51. This refers to a substance that can act as a
Which of the following parameters
chemical sponge, either soaking or releasing
hydrogen ion so that pH remains relatively
stable.
A. Catalyst
B. Buffer
C. Enzyme
D. Hormone
52. All but one of these statements describes the
normal compensation of our body in response to
acid base imbalances.
A. Maintenance of the 1:20 ratio of carbonic acid to
bicarbonate is crucial to keeping serum pH
within the normal levels
B. The kidneys attempt to compensate for changes
in blood CO2 by making a corresponding change
in blood bicarbonate
C. The lungs attempt to compensate by retaining or
excreting CO2 therefore controlling the amount
of HCO3 inside the body
D. Shifting of hydrogen ions from ICF to ECF or vice
versa can be used by the body in the presence of
acid base problems.
53. What would be the direction of hydrogen shifting
when there is metabolic acidosis?
A. Hydrogen shifts from the intracellular to the
extracellular compartment
B. Hydrogen shifts from the extracellular to the
intracellular compartment
C. Hydrogen shifts from the intravascular to the
interstitial compartment
D. Hydrogen shifts from the interstitial to the
intravascular compartment
54. In response to acidosis, the respiratory system
would lower the carbonic acid concentration by
A. Increasing respiratory rate & depth to excrete
carbon dioxide
B. Decreasing respiratory rate & depth to retain
carbon dioxide
C. Increasing respiratory rate & depth to excrete
bicarbonate
D. Increasing respiratory rate & depth to retain
bicarbonate
(Situation for nos. 55-59) Mr. Dela Fuente was
brought to the emergency hospital because of severe
chest pain, dyspnea, tachypnea, and mental
confusion. Laboratory tests were ordered revealing a
decreased pH, pCO2, level of 51 mmHg, and pO2 level
of 75 mmHg, X-ray showed accumulation of air in the
pleural space. Diagnosis: Right Pneumothorax.
55. Based from the clinical manifestations and
laboratory results, you would suspect that Mr.
Dela Fuente may be experiencing what acid base
imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
56. Chest tube drainage was ordered by the
physician to remove air from the patients
pleural space.
would indicate that the procedure was effective?
A. RR = 23/min
B. pCO2 = 49 mmHg
C. Lung has slight expansion on X-ray
D. Normal LOC, alert, & oriented
57. Mr. Dela Fuente reported severe chest pain and
the doctor prescribes a pain medication prn.
Which of the following medications would be
contraindicated to Mr. Dela Fuentes condition?
A. Ibuprofen
B. Paracetamol
C. Morphine
D. Mefanamic acid
58. In order to promote excretion of CO2 and lower
carbonic acid levels in a patient with respiratory
acidosis, you would include all these nursing
actions on the patients care plan, except?
A. Render chest physiotherapy as indicated
B. Encouraging pursed-lip breathing
C. Avoid sedatives or narcotics
D. Instruct patient to rebreathe into a paper bag
59. Based from Mr. Dela Fuentes condition, which of
the following laboratory results would indicate
compensation?
A. HCO3 = 20 mEq/L
B. HCO3 = 29 mEq/L
C. Serum K+ = 3.2 mEq/L
D. pCO2 = 51 mmHg
(Situation for nos. 60-64): Mrs. Conchita Smith
was brought to the hospital because of aspirin
overdose after ingesting 20 tablets of this medication
about an hour ago. During your observation you
noted that the patient was confused and was
hyperventilating. Mrs. Smith also reported blurring
of vision, light-headedness, and palpitations.
60. From the data presented in the situation, you can
infer that the patient may be experiencing what
acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
61. What would be your initial nursing action if the
patient is hyperventilating in order to prevent
worsening of the condition?
A. Administer sedatives or tranquilizers
B. Encourage the patient to do pursed-lip breathing
C. Instruct the patient to rebreathe into a paper bag
D. Suction the patient as necessary
62. In relation to the Mrs. Smiths acid-base
imbalance, what other electrolyte imbalances
may accompany this condition?
A. Hyperkalemia and hyponatremia
B. Hypokalemia and hypernatremia
C. Hyperkalemia and hypercalcemia
D. Hypokalemia and hypocalcemia
63. Mrs. Smith may show all of the following ABG
results, except:
A. pH = 7.48
B. PaCO2 = 27 mmHg
C. PaO2 = 80 mmHg
D. HCO3 = 24 mEq/L
64. A nurse preparing a care plan for Mrs. Smith
would exclude which interventions mentioned
below?
A. Monitor patients breathing and encourage to
breathe slowly
B. Monitor for possible hypokalemia and for signs
& symptoms of hypocalcemia
C. Instruct the patient to do pursed-lip breathing
D. Administer sedatives or tranquilizers as
prescribed
65. Mr. Allan Balnchard was brought to the nearest
hospital because of severe flank pain, anuria,
nausea/vomiting, and hyperventilation. Series of
laboratory & diagnostic tests revealed acute
renal failure. ABG sampling was also done
revealing a pH of 7.1; HCO3 of 10 mEq/L; &
PaCO2 of 35 mmHg. This is interpreted as:
A. Uncompensated metabolic alkalosis
B. Partially compensated metabolic acidosis
C. Uncompensated metabolic acidosis
D. Partially compensated metabolic alkalosis
69. A staff nurse asked student nurse Alvin
regarding metabolic acidosis, he answers
appropriately when she says:
A. There is an excess of bicarbonate in relation to
the amount of hydrogen ion.
B. The pH is above 7.42.
C. The bicarbonate concentration is greater than
26 mEq/L.
D. The amount of bicarbonate is reduced in
relation to the amount of acid in the body.
70. The physician asked the nurse to obtain the
patients ABGs after taking Sorbitol and sodium
bicarbonate and metaboilic acidosis. The
patients ABG reveals pH of 7.48, pCO2 of 38, and
HCO3 of 30. The nurse interprets this as:
A. Respiratory acidosis
B. Uncompensated metabolic alkalosis
C. Compensated metabolic alkalosis
D. Compensated metabolic acidosis
71. Due to drug overdose, gastric lavage is done to a
patient. It is important to assess the patient for
which of the following problems that may
develop after the procedure?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis

66. In relation to Mr. Blanchards ABG results, the 72. An anxious patient may experience:
physician prescribed sodium bicarbonate for the A. Respiratory acidosis
correction of his acid-base imbalance. Two days B. Respiratory alkalosis
after the therapy he experienced severe C. Metabolic acidosis
weakness, confusion, & paresthesia. ABG was D. Metabolic alkalosis
ordered and the results revealed pH of 7.49;
HCO3 of 29 mEq/L; & paCO2 of 27 mmHg. Mr. 73. In case of metabolic alkalosis, which of the
Blanchard may be experiencing what acid-base following drugs should be withheld?
imbalance? A. Carbonic anhydrase inhibitor
A. Compensated metabolic acidosis B. Ammonium chloride
B. Uncompensated metabolic acidosis C. Sodium chloride
C. Compensated metabolic alkalosis D. Sodium bicarbonate
D. Uncompensated metabolic alkalosis
74. A patient suffering from metabolic acidosis. If
67. The nurse is reviewing an arterial blood gas blood pH is 7, which of the following drugs
report for a client with chronic renal failure. The should be administered?
nurse understands that the result reflects uremic A. Sodium chloride, P.O.
acidosis if the ABG values will most likely be: B. Sodium chloride, I.V.
A. ph 7.28, PaCO2 28, HCO3 - 16 C. Sodium bicarbonate, P.O.
B. ph 7.30, PaCO2 54, HCO3 - 28 D. Sodium bicarbonate, I.V.
C. ph 7.50, PaCO2 49, HCO3 - 32
D. ph 7.52, PaCO2 26, HCO3 - 20 75. Tranquilizers should be withheld to a patient
suffering from what acid-base imbalance?
68. A client in the emergency department reports A. Respiratory acidosis
that he does not have a urine output for the past B. Respiratory alkalosis
2 days and was suspected to have renal failure. C. Metabolic acidosis
His arterial blood gas analysis shows a pH of D. Metabolic alkalosis
7.20. PaCO2 of 27 mmHg, PaO2 of 75 mmHg, and
HCO3 of 16 mEq/L. Based on these findings, the 76. Which promotes the excretion of bicarbonate via
nurse documents that the patient is experiencing the kidneys?
which type of acid-base imbalance? A. Carbonic anhydrase inhibitor
A. Compensated Respiratory alkalosis B. Acetazolamide
B. Metabolic alkalosis C. Diamox
C. Compensated Respiratory acidosis D. All of the above
D. Metabolic acidosis
77. Which of the following ABG result is expected to D. The major buffer system in the body is the
a hyperventilating patient? bicarbonate-carbonic buffer system with a ratio
A. Increase pH 1:20 respectively.
B. Decrease bicarbonate level
C. Increase carbon dioxide level 35. The following statements are appropriate in
D. Increase oxygen level relation to respiratory acidosis excluding:
A. Respiratory alkalosis occurs when carbon
78. When the amount of carbon dioxide in the blood dioxide is retained, increasing the amount of
rises, so does the concentration of carbonic acid. carbonic acid in the body
Based on the statement, a rise in CO2 would: B. The pH falls less than 7.35 and the PaCO2 is
A. Depress the pH greater than 45 mmHg
B. Elevate the pH C. The primary change is the concentration of
C. Normalize the pH carbonic acid
D. Exert no change in the pH D. Early salicylate intoxication may cause the
condition
79. When a person hyperventiliates, blood carbon
dioxide will: 86. Nursing interventions for a client with metabolic
A. Rise acidosis include the following but one:
B. Fall A. Monitor vital signs, including peripheral pulses
C. Remain normal capillary refill
D. Remain unchanged B. Monitor ECG patterns for dysrythmias and
changes characteristics of hyperkalemia
80. A rise in the bicarbonate level would: C. Monitor laboratory values including arterial
A. Depress the pH blood gases and serum electrolytes
B. Elevate the pH D. Potassium chloride administration per doctors
C. Normalize the pH order.
D. Not change the pH
87. Arterial blood gas results for a client show Ph
81. When a person hypoventiliates, bicarbonate 7.38, PaO2 99 mmHg, PaCO2 47mmHg and HCO3
level will: 30 mEq/L. The nurse correctly interprets these
A. Rise values as indicative of which of the following
B. Fall acid-base imbalances?
C. Remain normal A. Fully Compensated Metabolic alkalosis
D. Remain unchanged B. Partially Compensated Metabolic alkalosis
C. Fully Compensated Respiratory acidosis
82. The serum potassium of a patient who is in a D. Partially Compensated Respiratory acidosis
state of acidosis would:
A. Rise 88. Arterial blood gas results for a client show pH
B. Fall 7.21, PaO2 98 mmHg, PaCO2 32 mmHg and HCO3
C. Remain normal 17 mEq/L. The nurse correctly interprets these
D. Remain unchanged values as indicative of which of the following
acid-base imbalances?
83. The relationship between hydrogen on A. Metabolic acidosis
concentration and pH is inversely proportional B. Metabolic alkalosis
with each other. Which of the following C. Respiratory acidosis
explanations below affirms this statement? D. Respiratory alkalosis
A. As hydrogen ion concentration increases, the pH
falls, and the solution becomes more acidic. 89. The kidneys regulate acid base balance by all of
B. As hydrogen ion concentration increases, the pH the following except:
falls, and the solution becomes more alkaline. A. Retaining hydrogen ions (H)
C. As hydrogen ion concentration decreases, the pH B. Reabsorbing or excreting HCO3 into the blood
falls, and the solution becomes more acidic. C. Reabsorbing carbon dioxide into the blood
D. As hydrogen ion concentration increases, the pH D. Removing hydrogen ions (H)
falls, and the solution becomes more acidic.
90. The lungs regulate acid-base balance by all of the
84. All of the following are true to buffer systems but following mechanisms except:
one: A. Excreting HCO3 from the blood
A. These are substances that prevent major B. Slowing ventilation
changes in pH by removing or releasing C. Increasing the depth of ventilation
hydrogen ions. D. Controlling carbon dioxide levels
B. When excess acid is present in body fluids,
buffers bind with hydrogen ions to minimize the
change in pH.
C. If body fluids become too basic, buffers release
hydrogen ions, restoring the pH.
 ABG INTERPRETATION

1. pH 7.43
pCO2 48
HCO3 30
Interpretation: __________________________________

2. pH 7.45
pCO2 49
HCO3 32
Interpretation: __________________________________

3. pH 7.39
pCO2 46
HCO3 31
Interpretation: __________________________________

4. pH 7. 49
pCO2 32
HCO3 26
Interpretation: __________________________________

5. pH 7. 34
pCO2 48
HCO3 28
Interpretation: __________________________________

6. pH 7. 41
pCO2 30
HCO3 18
Interpretation: __________________________________

7. pH 7. 41
pCO2 49
HCO3 29
Interpretation: __________________________________

8. pH 7. 36
pCO2 32
HCO3 20
Interpretation: __________________________________

9. pH 7. 30
pCO2 49
HCO3 26
Interpretation: __________________________________

10. pH 7. 50
pCO2 39
HCO3 30
Interpretation: __________________________________