1. Patient X is diagnosed with constipation.

As a knowledgeable nurse, which

nursing intervention is appropriate for maintaining normal bowel function?

A. Assessing dietary intake

B. Decreasing fluid intake
C. Providing limited physical activity
D. Turning, coughing, and deep breathing
2. A 12-year-old boy was admitted in the hospital two days ago due to
hyperthermia. His attending nurse, Dennis, is quite unsure about his plan of care.
Which of the following nursing intervention should be included in the care of plan
for the client?

A. Room temperature reduction

B. Fluid restriction of 2,000 ml/day
C. Axillary temperature measurements every 4 hours
D. Antiemetic agent administration
3. Tom is ready to be discharged from the medical-surgical unit after 5 days of
hospitalization. Which client statement indicates to the nurse that Tom
understands the discharge teaching about cellular injury?

A. “I do not have to see my doctor unless i have problems.”

B. “I can stop taking my antibiotics once I am feeling better.”
C. “If I have redness, drainage, or fever, I should call my healthcare provider.”
D. “I can return to my normal activities as soon as I go home.”
4. Nurse Katee is caring for Adam, a 22-year-old client, in a long-term facility.
Which nursing intervention would be appropriate when identifying nursing
interventions aimed at promoting and preventing contractures? Select all that
apply.
A. Clustering activities to allow uninterrupted periods of rest
B. Maintaining correct body alignment at all times
C. Monitoring intake and output, using a urometer if necessary
D. Using a footboard or pillows to keep feet in correct position
E. Performing active and passive range-of-motion exercises
F. Weighing the client daily at the same time and in the same clothes
5. A 36-year-old male client is about to be discharged from the the hospital after 5
days due to surgery. Which intervention should be included in the home health
care nurse’s instructions about measures to prevent constipation?
 A. Discouraging the client from eating large amounts of roughage-containing
foods in the diet.
B. Encouraging the client to use laxatives routinely to ensure adequate bowel
elimination.
C. Instructing the client to establish a bowel evacuation schedule that changes
every day.
D. Instructing the client to fill a 2-L bottle with water every night and drink it the
next day.
6. Mr. McPartlin suffered abrasions and lacerations after a vehicular accident. He
was hospitalized and was treated for a couple of weeks. When planning care for a
client with cellular injury, the nurse should consider which scientific rationale?

A. Nutritional needs remain unchanged for the well-nourished adult.

B. Age is an insignificant factor in cellular repair.
C. The presence of infection may slow the healing process.
D. Tissue with inadequate blood supply may heal faster.
7. A 22-year-old lady is displaying facial grimaces during her treatment in the
hospital due to burn trauma. Which nursing intervention should be included for
reducing pain due to cellular injury?

A. Administering anti-inflammatory agents as prescribed

B. Elevating the injured area to decrease venous return to the heart
C. Keeping the skin clean and dry
D. Applying warm packs initially to reduce edema
8. Lisa, a client with altered urinary function, is under the care of nurse Tine.
Which intervention is appropriate to include when developing a plan of care for
Lisa who is experiencing urinary dribbling?

A. Inserting an indwelling Foley catheter

B. Having the client perform Kegel exercises
C. Keeping the skin clean and dry
D. Using pads or diapers on the client
9. Jeron is admitted in the hospital due to bacterial pneumonia. He is febrile,
diaphoretic, and has shortness of breath and asthma. Which goal is the most
important for the client?

A. Prevention of fluid volume excess

 B. Maintenance of adequate oxygenation
C. Education about infection prevention
D. Pain reduction
10. Mang Rogelio, a 32-year-old patient, is about to be discharged from the acute
care setting. Which nursing intervention is the most important to include in the
plan of care?

A. Stress-reduction techniques
B. Home environment evaluation
C. Skin-care measures
D. Participation in activities of daily living
11. Mrs. dela Riva is in her first trimester of pregnancy. She has been lying all day
because her OB-GYN requested her to have a complete bed rest. Which nursing
intervention is appropriate when addressing the client’s need to maintain skin
integrity?

A. Monitoring intake and output accurately

B. Instructing the client to cough and deep-breathe every 2 hours
C. Keeping the linens dry and wrinkle free
D. Using a foot board to maintain correct anatomic position
12. Maya, who is admitted in a hospital, is scheduled to have her general checkup
and physical assessment. Nurse Timothy observed a reddened area over her left
hip. Which should the nurse do first?

A. Massage the reddened are for a few minutes

B. Notify the physician immediately
C. Arrange for a pressure-relieving device
D. Turn the client to the right side for 2 hours
13. Pierro was noted to be displaying facial grimaces after nurse Kara assessed his
complaints of pain rated as 8 on a scale of 1 (no pain) 10 10 (worst pain). Which
intervention should the nurse do?

A. Administering the client’s ordered pain medication immediately

B. Using guided imagery instead of administering pain medication
C. Using therapeutic conversation to try to discourage pain medication
D. Attempting to rule out complications before administering pain medication
14. Nurse Marthia is teaching her students about bacterial control. Which
intervention is the most important factor in preventing the spread of
microorganism?

A. Maintenance of asepsis with indwelling catheter insertion

B. Use of masks, gowns, and gloves when caring for clients with infection
C. Correct handwashing technique
D. Cleanup of blood spills with sodium hydrochloride
15. A patient with tented skin turgor, dry mucous membranes, and decreased
urinary output is under nurse Mark’s care. Which nursing intervention should be
included the care plan of Mark for his patient?

A. Administering I.V. and oral fluids

B. Clustering necessary activities throughout the day
C. Assessing color, odor, and amount of sputum
D. Monitoring serum albumin and total protein levels
16. Khaleesi is admitted in the hospital due to having lower than normal
potassium level in her bloodstream. Her medical history reveals vomiting and
diarrhea prior to hospitalization. Which foods should the nurse instruct the client
to increase?

A. Whole grains and nuts

B. Milk products and green, leafy vegetables
C. Pork products and canned vegetables
D. Orange juice and bananas
17. Mary Jean, a first year nursing student, was rushed to the clinic department
due to hyperventilation. Which nursing intervention is the most appropriate for
the client who is subsequently developing respiratory alkalosis?

A. Administering sodium chloride I.V.

B. Encouraging slow, deep breaths
C. Preparing to administer sodium bicarbonate
D. Administer low-flow oxygen therapy
18. Nurse John Joseph is totaling the intake and output for Elena Reyes, a client
diagnosed with septicemia who is on a clear liquid diet. The client intakes 8 oz of
apple juice, 850 ml of water, 2 cups of beef broth, and 900 ml of half-normal
saline solution and outputs 1,500 ml of urine during the shift. How many
milliliters should the nurse document as the client’s intake.

A. 2,230
B. 2,740
C. 2,470
D. 2,320
19. Marie Joy’s lab test revealed that her serum calcium is 2.5 mEq/L. Which
assessment data does the nurse document when a client diagnosed with
hypocalcemia develops a carpopedal spasm after the blood-pressure cuff is
inflated?

A. Positive Trousseau’s sign

B. Positive Chvostek’s sign
C. Tetany
D. Paresthesia
20. Lab tests revealed that patient Z’s [Na+] is 170 mEq/L. Which clinical
manifestation would nurse Natty expect to assess?

A. Tented skin turgor and thirst

B. Muscle twitching and tetany
C. Fruity breath and Kussmaul’s respirations
D. Muscle weakness and paresthesia
21. Mang Teban has a history of chronic obstructive pulmonary disease and has
the following arterial blood gas results: partial pressure of oxygen (PO2), 55 mm
Hg, and partial pressure of carbon dioxide (PCO2), 60 mm Hg. When attempting
to improve the client’s blood gas values through improved ventilation and oxygen
therapy, which is the client’s primary stimulus for breathing?

A. High PCO2
B. Low PO2
C. Normal pH
D. Normal bicarbonate (HCO3)
22. A client with very dry mouth, skin and mucous membranes is diagnosed of
having dehydration. Which intervention should the nurse perform when caring
for a client diagnosed with fluid volume deficit?

A. Assessing urinary intake and output

 B. Obtaining the client’s weight weekly at different times of the day
C. Monitoring arterial blood gas (ABG) results
D. Maintaining I.V. therapy at the keep-vein-open rate
23. Which client situation requires the nurse to discuss the importance of
avoiding foods high in potassium?

A. 14-year-old Elena who is taking diuretics

B. 16-year-old John Joseph with ileostomy
C. 16-year-old Gabriel with metabolic acidosis
D. 18-year-old Albert who has renal disease
24. Genevieve is diagnosed with hypomagnesemia, which nursing intervention
would be appropriate?

A. Instituting seizure precaution to prevent injury

B. Instructing the client on the importance of preventing infection
C. Avoiding the use of tight tourniquet when drawing blood
D. Teaching the client the importance of early ambulation
25. Which electrolyte would the nurse identify as the major electrolyte
responsible for determining the concentration of the extracellular fluid?

A. Potassium
B. Phosphate
C. Chloride
D. Sodium
26. Jon has a potassium level of 6.5 mEq/L, which medication would nurse Wilma
anticipate?

A. Potassium supplements
B. Kayexalate
C. Calcium gluconate
D. Sodium tablets
27. Which clinical manifestation would lead the nurse to suspect that a client is
experiencing hypermagnesemia?

A. Muscle pain and acute rhabdomyolysis

B. Hot, flushed skin and diaphoresis
C. Soft-tissue calcification and hyperreflexia
D. Increased respiratory rate and depth
28. Joshua is receiving furosemide and Digoxin, which laboratory data would be
the most important to assess in planning the care for the client?

A. Sodium level
B. Magnesium level
C. Potassium level
D. Calcium level
29. Mr. Salcedo has the following arterial blood gas (ABG) values: pH of 7.34,
partial pressure of arterial oxygen of 80 mm Hg, partial pressure of arterial carbon
dioxide of 49 mm Hg, and a bicarbonate level of 24 mEq/L. Based on these results,
which intervention should the nurse implement?

A. Instructing the client to breathe slowly into a paper bag

B. Administering low-flow oxygen
C. Encouraging the client to cough and deep breathe
D. Nothing, because these ABG values are within normal limits.
30. A client is diagnosed with metabolic acidosis, which would the nurse expect
the health care provider to order?

A. Potassium
B. Sodium bicarbonate
C. Serum sodium level
D. Bronchodilator
31. Lee Angela’s lab test just revealed that her chloride level is 96 mEq/L. As a
nurse, you would interpret this serum chloride level as:

A. high
B. low
C. within normal range
D. high normal
32. Which of the following conditions is associated with elevated serum chloride
levels?

A. cystitis
B. diabetes
C. eclampsia
D. hypertension
33. In the extracellular fluid, chloride is a major:
 A. compound
B. ion
C. anion
D. cation
34. Nursing intervention for the patient with hyperphosphatemia include
encouraging intake of:

A. amphogel
B. Fleets phospho-soda
C. milk
D. vitamin D
35. Etiologies associated with hypocalcemia may include all of the following
except:

A. renal failure
B. inadequate intake calcium
C. metastatic bone lesions
D. vitamin D deficiency
36. Which of the following findings would the nurse expect to asses in
hypercalcemia?

A. prolonged QRS complex

B. tetany
C. petechiae
D. urinary calculi
37. Which of the following is not an appropriate nursing intervention for a patient
with hypercalcemia?

A. administering calcitonin
B. administering calcium gluconate
C. administering loop diuretics
D. encouraging ambulation
38. A patient in which of the following disorders is at high risk to develop
hypermagnesemia?

A. insulin shock
B. hyperadrenalism
C. nausea and vomiting
 D. renal failure
39. Nursing interventions for a patient with hypermagnesemia include
administering calcium gluconate to:

A. increase calcium levels

B. antagonize the cardiac effects of magnesium
C. lower calcium levels
D. lower magnesium levels
40. For a patient with hypomagnesemia, which of the following medications may
become toxic?

A. Lasix
B. Digoxin
C. calcium gluconate
D. CAPD
41. Which of the following is the most important physical assessment parameter
the nurse would consider when assessing fluid and electrolyte imbalance?

A. skin turgor
B. intake and output
C. osmotic pressure
D. cardiac rate and rhythm
42. Insensible fluid losses include:

A. urine
B. gastric drainage
C. bleeding
D. perspiration
43. Which of the following intravenous solutions would be appropriate for a
patient with severe hyponatremia secondary to syndrome of inappropriate
antidiuretic hormone (SIADH)?

A. hypotonic solution
B. hypertonic solution
C. isotonic solution
D. normotonic solution
44. Aldosterone secretion in response to fluid loss will result in which one of the
following electrolyte imbalances?
 A. hypokalemia
B. hyperkalemia
C. hyponatremia
D. hypernatremia
45. When assessing a patient for signs of fluid overload, the nurse would expect
to observe:

A. bounding pulse
B. flat neck veins
C. poor skin turgor
D. vesicular
46. The physician has ordered IV replacement of potassium for a patient with
severe hypokalemia. The nurse would administer this:

A. by rapid bolus
B. diluted in 100 cc over 1 hour
C. diluted in 10 cc over 10 minutes
D. IV push
47. Which of the following findings would the nurse exp[ect to assess in a patient
with hypokalemia?

A. hypertension
B. pH below 7.35
C. hypoglycemia
D. hyporeflexia
48. Vien is receiving oral potassium supplements for his condition. How should
the supplements be administered?

A. undiluted
B. diluted
C. on an empty stomach
D. at bedtime
49. Normal venous blood pH ranges from:

A. 6.8 to 7.2
B. 7.31 to 7.41
C. 7.35 to 7.45
D. 7.0 to 8.0
50. Respiratory regulation of acids and bases involves:

A. hydrogen
B. hydroxide
C. oxygen
D. carbon dioxide
51. To determine if a patient’s respiratory system is functioning, the nurse would
assess which of the following parameters:

A. respiratory rate
B. pulse
C. arterial blood gas
D. pulse oximetry
52. Which of the following conditions is an equal decrease of extracellular fluid
(ECF) solute and water volume?

A. hypotonic FVD
B. isotonic FVD
C. hypertonic FVD
D. isotonic FVE
53. When monitoring the daily weight of a patient with fluid volume deficit (FVD),
the nurse is aware that fluid loss may be considered when weight loss begins to
exceed:

A. 0.25 lb
B. 0.50 lb
C. 1 lb
D. 1 kg
54. Dietary recommendations for a patient with a hypotonic fluid excess should
include:

A. decreased sodium intake

B. increased sodium intake
C. increased fluid intake
D. intake of potassium-rich foods
55. Osmotic pressure is created through the process of:

A. osmosis
 B. diffusion
C. filtration
D. capillary dynamics
56. A rise in arterial pressure causes the baroreceptors and stretch receptors to
signal an inhibition of the sympathetic nervous system, resulting in:

A. decreased sodium reabsorption

B. increased sodium reabsorption
C. decreased urine output
D. increased urine output
57. Normal serum sodium concentration ranges from:

A. 120 to 125 mEq/L

B. 125 to 130 mEq/L
C. 136 to 145 mEq/L
D. 140 to 148 mEq/L
58. When assessing a patient for electrolyte balance, the nurse is aware that
etiologies for hyponatremia include:

A. water gain
B. diuretic therapy
C. diaphoresis
D. all of the following
59. Nursing interventions for a patient with hyponatremia include:

A. administering hypotonic IV fluids

B. encouraging water intake
C. restricting fluid intake
D. restricting sodium intake
60. The nurse would analyze an arterial pH of 7.46 as indicating:

A. acidosis
B. alkalosis
C. homeostasis
D. neutrality
1.The net diffusion of water from one solution of water from one solution
through a semipermeable membrane to another solution containing a lower
concentration of water is termed:

A. filtration
B. diffusion
C. osmosis
D. brownian motion
2. When assessing a patient’s total body water percentage, the nurse is aware
that all of the following factors influence this except:

A. age
B. fat tissue
C. muscle mass
D. gender
3. Orly Khan is suffering from fluid volume deficit (FVD), which of the following
symptoms would the nurse expect to assess in the patient?

A. rales
B. bounding pulse
C. tachycardia
D. bulging neck veins
4. John Reid is admitted in the hospital and is currently receiving hypertonic
fluids. Nursing management for the client includes monitoring for all of the
following potential complications except:

A. water intoxication
B. fluid volume excess (FVE)
C. cellular dehydration
D. cell shrinkage
5. Mr. Alberto is scheduled to receive an isotonic solution; which one of the
following is an example of such solution?

A. D10% W
B. 0.45% saline
C. 0.9% saline
 D. 3% normal saline W
6. Which of the following arterial blood gas (ABG) values indicates
uncompensated metabolic alkalosis?

A. pH 7.48, PaCO2 42, HCO3 30

B. pH 7.48, PaCO2 46, HCO3 30
C. pH 7.48, PaCO2 34, HCO3 20
D. pH 7.48, PaCO2 34, HCO3 26
7. The body’s compensation of metabolic alkalosis involves:

A. increasing the respiratory rate

B. decreasing the respiratory rate
C. increasing urine output
D. decreasing urine output
8. When assessing a patient for metabolic alkalosis, the nurse would expect to
find:

A. low serum potassium

B. changes in urine output
C. hypotension
D. increased CVP
9. Which of the following blood products should be infused rapidly?

A. packed red blood cells (PRBC)

B. fresh frozen plasma (FFP)
C. platelets
D. dextran
10. Which of the following statements provides the rationale for using a
hypotonic solution for a patient with FVD?

A. A hypotonic solution provides free water to help the kidneys eliminate the
solute.
B. A hypotonic solution supplies an excess of sodium and chloride ions.
C. Excessive volumes are recommended in the early postoperative period.
D. A hypotonic solution is used to treat hyponatremia.
11. Brad is receiving a blood transfusion. When monitoring the patient, the nurse
would analyze an elevated body temperature as indicating:

A. a normal physiologic process

B. evidence of sepsis
C. a possible transfusion reaction
D. an expected response to the transfusion
12. The process of endocrine regulation of electrolytes involves:

A. sodium reabsorption and chloride excretion

B. chloride reabsorption and sodium excretion
C. potassium reabsorption and sodium excretion
D. sodium reabsorption and potassium excretion
13. The chief anion in the intracellular fluid (ICF) is:

A. phosphorus
B. potassium
C. sodium
D. chloride
14. The major cation in the ICF is:

A. potassium
B. sodium
C. phosphorus
D. magnesium
15. Hypophosphatemia may result from which of the following diseases?

A. liver cirrhosis
B. renal failure
C. Paget’s disease
D. alcoholism
16. A patient with which of the following disorders is at high risk for developing
hyperphosphatemia?

A. hyperkalemia
B. hyponatremia
 C. hypocalcemia
D. hyperglycemia
17. Normal calcium levels must be analyzed in relation to:

A. sodium
B. glucose
C. protein
D. fats
18. Calcium is absorbed in the GI tract under the influence of:

A. vitamin D
B. glucose
C. HCl
D. vitamin C
19. Which of the following diagnoses is most appropriate for a patient with hypo
calcemia?

A. constipation, bowel
B. high risk for injury: bleeding
C. airway clearance, ineffective
D. high risk for injury: confusion
20. When serum calcium levels rise, which of the following hormones is secreted?

A. aldosterone
B. renin
C. parathyroid hormone
D. calcitonin
21. The presence of which of the following electrolytes contributes to acidosis?

A. sodium
B. potassium
C. hydrogen
D. chloride
22. The lungs participate in acid-base balance by:

A. reabsorbing bicarbonate
 B. splitting carbonic acid in two
C. using CO2 to regulate hydrogen ions
D. sending hydrogen ions to the renal tubules
23. The respiratory system regulates acid-base balance by:

A. increasing mucus production

B. changing the rate and depth of respirations
C. forming bicarbonate
D. reabsorbing bicarbonate
24. Which of the following is a gas component of the ABG measurement?

A. carbon dioxide
B. bicarbonate
C. hydrogen
D. pH
25. Chloride helps maintain acid-base balance by performing which of the
following roles?

A. participating in the chloride shift

B. following sodium to maintain serum osmolarity
C. maintaining the balance of cations in the ICF and ECF
D. separating carbonic acid
26. Which of the following hormones helps regulate chloride reabsorption?

A. antidiuretic hormone
B. renin
C. estrogen
D. aldosterone
27. Chloride is absorbed in the:

A. stomach
B. bowel
C. liver
D. kidney
28. When chloride concentration drops below 95 mEq/L, reabsorption of which of
the following electrolytes increases proportionally?
 A. hydrogen
B. potassium
C. sodium
D. bicarbonate
29. Jonas is admitted with 1,000 ml of diarrhea per day for the last 3 days. An IV
of 0.45% NaCl mixed with 5% dextrose is infusing. Which of the following nursing
interventions is the most appropriate?

A. Get an infusion controller from central supply.

B. Mix all antibiotics in 0.45% NaCl with 5% dextrose.
C. Check the patient’s potassium level and contact the doctor for IV additive
orders.
D. Assess the patient for signs of hyperkalemia.
30. Mrs. Waltraud is receiving digoxin and Lasix daily. Today, she complains of
nausea, and her apical pulse is 130 and irregular. Which of the following nursing
interventions is the most appropriate?

A. Hold the digoxin and check the patient’s potassium level.

B. Remove the orange juice from the patient’s tray.
C. Identify the patient as high risk for hyperkalemia.
D. Assess the patient for other signs of hypernatremia.
31. The type of fluid used to manipulate fluid shifts among compartments states
is:

A. whole blood
B. TPN
C. albumin
D. Ensure
32. Mr. Miyazaki who is diagnosed of bipolar disorder has been drinking copious
amounts of water and voiding frequently. The patient is experiencing muscle
cramps, twitching, and is reporting dizziness. the nurse checks lab work for:

A. complete blood count results, particularly the platelets.

B. electrolytes, particularly the serum sodium
C. urine analysis, particularly for the presence of white blood cells
D. EEG results
33. When teaching a patient about foods high in magnesium, the nurse would
include:

A. green vegetables
B. butter
C. cheese
D. tomatoes
34. The balance of anions and cations as it occurs across cell membranes is known
as:

A. osmotic activity
B. electrical neutrality
C. electrical stability
D. sodium-potassium pump
35. Maria, an 85-year-old patient with a feeding tube, has been experiencing
severe watery stool. The patient is lethargic and has poor skin turgor, a pulse of
120, and hyperactive reflexes. Nursing interventions would include:

A. measuring and recording intake and output and daily weights

B. administering salt tablets and monitoring hypertonic parenteral solutions
C. administering sedatives
D. applying wrist restraints to avoid displacement of the feeding tube
36. Disease of which of the following structures is most likely to affect electrolyte
reabsorption?

A. glomerulus
B. renal tubules
C. bladder
D. renal pelvis
37. Analiza is diagnosed with hypermagnesemia. Symptoms of her condition may
include:

A. hypertension
B. tachycardia
C. hyperactive deep-tendon reflex
D. cardiac arrhythmias
38. Daniel who is a marathon runner is at high risk for fluid volume deficit. Which
one of the following is a related factor?

A. decreased diuresis
B. disease-related process
C. decreased breathing and perspiration
D. increased breathing and perspiration
39. Jordan is diagnosed with FVD; which of the following nursing diagnoses might
apply to his condition?

A. altered urinary elimination

B. decreased cardiac output
C. increased cardiac output
D. vomiting
40. Body fluids perform which of the following functions?

A. transport nutrients
B. transport electrical charges
C. cushion the organs
D. facilitate fat metabolism
41. Sodium levels are affected by the secretion of which of the following
hormones?

A. progesterone and aldosterone

B. ADH and ACTH
C. antidiuretic hormone and FSH
D. ECF and aldosterone
42. Bicarbonate is lost during which of the following clinical conditions?

A. diarrhea
B. diuresis
C. diaphoresis
D. vomiting
43. Magnesium reabsorption is controlled by:

A. Loop of Henle
 B. glomerulus
C. pituitary
D. parathyroid hormone
44. Heidi has a nursing diagnosis of fluid volume deficit. Which one of the
following medications could potentially exacerbate the problem?

A. Synthroid
B. Digoxin
C. Lasix
D. insulin
45. Alexander has hypotonic FVE; which of the following findings would the nurse
expect to assess in the patient?

A. poor skin turgor and increased thirst

B. weight gain and thirst
C. interstitial edema and hypertension
D. hypotension and pitting edema
46. The interstitial space holds approximately how many liters?

A. 3 L
B. 6 L
C. 9 L
D. 12 L
47. Sodium balance is important for which of the following functions?

A. transmitting impulses in nerve and muscle fibers via the calcium-potassium

pump
B. exchanging for magnesium and attracting chloride
C. combining with hydrogen and chloride for acid-base balance
D. exchanging for potassium and attracting chloride
48. In renal regulation of water balance, the functions of angiotensin II include:

A. blood clotting within the nephron

B. increasing progesterone secretion into the renal tubules
C. catalyzing calcium-rich nutrients
D. selectively constricting portions of the arteriole in the nephron
49. Which of the following nursing diagnoses might apply to a patient with
hypertonic FVE?

A. ineffective airway clearance

B. potential for decreased cardiac output
C. ineffective breathing pattern
D. potential for increased cardiac output
50. The intracellular compartment holds water and:

A. proteins
B. glucose
C. sodium
D. uric acid
51. The majority gastrointestinal reabsorption of water occurs in:

A. small intestines
B. the esophagus
C. the colon
D. the stomach
52. Isotonic FVD can result from:

A. GI fluid loss through diarrhea

B. insensible water loss during prolonged fever
C. inadequate ingestion of fluids and electrolytes
D. impaired thirst regulation
53. The majority of the body’s water is contained in which of the following fluid
compartments?

A. intracellular
B. interstitial
C. intravascular
D. extracellular
54. Etiologies associated with hypomagnesemia include:

A. decreased vitamin D intake

B. constipation
 C. malabsorption syndrome
D. renal failure
55. The danger of fluid sequestered in the third space is that the fluid:

A. is hypertonic and can cause hypervolemia

B. is hypotonic and can cause water intoxication
C. is not available for circulation
D. contains large amounts of acids
56. The extracellular fluid space holds water, electrolytes, proteins and:

A. red blood cells

B. potassium
C. lipids
D. nucleic acids
57. Magnesium performs all of the following functions except:

A. contributing to vasoconstriction
B. assisting in cardiac muscle contraction
C. facilitating sodium transport
D. assisting in protein metabolism
58. Which of the following clinical conditions exacerbates electrolyte excretion?

A. nasogastric feedings
B. use of surgical drains
C. immobility from fractures
D. chronic water drinking
59. A diet containing the minimum daily sodium requirement for an adult would
be:

A. a no-salt diet
B. a diet including 2 gm sodium
C. a diet including 4 gm sodium
D. a 1500 calorie weight-loss diet
60. Which of the following electrolytes are lost as a result of vomiting?

A. bicarbonate and calcium

B. sodium and hydrogen
C. sodium and potassium
D. hydrogen and potassium

1. A chronic pain client reports to you, the charge nurse, that the nurse have not
been responding to requests for pain medication. What is your initial action?

A. Check the MARs and nurses’ notes for the past several days.
B. Ask the nurse educator to give an in-service about pain management.
C. Perform a complete pain assessment and history on the client.
D. Have a conference with the nurses responsible for the care of this client
2. Family members are encouraging your client to “tough it out” rather than run
the risk of becoming addicted to narcotics. The client is stoically abiding by the
family’s wishes. Priority nursing interventions for this client should target which
dimension of pain?

A. Sensory
B. Affective
C. Sociocultural
D. Behavioral
E. Cognitive
3. A client with diabetic neuropathy reports a burning, electrical-type in the lower
extremities that is not responding to NSAIDs. You anticipate that the physician
will order which adjuvant medication for this type of pain?

A. Amitriptyline (Elavil)
B. Corticosteroids
C. Methylphenidate (Ritalin)
D. Lorazepam (Ativan)
4. Which client is most likely to receive opioids for extended periods of time?

A. A client with fibrolyalgia

B. A client with phantom limb pain
C. A client with progressive pancreatic cancer
D. A client with trigeminal neuralgia
5. As the charge nurse, you are reviewing the charts of clients who were assigned
to a newly graduated RN. The RN has correctly charted dose and time of
medication, but there is no documentation regarding non-pharmaceutical
measures. What action should you take first?

A. Make a note in the nurse’s file and continue to observe clinical performance
B. Refer the new nurse to the in-service education department.
C. Quiz the nurse about knowledge of pain management
D. Give praise for the correct dose and time and discuss the deficits in charting.
6. In caring for a young child with pain, which assessment tool is the most useful?

A. Simple description pain intensity scale

B. 0-10 numeric pain scale
C. Faces pain-rating scale
D. McGill-Melzack pain questionnaire
7. In applying the principles of pain treatment, what is the first consideration?

A. Treatment is based on client goals.

B. A multidisciplinary approach is needed.
C. The client must be believed about perceptions of own pain.
D. Drug side effects must be prevented and managed.
8. Which route of administration is preferred if immediate analgesia and rapid
titration are necessary?

A. Intraspinal
B. Patient-controlled analgesia (PCA)
C. Intravenous (IV)
D. Sublingual
9. When titrating an analgesic to manage pain, what is the priority goal?

A. Administer smallest dose that provides relief with the fewest side effects.
B. Titrate upward until the client is pain free.
C. Titrate downwards to prevent toxicity.
D. Ensure that the drug is adequate to meet the client’s subjective needs.
10.In educating clients about non-pharmaceutical alternatives, which topic could
you delegate to an experienced LPN/LVN, who will function under your continued
support and supervision?

A. Therapeutic touch
B. Use of heat and cold applications
C. Meditation
D. Transcutaneous electrical nerve stimulation (TENS)
11.Place the examples of drugs in the order of usage according to the World
Health Organization (WHO) analgesic ladder.

1. Morphine, hydromorphone, acetaminophen and lorazepam

2. NSAIDs and corticosteroids
3. Codeine, oxycodone and diphenhydramine
A. 2,3,1
B. 2,1,3
C. 1,2,3
D. 3,1,2
12.Which client is at greater risk for respiratory depression while receiving opioids
for analgesia?

A. An elderly chronic pain client with a hip fracture

B. A client with a heroin addiction and back pain
C. A young female client with advanced multiple myeloma
D. A child with an arm fracture and cystic fibrosis
13.A client appears upset and tearful, but denies pain and refuses pain
medication, because “my sibling is a drug addict and has ruined out lives.” What is
the priority intervention for this client?

A. Encourage expression of fears on past experiences

B. Provide accurate information about use of pain medication
C. Explain that addiction is unlikely among acute care clients.
D. Seek family assistance in resolving this problem.
14.A client is being tapered off opioids and the nurse is watchful for signs of
withdrawal. What is one of the first signs of withdrawal?
 A. Fever
B. Nausea
C. Diaphoresis
D. Abdominal cramps
15.In caring for clients with pain and discomfort, which task is most appropriate
to delegate to the nursing assistant?

A. Assist the client with preparation of a sitz bath.

B. Monitor the client for signs of discomfort while ambulating
C. Coach the client to deep breathe during painful procedures
D. Evaluate relief after applying a cold application.
16.The physician has ordered a placebo for a chronic pain client. You are newly
hired nurse and you feel very uncomfortable administering the medication. What
is the first action that you should take?

A. Prepare the medication and hand it to the physician

B. Check the hospital policy regarding use of the placebo.
C. Follow a personal code of ethics and refuse to give it.
D. Contact the charge nurse for advice.
17.For a cognitively impaired client who cannot accurately report pain, what is
the first action that you should take?

A. Closely assess for nonverbal signs such as grimacing or rocking.

B. Obtain baseline behavioral indicators from family members.
C. Look at the MAR and chart, to note the time of the last dose and response.
D. Give the maximum PRS dose within the minimum time frame for relief.
18.Which route of administration is preferable for administration of daily
analgesics (if all body systems are functional)?

A. IV
B. IM or subcutaneous
C. Oral
D. Transdermal
E. PCA
19.A first day post-operative client on a PCA pump reports that the pain control is
inadequate. What is the first action you should take?
 A. Deliver the bolus dose per standing order.
B. Contact the physician to increase the dose.
C. Try non-pharmacological comfort measures.
D. Assess the pain for location, quality, and intensity.
20.Which non-pharmacological measure is particularly useful for a client with
acute pancreatitis?

A. Diversional therapy, such as playing cards or board games

B. Massage of back and neck with warmed lotion
C. Side-lying position with knees to chest and pillow against abdomen
D. Transcutaneous electrical nerve stimulation (TENS)
21.What is the best way to schedule medication for a client with constant pain?

A. PRN at the client’s request

B. Prior to painful procedures
C. IV bolus after pain assessment
D. Around-the-clock
22.Which client(s) are appropriate to assign to the LPN/LVN, who will function
under the supervision of the RN or team leader? (Choose all that apply.)

A. A client who needs pre-op teaching for use of a PCA pump

B. A client with a leg cast who needs neurologic checks and PRN hydrocodone
C. A client post-op toe amputation with diabetic neuropathic pain
D. A client with terminal cancer and severe pain who is refusing medication
23.For a client who is taking aspirin, which laboratory value should be reported to
the physician?

A. Potassium 3.6 mEq/L

B. Hematocrit 41%
C. PT 14 seconds
D. BUN 20 mg/dL
24.Which client(s) would be appropriate to assign to a newly graduated RN, who
has recently completed orientation? (Choose all that apply.)

A. An anxious, chronic pain client who frequently uses the call button
 B. A client second day post-op who needs pain medication prior to dressing
changes
C. A client with HIV who reports headache and abdominal and pleuritic chest
pain
D. A client who is being discharged with a surgically implanted catheter
25.A family member asks you, “Why can’t you give more medicine? He is still
having a lot of pain.” What is your best response?

A. “The doctor ordered the medicine to be given every 4 hours.”

B. “If the medication is given too frequently he could suffer ill effects.”
C. “Please tell him that I will be right there to check of him.”
D. “Let’s wait about 30-40 minutes. If there is no relief I’ll call the doctor.”

1. A client’s nursing diagnosis is Deficient Fluid Volume related to excessive fluid

loss. Which action related to the fluid management should be delegated to a
nursing assistant?

A. Administer IV fluids as prescribed by the physician.

B. Provide straws and offer fluids between meals.
C. Develop plan for added fluid intake over 24 hours
D. Teach family members to assist client with fluid intake
2. The client also has the nursing diagnosis Decreased Cardiac Output related to
decrease plasma volume. Which finding on assessment supports this nursing
diagnosis?

A. Flattened neck veins when client is in supine position

B. Full and bounding pedal and post-tibial pulses
C. Pitting edema located in feet, ankles, and calves
D. Shallow respirations with crackles on auscultation
3. The nursing care plan for the client with dehydration includes interventions for
oral health. Which interventions are within the scope of practice for the LPN/LVN
being supervised by the nurse? (Choose all that apply.)

A. Remind client to avoid commercial mouthwashes.

B. Encourage mouth rinsing with warm saline.
C. Assess lips, tongue, and mucous membranes
D. Provide mouth care every 2 hours while client is awake
 E. Seek dietary consult to increase fluids on meal trays.
4. The physician has written the following orders for the client with Excess Fluid
volume. The client’s morning assessment includes bounding peripheral pulses,
weight gain of 2 pounds, pitting ankle edema, and moist crackles bilaterally.
Which order takes priority at this time?

A. Weight client every morning.

B. Maintain accurate intake and output.
C. Restrict fluid to 1500 mL per day
D. Administer furosemide (Lasix) 40 mg IV push
5. You have been pulled to the telemetry unit for the day. The monitor informs
you that the client has developed prominent U waves. Which laboratory value
should you check immediately?

A. Sodium
B. Potassium
C. Magnesium
D. Calcium
6. The client’s potassium level is 6.7 mEq/L. Which intervention should you
delegate to the student nurse under your supervision?

A. Administer Kayexalate 15 g orally

B. Administer spironolactone 25 mg orally
C. Assess WCG strip for tall T waves
D. Administer potassium 10 mEq orally
7. A client is admitted to the unit with a diagnosis of syndrome of inappropriate
antidiuretic hormone secretion (SIADH). For which electrolyte abnormality will
you be sure to monitor?

A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypernatremia
8. The charge nurse assigned in the care for a client with acute renal failure and
hypernatremia to you, a newly graduated RN. Which actions can you delegate to
the nursing assistant?
 A. Provide oral care every 3-4 hours
B. Monitor for indications of dehydration
C. Administer 0.45% saline by IV line
D. Assess daily weights for trends
9. The experienced LPN/LVN reports that a client’s blood pressure and heart rate
have decreased and that when the face is assessed, one side twitches. What
action should you take at this time?

A. Reassess the client’s blood pressure and heart rate

B. Review the client’s morning calcium level
C. Request a neurologic consult today
D. Check the client’s papillary reaction to light
10.You are preparing to discharge a client whose calcium level was low but is now
just slightly within the normal range (9-10.5 mg/dL). Which statement by the
client indicates the need for additional teaching?

A. “I will call my doctor if I experience muscle twitching or seizures.”

B. “I will make sure to take my vitamin D with my calcium each day.”
C. “I will take my calcium pill every morning before breakfast.”
D. “I will avoid dairy products, broccoli, and spinach when I eat.”
11.A nursing assistant asks why the client with a chronically low phosphorus level
needs so much assistance with activities of daily living. What is your best
response?

A. “The client’s low phosphorus is probably due to malnutrition.”

B. “The client is just worn out form not getting enough rest.”
C. “The client’s skeletal muscles are weak because of the low phosphorus.”
D. “The client will do more for herself when her phosphorus is normal”
12.You are reviewing a client’s morning laboratory results. Which of these results
is of most concern?

A. Serum potassium 5.2 mEq/L

B. Serum sodium 134 mEq/L
C. Serum calcium 10.6 mg/dL
D. Serum magnesium 0.8 mEq/L
13. You are the charge nurse. Which client is most appropriate to assign to the
step-down unit nurse pulled to the intensive care unit for the day?
 A. A 68-year-old client on ventilator with acute respiratory failure and
respiratory acidosis
B. A 72-year-old client with COPD and normal arterial blood gases (ABGs) who is
ventilator-dependent
C. A 56-year-old new admission client with diabetic ketoacidosis (DKA) on a n
insulin drip
D. A 38-year-old client on a ventilator with narcotic overdose and respiratory
alkalosis
14.A client with respiratory failure is receiving mechanical ventilation and
continues to produce ABG results indicating respiratory acidosis. Which action
should you expect to correct this problem?

A. Increase the ventilator rate from 6 to 10 per minute

B. Decrease the ventilator rate from 10 to 6 per minute
C. Increase the oxygen concentration fro 30% to 40%
D. Decrease the oxygen concentration fro 40% to 30%
15.Which action should you delegate to the nursing assistant for the client with
diabetic ketoacidosis? (Choose all that apply.)

A. Check fingerstick glucose every hour.

B. Record intake and output every hour.
C. Check vital signs every 15 minutes.
D. Assess for indicators of fluid imbalance.
16.You are admitting an elderly client to the medical unit. Which factor indicates
that this client has a risk for acid-base imbalances?

A. Myocardial infarction 1 year ago

B. Occasional use of antacids
C. Shortness of breath with extreme exertion
D. Chronic renal insufficiency
17.A client with lung cancer has received oxycodone 10 mg orally for pain. When
the student nurse assesses the client, which finding should you instruct the
student to report immediately?

A. Respiratory rate of 8 to 10 per minute

B. Pain level decreased from 6/10 to 2/10
C. Client requests room door be closed.
 D. Heart rate 90-100 per minute
18.The nursing assistant reports to you that a client seems very anxious and that
vital signs included a respiratory rate of 38 per minute. Which acid-base
imbalance should you suspect?

A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
19.A client is admitted to the unit for chemotherapy. To prevent an acid-base
problem, which of the following would you instruct the nursing assistant to
report?

A. Repeated episodes of nausea and vomiting

B. Complaints of pain associated with exertion
C. Failure to eat all food on breakfast tray
D. Client hair loss during morning bath
20.A client has a nasogastric tube connected to intermittent wall suction. The
student nurse asks why the client’s respiratory rate has increased. What your best
response?

A. “It’s common for clients with uncomfortable procedures such as nasogastric

tubes to have a higher rate to breathing.”
B. “The client may have a metabolic alkalosis due to the NG suctioning and the
increased respiratory rate is a compensatory mechanism.”
C. “Whenever a client develops a respiratory acid-base problem, increasing the
respiratory rate helps correct the problem.”
D. “The client is hyperventilating because of anxiety and we will have to stay
alert for development of a respiratory acidosis.”
21. George Kent is a 54 year old widower with a history of chronic obstructive
pulmonary disease and was rushed to the emergency department with increasing
shortness of breath, pyrexia, and a productive cough with yellow-green sputum.
He has difficulty in communicating because of his inability to complete a
sentence. One of his sons, Jacob, says he has been unwell for three days. Upon
examination, crackles and wheezes can be heard in the lower lobes; he has a
tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH
7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you
interpret this?

A. Respiratory Acidosis, Uncompensated

B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially Compensated
22. Carl, an elementary student, was rushed to the hospital due to vomiting and a
decreased level of consciousness. The patient displays slow and deep (Kussmaul
breathing), and he is lethargic and irritable in response to stimulation. He appears
to be dehydrated—his eyes are sunken and mucous membranes are dry—and he
has a two week history of polydipsia, polyuria, and weight loss. Measurement of
arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg, and HCO3 12
mmol/L; other results are Na+ 126 mmol/L, K+ 5 mmol/L, and Cl- 95 mmol/L.
What is your assessment?

A. Respiratory Acidosis, Uncompensated

B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially, Compensated
23. A cigarette vendor was brought to the emergency department of a hospital
after she fell into the ground and hurt her left leg. She is noted to be tachycardic
and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she
started complaining that she is still in pain and now experiencing muscle cramps,
tingling, and paraesthesia. Measurement of arterial blood gas reveals pH 7.6,
PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L. What does this mean?

A. Respiratory Alkalosis, Uncompensated

B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated
24. Ricky’s grandmother is suffering from persistent vomiting for two days now.
She appears to be lethargic and weak and has myalgia. She is noted to have dry
mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as
having gastroenteritis and dehydration. Measurement of arterial blood gas shows
pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-base
disorder is shown?
 A. Respiratory Alkalosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated
25. Mrs. Johansson, who had undergone surgery in the post-anesthesia care unit
(PACU), is difficult to arouse two hours following surgery. Nurse Florence in the
PACU has been administering Morphine Sulfate intravenously to the client for
complaints of post-surgical pain. The client’s respiratory rate is 7 per minute and
demonstrates shallow breathing. The patient does not respond to any stimuli! The
nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and obtains
ABGs STAT! Measurement of arterial blood gas shows pH 7.10, PaCO2 70 mm Hg
and HCO3 24 mEq/L. What does this mean?

A. Respiratory Alkalosis, Partially Compensated

B. Respiratory Acidosis, Uncompensated
C. Metabolic Alkalosis, Partially Compensated
D. Metabolic Acidosis, Uncompensated
26. Baby Angela was rushed to the Emergency Room following her mother’s
complaint that the infant has been irritable, difficult to breastfeed and has had
diarrhea for the past 3 days. The infant’s respiratory rate is elevated and the
fontanels are sunken. The Emergency Room physician orders ABGs after assessing
the ABCs. The results from the ABG results show pH 7.39, PaCO2 27 mmHg and
HCO3 19 mEq/L. What does this mean?

A. Respiratory Alkalosis, Fully Compensated

B. Metabolic Acidosis, Uncompensated
C. Metabolic Acidosis, Fully Compensated
D. Respiratory Acidosis, Uncompensated
27. Mr. Wales, who underwent post-abdominal surgery, has a nasogastric tube.
The nurse on duty notes that the nasogastric tube (NGT) is draining a large
amount (900 cc in 2 hours) of coffee ground secretions. The client is not oriented
to person, place, or time. The nurse contacts the attending physician and STAT
ABGs are ordered. The results from the ABGs show pH 7.57, PaCO2 37 mmHg and
HCO3 30 mEq/L. What is your assessment?

A. Metabolic Acidosis, Uncompensated

B. Metabolic Alkalosis, Uncompensated
 C. Respiratory Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated
28. Client Z is admitted to the hospital and is to undergo brain surgery. The client
is very anxious and scared of the upcoming surgery. He begins to hyperventilate
and becomes very dizzy. The client loses consciousness and the STAT ABGs reveal
pH 7.61, PaCO2 22 mmHg and HCO3 25 mEq/L. What is the ABG interpretation
based on the findings?

A. Metabolic Acidosis, Uncompensated

B. Respiratory Alkalosis, Partially Compensated
C. Respiratory Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated
29. Three-year-old Adrian is admitted to the hospital with a diagnosis of asthma
and respiratory distress syndrome. The mother of the child reports to the nurse
on duty that she has witnessed slight tremors and behavioral changes in her child
over the past four days. The attending physician orders routine ABGs following an
assessment of the ABCs. The ABG results are pH 7.35, PaCO2 72 mmHg and HCO3
38 mEq/L. What acid-base disorder is shown?

A. Respiratory Acidosis, Uncompensated

B. Respiratory Acidosis, Fully Compensated
C. Respiratory Alkalosis, Fully Compensated
D. Metabolic Alkalosis, Partially Compensated
30. Anne, who is drinking beer at a party, falls and hits her head on the ground.
Her friend Liza dials “911” because Anne is unconscious, depressed ventilation
(shallow and slow respirations), rapid heart rate, and is profusely bleeding from
both ears. Which primary acid-base imbalance is Anne at risk for if medical
attention is not provided?

A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
31. Dave, a 6-year-old boy, was rushed to the hospital following her mother’s
complaint that her son has been vomiting, nauseated and has overall weakness.
After series of tests, the nurse notes the laboratory results: potassium: 2.9 mEq.
Which primary acid-base imbalance is this boy at risk for if medical intervention is
not carried out?

A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
32. An old beggar was admitted to the emergency department due to shortness
of breath, fever, and a productive cough. Upon examination, crackles and
wheezes are noted in the lower lobes; he appears to be tachycardic and has a
bounding pulse. Measurement of arterial blood gas shows pH 7.2, PaCO2 66 mm
Hg, HCO3 27 mmol/L, and PaO2 65 mm Hg. As a knowledgeable nurse, you know
that the normal value for pH is:

A. 7.20
B. 7.30
C. 7.40
D. 7.50
33. Liza’s mother is seen in the emergency department at a community hospital.
She admits that her mother is taking many tablets of aspirin (salicylates) over the
last 24-hour period because of a severe headache. Also, the mother complains of
an inability to urinate. The nurse on duty took her vital signs and noted the
following: Temp = 97.8 °F; apical pulse = 95; respiration = 32 and deep. Which
primary acid-base imbalance is the gentleman at risk for if medical attention is
not provided?

A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
34. A patient who is hospitalized due to vomiting and a decreased level of
consciousness displays slow and deep (Kussmaul breathing), and he is lethargic
and irritable in response to stimulation. The doctor diagnosed him of having
dehydration. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg,
PaCO2 22 mm Hg, and HCO3 14 mmol/L; other results are Na+ 120 mmol/L, K+
2.5 mmol/L, and Cl- 95 mmol/L. As a knowledgeable nurse, you know that the
normal value for PaCO2 is:
 A. 22 mm Hg
B. 36 mm Hg
C. 48 mm Hg
D. 50 mm Hg
35. A company driver is found at the scene of an automobile accident in a state of
emotional distress. He tells the paramedics that he feels dizzy, tingling in his
fingertips, and does not remember what happened to his car. Respiratory rate is
rapid at 34/minute. Which primary acid-base disturbance is the young man at risk
for if medical attention is not provided?

A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
36. An elderly client was admitted to hospital in a coma. Analysis of the arterial
blood gave the following values: PCO2 16 mm Hg, HCO3- 5 mmol/L and pH 7.1. As
a well-rounded nurse, you know that the normal value for HCO3 is:

A. 20 mmol/L
B. 24 mmol/L
C. 29 mmol/L
D. 31 mmol/L
37. In a patient undergoing surgery, it was vital to aspirate the contents of the
upper gastrointestinal tract. After the operation, the following values were
acquired from an arterial blood sample: pH 7.55, PCO2 52 mm Hg and HCO3- 40
mmol/l. What is the underlying disorder?

A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
38. A mountaineer attempts an assault on a high mountain in the Andes and
reaches an altitude of 5000 meters (16,400 ft) above sea level. What will happen
to his arterial PCO2 and pH?

A. Both will be lower than normal.

B. The pH will rise and PCO2 will fall.
 C. Both will be higher than normal due to the physical exertion.
D. The pH will fall and PCO2 will rise
39. A young woman is found comatose, having taken an unknown number of
sleeping pills an unknown time before. An arterial blood sample yields the
following values: pH 6.90, HCO3- 13 meq/liter and PaCO2 68 mmHg. This patient’s
acid-base status is most accurately described as:

A. Metabolic Acidosis
B. Respiratory Acidosis
C. Simultaneous Respiratory and Metabolic Acidosis
D. Respiratory Acidosis with Complete Renal Compensation
40. A mother is admitted in the emergency department following complaints of
fever and chills. The nurse on duty took her vital signs and noted the following:
Temp = 100 °F; apical pulse = 95; respiration = 20 and deep. Measurement of
arterial blood gas shows pH 7.37, PaO2 90 mm Hg, PaCO2 40 mm Hg, and HCO3
24 mmol/L. What is your assessment?

A. Hyperthermia
B. Hyperthermia and Respiratory Alkalosis
C. Hypothermia
D. Hypothermia and Respiratory Alkalosis