Medical Surgical 1- HESI Exam 2

Free preview · Original latest version

Sample questions from Medical Surgical 1- HESI Exam 2

This material has 75 questions with answers and rationales. Here are the first 5.

1. 1.Which set of reference ranges should be used when interpreting an adult arterial blood gas?

   • A.pH 7.25-7.35, PaCO2 25-35 mm Hg, HCO3 18-22 mEq/L
   • B.pH 7.35-7.45, PaCO2 35-45 mm Hg, HCO3 22-26 mEq/L
   • C.pH 7.35-7.45, PaCO2 45-55 mm Hg, HCO3 28-32 mEq/L
   • D.pH 7.45-7.55, PaCO2 35-45 mm Hg, HCO3 22-26 mEq/L

   Rationale: The usual adult reference ranges are pH 7.35-7.45, PaCO2 35-45 mm Hg, and HCO3 22-26 mEq/L. The other options shift one or more reference ranges and could lead to misclassification of an ABG. Identify whether the pH is acidotic or alkalotic before determining the primary cause.

2. 2.In the emergency department, a client with chronic obstructive pulmonary disease becomes increasingly drowsy. ABG results are pH 7.29, PaCO2 58 mm Hg, and HCO3 25 mEq/L. How should the nurse interpret these results?

   • A.Partially compensated respiratory acidosis
   • B.Uncompensated metabolic acidosis
   • C.Partially compensated metabolic alkalosis
   • D.Uncompensated respiratory acidosis

   Rationale: The pH is low, indicating acidemia, and the elevated PaCO2 identifies a respiratory cause; the normal HCO3 shows no measurable metabolic compensation. Partially compensated respiratory acidosis would have an elevated HCO3, while metabolic acidosis would have a low HCO3 as the primary change. Metabolic alkalosis would have an elevated pH and elevated HCO3.

3. 3.A client states, "I have been vomiting for two days, and now I feel weak." Which ABG pattern is most consistent with prolonged loss of gastric acid?

   • A.pH 7.49, PaCO2 47 mm Hg, HCO3 34 mEq/L
   • B.pH 7.48, PaCO2 30 mm Hg, HCO3 23 mEq/L
   • C.pH 7.31, PaCO2 32 mm Hg, HCO3 18 mEq/L
   • D.pH 7.30, PaCO2 50 mm Hg, HCO3 24 mEq/L

   Rationale: Prolonged vomiting removes gastric acid and can produce metabolic alkalosis, reflected by alkalemia and an elevated HCO3. The elevated PaCO2 is consistent with respiratory compensation. The other patterns represent respiratory acidosis, metabolic acidosis, and respiratory alkalosis, respectively.

4. 4.During a home visit, a client with a history of panic attacks reports sudden rapid breathing and tingling around the mouth. Which findings or actions are appropriate when considering possible respiratory alkalosis? Select all that apply.

   • A.An ABG with pH 7.50 and PaCO2 29 mm Hg supports respiratory alkalosis.
   • B.Use calm coaching to help slow breathing while promptly assessing for other causes.
   • C.Assess respiratory rate, depth, oxygenation, and possible triggers.
   • D.A normal SpO2 rules out an abnormal PaCO2.
   • E.Encourage the client to breathe into a paper bag.

   Answer and rationale are in the full material.

5. 5.A client's ABG results are pH 7.30, PaCO2 34 mm Hg, and HCO3 17 mEq/L. Which interpretation is correct?

   • A.Uncompensated respiratory acidosis
   • B.Fully compensated metabolic acidosis
   • C.Partially compensated metabolic acidosis
   • D.Partially compensated respiratory alkalosis

   Answer and rationale are in the full material.