Medical Surgical ANCC Exam Questions and Answers
Non-Small cell lung cancer with lymph node and chest wall invasion that requires
resection of the lung and ribs
Stage II Non-Small Cell Lung Cancer with
lymph node or chest wall invasion
-surgery
-Curative XRT or XRT then curative + adjuvant chemotherapy
pH - PaCO2 relationship = both will be acidotic.
pH down, pCO2 up, HCO3 normal.
Potential causes: respiratory depression, CNS trauma, ARDS, pneumonia, COPD,
other pulmonary diseases.
Caused by under-elimination of hydrogen ions or excess carbon dioxide in the body.
Respiratory Acidosis
Result of elevated CO2 from hypoventilation or compensatory response to
bicarbonate retention by the kidneys. Decreases in chest wall expansion because of
skeletal deformities or muscular weakness, airway obstruction, and respiratory
depression from drugs and electrolyte imbalances are some factors that can cause
this condition.
Compensation = renal, HCO3.
, pH - PaCO2 relationship = both will be alkalotic.
pH up, PCO2 down, HCO3 normal.
Potential causes: hyperventilation, pain, anxiety , sepsis, tetany, fever, pulmonary
emboli.
Caused by over elimination of hydrogen ions or a level of CO2 below normal in the
body. Result of decrease CO2 from hyperventilation or compensatory response to
Respiratory Alkalosis bicarbonate elimination by the kidneys. Fear, anxiety, mechanical ventilation,
excessive use of drugs such as aspirin or catecholamine, and alcohol intoxication
can cause this condition.
Compensation = Renal, HCO3 decreased. Immediate compensation can be obtained
by having the patient breathe into a nonrebreather mask or paper bag.
pCO2 value is in the opposite direction of Imbalance is of respiratory origin.
pH
HCO3 value is the same direction as the pH Imbalance is of metabolic origin.
pH - HCO3 relationship, both acidotic.
pH down, PCO2 normal, HCO3 down.
Potential causes: diabetes, shock, renal failure, burns, starvation, malnutrition.
Caused by production of acid and the presence of excessive hydrogen ions
Metabolic acidosis
secondary to illness. Diseases such as renal failure, sepsis, DKA, and loss of
bicarbonate from the lower GI tract through diarrhea or fistula drainage.
Compensation: respiratory, PCO2 <35 mm Hg. Sodium bicarbonate can be
administered intravenously. The kidneys can also work to increase excretion of
hydrogen ions in the urine.
pH - HCO3 relationship, both alkalotic.
pH up, PCO2 normal, HCO3 up.
Potential causes:
Caused by presence of excessive base or loss of hydrogen ions secondary to illness.
Severe vomiting, excessive gastric suctioning, diuretics, or excessive intake of
Metabolic alkalosis.
bicarbonate products such as antacids can cause this condition. Cushing's syndrome
or hepatic failure.
Compensation: respiratory, PaCO2 >45 mm Hg. Typically occurs by increasing
carbon dioxide retention by the lungs, increased retention of hydrogen ions by the
kidneys, and treating underlying cause of the condition.
Calorie malnutrition in which body fat and protein are wasted. Occurs due to
Marasmus inadequate intake of calories or prolonged starvation. Serum proteins are generally
preserved.
Protein malnutrition caused by inadequate protein quantity and quality despite
adequate caloric intake. May also result from long-term use of dextrose-containing
Kwashiorkor
IV fluids. Body weight is typically normal and serum proteins are low. Serum albumin
is <3.5 g/dL.
Non-Small cell lung cancer with lymph node and chest wall invasion that requires
resection of the lung and ribs
Stage II Non-Small Cell Lung Cancer with
lymph node or chest wall invasion
-surgery
-Curative XRT or XRT then curative + adjuvant chemotherapy
pH - PaCO2 relationship = both will be acidotic.
pH down, pCO2 up, HCO3 normal.
Potential causes: respiratory depression, CNS trauma, ARDS, pneumonia, COPD,
other pulmonary diseases.
Caused by under-elimination of hydrogen ions or excess carbon dioxide in the body.
Respiratory Acidosis
Result of elevated CO2 from hypoventilation or compensatory response to
bicarbonate retention by the kidneys. Decreases in chest wall expansion because of
skeletal deformities or muscular weakness, airway obstruction, and respiratory
depression from drugs and electrolyte imbalances are some factors that can cause
this condition.
Compensation = renal, HCO3.
, pH - PaCO2 relationship = both will be alkalotic.
pH up, PCO2 down, HCO3 normal.
Potential causes: hyperventilation, pain, anxiety , sepsis, tetany, fever, pulmonary
emboli.
Caused by over elimination of hydrogen ions or a level of CO2 below normal in the
body. Result of decrease CO2 from hyperventilation or compensatory response to
Respiratory Alkalosis bicarbonate elimination by the kidneys. Fear, anxiety, mechanical ventilation,
excessive use of drugs such as aspirin or catecholamine, and alcohol intoxication
can cause this condition.
Compensation = Renal, HCO3 decreased. Immediate compensation can be obtained
by having the patient breathe into a nonrebreather mask or paper bag.
pCO2 value is in the opposite direction of Imbalance is of respiratory origin.
pH
HCO3 value is the same direction as the pH Imbalance is of metabolic origin.
pH - HCO3 relationship, both acidotic.
pH down, PCO2 normal, HCO3 down.
Potential causes: diabetes, shock, renal failure, burns, starvation, malnutrition.
Caused by production of acid and the presence of excessive hydrogen ions
Metabolic acidosis
secondary to illness. Diseases such as renal failure, sepsis, DKA, and loss of
bicarbonate from the lower GI tract through diarrhea or fistula drainage.
Compensation: respiratory, PCO2 <35 mm Hg. Sodium bicarbonate can be
administered intravenously. The kidneys can also work to increase excretion of
hydrogen ions in the urine.
pH - HCO3 relationship, both alkalotic.
pH up, PCO2 normal, HCO3 up.
Potential causes:
Caused by presence of excessive base or loss of hydrogen ions secondary to illness.
Severe vomiting, excessive gastric suctioning, diuretics, or excessive intake of
Metabolic alkalosis.
bicarbonate products such as antacids can cause this condition. Cushing's syndrome
or hepatic failure.
Compensation: respiratory, PaCO2 >45 mm Hg. Typically occurs by increasing
carbon dioxide retention by the lungs, increased retention of hydrogen ions by the
kidneys, and treating underlying cause of the condition.
Calorie malnutrition in which body fat and protein are wasted. Occurs due to
Marasmus inadequate intake of calories or prolonged starvation. Serum proteins are generally
preserved.
Protein malnutrition caused by inadequate protein quantity and quality despite
adequate caloric intake. May also result from long-term use of dextrose-containing
Kwashiorkor
IV fluids. Body weight is typically normal and serum proteins are low. Serum albumin
is <3.5 g/dL.
