,Hondros NUR 160 Exam 2 | Fundamental Concepts
of Practical Nursing II (2026) Q&A
1. A client is admitted with severe vomiting and diarrhea. Which acid-base imbalance
should the nurse anticipate?
A) Metabolic alkalosis
B) Metabolic acidosis
C) Respiratory alkalosis
D) Respiratory acidosis
Correct Answer: Metabolic acidosis
Rationale: Severe vomiting and diarrhea cause significant loss of bicarbonate-rich
intestinal fluids, leading to metabolic acidosis. While vomiting alone can cause metabolic
alkalosis, the combination with diarrhea typically results in a net loss of bicarbonate,
producing a metabolic acidosis. Respiratory alkalosis and acidosis are not directly caused
by gastrointestinal fluid loss.
2. An arterial blood gas result shows pH 7.25, PaCO2 50 mm Hg, and HCO3 26 mEq/L. How
should the nurse interpret this finding?
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory acidosis
,Rationale: A pH below 7.35 indicates acidosis, and an elevated PaCO2 above 45 mm Hg
identifies the respiratory system as the primary cause. The bicarbonate level is near
normal, indicating no metabolic compensation has occurred yet. This pattern is
characteristic of respiratory acidosis, often due to hypoventilation.
3. A client with a history of COPD presents with a pH of 7.30, PaCO2 of 55 mm Hg, and
HCO3 of 28 mEq/L. Which condition is most consistent with these findings?
A) Uncompensated metabolic acidosis
B) Compensated respiratory acidosis
C) Uncompensated respiratory alkalosis
D) Partially compensated metabolic alkalosis
Correct Answer: Compensated respiratory acidosis
Rationale: The pH is acidotic, and the PaCO2 is elevated, indicating respiratory acidosis.
The bicarbonate level is elevated above normal, showing metabolic compensation by the
kidneys. Because the pH remains slightly below 7.35, the compensation is partial, making
compensated respiratory acidosis the most accurate description.
4. Which client is at highest risk for developing hypovolemia?
A) A client with heart failure receiving IV fluids
B) A client with prolonged diarrhea and inadequate oral intake
C) A client with syndrome of inappropriate antidiuretic hormone
D) A client receiving excessive sodium chloride infusions
, Correct Answer: A client with prolonged diarrhea and inadequate oral intake
Rationale: Prolonged diarrhea causes significant fluid and electrolyte loss, and
inadequate oral intake prevents replacement, leading to hypovolemia. Heart failure with IV
fluids, SIADH, and excessive sodium chloride infusions are associated with hypervolemia
rather than hypovolemia.
5. A nurse is assessing a client for hypovolemia. Which finding should the nurse expect?
A) Bounding pulses and hypertension
B) Crackles and jugular venous distention
C) Poor skin turgor and decreased urine output
D) Peripheral edema and weight gain
Correct Answer: Poor skin turgor and decreased urine output
Rationale: Hypovolemia reduces intravascular volume and tissue perfusion, leading to
poor skin turgor, decreased urine output, tachycardia, and orthostatic hypotension.
Bounding pulses, hypertension, crackles, jugular venous distention, edema, and weight gain
are signs of hypervolemia.
6. Which condition is a common cause of hypervolemia?
A) Excessive vomiting
B) Heart failure
C) Severe dehydration
D) Hemorrhage
of Practical Nursing II (2026) Q&A
1. A client is admitted with severe vomiting and diarrhea. Which acid-base imbalance
should the nurse anticipate?
A) Metabolic alkalosis
B) Metabolic acidosis
C) Respiratory alkalosis
D) Respiratory acidosis
Correct Answer: Metabolic acidosis
Rationale: Severe vomiting and diarrhea cause significant loss of bicarbonate-rich
intestinal fluids, leading to metabolic acidosis. While vomiting alone can cause metabolic
alkalosis, the combination with diarrhea typically results in a net loss of bicarbonate,
producing a metabolic acidosis. Respiratory alkalosis and acidosis are not directly caused
by gastrointestinal fluid loss.
2. An arterial blood gas result shows pH 7.25, PaCO2 50 mm Hg, and HCO3 26 mEq/L. How
should the nurse interpret this finding?
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory acidosis
,Rationale: A pH below 7.35 indicates acidosis, and an elevated PaCO2 above 45 mm Hg
identifies the respiratory system as the primary cause. The bicarbonate level is near
normal, indicating no metabolic compensation has occurred yet. This pattern is
characteristic of respiratory acidosis, often due to hypoventilation.
3. A client with a history of COPD presents with a pH of 7.30, PaCO2 of 55 mm Hg, and
HCO3 of 28 mEq/L. Which condition is most consistent with these findings?
A) Uncompensated metabolic acidosis
B) Compensated respiratory acidosis
C) Uncompensated respiratory alkalosis
D) Partially compensated metabolic alkalosis
Correct Answer: Compensated respiratory acidosis
Rationale: The pH is acidotic, and the PaCO2 is elevated, indicating respiratory acidosis.
The bicarbonate level is elevated above normal, showing metabolic compensation by the
kidneys. Because the pH remains slightly below 7.35, the compensation is partial, making
compensated respiratory acidosis the most accurate description.
4. Which client is at highest risk for developing hypovolemia?
A) A client with heart failure receiving IV fluids
B) A client with prolonged diarrhea and inadequate oral intake
C) A client with syndrome of inappropriate antidiuretic hormone
D) A client receiving excessive sodium chloride infusions
, Correct Answer: A client with prolonged diarrhea and inadequate oral intake
Rationale: Prolonged diarrhea causes significant fluid and electrolyte loss, and
inadequate oral intake prevents replacement, leading to hypovolemia. Heart failure with IV
fluids, SIADH, and excessive sodium chloride infusions are associated with hypervolemia
rather than hypovolemia.
5. A nurse is assessing a client for hypovolemia. Which finding should the nurse expect?
A) Bounding pulses and hypertension
B) Crackles and jugular venous distention
C) Poor skin turgor and decreased urine output
D) Peripheral edema and weight gain
Correct Answer: Poor skin turgor and decreased urine output
Rationale: Hypovolemia reduces intravascular volume and tissue perfusion, leading to
poor skin turgor, decreased urine output, tachycardia, and orthostatic hypotension.
Bounding pulses, hypertension, crackles, jugular venous distention, edema, and weight gain
are signs of hypervolemia.
6. Which condition is a common cause of hypervolemia?
A) Excessive vomiting
B) Heart failure
C) Severe dehydration
D) Hemorrhage
