MDC2 Study guide
READ ALL THE QUESTIONS AND ANSWER CHOICES
The nurse is caring for a client that presented with an asthma attack. The client was working out and forgot to take an inhaler. The respiratory rate is 24 breaths per minute. The pulse oximeter is 85% on room air. The arterial blood gas (ABG) is as follows: pH:7.33, PaCO2: 50 mm Hg, paO2: 70 mm Hg, HCO3: 26 mEq/L. What acid-base deficit is the client experiencing?
E. Respiratory acidosis with partial metabolic compensation
F. Respiratory acidosis with full metabolic compensation
G. Metabolic acidosis with full respiratory compensation
H. Metabolic alkalosis without compensation
A nurse is educating a Type 1 diabetic with metabolic acidosis. Which of the following statements indicates the teaching has been effective on the cause of metabolic acidosis?
a. metabolic acidosis can occur due to diabetic ketoacidosis
b. metabolic acidosis can occur due to excessive vomiting
c. metabolic acidosis can occur due to excessive urination
d. metabolic acidosis can occur due to overhydration
A nurse is caring for a client admitted with acute confusion and weakness. The client admitted to ingesting a large amount of aspirins. Vital signs reveal blood pressure 102/70 mm Hg. Heart rate 120 beats/minute and deep respirations at 42 breaths/minute. Arterial blood gas (ABG) results reveal pH. 7.2 paco2 35 mm hg, paO2 90MM HG, and HCO3 18 meq/L. how does the nurse interpret these results? A person who came to the hospital with acute confusion and weakness is being cared for by a nurse. The client said that he had taken a lot of aspirin. Blood pressure is 102/70 mm Hg, based on the vital signs. 120 beats per minute on the heart rate, and 42 deep breaths per minute. Arterial blood gas (ABG) results show a pH of 7.2, a CO2 level of 35 mm Hg, an O2 level of 90 mm Hg, and a CO3 level of 18 meq/L. how does the nurse figure out what these numbers mean?
a. Metabolic acidosis without compensation
b. Respiratory acidosis without compensation
c. Metabolic alkalosis with partial respiratory compensation
d. Metabolic acidosis with full respiratory compensation
The nurse is caring for a client who recently ingested a large amount of antacids. Which of the following conditions is this client at risk for?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory alkalosis
d. Respiratory acidosis
34. When assessing arterial blood gas (ABG) results, what is the first step that the nurse should take for interpretation?
A. Check for compensation
B. Notify the healthcare provider
C. Determine the primary cause
D. Determine oxygenation
What condition(s) does the nurse anticipate in a client with metabolic acidosis? ( select all thatapply)
A. Diabetic ketoacidosis
B. seizure activity
C. starvation
D. kidney failure
E. Airway obstruction
The nurse is caring for a client who is status post an upper endoscopic procedure. Which assessment finding would the nurse anticipate for the client to resume their diet?
a. Negative stool culture
b. Normal temperature
c. Effective swallowing
d. Bowel movement
A nurse is caring for a type one diabetic client with metabolic alkalosis. Which of the following symptoms would the nurse expect the client to exhibit?
A. Tachycardia
B. Kussmaul respirations
C. Bradycardia
D. decreased reflexes
While discharging a client with peptic ulcer disease. Which of these should the nurse include in the education? (select all that apply)
A. Resume diet as preferred
B. Avoid alcohol consumption
C. Adhere to prescribed medications
D. When to notify the healthcare provider
E. Encourage non-steroidal anti-inflammatory drugs (NSAIDs) for pain
A client has the following arterial blood gas (ABG) results. How would the nurse interpret these results?
pH 7.42
PaCO2 55 mm Hg
HCO3 32 mEq/L
A. Metabolic alkalosis with partial respiratory compensation
B. Metabolic alkalosis with full respiratory compensation
C. Respiratory alkalosis with full metabolic compensation
D. Respiratory alkalosis with partial respiratory compensation
The nurse is caring for a client that presented with an asthma attack. The client was workingout and forgot to take an inhaler. The respiratory rate is 38 breaths per minute. The pulse oximeter is 85% on room air. The arterial blood gas (ABG) is as follows: pH:7.35, PaCO2: 50 mm Hg, paO2: 70 mm Hg, HCO3: 32 mEq/L. What acid-base deficit is the client experiencing?
A. Respiratory acidosis with partial metabolic compensation
B. Respiratory acidosis with full metabolic compensation
C. Metabolic acidosis with full respiratory compensation
D. Metabolic alkalosis without compensation
The nurse is caring for an 80-year-old client diagnosed with gastric cancer three months ago.The client has undergone chemotherapy and radiation and recently had surgery to remove the cancer. During the surgical procedure, the surgeon discovered that the cancer had spread to other organs. The client’s family is having difficulty deciding treatment options. Which of the following interventions are appropriate for the RN in providing the client’s care?
A. Schedule client for additional chemotherapy
B. Schedule client for additional radiation therapy
C. Request a consult for palliative care services
D. Discharge client to hospice
4. Which of the following conditions would result in respiratory acidosis?
A. Diabetic ketoacidosis
B. Hypoglycemia
C. Chronic obstructive pulmonary disease
D. Salicylate toxicity
5. A nurse is providing discharge instructions to a client recently diagnosed with peptic ulcer disease. Which of the following should not be part of the discharge instructions?
A. Avoid spicy foods
B. Resume alcohol in moderation
C. Follow medications as prescribed
D. Signs and symptoms to report
8. What is the nurse’s priority to include when educating a client with esophageal cancer about their plan of care?
A. “One of the most important things we need to monitor for is weight loss. Please weigh yourself daily.”
B. “Esophageal dilation is only used once during the course of your treatment when your side effects are too severe to tolerate.”
C. “If you get tired in the afternoon, it’s good idea to take a nap after lunch to reenergize.”
D. “Hospice care might be needed towards the end, but you can still have chemotherapy at the same time.”
9. The following arterial blood gas reflects which of the following acid-base imbalance?
pH 7.38
PaCO2 40 mm Hg paO2 94 mm Hg
HCO3 26mEq/L
A. Respiratory acidosis fully compensated
B. Metabolic acidosis partially compensated
C. Normal arterial blood gas
D. Respiratory alkalosis
12 A nurse is caring for a client who identities as Native American and is being treated for metabolic alkalosis. Before discharge, which of the following will address the multidimensional needs of the client? (Select all that apply.)
A. Provide emotional support
B. Provide education
C. Conduct a cultural assessment
D. Consult the dietician
E. Ensure the client is on strict bed rest
16. A nurse is caring for a client admitted with a fever, cough, and body aches with a positive influenza A screening. The client states the sickness started last week but could not afford to miss work with a new job and no health insurance. The client expresses financial concern with the hospital stay. Which of the following intervention would the nurse implement to support the care of the client? (select all that apply.)
A. Consult social worker
B. Notify the client’s employer
C. Notify the dietician
D. Consult client financial services
E. Nurse requests psychiatric consult
17. A client has the following arterial blood gas (ABG) results. How would the nurse interpret these results? pH 7.36
PaCO2 58 mm Hg
HCO3 30mEq/L
A. Metabolic acidosis with full respiratory compensation
B. Metabolic alkalosis with partial respiratory compensation
C. Respiratory acidosis with full metabolic compensation
D. Respiratory acidosis with partial metabolic compensation
3. Which of the following signs and symptoms should the investigate first when assessing aclient diagnosed with respiratory acidosis?
A. Warm flushed skin
B. Skeletal muscle weakness
C. Confusion
D. Respiratory rate of 8 breaths/minutes
4. The nurse is caring for a 45-year-old client with asthma. The client presented to theemergency department with shortness of breath and arterial blood gas (ABG) result of pH:7.28, PaCO2: 50 mm Hg, PO2; 84 mm Hg, and HCO3: 26 mEq/L. Which of the following is the correct interpretation of the client’s ABG?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
5. The nurse provides discharge instructions to a client recently diagnosed with a hiatal hernia. The client also has a history of gastroesophageal reflux disease (GERD). Which of the following should be included in the client and family education?
A. Remain in an upright position once to two hours after eating
B. Take antacids before eating
C. Drink a carbonated beverage before meals
D. Sleep with the head of the bed flat
6. A nurse is performing discharge teaching for a client who was recently diagnosed withgastritis. Which of the following should be included in the texting?
A. Limit exercise
B. Eat three large meals each day
C. stress reduction
D. Take nonsteroidal anti-inflammatory drugs (NSAIDs) as prescribed
7. Which of the following laboratory tests does the nurse need to assess to determine if the client’s acid-base imbalance is respiratory or metabolic?
A. Complete blood count
B. Liver function test
C. Arterial blood gas
D. Complete metabolic panel
4. A nurse is caring for a client with metabolic acidosis from pancreatitis. The nurse anticipates implementing, which of the following?
A. Administer insulin
B. Administer sodium bicarbonate
C. Administer antiemetics
D. Administer mucolytic
28. The nurse is caring for a client who is concerned about developing oral tumors. Which client statement requires immediate nursing intervention?
A. “I used to chew tobacco but quit five years ago”
B. “I use sunscreen to cover my face and body when i’m at the beach.”
C. “I don’t have dental insurance, so i can’t get dental check ups.”
D. “I only drink alcohol on special occasions like my birthday and anniversary.”
31. Which of the following electrolyte imbalances would be the priority to address in a client with end-stage renal failure?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypermagnesemia
5. When assessing arterial blood gas (ABG) results, what is the first step that the nurse should take bowelfor interpretation?
A. Check for compensation
B. Label the pH
C. Determine
D. e primary cause
E. Determine oxygenation
6. A 42-year-old client was recently diagnosed with gastric cancer. The nurse has a wife and three small children. The client and the wife are having a difficult time dealing with the recent diagnosis. Which of the following nursing intervention is appropriate for this client?
A. Educate on treatment options
B. Consult the dietician regarding nutritional needs
C. Monitor lab values for abnormalities
D. Consult social services to provide support to the client and family
7. A nurse is caring for a 56-year-old client who presented to the emergency department with a feeling of fullness in the chest, dysphagia, and chest pain. The client states these symptoms for the past couple of months. Which of the following conditions could the client be exhibiting based on the symptoms?
A. Peptic ulcer disease
B. Gastritis
C. Hiatal hernia
D. Uvulitis
2. A nurse is caring for a 56-year-old client who presented to the emergency department with a feeling of abdominal fullness and dysphagia. The client states reports a recent bloody emesis and long term ibuprofen use. Which of the following conditions could the client be exhibiting based on the symptoms?
A. Peptic ulcer disease
B. Gastritis
C. Hiatal hernia
D. Uvulitis
8. The client’s arterial blood gas (ABG) results show an increase in pH greater than 7.45. Which conditions is most likely to contribute to this laboratory value?
A. Renal failure
B. Ketosis
C. Hyperventilation
D. Diarrhea
9. What condition(s) does the nurse anticipate in a client with aspirin toxicity? ( select all thatapply)
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis
E. No acid-base imbalance
10. A nurse is caring for a client who is status post an upper endoscopic procedure. Which ofthe following should be included as a priority in the post-procedure assessment?
A. Fecal occult test
B. Gag reflex
C. Temperature
D. Bowel sounds
11. A client has the following arterial blood gas (ABG) results. How does the nurse interpretthese results?
pH 7.50
PaCO2 30 mm Hg
HCO3 20mEq/L
A. Metabolic acidosis with partial respiratory compensation
B. Respiratory alkalosis with partial metabolic compensation
C. Respiratory alkalosis with partial full metabolic compensation
D. Metabolic alkalosis with partial respiratory compensation
12. A nurse is caring for a type one diabetic client with metabolic acidosis. Which of the following symptoms would the nurse expect the client to exhibit?
A. Hypertension
B. Kussmaul respirations
C. Hypoventilation
D. Hyperreflexia
43. Which of the following clients are at risk for developing stomatitis?
A. A 48-year-old client diagnosed with osteoarthritis
B. A 70-year-old client diagnosed with obesity
C. A 55-year-old client with colon cancer
D. A 50-year-old client diagnosed with heart failure
44. The nurse is caring for a 50-year-old client admitted to the emergency department for a suspected upper gastrointestinal bleed. Which of the following clinical findings would support this diagnosed? (select all that apply)
A. Bright red or coffee-ground vomitus
B. Vertigo or dizziness
C. Increased blood pressure
D. Weak peripheral pulses
E. Decreased hemoglobin and hematocrit values
46. The nurse is caring for a client who recently underwent a colon resection. The client issecond-day post-op with a nasogastric tube to low intermittent wall suction. Which of the following conditions is this client at risk for?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
13. Which of the following is a standard diagnostic study for clients with upper gastrointestinaldisorders?
A. Arterial blood gas
B. Liver function test
C. Barium enema
D. Esophagogastroduodenoscopy
14. When caring for a client suffering from metabolic acidosis, which of the following would thenurse anticipate as a treatment option?
A. Ammonium chloride
B. Acetazolamide
C. Sodium bicarbonate
D. Potassium
