Practical Nursing II (2026) Q&A
1. A client with prolonged vomiting is at risk for which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Prolonged vomiting causes loss of gastric acid (hydrochloric acid), leading to a
loss of hydrogen and chloride ions, which results in metabolic alkalosis. Metabolic acidosis
is more associated with diarrhea or renal failure, while respiratory imbalances affect
carbon dioxide levels.
2. Which finding is most consistent with metabolic acidosis?
A) pH 7.48, HCO3 30 mEq/L
B) pH 7.30, HCO3 18 mEq/L
C) pH 7.50, PaCO2 30 mm Hg
D) pH 7.30, PaCO2 50 mm Hg
Correct Answer: pH 7.30, HCO3 18 mEq/L
,Rationale: Metabolic acidosis is characterized by a low pH (below 7.35) and a low
bicarbonate level (below 22 mEq/L). Option A shows metabolic alkalosis, and options C and
D represent respiratory alkalosis and acidosis, respectively.
3. What is the primary treatment goal for a client with respiratory acidosis?
A) Increasing the respiratory rate
B) Improving ventilation and oxygenation
C) Administering sodium bicarbonate
D) Restricting fluids
Correct Answer: Improving ventilation and oxygenation
Rationale: Respiratory acidosis is caused by hypoventilation, leading to CO2 retention.
The primary treatment is to improve ventilation and oxygenation through measures such as
oxygen therapy, breathing treatments, and positioning (e.g., High Fowler's). Sodium
bicarbonate is not the primary treatment for respiratory acidosis.
4. A client's arterial blood gas shows a pH of 7.49, PaCO2 of 29 mm Hg, and HCO3 of 24
mEq/L. Which condition is this?
A) Respiratory alkalosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Metabolic acidosis
Correct Answer: Respiratory alkalosis
, Rationale: An elevated pH (above 7.45) with a decreased PaCO2 (below 35 mm Hg)
indicates respiratory alkalosis, often caused by hyperventilation. The bicarbonate level is
normal, ruling out a primary metabolic cause.
5. Diarrhea can lead to which acid-base imbalance?
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic acidosis
Rationale: Diarrhea causes a loss of bicarbonate-rich intestinal fluids, which can lead to a
decrease in serum bicarbonate and result in metabolic acidosis. Vomiting, in contrast,
typically causes metabolic alkalosis.
6. A client is prescribed 0.5 g of a medication. The pharmacy provides a liquid labeled 250
mg/5 mL. How many milliliters should the nurse administer?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
Correct Answer: 10 mL