Page |1
NURS 2243 FINAL EXAM 2025 |ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |NURS 2243 LATEST 2025/2026 ALREADY
GRADED A+ (BRAND NEW!!!)
MULTIPLE CHOICES
A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The clients arterial
blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3 18 mEq/L. Which manifestation
should the nurse identify as an example of the clients compensation mechanism?
a. Increased rate and depth of respirations
b. Increased urinary output
c. Increased thirst and hunger
d. Increased release of acids from the kidneys -Correct Ans ✓✓ ANS: A
This client has metabolic acidosis. The respiratory system compensates by increasing its activity and blowing
off excess carbon dioxide. Increased urinary output, thirst, and hunger are manifestations of hyperglycemia but
are not compensatory mechanisms for acid-base imbalances. The kidneys do not release acids
A nurse assesses a client who is experiencing an acid-base imbalance. The clients arterial blood gas values are
pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L. Which assessment should the nurse
perform first?
a. Cardiac rate and rhythm
b. Skin and mucous membranes
c. Musculoskeletal strength
d. Level of orientation -Correct Ans ✓✓ ANS: A
Early cardiovascular changes for a client experiencing moderate acidosis include increased heart rate and
cardiac output. As the acidosis worsens, the heart rate decreases and electrocardiographic changes will be
present. Central nervous system and neuromuscular system changes do not occur with mild acidosis and should
be monitored if the acidosis worsens. Skin and mucous membrane assessment is not a priority now, but will
change as acidosis worsens.
A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance
should the nurse assess to prevent complications of this therapy?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
, Page |2
d. Metabolic alkalosis -Correct Ans ✓✓ ANS: D
Many diuretics, especially loop diuretics, increase the excretion of hydrogen ions, leading to excess acid loss
through the renal system. This situation is an acid deficit of metabolic origin.
A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action should the nurse
take?
a. Monitor daily hemoglobin and hematocrit values.
b. Administer furosemide (Lasix) intravenously.
c. Encourage the client to take deep breaths.
d. Teach the client fall prevention measures. -Correct Ans ✓✓ ANS: D
The priority nursing care for a client who is experiencing moderate metabolic alkalosis is providing client safety.
Clients with metabolic alkalosis have muscle weakness and are at risk for falling. The other nursing
interventions are not appropriate for metabolic alkalosis
A nurse assesses a client who is admitted with an acid-base imbalance. The clients arterial blood gas values are
pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L. What action should the nurse take next?
a. Assess clients rate, rhythm, and depth of respiration.
b. Measure the clients pulse and blood pressure.
c. Document the findings and continue to monitor.
d. Notify the physician as soon as possible. -Correct Ans ✓✓ ANS: A
Progressive skeletal muscle weakness is associated with increasing severity of acidosis. Muscle weakness can
lead to severe respiratory insufficiency. Acidosis does lead to dysrhythmias (due to hyperkalemia), but these
would best be assessed with cardiac monitoring. Findings should be documented, but simply continuing to
monitor is not sufficient. Before notifying the physician, the nurse must have more data to report
A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65
mm Hg, and HCO3 22 mEq/L. Which clinical situation should the nurse correlate with these values?
a. Diabetic ketoacidosis in a person with emphysema
b. Bronchial obstruction related to aspiration of a hot dog
c. Anxiety-induced hyperventilation in an adolescent
d. Diarrhea for 36 hours in an older, frail woman -Correct Ans ✓✓ ANS: B
Arterial blood gas values indicate that the client has acidosis with normal levels of bicarbonate, suggesting that
the problem is not metabolic. Arterial concentrations of oxygen and carbon dioxide are abnormal, with low
oxygen and high carbon dioxide levels. Thus, this client has respiratory acidosis from inadequate gas exchange.
, Page |3
The fact that the bicarbonate level is normal indicates that this is an acute respiratory problem rather than a
chronic problem, because no renal compensation has occurred.
A nurse is caring for a client who has just experienced a 90-second tonic-clonic seizure. The clients arterial
blood gas values are pH 6.88, PaO2 50 mm Hg, PaCO2 60 mm Hg, and HCO3 22 mEq/L. Which action should
the nurse take first?
a. Apply oxygen by mask or nasal cannula.
b. Apply a paper bag over the clients nose and mouth.
c. Administer 50 mL of sodium bicarbonate intravenously.
d. Administer 50 mL of 20% glucose and 20 units of regular insulin. -Correct Ans ✓✓ ANS: A
The client has experienced a combination of metabolic and acute respiratory acidosis through heavy skeletal
muscle contractions and no gas exchange. When the seizures have stopped and the client can breathe again, the
fastest way to return acid-base balance is to administer oxygen. Applying a paper bag over the clients nose and
mouth would worsen the acidosis. Sodium bicarbonate should not be administered because the clients arterial
bicarbonate level is normal. Glucose and insulin are administered together to decrease serum potassium levels.
This action is not appropriate based on the information provided
After teaching a client who was malnourished and is being discharged, a nurse assesses the clients
understanding. Which statement indicates the client correctly understood teaching to decrease risk for the
development of metabolic acidosis?
a. I will drink at least three glasses of milk each day.
b. I will eat three well-balanced meals and a snack daily.
c. I will not take pain medication and antihistamines together.
d. I will avoid salting my food when cooking or during meals. -Correct Ans ✓✓ ANS: B
Starvation or a diet with too few carbohydrates can lead to metabolic acidosis by forcing cells to switch to using
fats for fuel and by creating ketoacids as a by-product of excessive fat metabolism. Eating sufficient calories
from all food groups helps reduce this risk.
A nurse evaluates the following arterial blood gas values in a client: pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm
Hg, and HCO3 22 mEq/L. Which client condition should the nurse correlate with these results?
a. Diarrhea and vomiting for 36 hours
b. Anxiety-induced hyperventilation
c. Chronic obstructive pulmonary disease (COPD)
d. Diabetic ketoacidosis and emphysema -Correct Ans ✓✓ ANS: B
, Page |4
The elevated pH level indicates alkalosis. The bicarbonate level is normal, and so is the oxygen partial pressure.
Loss of carbon dioxide is the cause of the alkalosis, which would occur in response to hyperventilation. Diarrhea
and vomiting would cause metabolic alterations, COPD would lead to respiratory acidosis, and the client with
emphysema most likely would have combined metabolic acidosis on top of a mild, chronic respiratory acidosis.
After providing discharge teaching, a nurse assesses the clients understanding regarding increased risk for
metabolic alkalosis. Which statement indicates the client needs additional teaching?
a. I dont drink milk because it gives me gas and diarrhea.
b. I have been taking digoxin every day for the last 15 years.
c. I take sodium bicarbonate after every meal to prevent heartburn.
d. In hot weather, I sweat so much that I drink six glasses of water each day. -Correct Ans ✓✓ ANS: C
Excessive oral ingestion of sodium bicarbonate and other bicarbonate-based antacids can cause metabolic
alkalosis. Avoiding milk, taking digoxin, and sweating would not lead to increased risk of metabolic alkalosis.
A nurse is caring for a client who is experiencing excessive diarrhea. The clients arterial blood gas values are pH
7.28, PaO2 98 mm Hg, PaCO2 45 mm Hg, and HCO3 16 mEq/L. Which provider order should the nurse expect
to receive?
a. Furosemide (Lasix) 40 mg intravenous push
b. Sodium bicarbonate 100 mEq diluted in 1 L of D5W
c. Mechanical ventilation
d. Indwelling urinary catheter -Correct Ans ✓✓ ANS: B
This clients arterial blood gas values represent metabolic acidosis related to a loss of bicarbonate ions from
diarrhea. The bicarbonate should be replaced to help restore this clients acid-base balance. Furosemide would
cause an increase in acid fluid and acid elimination via the urinary tract; although this may improve the clients
pH, the client has excessive diarrhea and cannot afford to lose more fluid. Mechanical ventilation is used to treat
respiratory acidosis for clients who cannot keep their oxygen saturation at 90%, or who have respirator muscle
fatigue. Mechanical ventilation and an indwelling urinary catheter would not be prescribed for this client.
A nurse evaluates a clients arterial blood gas values (ABGs): pH 7.30, PaO2 86 mm Hg, PaCO2 55 mm Hg, and
HCO3 22 mEq/L. Which intervention should the nurse implement first?
a. Assess the airway.
b. Administer prescribed bronchodilators.
c. Provide oxygen.
d. Administer prescribed mucolytics. -Correct Ans ✓✓ ANS: A
NURS 2243 FINAL EXAM 2025 |ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |NURS 2243 LATEST 2025/2026 ALREADY
GRADED A+ (BRAND NEW!!!)
MULTIPLE CHOICES
A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The clients arterial
blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3 18 mEq/L. Which manifestation
should the nurse identify as an example of the clients compensation mechanism?
a. Increased rate and depth of respirations
b. Increased urinary output
c. Increased thirst and hunger
d. Increased release of acids from the kidneys -Correct Ans ✓✓ ANS: A
This client has metabolic acidosis. The respiratory system compensates by increasing its activity and blowing
off excess carbon dioxide. Increased urinary output, thirst, and hunger are manifestations of hyperglycemia but
are not compensatory mechanisms for acid-base imbalances. The kidneys do not release acids
A nurse assesses a client who is experiencing an acid-base imbalance. The clients arterial blood gas values are
pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L. Which assessment should the nurse
perform first?
a. Cardiac rate and rhythm
b. Skin and mucous membranes
c. Musculoskeletal strength
d. Level of orientation -Correct Ans ✓✓ ANS: A
Early cardiovascular changes for a client experiencing moderate acidosis include increased heart rate and
cardiac output. As the acidosis worsens, the heart rate decreases and electrocardiographic changes will be
present. Central nervous system and neuromuscular system changes do not occur with mild acidosis and should
be monitored if the acidosis worsens. Skin and mucous membrane assessment is not a priority now, but will
change as acidosis worsens.
A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance
should the nurse assess to prevent complications of this therapy?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
, Page |2
d. Metabolic alkalosis -Correct Ans ✓✓ ANS: D
Many diuretics, especially loop diuretics, increase the excretion of hydrogen ions, leading to excess acid loss
through the renal system. This situation is an acid deficit of metabolic origin.
A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action should the nurse
take?
a. Monitor daily hemoglobin and hematocrit values.
b. Administer furosemide (Lasix) intravenously.
c. Encourage the client to take deep breaths.
d. Teach the client fall prevention measures. -Correct Ans ✓✓ ANS: D
The priority nursing care for a client who is experiencing moderate metabolic alkalosis is providing client safety.
Clients with metabolic alkalosis have muscle weakness and are at risk for falling. The other nursing
interventions are not appropriate for metabolic alkalosis
A nurse assesses a client who is admitted with an acid-base imbalance. The clients arterial blood gas values are
pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L. What action should the nurse take next?
a. Assess clients rate, rhythm, and depth of respiration.
b. Measure the clients pulse and blood pressure.
c. Document the findings and continue to monitor.
d. Notify the physician as soon as possible. -Correct Ans ✓✓ ANS: A
Progressive skeletal muscle weakness is associated with increasing severity of acidosis. Muscle weakness can
lead to severe respiratory insufficiency. Acidosis does lead to dysrhythmias (due to hyperkalemia), but these
would best be assessed with cardiac monitoring. Findings should be documented, but simply continuing to
monitor is not sufficient. Before notifying the physician, the nurse must have more data to report
A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65
mm Hg, and HCO3 22 mEq/L. Which clinical situation should the nurse correlate with these values?
a. Diabetic ketoacidosis in a person with emphysema
b. Bronchial obstruction related to aspiration of a hot dog
c. Anxiety-induced hyperventilation in an adolescent
d. Diarrhea for 36 hours in an older, frail woman -Correct Ans ✓✓ ANS: B
Arterial blood gas values indicate that the client has acidosis with normal levels of bicarbonate, suggesting that
the problem is not metabolic. Arterial concentrations of oxygen and carbon dioxide are abnormal, with low
oxygen and high carbon dioxide levels. Thus, this client has respiratory acidosis from inadequate gas exchange.
, Page |3
The fact that the bicarbonate level is normal indicates that this is an acute respiratory problem rather than a
chronic problem, because no renal compensation has occurred.
A nurse is caring for a client who has just experienced a 90-second tonic-clonic seizure. The clients arterial
blood gas values are pH 6.88, PaO2 50 mm Hg, PaCO2 60 mm Hg, and HCO3 22 mEq/L. Which action should
the nurse take first?
a. Apply oxygen by mask or nasal cannula.
b. Apply a paper bag over the clients nose and mouth.
c. Administer 50 mL of sodium bicarbonate intravenously.
d. Administer 50 mL of 20% glucose and 20 units of regular insulin. -Correct Ans ✓✓ ANS: A
The client has experienced a combination of metabolic and acute respiratory acidosis through heavy skeletal
muscle contractions and no gas exchange. When the seizures have stopped and the client can breathe again, the
fastest way to return acid-base balance is to administer oxygen. Applying a paper bag over the clients nose and
mouth would worsen the acidosis. Sodium bicarbonate should not be administered because the clients arterial
bicarbonate level is normal. Glucose and insulin are administered together to decrease serum potassium levels.
This action is not appropriate based on the information provided
After teaching a client who was malnourished and is being discharged, a nurse assesses the clients
understanding. Which statement indicates the client correctly understood teaching to decrease risk for the
development of metabolic acidosis?
a. I will drink at least three glasses of milk each day.
b. I will eat three well-balanced meals and a snack daily.
c. I will not take pain medication and antihistamines together.
d. I will avoid salting my food when cooking or during meals. -Correct Ans ✓✓ ANS: B
Starvation or a diet with too few carbohydrates can lead to metabolic acidosis by forcing cells to switch to using
fats for fuel and by creating ketoacids as a by-product of excessive fat metabolism. Eating sufficient calories
from all food groups helps reduce this risk.
A nurse evaluates the following arterial blood gas values in a client: pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm
Hg, and HCO3 22 mEq/L. Which client condition should the nurse correlate with these results?
a. Diarrhea and vomiting for 36 hours
b. Anxiety-induced hyperventilation
c. Chronic obstructive pulmonary disease (COPD)
d. Diabetic ketoacidosis and emphysema -Correct Ans ✓✓ ANS: B
, Page |4
The elevated pH level indicates alkalosis. The bicarbonate level is normal, and so is the oxygen partial pressure.
Loss of carbon dioxide is the cause of the alkalosis, which would occur in response to hyperventilation. Diarrhea
and vomiting would cause metabolic alterations, COPD would lead to respiratory acidosis, and the client with
emphysema most likely would have combined metabolic acidosis on top of a mild, chronic respiratory acidosis.
After providing discharge teaching, a nurse assesses the clients understanding regarding increased risk for
metabolic alkalosis. Which statement indicates the client needs additional teaching?
a. I dont drink milk because it gives me gas and diarrhea.
b. I have been taking digoxin every day for the last 15 years.
c. I take sodium bicarbonate after every meal to prevent heartburn.
d. In hot weather, I sweat so much that I drink six glasses of water each day. -Correct Ans ✓✓ ANS: C
Excessive oral ingestion of sodium bicarbonate and other bicarbonate-based antacids can cause metabolic
alkalosis. Avoiding milk, taking digoxin, and sweating would not lead to increased risk of metabolic alkalosis.
A nurse is caring for a client who is experiencing excessive diarrhea. The clients arterial blood gas values are pH
7.28, PaO2 98 mm Hg, PaCO2 45 mm Hg, and HCO3 16 mEq/L. Which provider order should the nurse expect
to receive?
a. Furosemide (Lasix) 40 mg intravenous push
b. Sodium bicarbonate 100 mEq diluted in 1 L of D5W
c. Mechanical ventilation
d. Indwelling urinary catheter -Correct Ans ✓✓ ANS: B
This clients arterial blood gas values represent metabolic acidosis related to a loss of bicarbonate ions from
diarrhea. The bicarbonate should be replaced to help restore this clients acid-base balance. Furosemide would
cause an increase in acid fluid and acid elimination via the urinary tract; although this may improve the clients
pH, the client has excessive diarrhea and cannot afford to lose more fluid. Mechanical ventilation is used to treat
respiratory acidosis for clients who cannot keep their oxygen saturation at 90%, or who have respirator muscle
fatigue. Mechanical ventilation and an indwelling urinary catheter would not be prescribed for this client.
A nurse evaluates a clients arterial blood gas values (ABGs): pH 7.30, PaO2 86 mm Hg, PaCO2 55 mm Hg, and
HCO3 22 mEq/L. Which intervention should the nurse implement first?
a. Assess the airway.
b. Administer prescribed bronchodilators.
c. Provide oxygen.
d. Administer prescribed mucolytics. -Correct Ans ✓✓ ANS: A
