Question 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?

Question 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?

Question 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?

Question 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?

Question 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?

Question 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?

Question 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?

Question 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?

Question 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?

Question 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?

Question 11

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?

Question 12

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?

Question 13

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?

Question 14

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?

Question 15

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?

Question 16

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?

Question 17

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?

Question 18

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?

Question 19

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?

Question 20

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?

Test 3

pH 7.57, PaCO2 22, HCO3- 17 Respiratory Alkalosis, Partially Compensated

pH 7.55, PaCO2 25, HCO3- 22 Respiratory Alkalosis, Uncompensated

pH 7.17, PaCO2 48, HCO3- 36 Respiratory Acidosis, Partially Compensated

pH 7.34, PaCO2 24, HCO3- 20 Metabolic Acidosis, Partially Compensated

pH 7.64, PaCO2 25, HCO3- 19 Respiratory Alkalosis, Partially Compensated

pH 7.45, PaCO2 50, HCO3- 30 Metabolic Alkalosis, Fully Compensated

pH 7.6, PaCO2 53, HCO3- 38 Respiratory Acidosis, Partially Compensated

pH 7.5, PaCO2 19, HCO3- 22 Respiratory Alkalosis, Uncompensated

pH 7.4, PaCO2 59, HCO3- 35 Respiratory Acidosis, Fully Compensated