NURS 1230 EXAM 3 QUESTIONS AND ANSWERS | NURS 1230 EXAM 3
STUDY GUIDE & PRACTICE TEST 2026/2027
What is the point of acid base balance in the body? - ANS ✔✔To maintain a steady balance between
acids and bases to achieve homeostasis
What are the health problems that lead to imbalance? - ANS ✔✔-Diabetes mellitus
-Chronic obstructive pulmonary disease (COPD)
-Kidney disease
Between treating a chronic disease and acid base balance, what comes first? - ANS ✔✔Disease first, acid
base imbalance will correct itself
What operates faster to correct acid base imbalances, lungs or kidneys? - ANS ✔✔-Lungs, it takes
minutes
-Kidneys take longer
What is pH? - ANS ✔✔Measure of H+ ion concentration
What are the normal blood pH levels? - ANS ✔✔-7.35 to 7.45
-<7.35 is acidosis
->7.45 alkalosis
What do metabolic processes produce normally? - ANS ✔✔-Acids; must be neutralized and excreted
-Ex: lactic acid
What regulatory mechanisms maintain acid base regulation? - ANS ✔✔-Buffers
-Respiratory system
-Renal system
How fast does each compensatory mechanism correct imbalances? - ANS ✔✔-Buffers; immediately
-Respiratory system; in minutes
-Renal system; 2-3 days
Where in the nephron is acid base balance corrected? - ANS ✔✔PCT
What does the buffer system do? - ANS ✔✔-Act chemically to change strong acids to weak acids or bind
acids
-Fast acting system
-Primary regulator of acid base balance
What are the types of buffer systems in the body? - ANS ✔✔-Carbonic acid/H2CO3 and
bicarbonate/HCO3-
-Phosphate
-Protein
-Hemoglobin
,-Cellular
What is the most common base in the body? - ANS ✔✔Bicarbonate (HCO3-)
What is the most common acid in the body? - ANS ✔✔Carbonic acid (H2CO3)
If a strong acid and a strong base is combined, what does it create? - ANS ✔✔Salt + weak acid
What is the ratio of bicarbonate and carbonic acid in the body to maintain a normal pH? - ANS ✔✔1
carbonic acid to 20 bicarbonate
How does phosphate act as a buffer system? - ANS ✔✔-Na and Phosphorous creates a strong base and
neutralizes strong acids
-Na and phosphate creates a strong acid and neutralizes strong bases
When sodium and phosphate act with a strong acid, what does it create? - ANS ✔✔NaCl (salt) + NaPO2
(weak acid)
How does protein act as a buffer system? - ANS ✔✔Chemical structure of amino acid (protein) has acid
& base component that accepts H+ if pH is low and release H+ if pH is high)
How does hemoglobin act as a buffer system? - ANS ✔✔Can bind to both H+ (forming weak acid) and
cO2 (forming carbaminohemoglobin in lungs releasing cO2 to be exhaled
Is arterial or venous blood a better buffer? - ANS ✔✔Venous; more binding sites d/t depositing oxygen
already
How does the cellular act as a buffer system? - ANS ✔✔Shifts H+ in and out of cells for exchange of K+
What controls the body's breathing rate? - ANS ✔✔Respiratory center in the medulla
How does increased respirations affect CO2 levels? - ANS ✔✔-Leads to increased CO2 elimination
-Leads to decreased CO2 in blood
How does decreased respirations affect CO2 levels? - ANS ✔✔Leads to CO2 retention
How does the renal system regulate acid base balance? - ANS ✔✔Conserves bicarbonate and excretes
acid
What are the three mechanisms for acid elimination in the renal system? - ANS ✔✔-Secrete free
hydrogen
-Binds H+ with ammonia in kidneys to get rid of excess H+
-Excrete weak acids
If compensatory (regulation) mechanisms fail, what kind of acid base imbalances can result? - ANS ✔✔-
Respiratory (CO2) or metabolic (HCO3)
-Acidosis or alkalosis
-Acute or chronic
, What are the four types of acid base imbalances? - ANS ✔✔-Respiratory acidosis; increased carbonic
acid/CO2
-Respiratory alkalosis; decreased carbonic acid/CO2
-Metabolic acidosis; decreased bicarb
-Metabolic alkalosis; increased bicarb
What do arterial blood gas values provide information about? - ANS ✔✔-Acid base balance
-Underlying cause of imbalance
-Body's ability to regulate pH
-Overall oxygen status
What is SpO2? - ANS ✔✔Overall oxygen status and used to identify hypoxemia; not used to determine
acid base balance
What are the steps to interpreting ABGs? - ANS ✔✔-Look at each of the values; pH first
-Evaluate pH; is it 7.35 to 7.45?
-Analyze PaCO2; lungs
-Analyze HCO3-; kidneys
-Determine if patient is compensating
-Assess the PaO2 and O2 saturation
What are the normal values for pH, PaCO2, PaO2, HCO3-? - ANS ✔✔-pH; 7.35 to 7.45
-PaCO2; 35 to 45
-PaO2; 80 to 100 mmHg
-HCO3-; 22 to 26 mEq/L
What is the ROME mnemonic? - ANS ✔✔-Respiratory Opposite
-Metabolic Equal
What does respiratory opposite mean? - ANS ✔✔-Alkalosis; Increased pH, Decreased PaCO2
-Acidosis; Decreased pH, Increased PaCO2
What does metabolic equal mean? - ANS ✔✔-Alkalosis; Increased pH, Increased HCO3-
-Acidosis; Decreased pH, Decreased HCO3-
In respiratory acidosis, what is the carbonic acid excess caused by? - ANS ✔✔-Hypoventilation
-Respiratory failure
How does the renal system correct respiratory acidosis? - ANS ✔✔Kidneys conserve HCO3- and secrete
H+ into urine
What are possible causes of underelimination of hydrogen ions leading to respiratory acidosis? - ANS
✔✔-Respiratory depression:
-Anesthetics
-Drugs (especially opioids); morphine, fentanyl
-Electrolyte imbalance
-Inadequate chest expansion:
STUDY GUIDE & PRACTICE TEST 2026/2027
What is the point of acid base balance in the body? - ANS ✔✔To maintain a steady balance between
acids and bases to achieve homeostasis
What are the health problems that lead to imbalance? - ANS ✔✔-Diabetes mellitus
-Chronic obstructive pulmonary disease (COPD)
-Kidney disease
Between treating a chronic disease and acid base balance, what comes first? - ANS ✔✔Disease first, acid
base imbalance will correct itself
What operates faster to correct acid base imbalances, lungs or kidneys? - ANS ✔✔-Lungs, it takes
minutes
-Kidneys take longer
What is pH? - ANS ✔✔Measure of H+ ion concentration
What are the normal blood pH levels? - ANS ✔✔-7.35 to 7.45
-<7.35 is acidosis
->7.45 alkalosis
What do metabolic processes produce normally? - ANS ✔✔-Acids; must be neutralized and excreted
-Ex: lactic acid
What regulatory mechanisms maintain acid base regulation? - ANS ✔✔-Buffers
-Respiratory system
-Renal system
How fast does each compensatory mechanism correct imbalances? - ANS ✔✔-Buffers; immediately
-Respiratory system; in minutes
-Renal system; 2-3 days
Where in the nephron is acid base balance corrected? - ANS ✔✔PCT
What does the buffer system do? - ANS ✔✔-Act chemically to change strong acids to weak acids or bind
acids
-Fast acting system
-Primary regulator of acid base balance
What are the types of buffer systems in the body? - ANS ✔✔-Carbonic acid/H2CO3 and
bicarbonate/HCO3-
-Phosphate
-Protein
-Hemoglobin
,-Cellular
What is the most common base in the body? - ANS ✔✔Bicarbonate (HCO3-)
What is the most common acid in the body? - ANS ✔✔Carbonic acid (H2CO3)
If a strong acid and a strong base is combined, what does it create? - ANS ✔✔Salt + weak acid
What is the ratio of bicarbonate and carbonic acid in the body to maintain a normal pH? - ANS ✔✔1
carbonic acid to 20 bicarbonate
How does phosphate act as a buffer system? - ANS ✔✔-Na and Phosphorous creates a strong base and
neutralizes strong acids
-Na and phosphate creates a strong acid and neutralizes strong bases
When sodium and phosphate act with a strong acid, what does it create? - ANS ✔✔NaCl (salt) + NaPO2
(weak acid)
How does protein act as a buffer system? - ANS ✔✔Chemical structure of amino acid (protein) has acid
& base component that accepts H+ if pH is low and release H+ if pH is high)
How does hemoglobin act as a buffer system? - ANS ✔✔Can bind to both H+ (forming weak acid) and
cO2 (forming carbaminohemoglobin in lungs releasing cO2 to be exhaled
Is arterial or venous blood a better buffer? - ANS ✔✔Venous; more binding sites d/t depositing oxygen
already
How does the cellular act as a buffer system? - ANS ✔✔Shifts H+ in and out of cells for exchange of K+
What controls the body's breathing rate? - ANS ✔✔Respiratory center in the medulla
How does increased respirations affect CO2 levels? - ANS ✔✔-Leads to increased CO2 elimination
-Leads to decreased CO2 in blood
How does decreased respirations affect CO2 levels? - ANS ✔✔Leads to CO2 retention
How does the renal system regulate acid base balance? - ANS ✔✔Conserves bicarbonate and excretes
acid
What are the three mechanisms for acid elimination in the renal system? - ANS ✔✔-Secrete free
hydrogen
-Binds H+ with ammonia in kidneys to get rid of excess H+
-Excrete weak acids
If compensatory (regulation) mechanisms fail, what kind of acid base imbalances can result? - ANS ✔✔-
Respiratory (CO2) or metabolic (HCO3)
-Acidosis or alkalosis
-Acute or chronic
, What are the four types of acid base imbalances? - ANS ✔✔-Respiratory acidosis; increased carbonic
acid/CO2
-Respiratory alkalosis; decreased carbonic acid/CO2
-Metabolic acidosis; decreased bicarb
-Metabolic alkalosis; increased bicarb
What do arterial blood gas values provide information about? - ANS ✔✔-Acid base balance
-Underlying cause of imbalance
-Body's ability to regulate pH
-Overall oxygen status
What is SpO2? - ANS ✔✔Overall oxygen status and used to identify hypoxemia; not used to determine
acid base balance
What are the steps to interpreting ABGs? - ANS ✔✔-Look at each of the values; pH first
-Evaluate pH; is it 7.35 to 7.45?
-Analyze PaCO2; lungs
-Analyze HCO3-; kidneys
-Determine if patient is compensating
-Assess the PaO2 and O2 saturation
What are the normal values for pH, PaCO2, PaO2, HCO3-? - ANS ✔✔-pH; 7.35 to 7.45
-PaCO2; 35 to 45
-PaO2; 80 to 100 mmHg
-HCO3-; 22 to 26 mEq/L
What is the ROME mnemonic? - ANS ✔✔-Respiratory Opposite
-Metabolic Equal
What does respiratory opposite mean? - ANS ✔✔-Alkalosis; Increased pH, Decreased PaCO2
-Acidosis; Decreased pH, Increased PaCO2
What does metabolic equal mean? - ANS ✔✔-Alkalosis; Increased pH, Increased HCO3-
-Acidosis; Decreased pH, Decreased HCO3-
In respiratory acidosis, what is the carbonic acid excess caused by? - ANS ✔✔-Hypoventilation
-Respiratory failure
How does the renal system correct respiratory acidosis? - ANS ✔✔Kidneys conserve HCO3- and secrete
H+ into urine
What are possible causes of underelimination of hydrogen ions leading to respiratory acidosis? - ANS
✔✔-Respiratory depression:
-Anesthetics
-Drugs (especially opioids); morphine, fentanyl
-Electrolyte imbalance
-Inadequate chest expansion:
