NSG 252 test 1 (Gas Exchange, Acid-Base
Balance, and Fluid and Electrolytes)
UPDATED ACTUAL Questions and
CORRECT Answers
acid-base balance - CORRECT ANSWER -equilibrium between acid and base concentrations in the
body fluids (CO2 and HCO3)
Metabolic acidosis - CORRECT ANSWER -Deficit of HCO3 caused by an increase in hydrogen
ions or a loss of bicarbonate
Metabolic alkalosis - CORRECT ANSWER -An excess of HCO3 caused by excessive loss of
hydrogen ions (acid) or excessive gain of bicarbonate
Respiratory acidosis - CORRECT ANSWER -Excess of CO2 caused by inadequate excretion of
CO2
Respiratory alkalosis - CORRECT ANSWER -deficit of CO2 caused by an increase in the
elimination of CO2
Patient Risk factors for acid base imbalances - CORRECT ANSWER -Acute and chronic illnesses
(e.g., diabetes mellitus, congestive heart failure, renal failure)
Abnormal losses of body fluids (e.g., prolonged or severe vomiting or diarrhea, draining wounds,
fistulas).
Burns
Trauma
Surgery
Therapies that may disrupt fluid and electrolyte balance, e.g., medications such as diuretics and steroids,
and treatments such as IV therapy and PN
Risk factors for Respiratory acidosis - CORRECT ANSWER -Acute respiratory disease
,Pulmonary edema
Aspiration of a foreign body
Atelectasis
Overdose of sedative or anesthetic
Cardiac arrest
Chronic respiratory disease
Emphysema
Bronchial asthma
Cystic fibrosis
Inadequate mechanical ventilation
CNS depression
Neuromuscular disease
Risk factors for respiratory alkalosis - CORRECT ANSWER -Hyperventilation
Extreme anxiety (most common cause)
Hypoxemia
High fever
Early sepsis
Excessive ventilation by mechanical ventilator
CNS lesion involving the respiratory center
Risk factors for metabolic acidosis - CORRECT ANSWER -Diarrhea
Intestinal fistulas
Parenteral nutrition
Excessive intake of acids, such as salicylates
Diabetic ketoacidosis
Renal failure
Starvational ketoacidosis
Risk factors for metabolic alkalosis - CORRECT ANSWER -Vomiting or gastric suction
, Hypokalemia
Potassium-wasting diuretics
Alkali ingestion (bicarbonate-containing antacids)
Renal loss of H+ (e.g., from steroid or diuretic use)
First system to show up to fix pH - CORRECT ANSWER -chemical buffer
Second line of defense for pH - CORRECT ANSWER -Lungs
Hydrogen ions in the blood are controlled by lungs which control the CO2 levels, lungs increase
respirations or decrease respirations to help control ion concentration
Hyperventilate- decrease hydrogen ion concentration
Hypoventilate- increase hydrogen ion concentration
third line of defense for pH - CORRECT ANSWER -kidney
Takes the longest to respond, but is the most effective
Controls the bicarb by excretion and absorption, and can create it itself,
If higher concentration, absorbed in the blood stream, and bicarb production increases
If lower concentration, bicarb is excreted in urine
S/S of respiratory acidosis - CORRECT ANSWER -Initially theres an increase in heart rate and
blood pressure,
Then bradycardia and hypotension as it worsens
Increase in anxiety, irritability, and confusion
More lethargic/coma
Rapid breathing
pale , cyanotic
Chronic respiratory acidosis in copd patients, sleep apnea and obese pts.
acute causes of respiratory acidosis - CORRECT ANSWER -Pneumonia, airway obstruction, chest
injuries
Balance, and Fluid and Electrolytes)
UPDATED ACTUAL Questions and
CORRECT Answers
acid-base balance - CORRECT ANSWER -equilibrium between acid and base concentrations in the
body fluids (CO2 and HCO3)
Metabolic acidosis - CORRECT ANSWER -Deficit of HCO3 caused by an increase in hydrogen
ions or a loss of bicarbonate
Metabolic alkalosis - CORRECT ANSWER -An excess of HCO3 caused by excessive loss of
hydrogen ions (acid) or excessive gain of bicarbonate
Respiratory acidosis - CORRECT ANSWER -Excess of CO2 caused by inadequate excretion of
CO2
Respiratory alkalosis - CORRECT ANSWER -deficit of CO2 caused by an increase in the
elimination of CO2
Patient Risk factors for acid base imbalances - CORRECT ANSWER -Acute and chronic illnesses
(e.g., diabetes mellitus, congestive heart failure, renal failure)
Abnormal losses of body fluids (e.g., prolonged or severe vomiting or diarrhea, draining wounds,
fistulas).
Burns
Trauma
Surgery
Therapies that may disrupt fluid and electrolyte balance, e.g., medications such as diuretics and steroids,
and treatments such as IV therapy and PN
Risk factors for Respiratory acidosis - CORRECT ANSWER -Acute respiratory disease
,Pulmonary edema
Aspiration of a foreign body
Atelectasis
Overdose of sedative or anesthetic
Cardiac arrest
Chronic respiratory disease
Emphysema
Bronchial asthma
Cystic fibrosis
Inadequate mechanical ventilation
CNS depression
Neuromuscular disease
Risk factors for respiratory alkalosis - CORRECT ANSWER -Hyperventilation
Extreme anxiety (most common cause)
Hypoxemia
High fever
Early sepsis
Excessive ventilation by mechanical ventilator
CNS lesion involving the respiratory center
Risk factors for metabolic acidosis - CORRECT ANSWER -Diarrhea
Intestinal fistulas
Parenteral nutrition
Excessive intake of acids, such as salicylates
Diabetic ketoacidosis
Renal failure
Starvational ketoacidosis
Risk factors for metabolic alkalosis - CORRECT ANSWER -Vomiting or gastric suction
, Hypokalemia
Potassium-wasting diuretics
Alkali ingestion (bicarbonate-containing antacids)
Renal loss of H+ (e.g., from steroid or diuretic use)
First system to show up to fix pH - CORRECT ANSWER -chemical buffer
Second line of defense for pH - CORRECT ANSWER -Lungs
Hydrogen ions in the blood are controlled by lungs which control the CO2 levels, lungs increase
respirations or decrease respirations to help control ion concentration
Hyperventilate- decrease hydrogen ion concentration
Hypoventilate- increase hydrogen ion concentration
third line of defense for pH - CORRECT ANSWER -kidney
Takes the longest to respond, but is the most effective
Controls the bicarb by excretion and absorption, and can create it itself,
If higher concentration, absorbed in the blood stream, and bicarb production increases
If lower concentration, bicarb is excreted in urine
S/S of respiratory acidosis - CORRECT ANSWER -Initially theres an increase in heart rate and
blood pressure,
Then bradycardia and hypotension as it worsens
Increase in anxiety, irritability, and confusion
More lethargic/coma
Rapid breathing
pale , cyanotic
Chronic respiratory acidosis in copd patients, sleep apnea and obese pts.
acute causes of respiratory acidosis - CORRECT ANSWER -Pneumonia, airway obstruction, chest
injuries
