1. A patient is brought into the ED with respiratory depression. The patient has a history of COPD. What acid-base
imbalance is most likely? - Respiratory Acidosis. The patient likely has a build-up of CO2, causing respiratory
acidosis.
2. The nurse is evaluating the lab work of a patient who has uncontrolled metabolic acidosis. Which lab result would
result from this condition? Serum potassium 5.7 mEq/L. Serum potassium increases during acidosis to try to buffer
the acidic conditions.
3. The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient
has a history of (COPD) and his laboratory results and assessment reveal that he has mild respiratory acidosis. The
nurse would question which order? Oxygen therapy at 4 L/min as needed - Oxygen therapy at 4L/ Min as needed.
Oxygen therapy is often ordered for =respiratory acidosis. However, COPD patients have a difficult time off-loading
carbon dioxide and giving too much oxygen can cause these patients to have a decrease in respiratory drive, leading
to respiratory arrest.
4. A client has acute alcohol intoxication. What acid-base imbalance is the client at risk for? Metabolic Acidosis
5. A client comes into the ED with respiratory acidosis. What type of medication would the nurse likely administer?
Bronchodilators
6. A client comes into the ED with a high fever and is hyperventilating. His ABG results are pH 7.51, PaCO2 28 mm Hg,
and HCO3 24 mEq/L. The nurse should identify that the client has which acid-base imbalance? Respiratory Alkalosis.
Because the client is breathing rapidly, he is exhaling excessive amounts of carbon dioxide. This loss of carbon
dioxide decreases the hydrogen ion levels of the blood, causing the pH to increase and resulting in respiratory
alkalosis.
7. A nurse is caring for a client who has metabolic alkalosis. As the client compensates for this acid-base imbalance,
which of the following mechanisms should the nurse expect the client's body to use? Hypoventilation.
8. A nurse is inserting an NG tube for a client who is beginning enteral feedings. What action should the nurse take to
verify tube placement before administering initial feeding? Verify tube placement with radiography
9. Which patient statement alerts the nurse to perform a thorough GI history and focused assessment? "I take
ibuprofen three times daily for arthritis.” large amounts of aspirin or NSAIDs can cause peptic ulcer disease and GI
bleeding.
10. After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic
movement is returning? "Have you passed flatus?"
11. When administering a new GI medication to an older patient, the nurse anticipates what? Close monitoring is
needed because toxic levels may develop.
12. A patient in the ED has been experiencing upper abdominal pain after meals for the past several months. She
reports pain after napping or sleeping at night. She has been taking OTC antacids with some relief. The nurse
understands that which assessment finding places the patient at risk for peptic ulcer disease? use of NSAIDS to
control arthritis pain - NSAID use and H. Pylori bacteria are the most common causes of ulcers.
13. Which diagnostic results does the nurse recognize that support the diagnosis of peptic ulcer disease (PUD)? (SATA)
Low hemoglobin (Hgb), Low hematocrit (Hct), Positive for H. pylori bacteria - Low hemoglobin and low hematocrit
are signs of bleeding. H. Pylori is a common cause of ulcers
14. An EGD confirms that the patient has PUD. Three hours later, the patient is admitted to the medical unit for workup
and further testing. On admission the patient reports midline epigastric tenderness and indigestion (dyspepsia). The
patient is prescribed triple therapy. Which drugs does the nurse prepare to administer? Proton pump inhibitor (PPI)
and two antibiotics
15. Which patient statement would cause the nurse to suspect that she may have Zollinger- Ellison syndrome (ZES)?
"The stomach pain hurts, but the foul-smelling diarrhea is worse."
16. Zollinger-Ellison syndrome - hypersecretion of gastric acid that produces peptic ulcers as a result of pancreatic
tumors
17. Zollinger-Ellison syndrome symptoms Peptic ulcers (not responding to tx), Dyspepsia, GERD, Diarrhea, foul smelling,
stomach pain
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, 18. As the patient prepares for discharge, the nurse provides education about behaviors that reduce symptoms and
aggravate peptic ulcers. Which teaching does the nurse provide? (SATA) Sit upright 30 to 60 minutes after meals.,
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vomiting should be reported to your physician., H. pylori can be a concern in patients with peptic ulcers, The goal of
initial intervention is to control symptoms and prevent further complications.
19. The nurse is caring for a patient with peptic ulcer disease (PUD). Which patient statement requires nursing
teaching? "My doctor said to take ibuprofen for my aches and pain."
20. A 68-year-old patient with a history of arthritis and hypertension is admitted reporting progressive epigastric
cramping, dyspepsia, nausea, and dark, sticky stools for 3 days. Which order will the nurse question? Naproxen
(Naprosyn) 500 mg twice daily
21. What is the nursing priority in the management of a patient with a newly active upper GI bleed? Apply oxygen by
nasal cannula - Oxygen will assist with delivery of oxygen to the tissues. Vital signs are then needed to evaluate the
severity of the patient's bleed and hypovolemic status, which can then be reported to the physician. A type and
cross match, although important, can take place afterward.
22. A 72-year-old man has recently been diagnosed with oral cancer. He has been undergoing both radiation and
chemotherapy. While visiting his oncologist, he mentions to the nurse that he has lost all of his hair and that his
mouth is very dry. He also states that he is certain he has a cavity, because one of his teeth is hurting. What
teaching will the nurse provide to decrease the incidence of dry mouth? Consume eight glasses of water daily.
23. Twenty minutes later after a careful assessment of the patient, the nurse notes that the patient's SaO2 is 89% and
he has crackles scattered bilaterally. The oncologist decides to admit the patient to an acute care oncology unit, and
within the hour, he is transported to a hospital unit. What is the priority nursing intervention upon admission?
Apply oxygen at 2 L per nasal cannula - Airway is always top priority
24. A patient is scheduled to start chemotherapy. What oral cavity problem does the nurse teach the patient that may
occur? Stomatitis
25. A 23-year-old female patient reports having red, raised lesions at the base of her tongue and on the inside of her
mouth for the past 3 weeks. What priority assessment question should the nurse ask? “Do you have a history of
human papillomavirus?"
26. An older patient with poor oral hygiene was admitted after a fall in which he sustained a fractured hip. What is the
priority nursing intervention? Implement aspiration precautions.
27. The nurse is caring for a patient with a long history of osteoarthritis. Which risk factors will the nurse teach the
patient that may contribute to development of gastroesophageal reflux disease (GERD)? Frequently takes NSAIDs
for pain
28. Which nursing intervention is the priority in the care of a patient with a hiatal hernia? Providing nutrition education
29. Which assessment variable requires immediate nursing intervention post esophagectomy? Respiratory rate of 28
30. Acids are substances that release _____when dissolved in body fluids? hydrogen ions
31. _____ work to bring fluids as close as possible to the normal body pH range of 7.35 to 7.45. Buffers
32. A base binds hydrogen ions in solution and decreases the amount of ____ ______ _____ in solution. free hydrogen
ions
33. The most common base in the human body is_____. Bicarbonate
34. __________is a gas that forms carbonic acid when combined with water Carbon dioxide
35. A decrease in bicarbonate will do what to the pH? decrease it (make the body more acidic)
36. Bicarbonate levels are controlled by which organ? the kidneys
37. What is the pH normal reference range? - 7.35 to 7.45
38. A person with a pH of 7.55 is acidotic or alkalotic? Alkalotic
39. What condition do these parameters indicate? pH: 7.3, pCO2 52, HCO3 22 - uncompensated respiratory acidosis
imbalance is most likely? - Respiratory Acidosis. The patient likely has a build-up of CO2, causing respiratory
acidosis.
2. The nurse is evaluating the lab work of a patient who has uncontrolled metabolic acidosis. Which lab result would
result from this condition? Serum potassium 5.7 mEq/L. Serum potassium increases during acidosis to try to buffer
the acidic conditions.
3. The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient
has a history of (COPD) and his laboratory results and assessment reveal that he has mild respiratory acidosis. The
nurse would question which order? Oxygen therapy at 4 L/min as needed - Oxygen therapy at 4L/ Min as needed.
Oxygen therapy is often ordered for =respiratory acidosis. However, COPD patients have a difficult time off-loading
carbon dioxide and giving too much oxygen can cause these patients to have a decrease in respiratory drive, leading
to respiratory arrest.
4. A client has acute alcohol intoxication. What acid-base imbalance is the client at risk for? Metabolic Acidosis
5. A client comes into the ED with respiratory acidosis. What type of medication would the nurse likely administer?
Bronchodilators
6. A client comes into the ED with a high fever and is hyperventilating. His ABG results are pH 7.51, PaCO2 28 mm Hg,
and HCO3 24 mEq/L. The nurse should identify that the client has which acid-base imbalance? Respiratory Alkalosis.
Because the client is breathing rapidly, he is exhaling excessive amounts of carbon dioxide. This loss of carbon
dioxide decreases the hydrogen ion levels of the blood, causing the pH to increase and resulting in respiratory
alkalosis.
7. A nurse is caring for a client who has metabolic alkalosis. As the client compensates for this acid-base imbalance,
which of the following mechanisms should the nurse expect the client's body to use? Hypoventilation.
8. A nurse is inserting an NG tube for a client who is beginning enteral feedings. What action should the nurse take to
verify tube placement before administering initial feeding? Verify tube placement with radiography
9. Which patient statement alerts the nurse to perform a thorough GI history and focused assessment? "I take
ibuprofen three times daily for arthritis.” large amounts of aspirin or NSAIDs can cause peptic ulcer disease and GI
bleeding.
10. After abdominal surgery, which question should the nurse ask the patient to determine whether peristaltic
movement is returning? "Have you passed flatus?"
11. When administering a new GI medication to an older patient, the nurse anticipates what? Close monitoring is
needed because toxic levels may develop.
12. A patient in the ED has been experiencing upper abdominal pain after meals for the past several months. She
reports pain after napping or sleeping at night. She has been taking OTC antacids with some relief. The nurse
understands that which assessment finding places the patient at risk for peptic ulcer disease? use of NSAIDS to
control arthritis pain - NSAID use and H. Pylori bacteria are the most common causes of ulcers.
13. Which diagnostic results does the nurse recognize that support the diagnosis of peptic ulcer disease (PUD)? (SATA)
Low hemoglobin (Hgb), Low hematocrit (Hct), Positive for H. pylori bacteria - Low hemoglobin and low hematocrit
are signs of bleeding. H. Pylori is a common cause of ulcers
14. An EGD confirms that the patient has PUD. Three hours later, the patient is admitted to the medical unit for workup
and further testing. On admission the patient reports midline epigastric tenderness and indigestion (dyspepsia). The
patient is prescribed triple therapy. Which drugs does the nurse prepare to administer? Proton pump inhibitor (PPI)
and two antibiotics
15. Which patient statement would cause the nurse to suspect that she may have Zollinger- Ellison syndrome (ZES)?
"The stomach pain hurts, but the foul-smelling diarrhea is worse."
16. Zollinger-Ellison syndrome - hypersecretion of gastric acid that produces peptic ulcers as a result of pancreatic
tumors
17. Zollinger-Ellison syndrome symptoms Peptic ulcers (not responding to tx), Dyspepsia, GERD, Diarrhea, foul smelling,
stomach pain
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document is illegal $103 per month?
, 18. As the patient prepares for discharge, the nurse provides education about behaviors that reduce symptoms and
aggravate peptic ulcers. Which teaching does the nurse provide? (SATA) Sit upright 30 to 60 minutes after meals.,
Extreme
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vomiting should be reported to your physician., H. pylori can be a concern in patients with peptic ulcers, The goal of
initial intervention is to control symptoms and prevent further complications.
19. The nurse is caring for a patient with peptic ulcer disease (PUD). Which patient statement requires nursing
teaching? "My doctor said to take ibuprofen for my aches and pain."
20. A 68-year-old patient with a history of arthritis and hypertension is admitted reporting progressive epigastric
cramping, dyspepsia, nausea, and dark, sticky stools for 3 days. Which order will the nurse question? Naproxen
(Naprosyn) 500 mg twice daily
21. What is the nursing priority in the management of a patient with a newly active upper GI bleed? Apply oxygen by
nasal cannula - Oxygen will assist with delivery of oxygen to the tissues. Vital signs are then needed to evaluate the
severity of the patient's bleed and hypovolemic status, which can then be reported to the physician. A type and
cross match, although important, can take place afterward.
22. A 72-year-old man has recently been diagnosed with oral cancer. He has been undergoing both radiation and
chemotherapy. While visiting his oncologist, he mentions to the nurse that he has lost all of his hair and that his
mouth is very dry. He also states that he is certain he has a cavity, because one of his teeth is hurting. What
teaching will the nurse provide to decrease the incidence of dry mouth? Consume eight glasses of water daily.
23. Twenty minutes later after a careful assessment of the patient, the nurse notes that the patient's SaO2 is 89% and
he has crackles scattered bilaterally. The oncologist decides to admit the patient to an acute care oncology unit, and
within the hour, he is transported to a hospital unit. What is the priority nursing intervention upon admission?
Apply oxygen at 2 L per nasal cannula - Airway is always top priority
24. A patient is scheduled to start chemotherapy. What oral cavity problem does the nurse teach the patient that may
occur? Stomatitis
25. A 23-year-old female patient reports having red, raised lesions at the base of her tongue and on the inside of her
mouth for the past 3 weeks. What priority assessment question should the nurse ask? “Do you have a history of
human papillomavirus?"
26. An older patient with poor oral hygiene was admitted after a fall in which he sustained a fractured hip. What is the
priority nursing intervention? Implement aspiration precautions.
27. The nurse is caring for a patient with a long history of osteoarthritis. Which risk factors will the nurse teach the
patient that may contribute to development of gastroesophageal reflux disease (GERD)? Frequently takes NSAIDs
for pain
28. Which nursing intervention is the priority in the care of a patient with a hiatal hernia? Providing nutrition education
29. Which assessment variable requires immediate nursing intervention post esophagectomy? Respiratory rate of 28
30. Acids are substances that release _____when dissolved in body fluids? hydrogen ions
31. _____ work to bring fluids as close as possible to the normal body pH range of 7.35 to 7.45. Buffers
32. A base binds hydrogen ions in solution and decreases the amount of ____ ______ _____ in solution. free hydrogen
ions
33. The most common base in the human body is_____. Bicarbonate
34. __________is a gas that forms carbonic acid when combined with water Carbon dioxide
35. A decrease in bicarbonate will do what to the pH? decrease it (make the body more acidic)
36. Bicarbonate levels are controlled by which organ? the kidneys
37. What is the pH normal reference range? - 7.35 to 7.45
38. A person with a pH of 7.55 is acidotic or alkalotic? Alkalotic
39. What condition do these parameters indicate? pH: 7.3, pCO2 52, HCO3 22 - uncompensated respiratory acidosis
