Rasmussen University NUR 2349 Exam 3 (pdf) | 2026/2027 |
Professional Nursing I Q&A | Nursing
**1. A client is admitted with severe diarrhea. Arterial blood gas (ABG) results
are pH 7.33, PaCO₂ 42 mm Hg, and HCO₃⁻ 20 mEq/L. The nurse concludes this
client has which acid-base imbalance?**
A) Uncompensated metabolic acidosis
B) Compensated metabolic acidosis
C) Uncompensated respiratory acidosis
D) Compensated respiratory acidosis
Correct Answer: A) Uncompensated metabolic acidosis
Rationale: The pH and HCO₃⁻ are decreased, indicating metabolic acidosis.
The PaCO₂ is normal, meaning compensatory mechanisms have not yet
begun. Compensation would involve a decrease in PaCO₂ to restore balance.
**2. A nurse is assessing a client who has been taking large doses of oral
antacids for chronic heartburn. The nurse should monitor the client for which
acid-base imbalance?**
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: D) Metabolic alkalosis
Rationale: Excessive use of oral antacids (calcium carbonate) can lead to
metabolic alkalosis, as the bicarbonate from the antacids increases the
serum bicarbonate level. Ibuprofen and acetaminophen are not associated
with metabolic alkalosis.
,**3. Arterial blood gas results for a client are pH 7.48, PaCO₂ 42 mm Hg, and
HCO₃⁻ 32 mEq/L. The nurse interprets these results as indicative of which
acid-base imbalance?**
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: C) Metabolic alkalosis
Rationale: The pH is elevated above 7.45, indicating alkalosis. The PaCO₂ is
normal, and the bicarbonate is elevated above 26 mEq/L, indicating a
metabolic origin. This is consistent with metabolic alkalosis.
**4. A client with a history of gastric outlet obstruction is admitted with
vomiting. The nurse would expect which acid-base imbalance to develop?**
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: D) Metabolic alkalosis
Rationale: Vomiting results in the loss of hydrochloric acid (HCl) from the
stomach. This loss of acid leads to an increase in serum bicarbonate,
resulting in metabolic alkalosis.
,**5. A client with chronic lung disease is exhibiting confusion and lethargy.
The nurse notes the client is breathing shallowly. Which acid-base imbalance
is the client most likely experiencing?**
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: B) Respiratory acidosis
Rationale: Chronic lung disease can lead to hypoventilation, causing
retention of carbon dioxide (CO₂). This results in respiratory acidosis, which
can cause confusion and lethargy due to the effects of CO₂ on the central
nervous system.
**6. A nurse is interpreting ABG results for a client with a pH of 7.32, PaCO₂
of 58 mm Hg, and HCO₃⁻ of 24 mEq/L. The nurse recognizes this as:**
A) Uncompensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Uncompensated metabolic acidosis
D) Partially compensated metabolic acidosis
Correct Answer: A) Uncompensated respiratory acidosis
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO₂ is elevated
(>45 mm Hg), indicating a respiratory cause. The HCO₃⁻ is normal, indicating
that renal compensation has not yet occurred. This is uncompensated
respiratory acidosis.
, **7. A client who is hyperventilating has an ABG result of pH 7.50,
PaCO₂ 30 mm Hg, and HCO₃⁻ 24 mEq/L. The nurse identifies this as:**
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: B) Respiratory alkalosis
Rationale: Hyperventilation causes a decrease in PaCO₂, leading to
respiratory alkalosis. The pH is elevated, the PaCO₂ is low, and the HCO₃⁻ is
normal, indicating the primary disturbance is respiratory.
**8. A client who has been vomiting for several days has the following ABG
results: pH 7.48, PaCO₂ 44 mm Hg, and HCO₃⁻ 32 mEq/L. The nurse should
interpret this as:**
A) Uncompensated respiratory acidosis
B) Uncompensated metabolic alkalosis
C) Partially compensated metabolic alkalosis
D) Partially compensated respiratory alkalosis
Correct Answer: B) Uncompensated metabolic alkalosis
Rationale: The pH is elevated (alkalemia). The HCO₃⁻ is elevated (metabolic
alkalosis), and the PaCO₂ is normal. Because the PaCO₂ is normal, there is no
respiratory compensation. This is uncompensated metabolic alkalosis.
**9. A nurse is reviewing a client's ABG results: pH 7.34, PaCO₂ 48 mm Hg,
HCO₃⁻ 28 mEq/L. Which of the following is the correct interpretation?**
Professional Nursing I Q&A | Nursing
**1. A client is admitted with severe diarrhea. Arterial blood gas (ABG) results
are pH 7.33, PaCO₂ 42 mm Hg, and HCO₃⁻ 20 mEq/L. The nurse concludes this
client has which acid-base imbalance?**
A) Uncompensated metabolic acidosis
B) Compensated metabolic acidosis
C) Uncompensated respiratory acidosis
D) Compensated respiratory acidosis
Correct Answer: A) Uncompensated metabolic acidosis
Rationale: The pH and HCO₃⁻ are decreased, indicating metabolic acidosis.
The PaCO₂ is normal, meaning compensatory mechanisms have not yet
begun. Compensation would involve a decrease in PaCO₂ to restore balance.
**2. A nurse is assessing a client who has been taking large doses of oral
antacids for chronic heartburn. The nurse should monitor the client for which
acid-base imbalance?**
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: D) Metabolic alkalosis
Rationale: Excessive use of oral antacids (calcium carbonate) can lead to
metabolic alkalosis, as the bicarbonate from the antacids increases the
serum bicarbonate level. Ibuprofen and acetaminophen are not associated
with metabolic alkalosis.
,**3. Arterial blood gas results for a client are pH 7.48, PaCO₂ 42 mm Hg, and
HCO₃⁻ 32 mEq/L. The nurse interprets these results as indicative of which
acid-base imbalance?**
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: C) Metabolic alkalosis
Rationale: The pH is elevated above 7.45, indicating alkalosis. The PaCO₂ is
normal, and the bicarbonate is elevated above 26 mEq/L, indicating a
metabolic origin. This is consistent with metabolic alkalosis.
**4. A client with a history of gastric outlet obstruction is admitted with
vomiting. The nurse would expect which acid-base imbalance to develop?**
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: D) Metabolic alkalosis
Rationale: Vomiting results in the loss of hydrochloric acid (HCl) from the
stomach. This loss of acid leads to an increase in serum bicarbonate,
resulting in metabolic alkalosis.
,**5. A client with chronic lung disease is exhibiting confusion and lethargy.
The nurse notes the client is breathing shallowly. Which acid-base imbalance
is the client most likely experiencing?**
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: B) Respiratory acidosis
Rationale: Chronic lung disease can lead to hypoventilation, causing
retention of carbon dioxide (CO₂). This results in respiratory acidosis, which
can cause confusion and lethargy due to the effects of CO₂ on the central
nervous system.
**6. A nurse is interpreting ABG results for a client with a pH of 7.32, PaCO₂
of 58 mm Hg, and HCO₃⁻ of 24 mEq/L. The nurse recognizes this as:**
A) Uncompensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Uncompensated metabolic acidosis
D) Partially compensated metabolic acidosis
Correct Answer: A) Uncompensated respiratory acidosis
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO₂ is elevated
(>45 mm Hg), indicating a respiratory cause. The HCO₃⁻ is normal, indicating
that renal compensation has not yet occurred. This is uncompensated
respiratory acidosis.
, **7. A client who is hyperventilating has an ABG result of pH 7.50,
PaCO₂ 30 mm Hg, and HCO₃⁻ 24 mEq/L. The nurse identifies this as:**
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: B) Respiratory alkalosis
Rationale: Hyperventilation causes a decrease in PaCO₂, leading to
respiratory alkalosis. The pH is elevated, the PaCO₂ is low, and the HCO₃⁻ is
normal, indicating the primary disturbance is respiratory.
**8. A client who has been vomiting for several days has the following ABG
results: pH 7.48, PaCO₂ 44 mm Hg, and HCO₃⁻ 32 mEq/L. The nurse should
interpret this as:**
A) Uncompensated respiratory acidosis
B) Uncompensated metabolic alkalosis
C) Partially compensated metabolic alkalosis
D) Partially compensated respiratory alkalosis
Correct Answer: B) Uncompensated metabolic alkalosis
Rationale: The pH is elevated (alkalemia). The HCO₃⁻ is elevated (metabolic
alkalosis), and the PaCO₂ is normal. Because the PaCO₂ is normal, there is no
respiratory compensation. This is uncompensated metabolic alkalosis.
**9. A nurse is reviewing a client's ABG results: pH 7.34, PaCO₂ 48 mm Hg,
HCO₃⁻ 28 mEq/L. Which of the following is the correct interpretation?**
