Name: _____________________________________
Section /Group: _________________________
DIRECTION: Read the questions carefully and select the BEST answer for each question. STRICTLY NO ERASURES
NOR SUPERIMPOSITIONS.
1. A nurse is caring for a patient with a nasogastric tube
that is attached to low suction. The nurse assesses
the patient for symptoms of which acid-base disorder?
a.Metabolic Acidosis b.Metabolic Alkalosis
c.Respiratory Acidosis d.Respiratory Alkalosis
2. A patient with diabetes mellitus has a blood glucose
level of 640 mg/dl. The nurse interprets that this
patient is most at risk of developing which type of acid-
base imbalance?
a.Respiratory Acidosis b.Respiratory Alkalosis
c.Metabolic Acidosis d.Metabolic Alkalosis
3. A nurse caring for a patient with late stage of salicylate
poisoning who is experiencing metabolic acidosis,
reviews the result of the patients blood chemistry
profile. The nurse anticipates that which laboratory
value is related to the patient acid-base disturbance?
a. Sodium: 145 meg/L
b. Magnesium: 2.0 meg/L
c. Potassium: 5.2 meg/L
d. Phosphorus : 2.3 meg/L
4. A 1000 ml intravenous (IV) solution of normal saline
0.9% is prescribed for the patient. The nurse
understands that this type of IV solution.
a. Is isotonic with the plasma and other body fluids
b. Is hypertonic with the plasma and other body fluids
c. Affects the plasma osmolarity.
d. Is the same solution as sodium chloride 0.45%
5. A patient who has fallen from a ladder fractured three
ribs has arterial blood gas (ABG) results of ph 7.38,
PCO2 38 mmHg PO2 86 mmHg. The nurse interprets
that the patients ABGs indicate which of the
following?
a. Normal results b. Metabolic Alkalosis
a. Metabolic Acidosis d. Respiratory Acidosis
6. A patient with pulmonary edema is receiving oxygen
via nasal cannula at 6 liters per minute. Arterial blood
gas results indicate: PH 7.29, PCO2 49 mmHg, PO2
58 mmHg, HCo3 18 meq/L. The nurse anticipates that
the physician will order which of the respiratory
support?
a. Lowering the oxygen to 4 liters per minute via nasal
cannula
b. Keeping the oxygen at 6 liters per minute via nasal
cannula
c. Adding a partial re-breather mask to the current order
d. Intubution and mechanical ventilation
Date:__________________
Score:_________________
7. A nurse caring for a patient with heart failure receives
a telephone call from the laboratory and is told that the
patient has a magnesium level of 1.4 mg/dl. The nurse
plans to:
a. Encourage intake of phosphate antacids
b. Monitor the patient for dysrhythmias
c. Instruct the patient to avoid foods that contain
magnesium
d. Encourage intake of foods such as ground beef, eggs,
or chicken breast
8. A nurse is assessing a client with a Cantor Tube.
Which finding indicates correct placement of the
tubes?
a. A PH of aspirate of 7.0 or greater
b. A PH of aspirate less than 7.0
c. The presence of gastric contents when checking
residuals
d. The auscultation of air when inserted into the
abdomen
9. A patient with significant Flail Chest has arterial blood
gases ( ABGs) that reveal a PaO2 of 68 and a PaCO2
of 51. Two hours ago the PaO2 was 82 and the
PaCO2 was 44. Based on these changes, the nurse
obtains which of the ff items?
a. Injectable Lidocaine
b. Portable Chest X-ray machine
c. Intubation tray
d. Chest tube insertion set.
10. A client acute respiratory distress syndrome has an
order to be placed on a continous positive airway
pressure (CPAP) face mask. The nurse implements
which of the following for this procedure to be most
effective:
a. Applies the mask to the face with a snug fit
b. Obtains baseline arterial blood gases
c. Obtains baseline pulse oximetry levels
d. d. Encourages the client to remove the mask
frequently for coughing and deep breathing exercises
11. A client with acute renal failure has been treated
(Kayexalate) by mouth. The nurse would evaluate this
therapy as effective if which of the following values
noted on ff-up laboratory testing?
a. Potassium: 4.9 meg/L b. Sodium: 142 meg/L
c. Phosporous: 3.9 mg/dl d. Calcium 9.8 mg/dl
12. A patient has a ph of 7-51 with a bicarbonate level a
of 29meq/L. the nurse prepares to administer w/c of
 the ff medication that would be prescribed to treat this
acid-base disorder?
a. sodium bicarbonate b. furosemide (lasix)
c. diamox d. aldactone
13. A patient is admitted to the hospital in metabolic
acidosis caused by diabetic ketoacidosis (DKA). The
nurse prepareS to administer w/c of the following
medications as a primARY initial treatment to this
problem?
a. sodium bicarbonate b. calcium gluconate
c. potassium d. regular insulin
14. A patient is diagnosed with respiratory alkalosis
induced by gram-negative sepsis. The nurse prepares
to implement w/c prescribed measure as the most
effective means to treat the problem?
a. administer prescribed antibiotics
b. admister antipyretics
c. have the patient breath into a paper bag
d. request on order for a partial rebreather oxygen mask
15. A patient with aldosteronism is being treated with
spironalactone (Aldactone ). Which of the ff indicates
to the nurse that the medication is effective?
a. A decrease in blood pressure
b. A decrease in sodium excretion
c. A decrease in plasma potassium
d. A decrease in body metabolism
16. A graduate nurse is assigned to admit a client with a
diagnosis of anorexia nervosa to the nursing unit.
The nurse preceptor remind the graduate nurse that
the assessment finding may indicate:
a. Elevated K levels
b. Low blood urea nitrogen
c. Weight loss of a 4% of original weight over a short
period
d. That the client is knowledgeable about nutrition.
17. A nurse is caring for a client with pneumonia who
suddenly becomes restless and has a PaO2 of
60mmHg.
Which of the following nursing diagnosis would be
most appropriate for this patient?
a. Fatigue related to debilitated state
b. Impaired gas exchange related to increase pulmonary
secretions
c. Ineffective airway clearance related to dilated
bronchioles
d. Impaired gas exchange related to pneumonia.
18. A client is due for a dose of Lasix (Furosemide). The
nurse would temporarily withhold the dose and notify
the physician if which of the ff lab results was noted ?
a. Na : 137 meq/L b. K : 2.9 meq/L
c. Mg : 2.6 mg/dl d. Chloride : 106 meq/L
19. A patient with late stage of Chronic Obstructive
Pulmonary Disease (COPD) is admitted to the hospital
with acute exacerbation. Which of the following blood
gas results would the nurse most likely expect to
note?
a. PO2 of 68 and PCO2 0f 40
b. PO2 of 55 and PCO2 of 40
c. PO2 of 70 and PCO2 Of 50
d. PO2 of 60 and PCO2 of 50
20. A nurse provides dietary instructions to the patient
receiving Aldactone (Spironolactone). Which food item
would the nurse instruct the client to avoid while taking
this medication?
a. Crackers
b. Shrimp
c. Bananas
d. Popcorn
21. A nurse is conducting dietary teaching with a patient
who is hypocalcemic. The nurse encourages the
patient to increase intake of which of the ff foods?
a. Apples
b. Chiken Breast
c. Cheese
d. Cooked Pasta
22. A patient is diagnosed with hyperphosphatemia. The
nurse encourages the client to limit intake of which
item that will aggravate the condition?
a. Bananas
b. Grapes
c. Coffee
d. Carbonated Beverages
23. A patient who has been receiving a long-term diuretic
therapy is admitted to the hospital with a diagnosis of
dehydration. The nurse would assess for which sign or
symptom that correlates with this fluid imbalance?
a. Increase Blood Pressure
b. Decreased Pulse
c. Decreased Central Venous Pressure
d. Bibasilar Crackles
24. A patient with a history of self managed peptic ulcer
disease has frequently used excessive amounts of
oral antacids. The nurse interprets that this client is at
risk for which acid-base imbalance?
a. Metabolic Acidosis
b. Metabolic Alkalosis
c. Respiratory Alkalosis
d. Respiratory Acidosis
25. A patient had arterial blood gases drawn. The results
are ph 7.34, PaCo2 of 37 mmHg, PaO2 of 79, HCo3
of 19 meq/L. The nurse interprets that the patient is
experiencing,________________________________
26. An adult client with a critically high potassium level d. 4+
has received ( Kayexalate).The nurse evaluates that 33. A nurse is assigned to care for a group of patients. On
the medication was most effective if the clients repeat review of the clients medical records, the nurse
serum potassium level is ? determines that which client is at risk for fluid volume
a. 6.2 meq/L deficit?
b. 5.8meq/L a. a client with colostomy
c. 5.4meq/L b. a client receiving frequent wound irrigations
d. 4.9meq/L c. a client with CHF
27. A nurse is reviewing the clients arterial blood gas ( d. a client with decreased kidney function
ABG ) results Which finding would indicate that the 34. A nurse is assigned to care for a group of clients. On
client has respiratory acidosis ? review of the clients medical records, the nurse
a. Ph 7.5, PCO2 30 determines that which patient is at risk for fluid volume
b. Ph7.3, PCO2 50 excess?
c. Ph 7.3,PC02 19 a. The client with renal failure
d. Ph 7.5,PCO2 30 b. The client with ileostomy
28. A nurse evalutes the arterial blood gas ( ABG ) results c. The client taking diuretics
of a client who is receiving supplemental oxygen. d. The client who requires gastrointestinal suctioning
Which finding would indicate that the O2 level was 35. A nurse is preparing to care for a patient with a K
adequate? deficit. The nurse reviews the patients record and
a. PO2 of 80 mmHg determines that the client is at risk for developing the
b. PO2 of 60 mmHg potassium deficit because the client,
c. Po2 of 50 mmHg
d. PO2 of 45 mmHg a. requires nasogastric suction
29. A patient has just been diagnosed with acute renal b. has a history of renal disease
failure. The laboratory calls the nurse to report a c. has a history of Addisons disease
serum potassium level of 6.1 meq/L on the client. d. is taking potassium sparing diuretics
a. calls the physician
b. checks the sodium level
c. encourages an extra 500ml of fluid intake
d. teach the client about foods low in K
30. A nurse reviews the serum laboratory results for a
patient taking Hydrochlorothiazide. The nurse
specifically monitors for which of the ff most frequent
medication side effect on a regular basis?
a. Hyperphosphatemia
b. Hypocalcemia
c. Hypernatremia
d. Hypokalemia
31. A patient having mild panic attack has the ff (ABG)
results ph 7.49,pc02 31mmHg, Pao2 97 mmHg, HCO3
22meq/L.The nurse reviews the results and
determines that the client has w/c acid-base
disturbance? _________________________
32. A nurse is monitoring for the presence of pitting
edema. The nurse presses the fingertips of the middle
and index fingers against the skin and holds pressure
for 2-3 seconds. The nurse notes that the indentation
is approximately 1in deep. The nurse documents that
the client has which level of pitting edema?
a. 1 +
b. 2+
c. 3+