Prep U Quiz 2 - Notes PDF

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Prep U Quiz 2: Acid-Base Balance

Question 1 A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO 2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3–) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? You Selected: 

Respiratory alkalosis

Correct response: 

Metabolic alkalosis

Explanation: A pH over 7.45 with a HCO3– level over 26 mEq/L indicates metabolic alkalosis. Metabolic alkalosis is always secondary to an underlying cause and is marked by decreased amounts of acid or increased amounts of base HCO3–. The client isn't experiencing respiratory alkalosis because the PaCO2 is normal. The client isn't experiencing respiratory or metabolic acidosis because the pH is greater than 7.35.

Question 2 A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instructions? Choose all that apply. Correct response: 

"Continue to take antacids even if your symptoms subside."



"You may be prescribed H2-receptor antagonists for up to 1 year."

Explanation: The client is advised to adhere to and complete the medication regimen to ensure complete healing of the ulcer. Because most clients become symptom-free within 1 week, the nurse stresses the importance of following the prescribed regimen so that the healing process can continue uninterrupted and the return of chronic ulcer symptoms can be prevented. Maintenance dosages of H2-receptor antagonists are usually recommended for 1 year. Taking antacids concomitantly with other drugs should be avoided. For best results antacids should be taken 1 hour before or 2 hours after meals. Antacids will not make the client sleepy.

Question 3 The nurse is evaluating a client’s blood gases. The client has a pH of 7.35. How does the nurse interpret this value? You Selected: 

It indicates acidosis.

Correct response: 

It is within a normal range.

Explanation: The normal body range of pH is 7.35 to 7.45. The other answers are incorrect. An acidotic value would be indicated by a pH less than 7.35 and an alkalotic level would be indicated by a pH greater than 7.45.

Question 4 A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? Correct response: 

pH 7.28, PaO2 50 mm Hg

Explanation: ARF is defined as a decrease in arterial oxygen tension (PaO 2) to less than 60 mm Hg (hypoxemia) and an increase in arterial carbon dioxide tension (PaCO2) to >50 mm Hg (hypercapnia), with an arterial pH less than 7.35.

Question 5 During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will: Correct response: 

stimulate the release of secretin, which then inhibits release of gastrin.

Explanation: Secretin, which is secreted by S cells in the mucosa of the duodenum and jejunum, inhibits gastric acid secretion. The entry of an acid chyme into the intestine stimulates the release of secretin, which inhibits the release of gastrin. Several gut-derived hormones have been identified as having what is termed an incretin effect, meaning that they increase insulin release after an oral glucose load. This suggests that gut-derived factors can stimulate insulin secretion after a high-carbohydrate meal. The two hormones that account for about 90% of the incretin effect are glucagon-like peptide 1 (GLP-1) and glucose-

dependent insulinotropic peptide (GIP). Because increased levels of GLP-1 and GIP can lower blood glucose levels by augmenting insulin release in a glucose-dependent manner (i.e., at low blood glucose levels) no further insulin is secreted, minimizing the risk of hypoglycemia....