NSG 223 Exam #2: ABG Interpretation, ARDS, Hepatitis, Pancreatitis,
Cirrhosis, Renal Failure, Dialysis, Pulmonary Embolism | Q&A | Grade A |
100% Correct (Verified Answers) – Nursing Program
Subject: Medical-Surgical Nursing II – ABG Interpretation (Metabolic Acidosis/Alkalosis, Respiratory
Acidosis/Alkalosis); ARDS (PEEP, Mechanical Ventilation, Vecuronium, Train-of-Four); Hepatitis A-E
(Transmission, S/S, Prevention, Treatment); Acute & Chronic Pancreatitis (Amylase/Lipase, Pain
Management, Nutrition, Surgery); Cirrhosis (3 Types, Clinical Manifestations, Spironolactone); Acute
Renal Failure (RIFLE Classification, Prerenal/Intrarenal/Postrenal Causes, AKI Phases); Chronic Kidney
Disease (GFR, Creatinine, Erythropoietin); Dialysis (Hemodialysis: AV Fistula/Graft; Peritoneal Dialysis:
APD/CAPD; Indications, Nutrition, Complications); Pulmonary Embolism (Heparin, Thrombolytics, V/Q
Scan, Prevention)
Source: NSG 223 Exam #2 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What are the ABG findings for Metabolic Acidosis?
Correct Answer: Low bicarbonate level less than 22 mEq/L and a low pH less than 7.35. The cardinal
feature is a decrease in the serum bicarbonate level.
1. Clinical manifestations: headache, confusion, increased respiratory rate and depth, hypotension, cool clammy skin,
dysrhythmias.
2. Treatment: Give bicarb; chronic metabolic acidosis treat calcium levels first; avoid tetany; watch for hypernatremia,
hyperkalemia, and hypocalcemia.
2. What are the ABG findings for Metabolic Alkalosis?
Correct Answer: pH greater than 7.45 and a serum bicarbonate concentration greater than 26.
1. Clinical manifestations: hypercalcemia, hypertonic muscles, depressed respirations, hypokalemia, decreased motility and
paralytic ileus. Potassium decreases causing PVCs or U waves on ECG.
2. Treatment: restore fluid volume, give electrolytes as needed (sodium chloride and potassium chloride), give Tagamet
(cimetidine).
3. What are the ABG findings for Respiratory Acidosis?
Correct Answer: pH is less than 7.35 and PaCO2 is greater than 45 with compensatory increases in
HCO3.
1. Acute clinical manifestations: wheezing, blurred vision, cyanosis in hands and feet. Chronic: memory loss, coordination
problems, sleepiness/headaches (obstructive sleep apnea), heart failure, polycythemia, pulmonary hypertension.
2. Acute treatment: underlying cause, bronchodilators, BiPAP. Chronic treatment: antibiotics, diuretics, bronchodilators,
corticosteroids, mechanical ventilation.
4. What are the ABG findings for Respiratory Alkalosis?
Correct Answer: pH is greater than 7.45 and the PaCO2 is less than 35.
1. Clinical manifestations: numbness or muscle spasms in hands and feet, tingling in arms, SOB, lightheaded.
2. Treatment: breathe into a bag (raise CO2), reassure patient, pursed lip breathing.
, 5. What are the clinical manifestations of ARDS?
Correct Answer: The acute phase of ARDS is marked by a rapid onset of severe dyspnea that usually
occurs less than 72 hours after the precipitating event. Arterial hypoxemia that does not respond to
supplemental oxygen is characteristic. Blue fingernails or blue tone to the skin or lips.
1. PEEP (positive end-expiratory pressure): increases residual capacity, opens collapsed alveoli, improves O2 with a lower
FiO2.
2. Mechanical ventilation goal: PaO2 >60 mm Hg or O2 saturation >90% at lowest possible FiO2.
6. What is Vecuronium and how is it monitored?
Correct Answer: Vecuronium: temporarily suspending nerve impulses at the neuromuscular junction. It
can be titrated to produce weakness through complete paralysis. Maximum neuromuscular blockade
occurs within 3-5 minutes, duration 25 to 40 minutes. A "train-of-four test" may be used to measure the
level of neuromuscular blockade.
1. Assess patient's airway and respiratory function following administration is most important.
2. With paralysis, patient appears unconscious; loses motor function; cannot breathe, talk, or blink independently. However,
patient retains sensation and is awake and able to hear.
7. What is the transmission route and prevention for Hepatitis A?
Correct Answer: Fecal-oral route. Ingestion of food or liquid infected with virus such as with fecal
matter, water, or shellfish from contaminated waters. Incubation period 2 to 6 weeks. Prevention:
Vaccine (2 doses, 6-12 months apart) and hand hygiene.
1. Hepatitis A S/S: flu-like upper respiratory tract infection with low-grade fever, vague epigastric distress (nausea,
heartburn, flatulence), sudden nausea and vomiting, RUQ pain, strong aversion to taste of cigarettes.
2. Intervention: bed rest, small frequent feedings, IV fluids with glucose, physical activity restrictions but ambulation is
encouraged.
8. What is the transmission route and prevention for Hepatitis B?
Correct Answer: Blood and body fluids. Having sex with an infected person, sharing needles, direct
contact with infected body fluids, mother to unborn child. Within 12 hours of birth, newborns need
treatment with Hep B antibody and Hep B vaccine. Prevention: Vaccine (3 doses over 6 months).
1. Hepatitis B S/S: fever, fatigue, loss of appetite, dark urine, jaundice, clay-colored stools.
2. Treatment: Injection antibody within 12 hours of exposure, rest, interferon. For chronic: anti-virals (pegylated interferon,
lamivudine, entecavir, tenofovir).
9. What is the transmission route for Hepatitis C and its treatment?
Correct Answer: Most common chronic bloodborne infection. NO BENEFIT from rest, diet, or
vitamin supplements. Treatment: combination of two antiviral agents, peginterferon and ribavirin
(Rebetol) for treating Hep C and preventing relapse. Acute Hep C: pegylated interferon. Chronic Hep C:
pegylated α-interferon given with ribavirin, DAAs.
1. Hepatitis C risk factors: children born to infected women, recipient of blood products/organ transplant before 1992,
sharing needles, long-term drug use.
2. Prevention: no vaccine available; avoid sharing needles; practice standard precautions.
Cirrhosis, Renal Failure, Dialysis, Pulmonary Embolism | Q&A | Grade A |
100% Correct (Verified Answers) – Nursing Program
Subject: Medical-Surgical Nursing II – ABG Interpretation (Metabolic Acidosis/Alkalosis, Respiratory
Acidosis/Alkalosis); ARDS (PEEP, Mechanical Ventilation, Vecuronium, Train-of-Four); Hepatitis A-E
(Transmission, S/S, Prevention, Treatment); Acute & Chronic Pancreatitis (Amylase/Lipase, Pain
Management, Nutrition, Surgery); Cirrhosis (3 Types, Clinical Manifestations, Spironolactone); Acute
Renal Failure (RIFLE Classification, Prerenal/Intrarenal/Postrenal Causes, AKI Phases); Chronic Kidney
Disease (GFR, Creatinine, Erythropoietin); Dialysis (Hemodialysis: AV Fistula/Graft; Peritoneal Dialysis:
APD/CAPD; Indications, Nutrition, Complications); Pulmonary Embolism (Heparin, Thrombolytics, V/Q
Scan, Prevention)
Source: NSG 223 Exam #2 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What are the ABG findings for Metabolic Acidosis?
Correct Answer: Low bicarbonate level less than 22 mEq/L and a low pH less than 7.35. The cardinal
feature is a decrease in the serum bicarbonate level.
1. Clinical manifestations: headache, confusion, increased respiratory rate and depth, hypotension, cool clammy skin,
dysrhythmias.
2. Treatment: Give bicarb; chronic metabolic acidosis treat calcium levels first; avoid tetany; watch for hypernatremia,
hyperkalemia, and hypocalcemia.
2. What are the ABG findings for Metabolic Alkalosis?
Correct Answer: pH greater than 7.45 and a serum bicarbonate concentration greater than 26.
1. Clinical manifestations: hypercalcemia, hypertonic muscles, depressed respirations, hypokalemia, decreased motility and
paralytic ileus. Potassium decreases causing PVCs or U waves on ECG.
2. Treatment: restore fluid volume, give electrolytes as needed (sodium chloride and potassium chloride), give Tagamet
(cimetidine).
3. What are the ABG findings for Respiratory Acidosis?
Correct Answer: pH is less than 7.35 and PaCO2 is greater than 45 with compensatory increases in
HCO3.
1. Acute clinical manifestations: wheezing, blurred vision, cyanosis in hands and feet. Chronic: memory loss, coordination
problems, sleepiness/headaches (obstructive sleep apnea), heart failure, polycythemia, pulmonary hypertension.
2. Acute treatment: underlying cause, bronchodilators, BiPAP. Chronic treatment: antibiotics, diuretics, bronchodilators,
corticosteroids, mechanical ventilation.
4. What are the ABG findings for Respiratory Alkalosis?
Correct Answer: pH is greater than 7.45 and the PaCO2 is less than 35.
1. Clinical manifestations: numbness or muscle spasms in hands and feet, tingling in arms, SOB, lightheaded.
2. Treatment: breathe into a bag (raise CO2), reassure patient, pursed lip breathing.
, 5. What are the clinical manifestations of ARDS?
Correct Answer: The acute phase of ARDS is marked by a rapid onset of severe dyspnea that usually
occurs less than 72 hours after the precipitating event. Arterial hypoxemia that does not respond to
supplemental oxygen is characteristic. Blue fingernails or blue tone to the skin or lips.
1. PEEP (positive end-expiratory pressure): increases residual capacity, opens collapsed alveoli, improves O2 with a lower
FiO2.
2. Mechanical ventilation goal: PaO2 >60 mm Hg or O2 saturation >90% at lowest possible FiO2.
6. What is Vecuronium and how is it monitored?
Correct Answer: Vecuronium: temporarily suspending nerve impulses at the neuromuscular junction. It
can be titrated to produce weakness through complete paralysis. Maximum neuromuscular blockade
occurs within 3-5 minutes, duration 25 to 40 minutes. A "train-of-four test" may be used to measure the
level of neuromuscular blockade.
1. Assess patient's airway and respiratory function following administration is most important.
2. With paralysis, patient appears unconscious; loses motor function; cannot breathe, talk, or blink independently. However,
patient retains sensation and is awake and able to hear.
7. What is the transmission route and prevention for Hepatitis A?
Correct Answer: Fecal-oral route. Ingestion of food or liquid infected with virus such as with fecal
matter, water, or shellfish from contaminated waters. Incubation period 2 to 6 weeks. Prevention:
Vaccine (2 doses, 6-12 months apart) and hand hygiene.
1. Hepatitis A S/S: flu-like upper respiratory tract infection with low-grade fever, vague epigastric distress (nausea,
heartburn, flatulence), sudden nausea and vomiting, RUQ pain, strong aversion to taste of cigarettes.
2. Intervention: bed rest, small frequent feedings, IV fluids with glucose, physical activity restrictions but ambulation is
encouraged.
8. What is the transmission route and prevention for Hepatitis B?
Correct Answer: Blood and body fluids. Having sex with an infected person, sharing needles, direct
contact with infected body fluids, mother to unborn child. Within 12 hours of birth, newborns need
treatment with Hep B antibody and Hep B vaccine. Prevention: Vaccine (3 doses over 6 months).
1. Hepatitis B S/S: fever, fatigue, loss of appetite, dark urine, jaundice, clay-colored stools.
2. Treatment: Injection antibody within 12 hours of exposure, rest, interferon. For chronic: anti-virals (pegylated interferon,
lamivudine, entecavir, tenofovir).
9. What is the transmission route for Hepatitis C and its treatment?
Correct Answer: Most common chronic bloodborne infection. NO BENEFIT from rest, diet, or
vitamin supplements. Treatment: combination of two antiviral agents, peginterferon and ribavirin
(Rebetol) for treating Hep C and preventing relapse. Acute Hep C: pegylated interferon. Chronic Hep C:
pegylated α-interferon given with ribavirin, DAAs.
1. Hepatitis C risk factors: children born to infected women, recipient of blood products/organ transplant before 1992,
sharing needles, long-term drug use.
2. Prevention: no vaccine available; avoid sharing needles; practice standard precautions.
