ALL THE MARK KLIMEK NCLEX LECTURE
MATERIALS STUDY GUIDE 2026 QUESTIONS
WITH COMPLETE SOLUTIONS
◉ What is the normal range for CO2 in acid-base balance? Answer:
35 to 45 mmHg
◉ What is the normal range for HCO3 (bicarbonate)? Answer: 22 to
26 mEq/L
◉ What indicates an acidotic state in terms of pH? Answer: pH <
7.35
◉ What indicates an alkalotic state in terms of pH? Answer: pH >
7.45
◉ What does it mean if pH and HCO3 move in the same direction?
Answer: The acid-base imbalance is metabolic.
◉ What does it mean if pH and HCO3 move in opposite directions?
Answer: The acid-base imbalance is respiratory.
,◉ What is an example of metabolic acidosis? Answer: pH 7.3 and
HCO3 20.
◉ What is an example of metabolic alkalosis? Answer: pH 7.58 and
HCO3 32.
◉ What is an example of respiratory acidosis? Answer: pH 7.22 and
HCO3 35.
◉ What happens to potassium levels in acidosis? Answer: Potassium
levels are high (hyperkalemia).
◉ What happens to potassium levels in alkalosis? Answer:
Potassium levels are low (hypokalemia).
◉ What is the nursing intervention for a patient in respiratory
acidosis? Answer: Ventilate the patient with an Ambu bag.
◉ What is the primary psychological problem associated with
alcoholism? Answer: Denial.
◉ How should you confront a patient in denial about their
alcoholism? Answer: Point out the difference between what they say
and what they do.
,◉ What are the stages of grief according to the DABDA model?
Answer: Denial, Anger, Bargaining, Depression, Acceptance.
◉ What is the difference between dependency and co-dependency?
Answer: Dependency is when the abuser relies on others; co-
dependency is when the significant other derives self-esteem from
helping the abuser.
◉ What is the treatment approach for dependency and co-
dependency? Answer: Support for the dependent and confrontation
for the co-dependent.
◉ What is the first step in addressing a high-pressure alarm on a
ventilator? Answer: Unkink the tubing.
◉ What causes low-pressure alarms on a ventilator? Answer:
Decreased resistance due to disconnections.
◉ What should you do if a patient is in respiratory acidosis and the
physician wants to wean them off the ventilator? Answer: Notify the
physician that the patient is not ready to be weaned.
◉ What is the default setting to remember for acid-base imbalances?
Answer: Metabolic acidosis.
, ◉ What is the significance of the phrase 'As the pH goes, so goes my
patient'? Answer: It indicates that changes in pH affect the patient's
overall condition, except for potassium levels.
◉ What is the nursing intervention for a patient with a pH > 7.45?
Answer: Monitor for signs of alkalosis such as tachycardia and
irritability.
◉ What is the nursing intervention for a patient with a pH < 7.35?
Answer: Monitor for signs of acidosis such as bradycardia and
lethargy.
◉ What is the impact of prolonged gastric vomiting on acid-base
balance? Answer: It can lead to metabolic alkalosis.
◉ What is the primary cause of respiratory acidosis in patients on
PCA pumps? Answer: Underventilation leading to CO2 retention.
◉ What should be done if a ventilator is set too high? Answer: The
patient may be overventilated, leading to respiratory alkalosis.
◉ What should be done if a ventilator is set too low? Answer: The
patient may be underventilated, leading to respiratory acidosis.
MATERIALS STUDY GUIDE 2026 QUESTIONS
WITH COMPLETE SOLUTIONS
◉ What is the normal range for CO2 in acid-base balance? Answer:
35 to 45 mmHg
◉ What is the normal range for HCO3 (bicarbonate)? Answer: 22 to
26 mEq/L
◉ What indicates an acidotic state in terms of pH? Answer: pH <
7.35
◉ What indicates an alkalotic state in terms of pH? Answer: pH >
7.45
◉ What does it mean if pH and HCO3 move in the same direction?
Answer: The acid-base imbalance is metabolic.
◉ What does it mean if pH and HCO3 move in opposite directions?
Answer: The acid-base imbalance is respiratory.
,◉ What is an example of metabolic acidosis? Answer: pH 7.3 and
HCO3 20.
◉ What is an example of metabolic alkalosis? Answer: pH 7.58 and
HCO3 32.
◉ What is an example of respiratory acidosis? Answer: pH 7.22 and
HCO3 35.
◉ What happens to potassium levels in acidosis? Answer: Potassium
levels are high (hyperkalemia).
◉ What happens to potassium levels in alkalosis? Answer:
Potassium levels are low (hypokalemia).
◉ What is the nursing intervention for a patient in respiratory
acidosis? Answer: Ventilate the patient with an Ambu bag.
◉ What is the primary psychological problem associated with
alcoholism? Answer: Denial.
◉ How should you confront a patient in denial about their
alcoholism? Answer: Point out the difference between what they say
and what they do.
,◉ What are the stages of grief according to the DABDA model?
Answer: Denial, Anger, Bargaining, Depression, Acceptance.
◉ What is the difference between dependency and co-dependency?
Answer: Dependency is when the abuser relies on others; co-
dependency is when the significant other derives self-esteem from
helping the abuser.
◉ What is the treatment approach for dependency and co-
dependency? Answer: Support for the dependent and confrontation
for the co-dependent.
◉ What is the first step in addressing a high-pressure alarm on a
ventilator? Answer: Unkink the tubing.
◉ What causes low-pressure alarms on a ventilator? Answer:
Decreased resistance due to disconnections.
◉ What should you do if a patient is in respiratory acidosis and the
physician wants to wean them off the ventilator? Answer: Notify the
physician that the patient is not ready to be weaned.
◉ What is the default setting to remember for acid-base imbalances?
Answer: Metabolic acidosis.
, ◉ What is the significance of the phrase 'As the pH goes, so goes my
patient'? Answer: It indicates that changes in pH affect the patient's
overall condition, except for potassium levels.
◉ What is the nursing intervention for a patient with a pH > 7.45?
Answer: Monitor for signs of alkalosis such as tachycardia and
irritability.
◉ What is the nursing intervention for a patient with a pH < 7.35?
Answer: Monitor for signs of acidosis such as bradycardia and
lethargy.
◉ What is the impact of prolonged gastric vomiting on acid-base
balance? Answer: It can lead to metabolic alkalosis.
◉ What is the primary cause of respiratory acidosis in patients on
PCA pumps? Answer: Underventilation leading to CO2 retention.
◉ What should be done if a ventilator is set too high? Answer: The
patient may be overventilated, leading to respiratory alkalosis.
◉ What should be done if a ventilator is set too low? Answer: The
patient may be underventilated, leading to respiratory acidosis.
