Final Exam Questions for MDC2 Exam 2 2026
1.) Which pH value indicates the highest concentration of free hydrogen ions in the blood and
other extracellular fluids?
A. 7.57
B. 7.47
C. 7.37
D. 7.27
Answer: D
Justification: The pH scale is inversely related to hydrogen ion concentration. The lower the pH
value, the higher the concentration of free hydrogen ions. A pH of 7.27 is the most acidic among
the options and therefore has the highest free hydrogen ion concentration.
2.) Which client arterial blood gas results would the nurse interpret as within normal limits?
A. pH 7.28, PaCO2 24, bicarbonate 15, PaO2 95
B. pH 7.45, PaCO2 41, bicarbonate 25, PaO2 97
C. pH 7.35, PaCO2 24, bicarbonate 15, PaO2 95
D. pH 7.30, PaCO2 66, bicarbonate 38, PaO2 70
Answer: B
Justification: Normal arterial blood gas values are pH 7.35–7.45, PaCO2 35–45 mm Hg,
bicarbonate 21–28 mEq/L, and PaO2 80–100 mm Hg. Option B falls within all these normal
ranges.
,3.) Which arterial blood pH level can be fatal?
A. 7.22
B. 7.11
C. 7.05
D. 6.85
Answer: D
Justification: An arterial pH below 6.85 is considered incompatible with life because all vital
organ functions would be inhibited at such an acidic level.
4.) By which mechanism do buffers help maintain arterial blood pH within the normal range?
A. Binding excess free hydrogen ions
B. Increasing kidney excretion of free hydrogen ions
C. Triggering increased bicarbonate production in the pancreas
D. Stimulating respiratory neurons to increase the rate and depth of ventilation
Answer: A
Justification: Buffers in body fluids act like hydrogen ion "sponges," soaking up hydrogen ions
when too many are present and releasing them when very few are available. Buffers do not
directly affect kidney, pancreas, or neuronal function.
5.) What changes in body functions does the nurse anticipate in a client who has lower than
normal blood pH levels? Select all that apply.
A. Decreased serum potassium levels
B. Increased effectiveness of drugs
C. Reduced function of hormones
,D. Increased function of enzymes
E. Decreased electrical conduction in the heart
F. Decreased skeletal muscle strength
Answer: B, C, F
Justification: Acidosis reduces the excitability of cardiovascular muscle, neurons, skeletal
muscle, and smooth muscle. It increases drug effectiveness, reduces hormone function, and
decreases skeletal muscle strength.
6.) Which arterial blood gas results would the nurse expect for a client admitted for diabetic
ketoacidosis? Select all that apply.
A. pH 7.32
B. PaCO2 50 mm Hg
C. Bicarbonate 18 mEq/L
D. pH 7.46
E. Bicarbonate 29 mEq/L
F. PaO2 98 mm Hg
Answer: A, C, F
Justification: DKA results from excessive production of ketoacids, which lower pH. Bicarbonate
levels are low due to buffering of these acids. PaO2 may remain normal unless respiratory
complications occur. PaCO2 is typically low due to Kussmaul breathing compensation.
7.) A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance.
The client's ABG values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3⁻ 18
mEq/L. Which manifestation should the nurse identify as an example of the client's
compensation mechanism?
, A. Increased rate and depth of respirations
B. Decreased rate and depth of respirations
C. Increased urinary output
D. Decreased urinary output
Answer: A
Justification: The client has mild metabolic acidosis (low HCO3⁻, pH on the low side of normal).
The low PaCO2 of 33 mm Hg indicates hyperventilation, which is the respiratory system's
compensatory response to blow off CO2 to correct acidosis.
8.) A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action
should the nurse take?
A. Administer IV sodium bicarbonate
B. Teach the client fall prevention measures
C. Restrict oral fluid intake
D. Prepare the client for hemodialysis
Answer: B
Justification: Metabolic alkalosis increases neuromuscular irritability, which can lead to muscle
twitching, tetany, and seizures. The client is at increased risk for falls and injury. Fall prevention
measures are an important safety intervention.
9.) A nurse is caring for a client who has just had a central venous access line inserted. Which
action should the nurse take next?
A. Flush the line with heparinized saline
B. Ensure an x-ray is completed to confirm placement
1.) Which pH value indicates the highest concentration of free hydrogen ions in the blood and
other extracellular fluids?
A. 7.57
B. 7.47
C. 7.37
D. 7.27
Answer: D
Justification: The pH scale is inversely related to hydrogen ion concentration. The lower the pH
value, the higher the concentration of free hydrogen ions. A pH of 7.27 is the most acidic among
the options and therefore has the highest free hydrogen ion concentration.
2.) Which client arterial blood gas results would the nurse interpret as within normal limits?
A. pH 7.28, PaCO2 24, bicarbonate 15, PaO2 95
B. pH 7.45, PaCO2 41, bicarbonate 25, PaO2 97
C. pH 7.35, PaCO2 24, bicarbonate 15, PaO2 95
D. pH 7.30, PaCO2 66, bicarbonate 38, PaO2 70
Answer: B
Justification: Normal arterial blood gas values are pH 7.35–7.45, PaCO2 35–45 mm Hg,
bicarbonate 21–28 mEq/L, and PaO2 80–100 mm Hg. Option B falls within all these normal
ranges.
,3.) Which arterial blood pH level can be fatal?
A. 7.22
B. 7.11
C. 7.05
D. 6.85
Answer: D
Justification: An arterial pH below 6.85 is considered incompatible with life because all vital
organ functions would be inhibited at such an acidic level.
4.) By which mechanism do buffers help maintain arterial blood pH within the normal range?
A. Binding excess free hydrogen ions
B. Increasing kidney excretion of free hydrogen ions
C. Triggering increased bicarbonate production in the pancreas
D. Stimulating respiratory neurons to increase the rate and depth of ventilation
Answer: A
Justification: Buffers in body fluids act like hydrogen ion "sponges," soaking up hydrogen ions
when too many are present and releasing them when very few are available. Buffers do not
directly affect kidney, pancreas, or neuronal function.
5.) What changes in body functions does the nurse anticipate in a client who has lower than
normal blood pH levels? Select all that apply.
A. Decreased serum potassium levels
B. Increased effectiveness of drugs
C. Reduced function of hormones
,D. Increased function of enzymes
E. Decreased electrical conduction in the heart
F. Decreased skeletal muscle strength
Answer: B, C, F
Justification: Acidosis reduces the excitability of cardiovascular muscle, neurons, skeletal
muscle, and smooth muscle. It increases drug effectiveness, reduces hormone function, and
decreases skeletal muscle strength.
6.) Which arterial blood gas results would the nurse expect for a client admitted for diabetic
ketoacidosis? Select all that apply.
A. pH 7.32
B. PaCO2 50 mm Hg
C. Bicarbonate 18 mEq/L
D. pH 7.46
E. Bicarbonate 29 mEq/L
F. PaO2 98 mm Hg
Answer: A, C, F
Justification: DKA results from excessive production of ketoacids, which lower pH. Bicarbonate
levels are low due to buffering of these acids. PaO2 may remain normal unless respiratory
complications occur. PaCO2 is typically low due to Kussmaul breathing compensation.
7.) A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance.
The client's ABG values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3⁻ 18
mEq/L. Which manifestation should the nurse identify as an example of the client's
compensation mechanism?
, A. Increased rate and depth of respirations
B. Decreased rate and depth of respirations
C. Increased urinary output
D. Decreased urinary output
Answer: A
Justification: The client has mild metabolic acidosis (low HCO3⁻, pH on the low side of normal).
The low PaCO2 of 33 mm Hg indicates hyperventilation, which is the respiratory system's
compensatory response to blow off CO2 to correct acidosis.
8.) A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action
should the nurse take?
A. Administer IV sodium bicarbonate
B. Teach the client fall prevention measures
C. Restrict oral fluid intake
D. Prepare the client for hemodialysis
Answer: B
Justification: Metabolic alkalosis increases neuromuscular irritability, which can lead to muscle
twitching, tetany, and seizures. The client is at increased risk for falls and injury. Fall prevention
measures are an important safety intervention.
9.) A nurse is caring for a client who has just had a central venous access line inserted. Which
action should the nurse take next?
A. Flush the line with heparinized saline
B. Ensure an x-ray is completed to confirm placement
