Chapter 8, Acid–Base Balances
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is analyzing an arterial blood gas report of a client with chronic obstructive pulmonary
disease and respiratory acidosis. Which compensation mechanism is likely to occur?
1. The kidneys will retain bicarbonate.
2. The kidneys will excrete bicarbonate.
3. The lungs will retain carbon dioxide.
4. The lungs will excrete carbon dioxide.
2. The nurse is caring for a client who has been diagnosed with renal failure. Which mechanism of
compensation for the acid–base disturbance does the nurse recognize in the client?
1. The client retains carbon dioxide in excess.
2. The client’s oxygen saturation level improves.
3. The client’s blood pH decreases from the present value.
4. The client breathes rapidly to eliminate carbon dioxide.
3. A nurse is caring for a client who is anxious and dizzy after a traumatic experience. The arterial
blood gas findings include a pH level of 7.48, partial pressure of oxygen at 110, partial pressure of
carbon dioxide at 25, and bicarbonate at 2D. Which initial intervention does the nurse implement?
1. Administer antidepressants
2. Administer oxygen throN ugUhRaSmIaNskGTB.COM
3. Encourage the client to breathe into a paper bag
4. Administer sodium bicarbonate intravenously
4. An unconscious client is brought to the hospital. The client’s arterial blood gases show a pH greater
than 7.45 and a bicarbonate level of 36 mEq/L. Which acid–base imbalance has the client
developed?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
5. An older adult client is exhibiting lethargy, confusion, and a respiratory rate of 8 breaths per minute.
The nurse sees that the last dose of medication administered through a client-controlled analgesic
pump was within the last 30 minutes. Which acid–base disorder might the client have developed?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
6. Which factor does hyperventilation of the lungs increase?
1. Blood pH
2. Acid in the blood
3. Carbon dioxide in the blood
4. Carbonic acid in the blood
, 7. The nurse is providing care for a client with an undiagnosed illness. Calculations of the anion gap
indicate an elevation, and the client is identified as being positive for metabolic acidosis. Which
question does the nurse ask the client?
1. “Do you have a history of cardiac problems?”
2. “Have you noticed any respiratory distress?”
3. “Are you taking regular doses of aspirin?”
4. “Do you medicate for any stomach issues?”
8. The nurse is reviewing the laboratory results for a client, which are blood pH 7.36, PCO2 48 mm Hg,
PO2 96 mm Hg, HCO3 24 mEq/L, and SaO2 98% on room air. Which condition does the nurse
recognize based on the displayed values?
1. Hypoxia
2. Respiratory acidosis
3. Hypercapnia
4. Metabolic alkalosis
9. Which is an acidic pH of blood?
1. 6.00
2. 7.40
3. 8.00
4. 8.35
10. Which condition develops due to metabolic acidosis with an elevated anion gap?
1. Ketoacidosis
2. Hypoaldosteronism
NURSINGTB.COM
3. Hyperalimentation
4. Increased renal HCO3– loss
11. A client who is taking a licensure examination is nervous and breathing rapidly in the examination
hall. Which acid–base imbalance is the client at risk for developing?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
12. The nurse is providing care to a client admitted to the intensive care unit (ICU) after a severe
accident. The client has several fractured ribs and lost a considerable amount of blood due to
lacerations. What is the nurse’s primary concern when monitoring the client for acid-base
imbalances?
1. Decreased protein levels
2. Increased phosphate levels
3. Increased carbonic acid and bicarbonate levels
4. Decreased carbon dioxide levels
13. Which condition is caused by an increase in the amount of potassium in the blood?
1. Hypocapnia
2. Hypotension
3. Hyperkalemia
, 4. Hypercalcemia
14. A comatose client’s blood pH is 7.1, partial pressure of carbon dioxide is 16 millimeters of mercury,
and bicarbonate concentration is 5 milliequivalent/liter. Which acid–base imbalance has the client
developed?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. None of the above
15. Which is a physical assessment finding of respiratory acidosis?
1. Cyanosis
2. Tachycardia
3. Hypotension
4. Hypertension
16. The nurse is providing care for a client experiencing respiratory acidosis. The health-care provider
prescribes that the client be placed on mechanical ventilation and be administered sodium
bicarbonate. Which understanding does the nurse have regarding the prescribed treatment?
1. Prescribed care will resolve the origin of the imbalance
2. The prescription will assist in retaining hydrogen (H+)
3. Kidney compensation for acidosis is a slow process
4. Respiratory acidosis does not respond to buffering
17. Which change in arterial bloNoU
dRgS
asI
esNdGoT
esBt.
heCnOuM
rse expect to occur as a result of hypoventilation?
1. Partial pressure of CO2 increases.
2. Lungs decrease carbon dioxide.
3. Respiratory alkalosis occurs.
4. The level of CO2 is decreased.
18. Which is the compound that donates hydrogen ions in a solution?
1. Acid
2. Base
3. Buffer
4. Oxygen
19. The nurse is providing care to a patient with metabolic acidosis. For which reason does the nurse
note a laboratory result indicating hyperkalemia?
1. K+ ions force the H+ ions into cells.
2. The kidneys are inundated with H+ ions.
3. The abundance of H+ ions moves into cells.
4. H+ ions are filtered out of the blood by the kidneys.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
20. Which information is interpreted from arterial blood gas values? Select all that apply.
1. Presence of acidosis and alkalosis
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is analyzing an arterial blood gas report of a client with chronic obstructive pulmonary
disease and respiratory acidosis. Which compensation mechanism is likely to occur?
1. The kidneys will retain bicarbonate.
2. The kidneys will excrete bicarbonate.
3. The lungs will retain carbon dioxide.
4. The lungs will excrete carbon dioxide.
2. The nurse is caring for a client who has been diagnosed with renal failure. Which mechanism of
compensation for the acid–base disturbance does the nurse recognize in the client?
1. The client retains carbon dioxide in excess.
2. The client’s oxygen saturation level improves.
3. The client’s blood pH decreases from the present value.
4. The client breathes rapidly to eliminate carbon dioxide.
3. A nurse is caring for a client who is anxious and dizzy after a traumatic experience. The arterial
blood gas findings include a pH level of 7.48, partial pressure of oxygen at 110, partial pressure of
carbon dioxide at 25, and bicarbonate at 2D. Which initial intervention does the nurse implement?
1. Administer antidepressants
2. Administer oxygen throN ugUhRaSmIaNskGTB.COM
3. Encourage the client to breathe into a paper bag
4. Administer sodium bicarbonate intravenously
4. An unconscious client is brought to the hospital. The client’s arterial blood gases show a pH greater
than 7.45 and a bicarbonate level of 36 mEq/L. Which acid–base imbalance has the client
developed?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
5. An older adult client is exhibiting lethargy, confusion, and a respiratory rate of 8 breaths per minute.
The nurse sees that the last dose of medication administered through a client-controlled analgesic
pump was within the last 30 minutes. Which acid–base disorder might the client have developed?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
6. Which factor does hyperventilation of the lungs increase?
1. Blood pH
2. Acid in the blood
3. Carbon dioxide in the blood
4. Carbonic acid in the blood
, 7. The nurse is providing care for a client with an undiagnosed illness. Calculations of the anion gap
indicate an elevation, and the client is identified as being positive for metabolic acidosis. Which
question does the nurse ask the client?
1. “Do you have a history of cardiac problems?”
2. “Have you noticed any respiratory distress?”
3. “Are you taking regular doses of aspirin?”
4. “Do you medicate for any stomach issues?”
8. The nurse is reviewing the laboratory results for a client, which are blood pH 7.36, PCO2 48 mm Hg,
PO2 96 mm Hg, HCO3 24 mEq/L, and SaO2 98% on room air. Which condition does the nurse
recognize based on the displayed values?
1. Hypoxia
2. Respiratory acidosis
3. Hypercapnia
4. Metabolic alkalosis
9. Which is an acidic pH of blood?
1. 6.00
2. 7.40
3. 8.00
4. 8.35
10. Which condition develops due to metabolic acidosis with an elevated anion gap?
1. Ketoacidosis
2. Hypoaldosteronism
NURSINGTB.COM
3. Hyperalimentation
4. Increased renal HCO3– loss
11. A client who is taking a licensure examination is nervous and breathing rapidly in the examination
hall. Which acid–base imbalance is the client at risk for developing?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
12. The nurse is providing care to a client admitted to the intensive care unit (ICU) after a severe
accident. The client has several fractured ribs and lost a considerable amount of blood due to
lacerations. What is the nurse’s primary concern when monitoring the client for acid-base
imbalances?
1. Decreased protein levels
2. Increased phosphate levels
3. Increased carbonic acid and bicarbonate levels
4. Decreased carbon dioxide levels
13. Which condition is caused by an increase in the amount of potassium in the blood?
1. Hypocapnia
2. Hypotension
3. Hyperkalemia
, 4. Hypercalcemia
14. A comatose client’s blood pH is 7.1, partial pressure of carbon dioxide is 16 millimeters of mercury,
and bicarbonate concentration is 5 milliequivalent/liter. Which acid–base imbalance has the client
developed?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. None of the above
15. Which is a physical assessment finding of respiratory acidosis?
1. Cyanosis
2. Tachycardia
3. Hypotension
4. Hypertension
16. The nurse is providing care for a client experiencing respiratory acidosis. The health-care provider
prescribes that the client be placed on mechanical ventilation and be administered sodium
bicarbonate. Which understanding does the nurse have regarding the prescribed treatment?
1. Prescribed care will resolve the origin of the imbalance
2. The prescription will assist in retaining hydrogen (H+)
3. Kidney compensation for acidosis is a slow process
4. Respiratory acidosis does not respond to buffering
17. Which change in arterial bloNoU
dRgS
asI
esNdGoT
esBt.
heCnOuM
rse expect to occur as a result of hypoventilation?
1. Partial pressure of CO2 increases.
2. Lungs decrease carbon dioxide.
3. Respiratory alkalosis occurs.
4. The level of CO2 is decreased.
18. Which is the compound that donates hydrogen ions in a solution?
1. Acid
2. Base
3. Buffer
4. Oxygen
19. The nurse is providing care to a patient with metabolic acidosis. For which reason does the nurse
note a laboratory result indicating hyperkalemia?
1. K+ ions force the H+ ions into cells.
2. The kidneys are inundated with H+ ions.
3. The abundance of H+ ions moves into cells.
4. H+ ions are filtered out of the blood by the kidneys.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
20. Which information is interpreted from arterial blood gas values? Select all that apply.
1. Presence of acidosis and alkalosis
