ABG PRACTICE II PRACTICE QUESTIONS AND
DETAILED SOLUTIONS
◉ A client with a history of lung disease is at risk for developing
respiratory acidosis. The nurse would assess the client for which
signs and symptoms characteristic of this disorder?
Bradycardia and hyperactivity
Decreased respiratory rate and depth
Headache, restlessness, and confusion
Bradypnea, dizziness, and paresthesias.
Answer: Headache, restlessness, and confusion
When a client is experiencing respiratory acidosis, the respiratory
rate and depth increase in an attempt to compensate. The client also
experiences headache; restlessness; mental status changes, such as
drowsiness and confusion; visual disturbances; diaphoresis;
cyanosis as the hypoxia becomes more acute; hyperkalemia; rapid,
irregular pulse; and dysrhythmias. Options 1, 2, and 4 are not
specifically associated with this disorder.
◉ A client with a fractured femur experiences sudden dyspnea,
tachypnea, and tachycardia. A set of arterial blood gas tests reveals
the following: pH, 7.35 (7.35); Paco2, 43 mm Hg (43 mm Hg); Pao2,
,58 mm Hg (58 mm Hg); HCO3, 23 mEq/L (23 mmol/L). The nurse
interprets that the client probably has experienced fat embolus
because of the result of which parameter?
pH
Pao2
Hco3
Paco2.
Answer: Pao2
A significant feature of fat embolism is a significant degree of
hypoxemia, with a Pao2 often less than 60 mm Hg (60 mm Hg). The
data in the question indicate that the items in the remaining options
are normal blood gas results.
◉ A client with chronic obstructive pulmonary disease who
sustained a head injury has a high level of carbon dioxide (CO2) in
the bloodstream, as measured by arterial blood gases. The nurse
anticipates that which underlying pathophysiology can occur as a
result of this elevated CO2?
It will cause arteriovenous shunting.
It will cause vasodilation of blood vessels in the brain.
It will cause blood vessels in the circle of Willis to collapse.
,It will cause hyperresponsiveness of blood vessels in the brain..
Answer: It will cause vasodilation of blood vessels in the brain.
CO2 is one of the metabolic end products that can alter the tone of
the blood vessels in the brain. High CO2 levels cause vasodilation,
which may cause headache, whereas low CO2 levels cause
vasoconstriction, which may cause light-headedness. The statements
included in the other options are incorrect effects.
◉ The nurse is caring for a hospitalized client with chronic
obstructive pulmonary disease who is retaining carbon dioxide
(CO2). The nurse anticipates which physical response will initially
occur?
The client will lose consciousness.
The client's sodium and chloride levels will rise.
The client will complain of facial numbness and tingling.
The client's arterial blood gas results will reflect acidosis..
Answer: The client's sodium and chloride levels will rise.
When the client with respiratory disease retains CO2, a rise in CO2
will occur. This results in a corresponding fall in pH, thus respiratory
acidosis. This concept forms the basis for key aspects of acid-base
balance. The other options are incorrect and are not associated with
this initial physical response.
, ◉ The nurse caring for a client with chronic obstructive pulmonary
disease (COPD) anticipates which arterial blood gas (ABG) findings?
pH, 7.40; PaO2, 90 mm Hg; CO2, 39 mEq/L; HCO3, 23 mEq/L
pH, 7.32; PaO2, 85 mm Hg; CO2, 57 mEq/L; HCO3, 26 mEq/L
pH, 7.47; PaO2, 82 mm Hg; CO2, 30 mEq/L; HCO3, 31 mEq/L
pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19 mEq/L.
Answer: pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19
mEq/L
A client with COPD will exist in a state of respiratory acidosis.
Options 2 and 4 reflect an acidotic pH. However, option 2
demonstrates increased CO2; a decreased pH and an increased CO2
indicate respiratory acidosis. Increased CO2 acts as an acid in the
body, and CO2 is elevated in the client with COPD because of an
inability to exhale well and eliminate CO2. Therefore, with a rise in
CO2, there is a corresponding fall in pH. The other options are
incorrect.
◉ A client with no history of respiratory disease is admitted to the
hospital with respiratory failure. Which results on the arterial blood
gas report that are consistent with this disorder would the nurse
expect to note?
DETAILED SOLUTIONS
◉ A client with a history of lung disease is at risk for developing
respiratory acidosis. The nurse would assess the client for which
signs and symptoms characteristic of this disorder?
Bradycardia and hyperactivity
Decreased respiratory rate and depth
Headache, restlessness, and confusion
Bradypnea, dizziness, and paresthesias.
Answer: Headache, restlessness, and confusion
When a client is experiencing respiratory acidosis, the respiratory
rate and depth increase in an attempt to compensate. The client also
experiences headache; restlessness; mental status changes, such as
drowsiness and confusion; visual disturbances; diaphoresis;
cyanosis as the hypoxia becomes more acute; hyperkalemia; rapid,
irregular pulse; and dysrhythmias. Options 1, 2, and 4 are not
specifically associated with this disorder.
◉ A client with a fractured femur experiences sudden dyspnea,
tachypnea, and tachycardia. A set of arterial blood gas tests reveals
the following: pH, 7.35 (7.35); Paco2, 43 mm Hg (43 mm Hg); Pao2,
,58 mm Hg (58 mm Hg); HCO3, 23 mEq/L (23 mmol/L). The nurse
interprets that the client probably has experienced fat embolus
because of the result of which parameter?
pH
Pao2
Hco3
Paco2.
Answer: Pao2
A significant feature of fat embolism is a significant degree of
hypoxemia, with a Pao2 often less than 60 mm Hg (60 mm Hg). The
data in the question indicate that the items in the remaining options
are normal blood gas results.
◉ A client with chronic obstructive pulmonary disease who
sustained a head injury has a high level of carbon dioxide (CO2) in
the bloodstream, as measured by arterial blood gases. The nurse
anticipates that which underlying pathophysiology can occur as a
result of this elevated CO2?
It will cause arteriovenous shunting.
It will cause vasodilation of blood vessels in the brain.
It will cause blood vessels in the circle of Willis to collapse.
,It will cause hyperresponsiveness of blood vessels in the brain..
Answer: It will cause vasodilation of blood vessels in the brain.
CO2 is one of the metabolic end products that can alter the tone of
the blood vessels in the brain. High CO2 levels cause vasodilation,
which may cause headache, whereas low CO2 levels cause
vasoconstriction, which may cause light-headedness. The statements
included in the other options are incorrect effects.
◉ The nurse is caring for a hospitalized client with chronic
obstructive pulmonary disease who is retaining carbon dioxide
(CO2). The nurse anticipates which physical response will initially
occur?
The client will lose consciousness.
The client's sodium and chloride levels will rise.
The client will complain of facial numbness and tingling.
The client's arterial blood gas results will reflect acidosis..
Answer: The client's sodium and chloride levels will rise.
When the client with respiratory disease retains CO2, a rise in CO2
will occur. This results in a corresponding fall in pH, thus respiratory
acidosis. This concept forms the basis for key aspects of acid-base
balance. The other options are incorrect and are not associated with
this initial physical response.
, ◉ The nurse caring for a client with chronic obstructive pulmonary
disease (COPD) anticipates which arterial blood gas (ABG) findings?
pH, 7.40; PaO2, 90 mm Hg; CO2, 39 mEq/L; HCO3, 23 mEq/L
pH, 7.32; PaO2, 85 mm Hg; CO2, 57 mEq/L; HCO3, 26 mEq/L
pH, 7.47; PaO2, 82 mm Hg; CO2, 30 mEq/L; HCO3, 31 mEq/L
pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19 mEq/L.
Answer: pH, 7.31; PaO2, 95 mm Hg; CO2, 22 mEq/L; HCO3, 19
mEq/L
A client with COPD will exist in a state of respiratory acidosis.
Options 2 and 4 reflect an acidotic pH. However, option 2
demonstrates increased CO2; a decreased pH and an increased CO2
indicate respiratory acidosis. Increased CO2 acts as an acid in the
body, and CO2 is elevated in the client with COPD because of an
inability to exhale well and eliminate CO2. Therefore, with a rise in
CO2, there is a corresponding fall in pH. The other options are
incorrect.
◉ A client with no history of respiratory disease is admitted to the
hospital with respiratory failure. Which results on the arterial blood
gas report that are consistent with this disorder would the nurse
expect to note?
