1.

Low plasma PaCO2

A. Metabolic Acidosis

5. What two organs in the body serve as a

compensatory function to maintain
acid base balance?

8. Alkalosis is characterized by
overexcitement of the nervous system.
A. True

B. Respiratory Alkalosis

A. Kidneys and Lungs

C. Metabolic Alkalosis

B. Lungs and Spleen

D. Respiratory Acidosis

C. Heart and Liver

B. False

2. High plasma PaCO2

A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
3. Decreased plasma bicarbonate (HCO3-)
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
4. Increased plasma bicarbonate (HCO3-)
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis

C. The major effect of Alkalosis is a

depression of the central nervous
system.

D. Gallbladder and Appendix

6. Arterial blood gas (ABG) measurement
will give the information needed to
determine if the primary disturbance of
acid-base balance is respiratory or
metabolic in nature.

D. Both Acidosis and Alkalosis result in

overexcitement of the central
nervous system.
9. The human body functions optimally in
a state of homeostasis.

A. True

A. True

B. False

B. False

C. Carbonic Acid Excess and Deficit

Only

C. Maybe

D. Both Bicarbonate Excess and Deficit

Only
7. The major effect of acidosis is
overexcitement of the central nervous
system.

D. Homeostasis has nothing to do with

metabolic balance.
10. Acids have no hydrogen ions and are
able to bind in a solution.
A. True

A. True

B. False

B. False

C. Acid is a substance that is not

capable of donating hydrogen ions.

C. Maybe
D. Both Acidosis and Alkalosis result in
overexcitement of the central
nervous system.

D. Acids and bases have nothing to do

with hydrogen ions.
Match the acid-base status of the
following blood samples to the

disorders in the given choices. (PaCO2

values are in mm Hg and bicarbonate
values in mmol/l).

A. Respiratory Acidosis,
Uncompensated

B. Respiratory Alkalosis, Fully

Compensated

B. Metabolic Acidosis, Partially

Compensated

C. Metabolic Alkalosis, Partially

Compensate

A. Respiratory Acidosis, Partially

Compensated

C. Respiratory Alkalosis, Partially

Compensated

D.

B. Respiratory Alkalosis,
Uncompensated

D. Respiratory Acidosis, Partially

Compensated

11. pH 7.57, PaCO2 22, HCO3- 17

C. Metabolic Acidosis, Partially

Compensated

15. pH 7.34, PaCO2 24, HCO3- 20

Respiratory Acidosis, Partially

Compensated

18. pH 7.6, PaCO2 53, HCO3- 38

A. Metabolic Alkalosis, Partially
Compensated

A. Respiratory Acidosis, Partially

Compensated

B. Metabolic Alkalosis, Fully

Compensated

B. Metabolic Acidosis, Partially

Compensated

C. Respiratory Acidosis, Partially

Compensated

A. Respiratory Acidosis

C. Metabolic Acidosis, Uncompensated

D. Respiratory Alkalosis, Fully

Compensated

B. Metabolic Acidosis

D. Metabolic Alkalosis, Partially

Compensated

D. Respiratory Alkalosis, Partially

Compensated
12. pH 7.39, PaCO2 44, HCO3- 26

19. pH 7.5, PaCO2 19, HCO3- 22

C. Respiratory Alkalosis
16. pH 7.64, PaCO2 25, HCO3- 19
D. Normal
13. pH 7.55, PaCO2 25, HCO3- 22

A. Respiratory Acidosis,
Uncompensated

A. Respiratory Acidosis, Partially

Compensated

B. Respiratory Alkalosis, Partially

Compensated

B. Respiratory Alkalosis,
Uncompensated

C. Respiratory Alkalosis,
Uncompensated

C. Metabolic Alkalosis, Partially

Compensated

D. Metabolic Alkalosis, Partially

Compensated

D. Metabolic Acidosis, Uncompensated

14. pH 7.17, PaCO2 48, HCO3- 36

17. pH 7.45, PaCO2 50, HCO3- 30

A. Metabolic Alkalosis, Fully
Compensated

A. Respiratory Alkalosis, Partially

Compensated
B. Metabolic Alkalosis, Partially
Compensated
C. Respiratory Acidosis,
Uncompensated
D. Respiratory Alkalosis,
Uncompensated
20. pH 7.4, PaCO2 59, HCO3- 35
A. Respiratory Acidosis,
Uncompensated
B. Metabolic Alkalosis, Uncompensated

C. Respiratory Acidosis, Fully

Compensated
D. Metabolic Alkalosis, Partially
Compensated
21. George Kent is a 54 year old widower with a
history of chronic obstructive pulmonary
disease and was rushed to the emergency
department with increasing shortness of
breath, pyrexia, and a productive cough
with yellow-green sputum. He has difficulty
in communicating because of his inability to
complete a sentence. One of his sons, Jacob,
says he has been unwell for three days.
Upon examination, crackles and wheezes
can be heard in the lower lobes; he has a
tachycardia and a bounding pulse.
Measurement of arterial blood gas shows pH
7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L,
and PaO2 60 mm Hg. How would you
interpret this?
A. Respiratory Acidosis,
Uncompensated
B. Respiratory Acidosis, Partially
Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially
Compensated
22. Carl, an elementary student, was rushed to
the hospital due to vomiting and a
decreased level of consciousness. The
patient displays slow and deep (Kussmaul
breathing), and he is lethargic and irritable
in response to stimulation. He appears to be
dehydratedhis eyes are sunken and
mucous membranes are dryand he has a
two week history of polydipsia, polyuria, and
weight loss. Measurement of arterial blood
gas shows pH 7.0, PaO2 90 mm Hg, PaCO2
23 mm Hg, and HCO3 12 mmol/L; other
results are Na+ 126 mmol/L, K+ 5 mmol/L,
and Cl- 95 mmol/L. What is your
assessment?
A. Respiratory Acidosis,
Uncompensated
B. Respiratory Acidosis, Partially
Compensated
C. Metabolic Alkalosis, Uncompensated

D. Metabolic Acidosis, Partially,

Compensated
23. A cigarette vendor was brought to the
emergency department of a hospital after
she fell into the ground and hurt her left leg.
She is noted to be tachycardic and
tachypneic. Painkillers were carried out to
lessen her pain. Suddenly, she started
complaining that she is still in pain and now
experiencing muscle cramps, tingling, and
paraesthesia. Measurement of arterial blood
gas reveals pH 7.6, PaO2 120 mm Hg,
PaCO2 31 mm Hg, and HCO3 25 mmol/L.
What does this mean?
A. Respiratory Alkalosis,
Uncompensated
B. Respiratory Acidosis, Partially
Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially
Compensated
24. Rickys grandmother is suffering from
persistent vomiting for two days now. She
appears to be lethargic and weak and has
myalgia. She is noted to have dry mucus
membranes and her capillary refill takes >4
seconds. She is diagnosed as having
gastroenteritis and dehydration.
Measurement of arterial blood gas shows pH
7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and
HCO3 34 mmol/L. What acid-base disorder is
shown?
A. Respiratory Alkalosis,
Uncompensated
B. Respiratory Acidosis, Partially
Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially
Compensated
25. Mrs. Johansson, who had undergone surgery
in the post-anesthesia care unit (PACU), is
difficult to arouse two hours following
surgery. Nurse Florence in the PACU has
been administering Morphine Sulfate
intravenously to the client for complaints of
post-surgical pain. The clients respiratory
rate is 7 per minute and demonstrates
shallow breathing. The patient does not
respond to any stimuli! The nurse assesses
the ABCs (remember Airway, Breathing,
Circulation!) and obtains ABGs STAT!

Measurement of arterial blood gas shows pH

7.10, PaCO2 70 mm Hg and HCO3 24 mEq/L.
What does this mean?
A. Respiratory Alkalosis, Partially
Compensated
B. Respiratory Acidosis,
Uncompensated
C. Metabolic Alkalosis, Partially
Compensated
D. Metabolic Acidosis, Uncompensated
26. Baby Angela was rushed to the Emergency
Room following her mothers complaint that
the infant has been irritable, difficult to
breastfeed and has had diarrhea for the
past 3 days. The infants respiratory rate is
elevated and the fontanels are sunken. The
Emergency Room physician orders ABGs
after assessing the ABCs. The results from
the ABG results show pH 7.39, PaCO2 27
mmHg and HCO3 19 mEq/L. What does this
mean?
A. Respiratory Alkalosis, Fully
Compensated
B. Metabolic Acidosis, Uncompensated
C. Metabolic Acidosis, Fully
Compensated
D. Respiratory Acidosis,
Uncompensated
27. Mr. Wales, who underwent post-abdominal
surgery, has a nasogastric tube. The nurse
on duty notes that the nasogastric tube
(NGT) is draining a large amount (900 cc in
2 hours) of coffee ground secretions. The
client is not oriented to person, place, or
time. The nurse contacts the attending
physician and STAT ABGs are ordered. The
results from the ABGs show pH 7.57, PaCO2
37 mmHg and HCO3 30 mEq/L. What is your
assessment?
A. Metabolic Acidosis, Uncompensated
B. Metabolic Alkalosis, Uncompensated
C. Respiratory Alkalosis,
Uncompensated
D. Metabolic Alkalosis, Partially
Compensated
28. Client Z is admitted to the hospital and is to
undergo brain surgery. The client is very
anxious and scared of the upcoming
surgery. He begins to hyperventilate and
becomes very dizzy. The client loses
consciousness and the STAT ABGs reveal pH

7.61, PaCO2 22 mmHg and HCO3 25 mEq/L.

What is the ABG interpretation based on the
findings?
A. Metabolic Acidosis, Uncompensated
B. Respiratory Alkalosis, Partially
Compensated
C. Respiratory Alkalosis,
Uncompensated
D. Metabolic Alkalosis, Partially
Compensated
29. Three-year-old Adrian is admitted to the
hospital with a diagnosis of asthma and
respiratory distress syndrome. The mother
of the child reports to the nurse on duty that
she has witnessed slight tremors and
behavioral changes in her child over the
past four days. The attending physician
orders routine ABGs following an
assessment of the ABCs. The ABG results
are pH 7.35, PaCO2 72 mmHg and HCO3 38
mEq/L. What acid-base disorder is shown?
A. Respiratory Acidosis,
Uncompensated
B. Respiratory Acidosis, Fully
Compensated
C. Respiratory Alkalosis, Fully
Compensated
D. Metabolic Alkalosis, Partially
Compensated
30. Anne, who is drinking beer at a party, falls
and hits her head on the ground. Her friend
Liza dials 911 because Anne is
unconscious, depressed ventilation (shallow
and slow respirations), rapid heart rate, and
is profusely bleeding from both ears. Which
primary acid-base imbalance is Anne at risk
for if medical attention is not provided?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
31. Dave, a 6-year-old boy, was rushed to the
hospital following her mothers complaint
that her son has been vomiting, nauseated
and has overall weakness. After series of
tests, the nurse notes the laboratory results:
potassium: 2.9 mEq. Which primary acidbase imbalance is this boy at risk for if
medical intervention is not carried out?
A. Respiratory Acidosis
B. Respiratory Alkalosis

C. Metabolic Acidosis
D. Metabolic Alkalosis
32. An old beggar was admitted to the
emergency department due to shortness of
breath, fever, and a productive cough. Upon
examination, crackles and wheezes are
noted in the lower lobes; he appears to be
tachycardic and has a bounding pulse.
Measurement of arterial blood gas shows pH
7.2, PaCO2 66 mm Hg, HCO3 27 mmol/L,
and PaO2 65 mm Hg. As a knowledgeable
nurse, you know that the normal value for
pH is:
A. 7.20
B. 7.30
C. 7.40
D. 7.50
33. Lizas mother is seen in the emergency
department at a community hospital. She
admits that her mother is taking many
tablets of aspirin (salicylates) over the last
24-hour period because of a severe
headache. Also, the mother complains of an
inability to urinate. The nurse on duty took
her vital signs and noted the following:
Temp = 97.8 F; apical pulse = 95;
respiration = 32 and deep. Which primary
acid-base imbalance is the gentleman at
risk for if medical attention is not provided?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
34. A patient who is hospitalized due to
vomiting and a decreased level of
consciousness displays slow and deep
(Kussmaul breathing), and he is lethargic
and irritable in response to stimulation. The
doctor diagnosed him of having
dehydration. Measurement of arterial blood
gas shows pH 7.0, PaO2 90 mm Hg, PaCO2
22 mm Hg, and HCO3 14 mmol/L; other
results are Na+ 120 mmol/L, K+ 2.5 mmol/L,
and Cl- 95 mmol/L. As a knowledgeable
nurse, you know that the normal value for
PaCO2 is:
A. 22 mm Hg
B. 36 mm Hg
C. 48 mm Hg
D. 50 mm Hg

35. A company driver is found at the scene of

an automobile accident in a state of
emotional distress. He tells the paramedics
that he feels dizzy, tingling in his fingertips,
and does not remember what happened to
his car. Respiratory rate is rapid at
34/minute. Which primary acid-base
disturbance is the young man at risk for if
medical attention is not provided?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
36. An elderly client was admitted to hospital in
a coma. Analysis of the arterial blood gave
the following values: PCO2 16 mm Hg,
HCO3- 5 mmol/L and pH 7.1. As a wellrounded nurse, you know that the normal
value for HCO3 is:
A. 20 mmol/L
B. 24 mmol/L
C. 29 mmol/L
D. 31 mmol/L
37. In a patient undergoing surgery, it was vital
to aspirate the contents of the upper
gastrointestinal tract. After the operation,
the following values were acquired from an
arterial blood sample: pH 7.55, PCO2 52 mm
Hg and HCO3- 40 mmol/l. What is the
underlying disorder?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
38. A mountaineer attempts an assault on a
high mountain in the Andes and reaches an
altitude of 5000 meters (16,400 ft) above
sea level. What will happen to his arterial
PCO2 and pH?
A. Both will be lower than normal.
B. The pH will rise and PCO2 will fall.
C. Both will be higher than normal due
to the physical exertion.
D. The pH will fall and PCO2 will rise
39. A young woman is found comatose, having
taken an unknown number of sleeping pills
an unknown time before. An arterial blood
sample yields the following values: pH 6.90,
HCO3- 13 meq/liter and PaCO2 68 mmHg.
This patients acid-base status is most
accurately described as:

A. Metabolic Acidosis
B. Respiratory Acidosis
C. Simultaneous Respiratory and
Metabolic Acidosis
D. Respiratory Acidosis with Complete
Renal Compensation
40. A mother is admitted in the emergency
department following complaints of fever

and chills. The nurse on duty took her vital

signs and noted the following: Temp = 100
F; apical pulse = 95; respiration = 20 and
deep. Measurement of arterial blood gas
shows pH 7.37, PaO2 90 mm Hg, PaCO2 40
mm Hg, and HCO3 24 mmol/L. What is your
assessment?
A. Hyperthermia

B. Hyperthermia and Respiratory

Alkalosis
C. Hypothermia
D. Hypothermia and Respiratory
Alkalosis