NCLEX-RN
Fluid and Electrolytes NCLEX RN Questions Questions
Question 1 of 5
The nurse recognizes which of the following are potential causes of metabolic alkalosis? Select all that apply.
Correct Answer: A,C,E
Rationale: Metabolic alkalosis is caused by an increase in bicarbonate or loss of acid. Vomiting (
A) leads to loss of gastric acid, increasing bicarbonate. Antacids (
C) neutralize acid, raising bicarbonate levels. Hypokalemia (E) can cause hydrogen ion shifts, contributing to alkalosis. Diarrhea (
B) causes bicarbonate loss, leading to acidosis, not alkalosis. Starvation (
D) is associated with ketoacidosis, not alkalosis.
Question 2 of 5
Based on the results, which of the following orders should the nurse anticipate the physician would order? Laboratory: pH 7.33 [7.35-7.45], PaCO2 53 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 95 mm Hg [80-100 mm Hg]
Correct Answer: B
Rationale: The ABG shows respiratory acidosis (pH 7.33, PaCO2 53 mm Hg). Bronchodilators (
B) improve ventilation, reducing PaCO2. Supplemental oxygen (
A) is unnecessary as PaO2 is normal. Insulin (
C) and sodium polystyrene (
D) address metabolic issues, not respiratory acidosis.
Question 3 of 5
Which essential action should the nurse take based on the results? Laboratory: pH 7.30 [7.35-7.45], PaCO2 66 mm Hg [35-45 mm Hg], HCO3 23 mEq/L [22-28 mEq/L], PaO2 77 mm Hg [80-100 mm Hg]
Correct Answer: B
Rationale: The ABG indicates respiratory acidosis (pH 7.30, PaCO2 66 mm Hg) and hypoxemia (PaO2 77 mm Hg). Supplemental oxygen (
B) addresses low PaO2. Chest radiograph (
A) and incentive spirometry (
C) are secondary. Sodium bicarbonate (
D) is for metabolic acidosis, not respiratory.
Question 4 of 5
The nurse cares for a client receiving mechanical ventilation and reviews the client's most recent arterial blood gas (ABG). The nurse communicates the result with the primary healthcare provider (PHCP) and should recommend a prescription for which medication? Laboratory: pH 7.33 [7.35-7.45], PaCO2 53 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 89 mm Hg [80-100 mm Hg]
Correct Answer: C
Rationale: The ABG shows respiratory acidosis (pH 7.33, PaCO2 53 mm Hg) due to hypoventilation. Theophylline (
C) improves respiratory drive and ventilation. Pancuronium (
A) and midazolam (
B) suppress ventilation, worsening acidosis. Famotidine (
D) addresses gastric issues, not respiratory.
Question 5 of 5
The nurse is working in the emergency department caring for a client with diabetic ketoacidosis (DKA). Which of the following arterial blood gas (ABG) results would be expected?
Correct Answer: D
Rationale: DKA causes metabolic acidosis due to ketone accumulation, lowering pH and HCO3-. Option D (pH 7.31, HCO3- 15 mEq/L) reflects uncompensated metabolic acidosis. Options A and C show alkalosis, and B shows respiratory acidosis.