Respiratory Acidosis | Arterial Blood Gas NCLEX & Nursing School Exams Like A Boss

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RESPIRATORY ACIDOSIS NCLEX QUIZ QUESTIONS

Question 1: A patient who was found unresponsive in the field has arterial blood gas results of pH 7.15, PaCO2 85 mmHg, and HCO3 21 mEq/L. The nurse interprets the results as ___________.

1. Partially Compensated Respiratory Acidosis
2. Uncompensated Respiratory Acidosis
3. Partially Compensated Respiratory Alkalosis
4. Uncompensated Respiratory Alkalosis

 

Question 2: The nurse is caring for a patient with atelectasis. The nurse interprets the arterial blood gas results and determines the patient is experiencing respiratory acidosis. Which results validates the nurse’s interpretation?

1. pH 7.28, PaCO2 55 mmHg
2. pH 7.40, PaCO2 40 mmHg
3. pH 7.55, PaCO2 50 mmHg
4. pH 7.48, PaCO2 25 mmHg

 

Question 3: The nurse is caring for a patient involved in a motor vehicle accident with broken ribs. The patient is most likely to experience which of the following acid base imbalance?

1. Respiratory Alkalosis due to hyperventilation
2. Respiratory Acidosis due to inadequate ventilation
3. Metabolic Acidosis due to hypocalcemia effects of broken ribs
4. Metabolic Alkalosis due to medications containing bicarbonate

 

Question 4: A patient is admitted to the Progressive Care Unit after a suspected opioid overdose. The ABG results show pH of 7.25, PaCO2 of 60, and an HCO3 of 24. Based on the results and patient condition, the nurse would provide an intervention for which of the following?

1. Decreased level of consciousness
2. Diarrhea
3. Tachypnea
4. Bradypnea

 

Question 5: Potential causes for respiratory acidosis include all of the following, except:

1. Hyperventilation
2. Hypoventilation
3. Airway obstruction
4. Pneumothorax
5. Overventilation by mechanical ventilation

 

Question 6: When caring for a patient diagnosed with opioid overdose, which of the following is the priority intervention?

1. Proper oxygenation and ventilation
2. Nausea and vomiting control
3. Fever reduction
4. Anxiety maintenance

 

RESPIRATORY ACIDOSIS NCLEX QUIZ ANSWERS

Question 1: A patient who was found unresponsive in the field has arterial blood gas results of pH 7.15, PaCO2 85 mmHg, and HCO3 21 mEq/L. The nurse interprets the results as ___________.

1. Partially Compensated Respiratory Acidosis
2. Uncompensated Respiratory Acidosis
3. Partially Compensated Respiratory Alkalosis
4. Uncompensated Respiratory Alkalosis

The acid base imbalance is respiratory acidosis without compensation. Normal ABG levels include pH is between 7.35 – 7.45, PaCO2 35 – 45, HCO3 21 – 28. In respiratory acidosis, the pH is decreased and the PaCO2 is increased. Because the bicarbonate is still within normal limits, the kidneys have not had enough time to adjust for the acid base imbalance. In addition, the pH is not within normal limits making the condition uncompensated.

 

Question 2: The nurse is caring for a patient with atelectasis. The nurse interprets the arterial blood gas results and determines the patient is experiencing respiratory acidosis. Which results validates the nurse’s interpretation?

1. pH 7.28, PaCO2 55 mmHg
2. pH 7.40, PaCO2 40 mmHg
3. pH 7.55, PaCO2 50 mmHg
4. pH 7.48, PaCO2 25 mmHg

Atelectasis is a condition characterized by the collapse of alveoli. This collapse impairs respiratory gas exchange from occurring. Carbon dioxide builds up in the circulatory system and oxygenation continues to worsen. Normal ABG levels include pH is between 7.35 – 7.45, PaCO2 35 – 45, HCO3 21 – 28. In respiratory acidosis, the pH is decreased and the PaCO2 is increased.

 

Question 3: The nurse is caring for a patient involved in a motor vehicle accident with broken ribs. The patient is most likely to experience which of the following acid base imbalance?

1. Respiratory Alkalosis due to hyperventilation
2. Respiratory Acidosis due to inadequate ventilation
3. Metabolic Acidosis due to hypocalcemia effects of broken ribs
4. Metabolic Alkalosis due to medications containing bicarbonate

Respiratory acidosis can occur post motor vehicle accidents when broken ribs are involved. Broken ribs make it difficult to breath causing inadequate ventilation due to the pain. This can results in respiratory acidosis.

 

Question 4: A patient is admitted to the Progressive Care Unit after a suspected opioid overdose. The ABG results show pH of 7.25, PaCO2 of 60, and an HCO3 of 24. Based on the results and patient condition, the nurse would provide an intervention for which of the following?

1. Decreased level of consciousness
2. Diarrhea
3. Tachypnea
4. Bradypnea

Patients who present with opioid overdoses can exhibit shallow and slow respirations. Normal ABG levels include pH is between 7.35 – 7.45, PaCO2 35 – 45, HCO3 21 – 28. The patient’s ABG results show respiratory acidosis. The nurse would need to provide an intervention to increase the rate and depth of breathing by either administering naloxone or preparing the patient for intubation (non-invasive or invasive). This patient may also need to be transferred to the ICU.

 

Question 5: Potential causes for respiratory acidosis include all of the following, except:

1. Hyperventilation
2. Hypoventilation
3. Airway obstruction
4. Pneumothorax
5. Overventilation by mechanical ventilation

Hypoventilation is caused by primary defects in the function of the lungs or changes in normal respiratory patterns. Decreased respiratory rate and shallow breathing have been noted as respiratory acidosis causes. Airway obstruction leads to hypoventilation or depression of the respiratory system. Lung collapse conditions such as a pneumothorax or atelectasis can lead to impaired gas exchange causing an increase in PaCO2 levels. Hyperventilation and overventilation by mechanical ventilation are both causes of respiratory alkalosis.

 

Question 6: When caring for a patient diagnosed with opioid overdose, which of the following is the priority intervention?

1. Proper oxygenation and ventilation
2. Nausea and vomiting control
3. Fever reduction
4. Anxiety maintenance

The most concerning side effect of opioid overdoses is sedation and depression of the respiratory system. Naloxone can be a great tool for opioid overdose reversal; however, many patients can become re-sedated as the half-life for naloxone may not exceed the half-life of the opioids ingested. Nausea/vomiting control, fever reduction, and anxiety maintenance are also important but are not priority.