Rasmussen NUR2571 Final (Electrolytes/ABGs) Exam
Questions AND Correct Answers
A client has been admitted for dehydration after fasting for 5
days. For which acid-base imbalance should the nurse assess
this client?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - ✔✔Answer: A; A prolonged fasting
state can lead to dehydration. During fasting, the body
reverts to cellular breakdown to maintain energy, and lactic
and pyruvic acids build up in the body. This accumulation of
acids leads to the development of metabolic acidosis.
Metabolic and respiratory alkalosis are incorrect because
alkalosis would not occur. Respiratory acidosis is incorrect
because the primary disturbance is not respiratory.
A client is admitted to the hospital after vomiting for 3 days.
What arterial blood gas (ABG) results should the nurse
expect?
a. pH 7.30; PaCO 2 PaCO2 50; HCO − 3 HCO3− 27
b. pH 7.47; PaCO 2 PaCO2 43; HCO − 3 HCO3− 28
c. pH 7.34; PaCO 2 PaCO2 50; HCO − 3 HCO3− 28
d. pH 7.48; PaCO 2 PaCO2 30; HCO − 3 HCO3− 23 -
✔✔Answer: B; Vomiting leads to the loss of hydrochloric acid
from gastric acids. Hydrogen ions must leave the blood to
replace this acidity in the stomach. Metabolic alkalosis occurs
,and is reflected by elevated pH and HCO − 3 HCO3− and
normal PaCO 2 . PaCO2. The ABG with the pH of 7.30 is
incorrect because it reflects respiratory acidosis with partial
compensation (decreased pH and elevated PaCO 2 PaCO2 and
HCO − 3 HCO3−). The ABG with the pH of 7.34 is incorrect
because it reflects a mixed acid-base imbalance (metabolic
alkalosis with respiratory acidosis) with a normal pH and
elevated PaCO 2 PaCO2 and HCO − 3 . HCO3−. The ABG with
the pH of 7.48 is incorrect because it reflects respiratory
alkalosis (increased pH, decreased PaCO 2 , PaCO2, and
normal HCO − 3 HCO3−)
A client is admitted to the hospital with atelectasis and
reports of chest pain. For which acid-base imbalance should
the nurse assess this client?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Metabolic alkalosis
d. Respiratory acidosis - ✔✔Answer: D; A client with
atelectasis has collapsed alveoli that retain CO 2 , CO2, which
can lead to respiratory acidosis. The client most likely would
have hypoventilation as a respiratory pattern, which would
further contribute to the development of respiratory acidosis.
Respiratory and metabolic alkalosis are incorrect because the
client would not be in an alkalotic state. Metabolic acidosis is
incorrect because the primary disturbance is respiratory.
, A client is admitted with a diagnosis of renal failure. What
arterial blood gas (ABG) result should the nurse expect to see
with this client?
a. pH 7.49; PaCO 2 PaCO2 36; HCO − 3 HCO3− 30
b. pH 7.30; PaCO 2 PaCO2 35; HCO − 3 HCO3− 18
c. pH 7.31; PaCO 2 PaCO2 50; HCO − 3 HCO3− 23
d. pH 7.43; PaCO 2 PaCO2 48; HCO − 3 HCO3− 30 -
✔✔Answer: B; Clients with renal failure have difficulty
synthesizing HCO − 3 HCO3− in the renal tubules secondary to
the renal failure. These clients also retain K + K+ and
subsequently develop metabolic acidosis. The ABG with the
pH of 7.30 reflects uncompensated metabolic acidosis. The
ABG with the pH of 7.49 is incorrect because it reflects
metabolic alkalosis (increased pH and HCO − 3 HCO3−) and
normal PaCO 2 . PaCO2. The ABG with the pH of 7.31 is
incorrect because it reflects respiratory acidosis (decreased
pH, increased PaCO 2 PaCO2) and normal HCO − 3 . HCO3−.
The ABG with the pH of 7.43 is incorrect because it reflects a
mixed acid-base imbalance metabolic alkalosis with a
respiratory acidosis (normal pH and increased PaCO 2 PaCO2
and HCO − 3 HCO3−).
A client with hypocalcemia is taking supplemental vitamin D.
When the client asks the purpose of this therapy, what
explanation should the nurse give?
a. It directly opposes calcitonin.
b. It prevents renal disease in clients with hypocalcemia.
Questions AND Correct Answers
A client has been admitted for dehydration after fasting for 5
days. For which acid-base imbalance should the nurse assess
this client?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - ✔✔Answer: A; A prolonged fasting
state can lead to dehydration. During fasting, the body
reverts to cellular breakdown to maintain energy, and lactic
and pyruvic acids build up in the body. This accumulation of
acids leads to the development of metabolic acidosis.
Metabolic and respiratory alkalosis are incorrect because
alkalosis would not occur. Respiratory acidosis is incorrect
because the primary disturbance is not respiratory.
A client is admitted to the hospital after vomiting for 3 days.
What arterial blood gas (ABG) results should the nurse
expect?
a. pH 7.30; PaCO 2 PaCO2 50; HCO − 3 HCO3− 27
b. pH 7.47; PaCO 2 PaCO2 43; HCO − 3 HCO3− 28
c. pH 7.34; PaCO 2 PaCO2 50; HCO − 3 HCO3− 28
d. pH 7.48; PaCO 2 PaCO2 30; HCO − 3 HCO3− 23 -
✔✔Answer: B; Vomiting leads to the loss of hydrochloric acid
from gastric acids. Hydrogen ions must leave the blood to
replace this acidity in the stomach. Metabolic alkalosis occurs
,and is reflected by elevated pH and HCO − 3 HCO3− and
normal PaCO 2 . PaCO2. The ABG with the pH of 7.30 is
incorrect because it reflects respiratory acidosis with partial
compensation (decreased pH and elevated PaCO 2 PaCO2 and
HCO − 3 HCO3−). The ABG with the pH of 7.34 is incorrect
because it reflects a mixed acid-base imbalance (metabolic
alkalosis with respiratory acidosis) with a normal pH and
elevated PaCO 2 PaCO2 and HCO − 3 . HCO3−. The ABG with
the pH of 7.48 is incorrect because it reflects respiratory
alkalosis (increased pH, decreased PaCO 2 , PaCO2, and
normal HCO − 3 HCO3−)
A client is admitted to the hospital with atelectasis and
reports of chest pain. For which acid-base imbalance should
the nurse assess this client?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Metabolic alkalosis
d. Respiratory acidosis - ✔✔Answer: D; A client with
atelectasis has collapsed alveoli that retain CO 2 , CO2, which
can lead to respiratory acidosis. The client most likely would
have hypoventilation as a respiratory pattern, which would
further contribute to the development of respiratory acidosis.
Respiratory and metabolic alkalosis are incorrect because the
client would not be in an alkalotic state. Metabolic acidosis is
incorrect because the primary disturbance is respiratory.
, A client is admitted with a diagnosis of renal failure. What
arterial blood gas (ABG) result should the nurse expect to see
with this client?
a. pH 7.49; PaCO 2 PaCO2 36; HCO − 3 HCO3− 30
b. pH 7.30; PaCO 2 PaCO2 35; HCO − 3 HCO3− 18
c. pH 7.31; PaCO 2 PaCO2 50; HCO − 3 HCO3− 23
d. pH 7.43; PaCO 2 PaCO2 48; HCO − 3 HCO3− 30 -
✔✔Answer: B; Clients with renal failure have difficulty
synthesizing HCO − 3 HCO3− in the renal tubules secondary to
the renal failure. These clients also retain K + K+ and
subsequently develop metabolic acidosis. The ABG with the
pH of 7.30 reflects uncompensated metabolic acidosis. The
ABG with the pH of 7.49 is incorrect because it reflects
metabolic alkalosis (increased pH and HCO − 3 HCO3−) and
normal PaCO 2 . PaCO2. The ABG with the pH of 7.31 is
incorrect because it reflects respiratory acidosis (decreased
pH, increased PaCO 2 PaCO2) and normal HCO − 3 . HCO3−.
The ABG with the pH of 7.43 is incorrect because it reflects a
mixed acid-base imbalance metabolic alkalosis with a
respiratory acidosis (normal pH and increased PaCO 2 PaCO2
and HCO − 3 HCO3−).
A client with hypocalcemia is taking supplemental vitamin D.
When the client asks the purpose of this therapy, what
explanation should the nurse give?
a. It directly opposes calcitonin.
b. It prevents renal disease in clients with hypocalcemia.
