Miami Dade College
2 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 2
AC I D - B A S E B A L A N C E · G I D I S O R D E RS · N U T R I T I O N & E L I M I N AT I O N
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Examination 2 — COURSE TITLE Med-Surg Nursing II
Comprehensive
TOTAL QUESTIONS 54 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers acid-base balance interpretation, GI disorders, GERD/PUD management, IBD vs. IBS,
ostomy care, parenteral nutrition, and GI medications.
▸ Normal lab values are integrated throughout the rationales for clinical decision-making.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All pharmacological and clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 54
1. What is the normal pH range for arterial blood?
A. 7.25–7.35
B. 7.35–7.45
C. 7.45–7.55
D. 7.20–7.30
CORRECT ANSWER B — 7.35–7.45.
RATIONALE Normal arterial blood pH is 7.35–7.45. A pH below 7.35 indicates acidosis; a pH
above 7.45 indicates alkalosis. The body maintains this narrow range through
buffer systems, respiratory regulation (CO₂ via lungs), and renal regulation (HCO₃
via kidneys). Even small deviations can significantly impair enzyme function and
cellular processes.
2. What is the normal range for PaCO₂ (partial pressure of carbon dioxide)?
A. 22–26 mEq/L
B. 35–45 mmHg
C. 80–100 mmHg
D. 7.35–7.45
CORRECT ANSWER B — 35–45 mmHg.
RATIONALE Normal PaCO₂ is 35–45 mmHg. CO₂ is regulated by the lungs — it is the respiratory
component of acid-base balance. CO₂ + H₂O ↔ H₂CO₃ ↔ H⁺ + HCO₃⁻. Elevated CO₂
(>45) = respiratory acidosis (hypoventilation). Decreased CO₂ (<35) = respiratory
alkalosis (hyperventilation). Remember: CO₂ = lungs.
, 3. What is the normal range for HCO₃⁻ (bicarbonate)?
A. 35–45 mmHg
B. 7.35–7.45
C. 22–26 mEq/L
D. 3.5–5.0 mEq/L
CORRECT ANSWER C — 22–26 mEq/L.
RATIONALE Normal HCO₃⁻ is 22–26 mEq/L. Bicarbonate is the metabolic component of acid-
base balance, regulated by the kidneys. Decreased HCO₃ (<22) = metabolic
acidosis. Increased HCO₃ (>26) = metabolic alkalosis. Remember: HCO₃ = kidneys.
The kidneys compensate for respiratory disorders by retaining or excreting
bicarbonate, though this process takes hours to days.
4. Which conditions commonly cause respiratory acidosis?
A. Anxiety, hyperventilation, fever, early sepsis
B. DKA, renal failure, diarrhea, shock/lactic acidosis
C. COPD, hypoventilation, opioids/sedatives, airway obstruction
D. Vomiting, NG suction, excess antacids, diuretics
CORRECT ANSWER C — COPD, hypoventilation, opioids/sedatives, airway obstruction.
RATIONALE Respiratory acidosis results from CO₂ retention due to alveolar hypoventilation.
Causes: COPD (chronic CO₂ retention), respiratory depression from opioids or
sedatives, airway obstruction, pneumonia, and neuromuscular disorders
impairing respiratory muscles. The lungs are the cause; the kidneys compensate
by retaining bicarbonate. Symptoms: confusion, drowsiness, hypoxia, slow
breathing, headache.
2 MAXE · 2CDM
★ ★
MDC Medical Campus — School of Nursing
EST. 1960
THE COLLEGE OF THE AMERICAN DREAM.
MDC2 — Examination 2
AC I D - B A S E B A L A N C E · G I D I S O R D E RS · N U T R I T I O N & E L I M I N AT I O N
INSTITUTION Miami Dade College COURSE CODE MDC2
PROGRAM Associate of Science in Nursing — ACADEMIC YEAR
ADN
EXAM TITLE MDC2 Examination 2 — COURSE TITLE Med-Surg Nursing II
Comprehensive
TOTAL QUESTIONS 54 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question.
▸ Content covers acid-base balance interpretation, GI disorders, GERD/PUD management, IBD vs. IBS,
ostomy care, parenteral nutrition, and GI medications.
▸ Normal lab values are integrated throughout the rationales for clinical decision-making.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All pharmacological and clinical data reflects current evidence-based nursing practice.
, COMPREHENSIVE EXAMINATION Questions 1 – 54
1. What is the normal pH range for arterial blood?
A. 7.25–7.35
B. 7.35–7.45
C. 7.45–7.55
D. 7.20–7.30
CORRECT ANSWER B — 7.35–7.45.
RATIONALE Normal arterial blood pH is 7.35–7.45. A pH below 7.35 indicates acidosis; a pH
above 7.45 indicates alkalosis. The body maintains this narrow range through
buffer systems, respiratory regulation (CO₂ via lungs), and renal regulation (HCO₃
via kidneys). Even small deviations can significantly impair enzyme function and
cellular processes.
2. What is the normal range for PaCO₂ (partial pressure of carbon dioxide)?
A. 22–26 mEq/L
B. 35–45 mmHg
C. 80–100 mmHg
D. 7.35–7.45
CORRECT ANSWER B — 35–45 mmHg.
RATIONALE Normal PaCO₂ is 35–45 mmHg. CO₂ is regulated by the lungs — it is the respiratory
component of acid-base balance. CO₂ + H₂O ↔ H₂CO₃ ↔ H⁺ + HCO₃⁻. Elevated CO₂
(>45) = respiratory acidosis (hypoventilation). Decreased CO₂ (<35) = respiratory
alkalosis (hyperventilation). Remember: CO₂ = lungs.
, 3. What is the normal range for HCO₃⁻ (bicarbonate)?
A. 35–45 mmHg
B. 7.35–7.45
C. 22–26 mEq/L
D. 3.5–5.0 mEq/L
CORRECT ANSWER C — 22–26 mEq/L.
RATIONALE Normal HCO₃⁻ is 22–26 mEq/L. Bicarbonate is the metabolic component of acid-
base balance, regulated by the kidneys. Decreased HCO₃ (<22) = metabolic
acidosis. Increased HCO₃ (>26) = metabolic alkalosis. Remember: HCO₃ = kidneys.
The kidneys compensate for respiratory disorders by retaining or excreting
bicarbonate, though this process takes hours to days.
4. Which conditions commonly cause respiratory acidosis?
A. Anxiety, hyperventilation, fever, early sepsis
B. DKA, renal failure, diarrhea, shock/lactic acidosis
C. COPD, hypoventilation, opioids/sedatives, airway obstruction
D. Vomiting, NG suction, excess antacids, diuretics
CORRECT ANSWER C — COPD, hypoventilation, opioids/sedatives, airway obstruction.
RATIONALE Respiratory acidosis results from CO₂ retention due to alveolar hypoventilation.
Causes: COPD (chronic CO₂ retention), respiratory depression from opioids or
sedatives, airway obstruction, pneumonia, and neuromuscular disorders
impairing respiratory muscles. The lungs are the cause; the kidneys compensate
by retaining bicarbonate. Symptoms: confusion, drowsiness, hypoxia, slow
breathing, headache.
