MDC II (NUR2392) Exam 2
Multidimensional Care II:
Questions with Answers| Rasmussen University| Updated|
Pass Guaranteed
1. Which ABG result represents uncompensated respiratory acidosis?
A. pH 7.30, PaCO2 40, HCO3 16
B. pH 7.48, PaCO2 30, HCO3 24
C. pH 7.49, PaCO2 40, HCO3 32
D. pH 7.30, PaCO2 56, HCO3 24
Answer: D. pH 7.30, PaCO2 56, HCO3 24
Rationale: Normal values: pH 7.35–7.45, PaCO2 35–45 mmHg, HCO3
22–26 mEq/L. A low pH with high PaCO2 and normal HCO3 shows a
respiratory cause with no renal compensation yet.
2. A patient with panic and hyperventilation has ABGs of pH 7.51,
PaCO2 29, HCO3 24. Which is the correct interpretation?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: B. Respiratory alkalosis
Rationale: High pH with low PaCO2 and normal HCO3 is respiratory
alkalosis. Treat the cause (anxiety, pain, hypoxemia, pulmonary embolism,
fever), coach slow breathing, and expect tingling and lightheadedness.
MDC II Exam 2 | Page 1
,3. ABGs: pH 7.30, PaCO2 30, HCO3 14. What is the interpretation?
A. Partially compensated metabolic acidosis
B. Compensated metabolic alkalosis
C. Partially compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: A. Partially compensated metabolic acidosis
Rationale: Low pH and low HCO3 indicate metabolic acidosis; the low
PaCO2 shows respiratory compensation, but pH remains abnormal, so it is
partial.
4. A patient with chronic COPD has ABGs of pH 7.37, PaCO2 58, HCO3
34. What does this most likely indicate?
A. Normal ABGs
B. Metabolic alkalosis
C. Fully compensated respiratory acidosis
D. Acute respiratory failure
Answer: C. Fully compensated respiratory acidosis
Rationale: The pH is normal (on the acidic side of 7.40) while PaCO2 is
high; the kidneys have retained bicarbonate to compensate over days.
Chronic CO2 retainers should receive cautious oxygen titration.
5. Which condition commonly causes metabolic acidosis with an
increased anion gap?
A. Renal tubular acidosis
B. Severe diarrhea
C. Diabetic ketoacidosis
D. Excessive normal saline
Answer: C. Diabetic ketoacidosis
Rationale: High anion gap causes follow the mnemonic MUDPILES
(methanol, uremia, DKA, propylene glycol, isoniazid/iron, lactic acidosis,
ethylene glycol, salicylates). Diarrhea and renal tubular acidosis cause
normal-gap acidosis.
MDC II Exam 2 | Page 2
, 6. A patient with persistent vomiting and NG suction develops
metabolic alkalosis. Which finding is expected?
A. Slow, shallow respirations, hypokalemia, and possible tetany
B. Hyperventilation with tingling only
C. Warm, flushed skin and hypotension
D. Kussmaul breathing and hyperkalemia
Answer: A. Slow, shallow respirations, hypokalemia, and possible
tetany
Rationale: Loss of hydrochloric acid raises pH. The lungs compensate by
hypoventilating. Treat with isotonic saline, potassium replacement, and
antiemetics.
7. A patient with an opioid overdose has RR 6 and ABGs of pH 7.25,
PaCO2 68. What is the priority intervention?
A. Support ventilation and administer naloxone as ordered
B. Encourage deep breathing only
C. Administer oxygen at 2 L and observe
D. Give sodium bicarbonate
Answer: A. Support ventilation and administer naloxone as ordered
Rationale: Hypoventilation causes CO2 retention and respiratory acidosis.
Naloxone reverses opioids; ventilation with bag-valve mask or intubation
may be needed.
8. Which nursing action is appropriate for a patient with chronic CO2
retention in respiratory acidosis due to COPD exacerbation?
A. Restrict all oxygen
B. Titrate oxygen carefully to target SpO2 88–92% and consider
noninvasive ventilation
C. Apply oxygen at 15 L non-rebreather routinely
D. Sedate the patient
Answer: B. Titrate oxygen carefully to target SpO2 88–92% and
consider noninvasive ventilation
Rationale: Excess oxygen can blunt hypoxic drive and worsen
hypercapnia in some patients. BiPAP, bronchodilators, and steroids treat
the underlying problem.
MDC II Exam 2 | Page 3
Multidimensional Care II:
Questions with Answers| Rasmussen University| Updated|
Pass Guaranteed
1. Which ABG result represents uncompensated respiratory acidosis?
A. pH 7.30, PaCO2 40, HCO3 16
B. pH 7.48, PaCO2 30, HCO3 24
C. pH 7.49, PaCO2 40, HCO3 32
D. pH 7.30, PaCO2 56, HCO3 24
Answer: D. pH 7.30, PaCO2 56, HCO3 24
Rationale: Normal values: pH 7.35–7.45, PaCO2 35–45 mmHg, HCO3
22–26 mEq/L. A low pH with high PaCO2 and normal HCO3 shows a
respiratory cause with no renal compensation yet.
2. A patient with panic and hyperventilation has ABGs of pH 7.51,
PaCO2 29, HCO3 24. Which is the correct interpretation?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: B. Respiratory alkalosis
Rationale: High pH with low PaCO2 and normal HCO3 is respiratory
alkalosis. Treat the cause (anxiety, pain, hypoxemia, pulmonary embolism,
fever), coach slow breathing, and expect tingling and lightheadedness.
MDC II Exam 2 | Page 1
,3. ABGs: pH 7.30, PaCO2 30, HCO3 14. What is the interpretation?
A. Partially compensated metabolic acidosis
B. Compensated metabolic alkalosis
C. Partially compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: A. Partially compensated metabolic acidosis
Rationale: Low pH and low HCO3 indicate metabolic acidosis; the low
PaCO2 shows respiratory compensation, but pH remains abnormal, so it is
partial.
4. A patient with chronic COPD has ABGs of pH 7.37, PaCO2 58, HCO3
34. What does this most likely indicate?
A. Normal ABGs
B. Metabolic alkalosis
C. Fully compensated respiratory acidosis
D. Acute respiratory failure
Answer: C. Fully compensated respiratory acidosis
Rationale: The pH is normal (on the acidic side of 7.40) while PaCO2 is
high; the kidneys have retained bicarbonate to compensate over days.
Chronic CO2 retainers should receive cautious oxygen titration.
5. Which condition commonly causes metabolic acidosis with an
increased anion gap?
A. Renal tubular acidosis
B. Severe diarrhea
C. Diabetic ketoacidosis
D. Excessive normal saline
Answer: C. Diabetic ketoacidosis
Rationale: High anion gap causes follow the mnemonic MUDPILES
(methanol, uremia, DKA, propylene glycol, isoniazid/iron, lactic acidosis,
ethylene glycol, salicylates). Diarrhea and renal tubular acidosis cause
normal-gap acidosis.
MDC II Exam 2 | Page 2
, 6. A patient with persistent vomiting and NG suction develops
metabolic alkalosis. Which finding is expected?
A. Slow, shallow respirations, hypokalemia, and possible tetany
B. Hyperventilation with tingling only
C. Warm, flushed skin and hypotension
D. Kussmaul breathing and hyperkalemia
Answer: A. Slow, shallow respirations, hypokalemia, and possible
tetany
Rationale: Loss of hydrochloric acid raises pH. The lungs compensate by
hypoventilating. Treat with isotonic saline, potassium replacement, and
antiemetics.
7. A patient with an opioid overdose has RR 6 and ABGs of pH 7.25,
PaCO2 68. What is the priority intervention?
A. Support ventilation and administer naloxone as ordered
B. Encourage deep breathing only
C. Administer oxygen at 2 L and observe
D. Give sodium bicarbonate
Answer: A. Support ventilation and administer naloxone as ordered
Rationale: Hypoventilation causes CO2 retention and respiratory acidosis.
Naloxone reverses opioids; ventilation with bag-valve mask or intubation
may be needed.
8. Which nursing action is appropriate for a patient with chronic CO2
retention in respiratory acidosis due to COPD exacerbation?
A. Restrict all oxygen
B. Titrate oxygen carefully to target SpO2 88–92% and consider
noninvasive ventilation
C. Apply oxygen at 15 L non-rebreather routinely
D. Sedate the patient
Answer: B. Titrate oxygen carefully to target SpO2 88–92% and
consider noninvasive ventilation
Rationale: Excess oxygen can blunt hypoxic drive and worsen
hypercapnia in some patients. BiPAP, bronchodilators, and steroids treat
the underlying problem.
MDC II Exam 2 | Page 3
