correct Answer: C) Hyperventilation due to anxiety
Rationale: Hyperventilation causes an excessive "blowing off" of carbon dioxide (CO2). Since
CO2 acts as an acid in the blood, losing too much of it leads to a decrease in PaCO2 and an
increase in pH, resulting in respiratory alkalosis.
Question 4
A nurse is caring for a client with respiratory alkalosis. The nurse should monitor for which of
the following clinical manifestations?
A) Kussmaul respirations
B) Bradypnea (RR <12)
C) Muscle cramps and tetany
D) Bradycardia
E) Warm, flushed skin
Correct Answer: C) Muscle cramps and tetany
Rationale: Respiratory alkalosis can cause a temporary shift of calcium into the cells, leading
to a decrease in ionized calcium in the blood (hypocalcemia). This can cause increased
neuromuscular excitability, manifesting as muscle cramps, spasms, and tetany (like a positive
Chvostek's sign).
Question 5
A client in the ICU on a mechanical ventilator has a PaCO2 of 53 mmHg. The nurse should
anticipate which of the following interventions?
A) Decreasing the respiratory rate on the ventilator.
B) Administering a sedative.
C) Increasing the respiratory rate on the ventilator.
,D) Administering sodium bicarbonate.
E) Suctioning the client's nasogastric tube.
Correct Answer: C) Increasing the respiratory rate on the ventilator.
Rationale: A PaCO2 of 53 indicates respiratory acidosis, meaning the client is retaining too
much CO2. The treatment is to improve ventilation. On a ventilator, this is achieved by
increasing the rate or the tidal volume to help the client "blow off" the excess CO2.
Question 6
Which condition places a client at the highest risk for developing respiratory acidosis?
A) Severe anxiety attack
B) Sepsis
C) Narcotic overdose
D) Uncontrolled diabetes mellitus
E) Excessive NG suctioning
Correct Answer: C) Narcotic overdose
Rationale: Narcotics (opioids) are central nervous system depressants that can cause severe
respiratory depression. A slow, shallow respiratory rate prevents the effective elimination of
CO2, leading to CO2 retention and respiratory acidosis.
Question 7
A client with end-stage renal disease is most at risk for which acid-base imbalance?
A) Respiratory Acidosis
B) Respiratory Alkalosis
C) Metabolic Acidosis
D) Metabolic Alkalosis
E) No risk for imbalance
Correct Answer: C) Metabolic Acidosis
Rationale: Healthy kidneys are responsible for excreting metabolic acids and regenerating
bicarbonate. In renal failure, these functions are impaired, leading to the accumulation of
, acids (like sulfates and phosphates) and a decrease in bicarbonate, resulting in metabolic
acidosis.
Question 8
A client with diabetic ketoacidosis (DKA) is experiencing deep, rapid respirations. The nurse
recognizes this as Kussmaul breathing, which is the body's attempt to compensate for:
A) Respiratory Acidosis
B) Respiratory Alkalosis
C) Metabolic Acidosis
D) Metabolic Alkalosis
E) Hypokalemia
Correct Answer: C) Metabolic Acidosis
Rationale: In DKA, the body produces excess ketoacids, causing a severe metabolic acidosis.
The respiratory system attempts to compensate by increasing the rate and depth of breathing
(Kussmaul respirations) to blow off as much CO2 (an acid) as possible to raise the blood pH.
Question 9
A client has been vomiting for three days. The nurse should monitor the client for which acid-
base imbalance?
A) Respiratory Acidosis
B) Respiratory Alkalosis
C) Metabolic Acidosis
D) Metabolic Alkalosis
E) Hyperkalemia
Correct Answer: D) Metabolic Alkalosis
Rationale: Vomiting causes a loss of gastric acid (hydrochloric acid). The loss of hydrogen ions
(H+), combined with the volume depletion that stimulates renal bicarbonate retention, leads
to an excess of bicarbonate in the blood, resulting in metabolic alkalosis.
Question 10
A client with metabolic alkalosis would likely exhibit which of the following signs and
CORRECT ANSWERS | VERIFIED ANSWERS | GRADED A+ | JUST
RELEASED
Question 1
Which component of an arterial blood gas (ABG) is the primary indicator of the respiratory
system's contribution to acid-base balance?
A) pH
B) PaO2
C) PaCO2
D) HCO3
E) Base Excess
Correct Answer: C) PaCO2
Rationale: PaCO2 (Partial Pressure of Carbon Dioxide) reflects how effectively the lungs are
ventilating and removing CO2, which acts as an acid in the body. Therefore, it is the
respiratory component of the ABG.
Question 2
A client's ABG results are: pH 7.30, PaCO2 30, HCO3 18. The nurse interprets this as:
A) Uncompensated Respiratory Acidosis
B) Fully Compensated Metabolic Acidosis
C) Partially Compensated Metabolic Acidosis
D) Uncompensated Metabolic Alkalosis
E) Partially Compensated Respiratory Alkalosis
Correct Answer: C) Partially Compensated Metabolic Acidosis
Rationale: The pH is low (acidosis). The HCO3 is low (metabolic cause). The PaCO2 is also low,
indicating the respiratory system is trying to compensate by blowing off CO2 (an acid).
Because the pH is still abnormal, the compensation is only partial.
Question 3
Which of the following is a common cause of respiratory alkalosis?
A) Opioid overdose
,B) Chronic Obstructive Pulmonary Disease (COPD)
C) Hyperventilation due to anxiety
D) Severe diarrhea
E) Renal failure
Correct Answer: C) Hyperventilation due to anxiety
Rationale: Hyperventilation causes an excessive "blowing off" of carbon dioxide (CO2). Since
CO2 acts as an acid in the blood, losing too much of it leads to a decrease in PaCO2 and an
increase in pH, resulting in respiratory alkalosis.
Question 4
A nurse is caring for a client with respiratory alkalosis. The nurse should monitor for which of
the following clinical manifestations?
A) Kussmaul respirations
B) Bradypnea (RR <12)
C) Muscle cramps and tetany
D) Bradycardia
E) Warm, flushed skin
Correct Answer: C) Muscle cramps and tetany
Rationale: Respiratory alkalosis can cause a temporary shift of calcium into the cells, leading
to a decrease in ionized calcium in the blood (hypocalcemia). This can cause increased
neuromuscular excitability, manifesting as muscle cramps, spasms, and tetany (like a positive
Chvostek's sign).
Question 5
A client in the ICU on a mechanical ventilator has a PaCO2 of 53 mmHg. The nurse should
anticipate which of the following interventions?
A) Decreasing the respiratory rate on the ventilator.
B) Administering a sedative.
C) Increasing the respiratory rate on the ventilator.
,D) Administering sodium bicarbonate.
E) Suctioning the client's nasogastric tube.
Correct Answer: C) Increasing the respiratory rate on the ventilator.
Rationale: A PaCO2 of 53 indicates respiratory acidosis, meaning the client is retaining too
much CO2. The treatment is to improve ventilation. On a ventilator, this is achieved by
increasing the rate or the tidal volume to help the client "blow off" the excess CO2.
Question 6
Which condition places a client at the highest risk for developing respiratory acidosis?
A) Severe anxiety attack
B) Sepsis
C) Narcotic overdose
D) Uncontrolled diabetes mellitus
E) Excessive NG suctioning
Correct Answer: C) Narcotic overdose
Rationale: Narcotics (opioids) are central nervous system depressants that can cause severe
respiratory depression. A slow, shallow respiratory rate prevents the effective elimination of
CO2, leading to CO2 retention and respiratory acidosis.
Question 7
A client with end-stage renal disease is most at risk for which acid-base imbalance?
A) Respiratory Acidosis
B) Respiratory Alkalosis
C) Metabolic Acidosis
D) Metabolic Alkalosis
E) No risk for imbalance
Correct Answer: C) Metabolic Acidosis
Rationale: Healthy kidneys are responsible for excreting metabolic acids and regenerating
bicarbonate. In renal failure, these functions are impaired, leading to the accumulation of
, acids (like sulfates and phosphates) and a decrease in bicarbonate, resulting in metabolic
acidosis.
Question 8
A client with diabetic ketoacidosis (DKA) is experiencing deep, rapid respirations. The nurse
recognizes this as Kussmaul breathing, which is the body's attempt to compensate for:
A) Respiratory Acidosis
B) Respiratory Alkalosis
C) Metabolic Acidosis
D) Metabolic Alkalosis
E) Hypokalemia
Correct Answer: C) Metabolic Acidosis
Rationale: In DKA, the body produces excess ketoacids, causing a severe metabolic acidosis.
The respiratory system attempts to compensate by increasing the rate and depth of breathing
(Kussmaul respirations) to blow off as much CO2 (an acid) as possible to raise the blood pH.
Question 9
A client has been vomiting for three days. The nurse should monitor the client for which acid-
base imbalance?
A) Respiratory Acidosis
B) Respiratory Alkalosis
C) Metabolic Acidosis
D) Metabolic Alkalosis
E) Hyperkalemia
Correct Answer: D) Metabolic Alkalosis
Rationale: Vomiting causes a loss of gastric acid (hydrochloric acid). The loss of hydrogen ions
(H+), combined with the volume depletion that stimulates renal bicarbonate retention, leads
to an excess of bicarbonate in the blood, resulting in metabolic alkalosis.
Question 10
A client with metabolic alkalosis would likely exhibit which of the following signs and
