NURS 3632 UPDATED EXAM SCRIPT QUESTIONS AND
SOLUTIONS GRADED A+
✔✔A patient with vomiting from early pregnancy has been admitted. She is quite
dehydrated. Her electrolytes and ABGs were drawn to determine her status and fluid
needs. The values are listed below. What IV fluids might be anticipated?
Na 129; K+ 3.4, Mg 1.6
ABGs: pH 7.47; pCO2 46; HCO3 27
a. 1/2 NS at 100 ml/hr
b. D5W at 100 ml/hr
c. D5RL at 100 ml/hr
d. NS with 20 mEq KCL at 100 ml/hr - ✔✔D. NS with 20 mEc KCL at 100 ml/hr
✔✔A patient has the following ABGs:
pH: 7.51
pCO2: 48
HCO3: 32
What is going on here?
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis - ✔✔B. metabolic alkalosis
✔✔A patient has the following ABGs:
pH: 7.51
pCO2: 48
HCO3: 32
The respiratory is starting to compensate because the pCO2, which is an acid, is also
high. When metabolic alkalosis is fully compensated, which values might we see in this
patient?
a. pH 7.45; pCO2 49; HCO3 32
b. pH 7.35; pCO2 45; HCO3 26
c. pH 7.34; pCO2 47; HCO3 21
d. pH 7.46; pCO2 47; HCO3 27 - ✔✔a. pH 7.45; pCO2 49; HCO3 32
✔✔Arterial blood gases on a client with pneumonia indicate the client is in respiratory
acidosis. In order to best improve this acid-base imbalance, the nurse implements which
of the following interventions? Select all that apply.
1. Restrict oral fluid intake to water only
2. Ambulate client in hallways twice a shift
3. Encourage frequent cough and deep breathing exercises
,4. Medicate with nonopiate pain medication frequently for intercostal muscle pain
5. Give magnesium - ✔✔3. Encourage frequent cough and deep breathing exercises
4. Medicate with nonopiate pain medications frequently for intercostal muscle pain
✔✔Which of the following arterial blood gases (ABGs) would the nurse expect to see
when a client has apnea and develops acidosis?
1. pH 7.43; pCO2 48; HCO3 25
2. pH 7.29; pCO2 62; HCO3 23
3. pH 7.36; pCO2 42; HCO3 26
4. pH 7.49; pCO2 30; HCO3 35 - ✔✔2. pH 7.29; pCO2 62; HCO3 23
✔✔Which of the following pH values would the nurse expect to see in an anxious client?
1. 7.45
2. 7.38
3. 7.50
4. 7.20 - ✔✔3. 7.50
✔✔A client admitted to the emergency department with chest injuries following a motor
vehicle accident complains that it hurts to breathe. The client's respiratory rate is 12 and
very shallow. The nurse would anticipate which of the following results on the ABGs?
1. pH 7.42, PaCO2 41, HCO3 23, SaO2 96%
2. pH 7.31, PaCO2 49, HCO3 24, SaO2 87%
3. pH 7.49, PaCO2 34, HCO3 30, SaO2 89%
4. pH 7.38, PaCO2 38, HCO3 22, SaO2 90% - ✔✔2. pH 7.31, PaCO2 49, HCO3 24,
SaO2 87%
✔✔A client with COPD is admitted to the hospital with an exacerbation of the disease.
Arterial blood gas (ABG) results are pH 7.30, PaCO2 51, and HCO3 25. How would the
nurse interpret these?
1. Respiratory acidosis, uncompensated
2. Respiratory alkalosis, partially compensated
3. Respiratory acidosis, compensated
4. Metabolic acidosis , compensated - ✔✔1. Respiratory acidosis, uncompensated
✔✔A 36-year-old is admitted with vomiting and dehydration after having the flu for 3
days. ABG results are pH 7.46, PaCO2 50, HCO3 33, SaO2 95%. What do these
values indicate to the nurse?
1. metabolic acidosis, uncompensated
2. respiratory acidosis, compensated
3. metabolic alkalosis, partially compensated
,4. metabolic alkalosis, uncompensated - ✔✔3. metabolic alkalosis, partially
compensated
✔✔The nurse identifies which of the following clients to be at risk for developing
metabolic alkalosis? The client who: (select all that apply)
1. has a NG tube to continuous suction
2. has had diarrhea for two days
3. is admitted with a salicylate toxicity
4. takes antacids frequently for heartburn
5. is admitted with asthmatic bronchitis - ✔✔1. has a NG tube to continuous suction
4. takes antacids frequently for heartburn
✔✔The ABG results of a 68-year-old client admitted with pneumonia are pH 7.46,
PaCO2 30, HCO3 19, SaO2 72. The nurse interprets this as:
1. Respiratory acidosis, uncompensated
2. Respiratory alkalosis, partially compensated
3. Respiratory alkalosis, compensated
4. Metabolic alkalosis , partially compensated - ✔✔2. Respiratory alkalosis, partially
compensated
✔✔A 71-year-old client develops HTN, tachycardia, and increased respirations two
days after surgery. ABG results are pH 7.29, PaCO2 52, HCO3 24, SaO2 95%. The
nurse interprets that these results indicate which of the following?
1. Respiratory acidosis, uncompensated
2. Respiratory acidosis, partially compensated
3. Respiratory acidosis, uncompensated
4. Metabolic acidosis , partially compensated - ✔✔1. Respiratory acidosis,
uncompensated
✔✔A 57-year-old client is admitted with a diagnosis of acute myocardial infarction. ABG
results are pH 7.36, PaCO2 29, HCO3 20, SaO2 100%. The nurse interprets that this
client is:
1. well-oxygenated with uncompensated respiratory alkalosis
2. hypoxemia with compensated respiratory acidosis
3. well-oxygenated with compensated metabolic acidosis
4. hypoxemia with compensated metabolic acidosis - ✔✔3. well-oxygenated with
compensated metabolic acidosis
✔✔A patient has salmonella and diarrhea. The nurse suspects the potassium values
may be dropping when the patient complains of
, a. headache
b. leg cramps
c. nausea
d. burning with urination - ✔✔b. leg cramps
✔✔A patient has salmonella and diarrhea, unabated, for several days and is receiving
fluid replacement to expand the volume of fluid intravascularly and prevent dehydration.
Which type of fluid would the nurse expect to infuse?
a. NS, an isotonic fluid
b. Ringer's lactate, an isotonic fluid
c. .5% NS, a hypotonic fluid
d, .3% NS, a hypertonic fluid - ✔✔a. NS, an isotonic fluid
✔✔The patient with salmonella who has had diarrhea for several days and is fatigued
has now been admitted. Which ABG values would the nurse anticipate for a patient in
this situation?
a. pH 7.36, pCO2 35, HCO3 23
b. pH 7.46, pCO2 34, HCO3 27
c. pH 7.33, pCO2 35, HCO3 19
d. pH 7.44, pCO2 33, HCO3 26 - ✔✔c. pH 7.33, pCO2 35, HCO3 19
✔✔A nurse is supervising a nursing student and ask what the best means of assessing
a patient's fluid balance. Which answer by the nursing student indicates a thorough
understanding of the problem?
a. daily weights
b. 24-hour intake and output
c. weekly tally of intake and output
d. 24-hour intake and output with weight of linens to asses insensible loss - ✔✔a. daily
weights
✔✔A nurse is assessing a patient in a long-term care facility. The nurse notes that the
patient is at risk for sensory deprivation due to limited activity related to severe
rheumatoid arthritis. Which interventions would the nurse recommend based on this
finding? Select all that apply.
a. Use a lower tone when communicating with the patient.
b. Provide interaction with children and pets.
c. Decrease environmental noise.Ensure that the patient shares meals with other
patients.
d. Discourage the use of sedatives.
e. Provide adequate lighting and clear pathways of clutter. - ✔✔b. Provide interaction
with children and pets.
d. Discourage the use of sedatives.
SOLUTIONS GRADED A+
✔✔A patient with vomiting from early pregnancy has been admitted. She is quite
dehydrated. Her electrolytes and ABGs were drawn to determine her status and fluid
needs. The values are listed below. What IV fluids might be anticipated?
Na 129; K+ 3.4, Mg 1.6
ABGs: pH 7.47; pCO2 46; HCO3 27
a. 1/2 NS at 100 ml/hr
b. D5W at 100 ml/hr
c. D5RL at 100 ml/hr
d. NS with 20 mEq KCL at 100 ml/hr - ✔✔D. NS with 20 mEc KCL at 100 ml/hr
✔✔A patient has the following ABGs:
pH: 7.51
pCO2: 48
HCO3: 32
What is going on here?
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis - ✔✔B. metabolic alkalosis
✔✔A patient has the following ABGs:
pH: 7.51
pCO2: 48
HCO3: 32
The respiratory is starting to compensate because the pCO2, which is an acid, is also
high. When metabolic alkalosis is fully compensated, which values might we see in this
patient?
a. pH 7.45; pCO2 49; HCO3 32
b. pH 7.35; pCO2 45; HCO3 26
c. pH 7.34; pCO2 47; HCO3 21
d. pH 7.46; pCO2 47; HCO3 27 - ✔✔a. pH 7.45; pCO2 49; HCO3 32
✔✔Arterial blood gases on a client with pneumonia indicate the client is in respiratory
acidosis. In order to best improve this acid-base imbalance, the nurse implements which
of the following interventions? Select all that apply.
1. Restrict oral fluid intake to water only
2. Ambulate client in hallways twice a shift
3. Encourage frequent cough and deep breathing exercises
,4. Medicate with nonopiate pain medication frequently for intercostal muscle pain
5. Give magnesium - ✔✔3. Encourage frequent cough and deep breathing exercises
4. Medicate with nonopiate pain medications frequently for intercostal muscle pain
✔✔Which of the following arterial blood gases (ABGs) would the nurse expect to see
when a client has apnea and develops acidosis?
1. pH 7.43; pCO2 48; HCO3 25
2. pH 7.29; pCO2 62; HCO3 23
3. pH 7.36; pCO2 42; HCO3 26
4. pH 7.49; pCO2 30; HCO3 35 - ✔✔2. pH 7.29; pCO2 62; HCO3 23
✔✔Which of the following pH values would the nurse expect to see in an anxious client?
1. 7.45
2. 7.38
3. 7.50
4. 7.20 - ✔✔3. 7.50
✔✔A client admitted to the emergency department with chest injuries following a motor
vehicle accident complains that it hurts to breathe. The client's respiratory rate is 12 and
very shallow. The nurse would anticipate which of the following results on the ABGs?
1. pH 7.42, PaCO2 41, HCO3 23, SaO2 96%
2. pH 7.31, PaCO2 49, HCO3 24, SaO2 87%
3. pH 7.49, PaCO2 34, HCO3 30, SaO2 89%
4. pH 7.38, PaCO2 38, HCO3 22, SaO2 90% - ✔✔2. pH 7.31, PaCO2 49, HCO3 24,
SaO2 87%
✔✔A client with COPD is admitted to the hospital with an exacerbation of the disease.
Arterial blood gas (ABG) results are pH 7.30, PaCO2 51, and HCO3 25. How would the
nurse interpret these?
1. Respiratory acidosis, uncompensated
2. Respiratory alkalosis, partially compensated
3. Respiratory acidosis, compensated
4. Metabolic acidosis , compensated - ✔✔1. Respiratory acidosis, uncompensated
✔✔A 36-year-old is admitted with vomiting and dehydration after having the flu for 3
days. ABG results are pH 7.46, PaCO2 50, HCO3 33, SaO2 95%. What do these
values indicate to the nurse?
1. metabolic acidosis, uncompensated
2. respiratory acidosis, compensated
3. metabolic alkalosis, partially compensated
,4. metabolic alkalosis, uncompensated - ✔✔3. metabolic alkalosis, partially
compensated
✔✔The nurse identifies which of the following clients to be at risk for developing
metabolic alkalosis? The client who: (select all that apply)
1. has a NG tube to continuous suction
2. has had diarrhea for two days
3. is admitted with a salicylate toxicity
4. takes antacids frequently for heartburn
5. is admitted with asthmatic bronchitis - ✔✔1. has a NG tube to continuous suction
4. takes antacids frequently for heartburn
✔✔The ABG results of a 68-year-old client admitted with pneumonia are pH 7.46,
PaCO2 30, HCO3 19, SaO2 72. The nurse interprets this as:
1. Respiratory acidosis, uncompensated
2. Respiratory alkalosis, partially compensated
3. Respiratory alkalosis, compensated
4. Metabolic alkalosis , partially compensated - ✔✔2. Respiratory alkalosis, partially
compensated
✔✔A 71-year-old client develops HTN, tachycardia, and increased respirations two
days after surgery. ABG results are pH 7.29, PaCO2 52, HCO3 24, SaO2 95%. The
nurse interprets that these results indicate which of the following?
1. Respiratory acidosis, uncompensated
2. Respiratory acidosis, partially compensated
3. Respiratory acidosis, uncompensated
4. Metabolic acidosis , partially compensated - ✔✔1. Respiratory acidosis,
uncompensated
✔✔A 57-year-old client is admitted with a diagnosis of acute myocardial infarction. ABG
results are pH 7.36, PaCO2 29, HCO3 20, SaO2 100%. The nurse interprets that this
client is:
1. well-oxygenated with uncompensated respiratory alkalosis
2. hypoxemia with compensated respiratory acidosis
3. well-oxygenated with compensated metabolic acidosis
4. hypoxemia with compensated metabolic acidosis - ✔✔3. well-oxygenated with
compensated metabolic acidosis
✔✔A patient has salmonella and diarrhea. The nurse suspects the potassium values
may be dropping when the patient complains of
, a. headache
b. leg cramps
c. nausea
d. burning with urination - ✔✔b. leg cramps
✔✔A patient has salmonella and diarrhea, unabated, for several days and is receiving
fluid replacement to expand the volume of fluid intravascularly and prevent dehydration.
Which type of fluid would the nurse expect to infuse?
a. NS, an isotonic fluid
b. Ringer's lactate, an isotonic fluid
c. .5% NS, a hypotonic fluid
d, .3% NS, a hypertonic fluid - ✔✔a. NS, an isotonic fluid
✔✔The patient with salmonella who has had diarrhea for several days and is fatigued
has now been admitted. Which ABG values would the nurse anticipate for a patient in
this situation?
a. pH 7.36, pCO2 35, HCO3 23
b. pH 7.46, pCO2 34, HCO3 27
c. pH 7.33, pCO2 35, HCO3 19
d. pH 7.44, pCO2 33, HCO3 26 - ✔✔c. pH 7.33, pCO2 35, HCO3 19
✔✔A nurse is supervising a nursing student and ask what the best means of assessing
a patient's fluid balance. Which answer by the nursing student indicates a thorough
understanding of the problem?
a. daily weights
b. 24-hour intake and output
c. weekly tally of intake and output
d. 24-hour intake and output with weight of linens to asses insensible loss - ✔✔a. daily
weights
✔✔A nurse is assessing a patient in a long-term care facility. The nurse notes that the
patient is at risk for sensory deprivation due to limited activity related to severe
rheumatoid arthritis. Which interventions would the nurse recommend based on this
finding? Select all that apply.
a. Use a lower tone when communicating with the patient.
b. Provide interaction with children and pets.
c. Decrease environmental noise.Ensure that the patient shares meals with other
patients.
d. Discourage the use of sedatives.
e. Provide adequate lighting and clear pathways of clutter. - ✔✔b. Provide interaction
with children and pets.
d. Discourage the use of sedatives.
