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Res 140
Res 140 ex 3
| Question | Answer |
|---|---|
| Correction of metabolic alkalosis may involve which of the following? | D) I, II, and III I. Restoring normal fluid volume II. Administering acidifying agents III. Restoring normal K+ and Cl– levels |
| In order to eliminate the influence of PCO2 changes on plasma HCO3- concentrations, what additional measures of the metabolic component of acid-base balance can be used? | D) Standard bicarbonate |
| Which organ system actually excretes H+ from the body? | A) Kidneys |
| An ABG result shows the pH to be 7.56 and the HCO3- to be 23 mEq/L. Which of the following is the most likely disorder? | D) Respiratory alkalosis |
| What compensates for a metabolic alkalosis? | B) Hypoventilation |
| Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.43, PCO2 = 39 mm Hg, HCO3- = 25.1 mEq/L | A) Acid-base status within normal limits. |
| What explains the lack of an increased anion gap seen in metabolic acidosis caused by HCO3- loss? | A) For each HCO3- ion lost, a Cl- ion is reabsorbed by the kidney. |
| Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.08, PCO2 = 39 mm Hg, HCO3- = 11.8 mEq/L | A) Acute metabolic acidosis |
| What affect does hyperventilation have on the closed buffer systems? | B) Causes them to release more H+. |
| A patient has a confirmed metabolic acidosis with a normal PCO2. What inference can you draw from these findings? | A) A ventilatory disorder must coexist. |
| What drives the bicarbonate buffer systems enormous ability to buffer acids? | D) Ventilation continually removing CO2 from system. |
| Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.38, PCO2 = 21 mm Hg, HCO3- = 11.7 mEq/L | B) Fully compensated metabolic acidosis |
| With partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter? | D) II, III, and IV II. Decreased HCO3- III. Decreased PCO2 IV. Increased pH |
| Fixed acids are produced primarily from the catabolism of which of the following? | C) Proteins |
| A patient with a measured plasma HCO3- concentration of 24 mmol/L has an episode of acute hypoventilation, with the PCO2 rising from 40 to 70 mm Hg. What do you predict will happen acutely to the plasma HCO3- concentration? | B) HCO3- will rise to about 27 to 28 mmol/L. |
| By comparison, how much fixed acid is produced in any given period compared to the volatile acid CO2? | B) Less fixed than volatile. |
| Which of the following clinical findings would you expect in a fully compensated respiratory acidosis? | I. elevated HCO3- III. pH between 7.35 and 7.39 I. elevated HCO3- III. pH between 7.35 and 7.39 I. elevated HCO3- III. pH between 7.35 and 7.39 A) I and III |
| What is the primary chemical event in respiratory acidosis? | C) Increase in blood CO2 levels |
| A patient with Kussmaul's respirations most likely has: | A) metabolic acidosis. |
| What is the treatment for severe metabolic acidosis? | D) NaHCO3- infusion |
| If the blood PCO2 is high, the kidneys will do which of the following? | A) Excrete more H+ and reabsorb more HCO3- |
| Which buffer system has the greatest capacity? | A) Bicarbonate |
| Of what use is the Henderson-Hasselbalch equation for a clinician? | D) It allows validation of the reported values on a blood gas report. |
| Which of the following is FALSE about the relationship between chloride (Cl-) and bicarbonate HCO3- in acid-base balance? | D) Activation of the NH3 buffer system enhances Cl- gain and HCO3 loss. |
| What is the main compensatory mechanism for metabolic acidosis? | B) Hyperventilation |
| The majority of the acid the body produces in a day is excreted through the lungs as CO2. What happens to the H+ ions? | D) They bind to an OH-forming H2O. |
| What are some causes of metabolic acidosis with an increased anion gap? | II. Ketoacidosis III. Lactic acidosis IV. Renal failure C) II, III, and IV |
| Which of the following are components of the body's nonbicarbonate buffer system? | I. Hemoglobin II. Plasma proteins III. Organic phosphates IV. Inorganic phosphates D) I, II, III, and IV |
| What is the limiting factor for H+ excretion in the renal tubules? | C) Insufficient buffers |
| Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.35, PCO2 = 68 mm Hg, HCO3- = 34.3 mEq/L | C) Fully compensated respiratory acidosis |
| In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter? | I. Decreased pH III. Increased PCO2 B) I and III |
| What is a normal response of the body to a failure in one component of the acid–base regulatory mechanism? | B) Compensation |
| Which of the following are potential causes of respiratory alkalosis? | I. Anxiety III. Hypoxemia IV. Pain B) I, III, and IV |
| Which of the following is NOT a clinical sign of acute respiratory alkalosis? | B) Depressed reflexes |
| The primary goal of acid-base homeostasis is to maintain which of the following? | C) Normal pH |
| Compensation for respiratory acidosis occurs through which of the following? | D) Increase in blood HCO3- levels |
| Which of the following accurately describes compensation for acid-base disorders? | A) Kidneys take hours to days to compensate for respiratory disorders. |
| Primary metabolic alkalosis is associated with which of the following? | A) Gain of buffer base |
| Using the Henderson-Hasselbalch equation, determine the accuracy of the gas below. To be considered accurate, it must be within 0.03 pH unit. pH = 7.22, PCO2 = 49 mm Hg, HCO3- = 20 mEq/L | B) This gas is accurate as the calculated pH is 7.23. |
| What is the primary buffer system for fixed acids? | B) HCO3- |
| What condition or treatment could cause iatrogenic respiratory alkalosis? | B) Mechanical hyperventilation |
| Using the Henderson-Hasselbalch equation, determine the accuracy of the gas below. To be considered accurate, it must be within 0.03 pH unit. pH = 7.35, PCO2 = 77 mm Hg, HCO3- = 41 mEq/L | A) This gas is completely accurate. |
| Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.01, PCO2 = 71 mm Hg, HCO3- = 16.3 mEq/L | C) Combined respiratory and metabolic acidosis |
| What are the major mechanisms responsible for maintaining a stable pH despite massive CO2 production? | I. Isohydric buffering III. Pulmonary ventilation D) I and III |
| A patient who has fully compensated respiratory acidosis becomes severely hypoxic. If her lungs are not too compromised, what might her gases now appear to be? | B) Fully compensated metabolic alkalosis |
| The numerator of the Henderson-Hasselbalch (H-H) equation (HCO3-) relates to which of the following? | C) Renal buffering and excretion of fixed acids. |
| Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.43, PCO2 = 20 mm Hg, HCO3- = 12.6 mEq/L | C) Fully compensated respiratory alkalosis |
| A patient has a bicarbonate concentration of 36 mEq and a PCO2 of 60 mm Hg. What is the approximate pH? | C) 7.4 |
| Correction of acute respiratory acidosis is accomplished by which of the following? | B) Increasing alveolar ventilation |
| Which of the following systems is primarily responsible for the buffering of fixed acids? | B) HCO3- |
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