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NUR 2243 Exam 1 Questions and
Answers (100% Pass)
A nurse assesses a client with diabetes mellitus who is admitted with an acid-
base imbalance. The clients arterial blood gas 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 clients compensation mechanism?
a. Increased rate and depth of respirations
b. Increased urinary output
c. Increased thirst and hunger
d. Increased release of acids from the kidneys
✓ ANS: A
✓ This client has metabolic acidosis. The respiratory system compensates
by increasing its activity and blowing off excess carbon dioxide.
Increased urinary output, thirst, and hunger are manifestations of
hyperglycemia but are not compensatory mechanisms for acid-base
imbalances. The kidneys do not release acids
A nurse assesses a client who is experiencing an acid-base imbalance. The
clients arterial blood gas values are pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm
Hg, and HCO3 19 mEq/L. Which assessment should the nurse perform first?
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a. Cardiac rate and rhythm
b. Skin and mucous membranes
c. Musculoskeletal strength
d. Level of orientation
✓ ANS: A
✓ Early cardiovascular changes for a client experiencing moderate
acidosis include increased heart rate and cardiac output. As the
acidosis worsens, the heart rate decreases and electrocardiographic
changes will be present. Central nervous system and neuromuscular
system changes do not occur with mild acidosis and should be
monitored if the acidosis worsens. Skin and mucous membrane
assessment is not a priority now, but will change as acidosis worsens.
A nurse assesses a client who is prescribed furosemide (Lasix) for
hypertension. For which acid-base imbalance should the nurse assess to
prevent complications of this therapy?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
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✓ ANS: D
✓ Many diuretics, especially loop diuretics, increase the excretion of
hydrogen ions, leading to excess acid loss through the renal system.
This situation is an acid deficit of metabolic origin.
A nurse is caring for a client who is experiencing moderate metabolic
alkalosis. Which action should the nurse take?
a. Monitor daily hemoglobin and hematocrit values.
b. Administer furosemide (Lasix) intravenously.
c. Encourage the client to take deep breaths.
d. Teach the client fall prevention measures.
✓ ANS: D
✓ The priority nursing care for a client who is experiencing moderate
metabolic alkalosis is providing client safety. Clients with metabolic
alkalosis have muscle weakness and are at risk for falling. The other
nursing interventions are not appropriate for metabolic alkalosis
A nurse assesses a client who is admitted with an acid-base imbalance. The
clients arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm
Hg, and HCO3 16 mEq/L. What action should the nurse take next?
a. Assess clients rate, rhythm, and depth of respiration.
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b. Measure the clients pulse and blood pressure.
c. Document the findings and continue to monitor.
d. Notify the physician as soon as possible.
✓ ANS: A
✓ Progressive skeletal muscle weakness is associated with increasing
severity of acidosis. Muscle weakness can lead to severe respiratory
insufficiency. Acidosis does lead to dysrhythmias (due to
hyperkalemia), but these would best be assessed with cardiac
monitoring. Findings should be documented, but simply continuing to
monitor is not sufficient. Before notifying the physician, the nurse must
have more data to report
A nurse is caring for a client who has the following arterial blood values: pH
7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L. Which clinical
situation should the nurse correlate with these values?
a. Diabetic ketoacidosis in a person with emphysema
b. Bronchial obstruction related to aspiration of a hot dog
c. Anxiety-induced hyperventilation in an adolescent
d. Diarrhea for 36 hours in an older, frail woman
Master01 |Excellent Study Material| Latest update
NUR 2243 Exam 1 Questions and
Answers (100% Pass)
A nurse assesses a client with diabetes mellitus who is admitted with an acid-
base imbalance. The clients arterial blood gas 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 clients compensation mechanism?
a. Increased rate and depth of respirations
b. Increased urinary output
c. Increased thirst and hunger
d. Increased release of acids from the kidneys
✓ ANS: A
✓ This client has metabolic acidosis. The respiratory system compensates
by increasing its activity and blowing off excess carbon dioxide.
Increased urinary output, thirst, and hunger are manifestations of
hyperglycemia but are not compensatory mechanisms for acid-base
imbalances. The kidneys do not release acids
A nurse assesses a client who is experiencing an acid-base imbalance. The
clients arterial blood gas values are pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm
Hg, and HCO3 19 mEq/L. Which assessment should the nurse perform first?
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a. Cardiac rate and rhythm
b. Skin and mucous membranes
c. Musculoskeletal strength
d. Level of orientation
✓ ANS: A
✓ Early cardiovascular changes for a client experiencing moderate
acidosis include increased heart rate and cardiac output. As the
acidosis worsens, the heart rate decreases and electrocardiographic
changes will be present. Central nervous system and neuromuscular
system changes do not occur with mild acidosis and should be
monitored if the acidosis worsens. Skin and mucous membrane
assessment is not a priority now, but will change as acidosis worsens.
A nurse assesses a client who is prescribed furosemide (Lasix) for
hypertension. For which acid-base imbalance should the nurse assess to
prevent complications of this therapy?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
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✓ ANS: D
✓ Many diuretics, especially loop diuretics, increase the excretion of
hydrogen ions, leading to excess acid loss through the renal system.
This situation is an acid deficit of metabolic origin.
A nurse is caring for a client who is experiencing moderate metabolic
alkalosis. Which action should the nurse take?
a. Monitor daily hemoglobin and hematocrit values.
b. Administer furosemide (Lasix) intravenously.
c. Encourage the client to take deep breaths.
d. Teach the client fall prevention measures.
✓ ANS: D
✓ The priority nursing care for a client who is experiencing moderate
metabolic alkalosis is providing client safety. Clients with metabolic
alkalosis have muscle weakness and are at risk for falling. The other
nursing interventions are not appropriate for metabolic alkalosis
A nurse assesses a client who is admitted with an acid-base imbalance. The
clients arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm
Hg, and HCO3 16 mEq/L. What action should the nurse take next?
a. Assess clients rate, rhythm, and depth of respiration.
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b. Measure the clients pulse and blood pressure.
c. Document the findings and continue to monitor.
d. Notify the physician as soon as possible.
✓ ANS: A
✓ Progressive skeletal muscle weakness is associated with increasing
severity of acidosis. Muscle weakness can lead to severe respiratory
insufficiency. Acidosis does lead to dysrhythmias (due to
hyperkalemia), but these would best be assessed with cardiac
monitoring. Findings should be documented, but simply continuing to
monitor is not sufficient. Before notifying the physician, the nurse must
have more data to report
A nurse is caring for a client who has the following arterial blood values: pH
7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L. Which clinical
situation should the nurse correlate with these values?
a. Diabetic ketoacidosis in a person with emphysema
b. Bronchial obstruction related to aspiration of a hot dog
c. Anxiety-induced hyperventilation in an adolescent
d. Diarrhea for 36 hours in an older, frail woman
Master01 |Excellent Study Material| Latest update
