Friday, September 2, 2016

ABG Analysis NCLEX Exam 1 (10 Items)

http://www.nclexrnlab.com/2016/09/abg-analysis-nclex-exam-3-10-items.html

Are you an expert in interpreting ABGs? Once you have finished doing this activity, you’ll be doing actual ABG analysis in the NCLEX with fun and excitement. So here’s a 10-question practice exam!

Always do your best. What you plant now, you will harvest later.

—Og Mandino

Topics

Included topics in this quiz are:
  • ABG Analysis
  • Acid-Base Balance/Imbalance
  • Respiratory Acidosis/Alkalosis
  • Metabolic Acidosis/Alkalosis

Guidelines

Follow the guidelines below to make the most out of this exam:
  • Read each question carefully and choose the best answer.
  • You are given one minute per question. Spend your time wisely!
  • Answers and rationales are given below. Be sure to read them.
  • If you need more clarifications, please direct them to the comments section.
 ABG Analysis NCLEX Exam 1 (10 Items)
 Just Scroll Down For All questions and answers
In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.


 
1. 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


2. 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


3. 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


4. 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



5. 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


6. 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


7. 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


8. 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


9. 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


10. 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



Answers and Rationale

1. Answer: B. Respiratory Acidosis, Partially Compensated
The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute exacerbation of chronic obstructive pulmonary disease, with partial compensation.

2. Answer: D. Metabolic Acidosis, Partially, Compensated
The student was diagnosed having diabetes mellitus. The results show that he has metabolic acidosis (low HCO3 -) with respiratory compensation (low CO2).

3. Answer: A. Respiratory Alkalosis, Uncompensated
The primary disorder is acute respiratory alkalosis (low CO2) due to the pain and anxiety causing her to hyperventilate. There has not been time for metabolic compensation.

4. Answer: C. Metabolic Alkalosis, Uncompensated
The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the strongest driver of respiration, it generally will not allow hypoventilation as compensation for metabolic alkalosis.

5. Answer: B. Respiratory Acidosis, Uncompensated
The results show that Mrs. Johansson has respiratory acidosis because of decreased pH and increased PaCO2 which mean acidic in nature. Meanwhile, it is uncompensated because HCO3 is within the normal range.


6. Answer: C. Metabolic Acidosis, Fully Compensated
Baby Angela has metabolic acidosis due to decreased HCO3 and slightly acidic pH. Her pH value is within the normal range which made the result fully compensated.

7. Answer: B. Metabolic Alkalosis, Uncompensated
The postoperative client’s ABG results show that he has metabolic alkalosis because of an increased pH and HCO3. It is uncompensated due to the normal PaCO2 which is within 35 to 45 mmHg.

8. Answer: C. Respiratory Alkalosis, Uncompensated
The results show that client Z has respiratory alkalosis since there is an increase in the pH value and a decrease in PaCO2 which are both basic. It is uncompensated due to the normal HCO3 which is within 22-26 mEq/L.

9. Answer: B. Respiratory Acidosis, Fully Compensated
The patient has respiratory acidosis (raised carbon dioxide) resulting from asthma and respiratory distress syndrome, with compensation having normal pH value within 7.35to 7.45, increased PaCO2 which is acidic and increased HCO3 which is basic.

10. Answer: C. Respiratory Acidosis
One of the risk factors of having respiratory acidosis is hypoventilation which may be due to brain trauma, coma, and hypothyroidism or myxedema. Other risk factors include COPD, Respiratory conditions such as pneumothorax, pneumonia and status asthmaticus. Drugs such as Morphine and MgSO4 toxicity are also risk factors of respiratory acidosis.

See Also

If you enjoyed this quiz, check out the rest of them below:

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