Portage Learning
LANIF · 132 SRUN
★ ★
PN School of Nursing
EST. 2009
FLEXIBLE. AFFORDABLE. ACCREDITED.
NURS 231 Final Exam — Comprehensive Review
AC I D - B A S E , R E S P I RATO RY, C A R D I AC , & C R I T I C A L C A R E
INSTITUTION Portage Learning COURSE CODE NURS 231
PROGRAM Nursing ACADEMIC YEAR
EXAM TITLE NURS 231 Final Exam — TOTAL QUESTIONS 128 Questions
Comprehensive Review
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover acid-base balance, respiratory failure, mechanical ventilation, shock, dysrhythmias,
and critical care nursing.
▸ Correct answers and detailed rationales appear below each question.
▸ Use these rationales to reinforce key nursing concepts for clinical practice.
, SECTION I — ACID-BASE, RESPIRATORY, & CARDIAC Questions 1 – 128
1. What is the formula used to determine actual O2 content of the blood?
A. SpO2 x hgb x 1.34
B. PaO2 x hgb x 1.34
C. SpO2 x PaO2 x 1.34
D. Hgb x PaO.34
CORRECT ANSWER A — SpO2 x hgb x 1.34
RATIONALE The formula for actual O2 content of the blood is SpO2 x hgb x 1.34. This tells how
much O2 is available for tissues and cells because O2 is carried on hemoglobin.
Example: SpO2 95%, Hgb 7.8 = 9.9.
2. Which patient is the nurse more concerned about: a) SaO2 95%, PaO2 85, Hgb 7.8 or b)
SaO2 88%, PaO2 70, Hgb 13.2?
A. Patient A — SaO2 95%, PaO2 85, Hgb 7.8
B. Patient B — SaO2 88%, PaO2 70, Hgb 13.2
C. Both patients are equally concerning
D. Neither patient is concerning
CORRECT ANSWER A — Patient A — SaO2 95%, PaO2 85, Hgb 7.8
RATIONALE Using the O2 content formula: SaO2 x hgb x 1.34. Patient A: 0.95 x 7.8 x 1.34 = 9.9.
Patient B: 0.88 x 13.2 x 1.34 = 15.6. Patient A has significantly less oxygen available
to tissues despite higher SaO2 due to anemia.
,3. What are potential causes of respiratory alkalosis?
A. Anything causing hyperventilation: anxiety, panic disorder, mechanical ventilation,
hypoxemia, CNS stimulation
B. Hypoventilation from opioid use or COPD
C. Renal failure or diabetic ketoacidosis
D. Severe dehydration or burns
CORRECT ANSWER A — Anything causing hyperventilation: anxiety, panic disorder, mechanical
ventilation, hypoxemia, CNS stimulation
RATIONALE Respiratory alkalosis is caused by hyperventilation, which leads to excessive
elimination of CO2. Causes include anxiety, panic disorder, mechanical
ventilation, hypoxemia, and CNS stimulation from drugs that increase respiratory
rate and depth.
4. What are the characteristics of alkalosis?
A. Hypokalemia, hypocalcemia, numbness and tingling, tetany, CNS excitation, tachycardia
B. Hyperkalemia, hypercalcemia, lethargy, CNS depression, bradycardia
C. Hypokalemia, hypercalcemia, confusion, decreased DTR
D. Hyperkalemia, hypocalcemia, seizures, increased DTR
CORRECT ANSWER A — Hypokalemia, hypocalcemia, numbness and tingling, tetany, CNS
excitation, tachycardia
RATIONALE Alkalosis is characterized by hypokalemia and hypocalcemia, numbness and
tingling of fingers, toes, and mouth, tetany and convulsions, increased DTR, +
Chvostek sign, CNS excitation, N/V, lightheadedness, dizziness, blurred vision,
tachycardia, and ventricular arrhythmias.
, 5. What is the patient experiencing as indicated by the following ABG: pH 7.5, pCO2 29, PaO2
63, HCO3 23, SaO2 91?
A. Respiratory Acidosis with no metabolic compensation
B. Respiratory Alkalosis with no metabolic compensation & mild to moderate hypoxemia
C. Metabolic Acidosis with respiratory compensation
D. Metabolic Alkalosis with respiratory compensation
CORRECT ANSWER B — Respiratory Alkalosis with no metabolic compensation & mild to
moderate hypoxemia
RATIONALE pH 7.5 (elevated = alkalosis), pCO2 29 (decreased = respiratory), HCO3 23
(normal), PaO2 63 (decreased = hypoxemia). This indicates respiratory alkalosis
with no metabolic compensation and mild to moderate hypoxemia.
6. What would the nurse expect to see with the following assessments for a patient with
Respiratory Alkalosis with no metabolic compensation & mild to moderate hypoxemia:
HR, RR & pattern, LOC, Neuromuscular?
A. Tachycardia, tachypnea, altered LOC, increased neuromuscular excitability
B. Bradycardia, bradypnea, normal LOC, decreased neuromuscular excitability
C. Tachycardia, bradypnea, confusion, flaccid muscles
D. Bradycardia, tachypnea, coma, spastic muscles
CORRECT ANSWER A — Tachycardia, tachypnea, altered LOC, increased neuromuscular
excitability
RATIONALE Respiratory alkalosis with hypoxemia presents with tachycardia, dysrhythmias,
tachypnea, altered LOC, and increased neuromuscular excitability including
numbness, tingling, paresthesia, twitching, and tremors.
LANIF · 132 SRUN
★ ★
PN School of Nursing
EST. 2009
FLEXIBLE. AFFORDABLE. ACCREDITED.
NURS 231 Final Exam — Comprehensive Review
AC I D - B A S E , R E S P I RATO RY, C A R D I AC , & C R I T I C A L C A R E
INSTITUTION Portage Learning COURSE CODE NURS 231
PROGRAM Nursing ACADEMIC YEAR
EXAM TITLE NURS 231 Final Exam — TOTAL QUESTIONS 128 Questions
Comprehensive Review
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover acid-base balance, respiratory failure, mechanical ventilation, shock, dysrhythmias,
and critical care nursing.
▸ Correct answers and detailed rationales appear below each question.
▸ Use these rationales to reinforce key nursing concepts for clinical practice.
, SECTION I — ACID-BASE, RESPIRATORY, & CARDIAC Questions 1 – 128
1. What is the formula used to determine actual O2 content of the blood?
A. SpO2 x hgb x 1.34
B. PaO2 x hgb x 1.34
C. SpO2 x PaO2 x 1.34
D. Hgb x PaO.34
CORRECT ANSWER A — SpO2 x hgb x 1.34
RATIONALE The formula for actual O2 content of the blood is SpO2 x hgb x 1.34. This tells how
much O2 is available for tissues and cells because O2 is carried on hemoglobin.
Example: SpO2 95%, Hgb 7.8 = 9.9.
2. Which patient is the nurse more concerned about: a) SaO2 95%, PaO2 85, Hgb 7.8 or b)
SaO2 88%, PaO2 70, Hgb 13.2?
A. Patient A — SaO2 95%, PaO2 85, Hgb 7.8
B. Patient B — SaO2 88%, PaO2 70, Hgb 13.2
C. Both patients are equally concerning
D. Neither patient is concerning
CORRECT ANSWER A — Patient A — SaO2 95%, PaO2 85, Hgb 7.8
RATIONALE Using the O2 content formula: SaO2 x hgb x 1.34. Patient A: 0.95 x 7.8 x 1.34 = 9.9.
Patient B: 0.88 x 13.2 x 1.34 = 15.6. Patient A has significantly less oxygen available
to tissues despite higher SaO2 due to anemia.
,3. What are potential causes of respiratory alkalosis?
A. Anything causing hyperventilation: anxiety, panic disorder, mechanical ventilation,
hypoxemia, CNS stimulation
B. Hypoventilation from opioid use or COPD
C. Renal failure or diabetic ketoacidosis
D. Severe dehydration or burns
CORRECT ANSWER A — Anything causing hyperventilation: anxiety, panic disorder, mechanical
ventilation, hypoxemia, CNS stimulation
RATIONALE Respiratory alkalosis is caused by hyperventilation, which leads to excessive
elimination of CO2. Causes include anxiety, panic disorder, mechanical
ventilation, hypoxemia, and CNS stimulation from drugs that increase respiratory
rate and depth.
4. What are the characteristics of alkalosis?
A. Hypokalemia, hypocalcemia, numbness and tingling, tetany, CNS excitation, tachycardia
B. Hyperkalemia, hypercalcemia, lethargy, CNS depression, bradycardia
C. Hypokalemia, hypercalcemia, confusion, decreased DTR
D. Hyperkalemia, hypocalcemia, seizures, increased DTR
CORRECT ANSWER A — Hypokalemia, hypocalcemia, numbness and tingling, tetany, CNS
excitation, tachycardia
RATIONALE Alkalosis is characterized by hypokalemia and hypocalcemia, numbness and
tingling of fingers, toes, and mouth, tetany and convulsions, increased DTR, +
Chvostek sign, CNS excitation, N/V, lightheadedness, dizziness, blurred vision,
tachycardia, and ventricular arrhythmias.
, 5. What is the patient experiencing as indicated by the following ABG: pH 7.5, pCO2 29, PaO2
63, HCO3 23, SaO2 91?
A. Respiratory Acidosis with no metabolic compensation
B. Respiratory Alkalosis with no metabolic compensation & mild to moderate hypoxemia
C. Metabolic Acidosis with respiratory compensation
D. Metabolic Alkalosis with respiratory compensation
CORRECT ANSWER B — Respiratory Alkalosis with no metabolic compensation & mild to
moderate hypoxemia
RATIONALE pH 7.5 (elevated = alkalosis), pCO2 29 (decreased = respiratory), HCO3 23
(normal), PaO2 63 (decreased = hypoxemia). This indicates respiratory alkalosis
with no metabolic compensation and mild to moderate hypoxemia.
6. What would the nurse expect to see with the following assessments for a patient with
Respiratory Alkalosis with no metabolic compensation & mild to moderate hypoxemia:
HR, RR & pattern, LOC, Neuromuscular?
A. Tachycardia, tachypnea, altered LOC, increased neuromuscular excitability
B. Bradycardia, bradypnea, normal LOC, decreased neuromuscular excitability
C. Tachycardia, bradypnea, confusion, flaccid muscles
D. Bradycardia, tachypnea, coma, spastic muscles
CORRECT ANSWER A — Tachycardia, tachypnea, altered LOC, increased neuromuscular
excitability
RATIONALE Respiratory alkalosis with hypoxemia presents with tachycardia, dysrhythmias,
tachypnea, altered LOC, and increased neuromuscular excitability including
numbness, tingling, paresthesia, twitching, and tremors.
