NATIONAL AND STATE NURSING EXAM- MCQ _MG_00 149
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1. Which lab test is useful to find out the blood pH:
a. Arterial blood gas (ABG) levels
b. X-ray
c. Ventilation perfusion match
d. Blood electrolyte
Answer: a. Arterial blood gas (ABG) levels
Description:The lab test that is useful for finding out the blood pH is option a: Arterial Blood Gas (ABG) levels. This test measures the acidity or alkalinity of the blood, which is indicated by its pH value. Other options like X-ray, ventilation perfusion match, and blood electrolyte tests do not directly assess blood pH.
2. Features of metabolic acidosis?
a. Low plasma bicarbonate
b. High plasma CO2
c. pH above 7.45
d. Both a and b
Answer: a. Low plasma bicarbonate
Description:The features of metabolic acidosis include option a: Low plasma bicarbonate. This means that there's a decrease in the level of bicarbonate, a key chemical in the body that helps balance its acidity. Option b (High plasma CO2) is not a feature of metabolic acidosis. Option c (pH above 7.45) also isn't a characteristic of this condition. The correct answer is option a, which points to the lowered bicarbonate levels that signify metabolic acidosis.
3. ABG values pH: 7.6 PaCO2; 30 mm Hg, HCO3; 24 mEq and normal PaO2 suggests:
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
Answer: b. Respiratory alkalosis
Description:The ABG values provided (pH: 7.6, PaCO2: 30 mm Hg, HCO3: 24 mEq, normal PaO2) suggest option b: Respiratory alkalosis. In this case, the blood's pH is higher than usual (more alkaline), the PaCO2 is lower than normal (indicating less carbon dioxide in the blood), and the other values are within normal ranges. This combination of values points towards respiratory alkalosis, which is a condition where the body's breathing rate is higher than needed, causing a decrease in carbon dioxide levels and an increase in pH.
4. ABG analysis of an adult patient is as follows; pH = 7.29, PaCO2=47, and HCO3 =24. This can be interpreted as:
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
Answer: c. Respiratory acidosis
Description:pH below 7.35 indicates acidosis. An elevated PaCO2 indicates the acidosis is due to respiratory problem. So the condition is respiratory acidosis.
5. Ph = 7.55 PCO2 = 38, HCO3 = 33, what is the primary abnormality:
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Mixed alkalosis
Answer: d. Mixed alkalosis
Description:The given values (pH: 7.55, PCO2: 38, HCO3: 33) suggest a mixed alkalosis, which means there are abnormalities in both the respiratory and metabolic systems that are pushing the blood pH towards the alkaline side. In this scenario, neither the respiratory nor metabolic factors alone can account for the high pH. So, the correct answer is option d: Mixed alkalosis.
6. Which of the following nursing intervention is the most appropriate for the client who has developed respiratory alkalosis due to hyperventilation?
a. Encourage slow, deep breath
b. Start low-flow oxygen therapy
c. Administer sodium bicarbonate
d. Administer Ringer Lactate solution
Answer: a. Encourage slow, deep breath
Description:The carbon dioxide level of hyperventilated patient is low that leads to respiratory alkalosis. In order to increase the carbon dioxide concentration, the patient should be encouraged to slow, deep breath which will retain carbon dioxide and reverse alkalosis
7. The cause for respiratory acidosis among the following is:
a. Hyperventilation
b. Excessive vomiting
c. Respiratory obstruction
d. Diabetic ketoacidosis
Answer: c. Respiratory obstruction
Description:Respiratory acidosis develops when the lungs do not expel carbon dioxide adequately (inadequate ventilation), a problem that can occur in disorder that severally affect the lungs (such as chronic obstructive pulmonary disease, sever pneumonia, and asthma)
8. Reason behind metabolic alkalosis after massive blood transfusion in:
a. Anticoagulant sodium citrate will be metabolized to sodium bicarbonate
b. Because of hemolysis of RBCs
c. Electrolyte imbalance in potassium will cause this
d. All of the above.
Answer: a. Anticoagulant sodium citrate will be metabolized to sodium bicarbonate
Description:Metabolic alkalosis can happen after a significant blood transfusion due to a specific reason. The anticoagulant called sodium citrate used in stored blood can be broken down in the body to form sodium bicarbonate, which is a base. This can slightly increase the body's overall alkalinity, leading to metabolic alkalosis. So, the correct answer is option a, anticoagulant sodium citrate being metabolized to sodium bicarbonate.
9. Which among the following metabolic abnormality is seen in a client with vomiting?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Hypokalemia
d. Both b and c
Answer: d. Both b and c
Description:When a person vomits, they lose stomach acid along with the contents of their stomach. This can disrupt the body's balance, leading to both metabolic alkalosis (due to loss of stomach acid) and hypokalemia (low potassium levels). So, the correct answer is option d, both metabolic alkalosis and hypokalemia can be seen in a client with vomiting.
10. Interpret the following lab report of ABG analysis; pH = 7.27, HCO3 = 10mEq/dl Pco2 = 23 mm Hg
a. Respiratory alkalosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Metabolic acidosis
Answer: d. Metabolic acidosis
Description:This lab report shows that the pH is lower than normal, indicating acidity. The HCO3 (bicarbonate) level is also lower than normal, while the Pco2 (carbon dioxide) level is lower than normal as well. This pattern suggests that the body is experiencing both metabolic acidosis and compensatory respiratory alkalosis. However, since you've asked for the single most appropriate option, the best answer is option d, metabolic acidosis. This is because the primary issue reflected in the report is low bicarbonate levels, which points toward metabolic acidosis.
11. Best for management of respiratory alkalosis?
a. Mechanical ventilation
b. IPPV
c. Normal saline
d. Rebreathing in paper bag.
Answer: d. Rebreathing in paper bag.
Description:Respiratory alkalosis happens when there's too little acid in the blood, often due to breathing too fast. To help manage this, a simple method is to breathe in and out of a paper bag. This helps to bring back the balance of acids and bases in the blood. So, the best answer is option d, rebreathing in a paper bag.
12. When Allen’s test in performed?
a. Before venous line insertion
b. Before CVP line insertion
c. Before femoral arterial line insertion
d. Before ABG sampling
Answer: d. Before ABG sampling
Description:Allen's test is performed to check the adequacy of blood flow in the hand's arteries before certain medical procedures. The correct answer is option a, before venous line insertion. This test helps ensure that the hand's blood supply is good enough to handle the procedure without causing circulation problems.
13. Which of the following is the function of sodium in the body?
a. Formation of bones
b. Functioning of skeletal muscle
c. Functioning of cardiac muscle
d. Maintenance of serum osmolarity
Answer: d. Maintenance of serum osmolarity
Description:The function of sodium in the body is primarily related to maintaining the balance of fluid levels and regulating the concentration of various substances. Sodium plays a crucial role in maintaining serum osmolarity, which refers to the balance of water and electrolytes in the blood. This balance is essential for various bodily functions and helps ensure that cells function properly. The correct answer is option d: Maintenance of serum osmolarity.
14. Hyperkalemia refers to:
a. High chloride
b. High potassium
c. High calcium
d. High sodium
Answer: b. High potassium
Description:Hyperkalemia refers to having a high level of potassium in the blood. Potassium is an important electrolyte that helps with various bodily functions, including muscle contractions and maintaining proper heart rhythm. When the potassium level becomes too high, it can disrupt these functions and lead to health issues. So, the correct answer is option b: High potassium.
15. Aldosterone is directly regulating the concentration of ………………electrolyte.
a. Calcium
b. Potassium
c. Sodium
d. Chlorine
Answer: c. Sodium
Description:Aldosterone directly regulates the concentration of sodium electrolyte in the body. Aldosterone is a hormone produced by the adrenal glands that plays a significant role in maintaining the balance of sodium and potassium levels in the bloodstream.
16. Movement of particles (ions or molecules) from an area of higher concertation to an area of lower concentration in referred to as:
a. Inhibition
b. Ultrafiltration
c. Diffusion
d. Osmosis
Answer: c. Diffusion
Description:The movement of particles (like ions or molecules) from a place where there are many of them to a place where there are fewer of them is called diffusion. It's like when a pleasant smell spreads from a strong source to a wider area. This happens naturally to even out the concentrations. So, the correct answer is option c: Diffusion.
17. Potassium intake is restricted in:
a. Cardiac failure
b. Liver failure
c. Real failure
d. Lung failure
Answer: c. Real failure
Description:Potassium intake is restricted in cases of kidney failure. The kidneys play a vital role in regulating potassium levels in the body. When the kidneys aren't functioning well, they might struggle to properly remove excess potassium from the bloodstream, leading to a potential buildup of potassium in the body. This can be risky, as high potassium levels can affect heart rhythm and other bodily functions.
18. Parenteral preparation of potassium should be administered slowly to prevent:
a. Acidosis
b. Cardiac arrest
c. Respiratory arrest
d. Over load
Answer: b. Cardiac arrest
Description:When giving potassium through methods like injections or IVs (parenteral preparation), it's important to administer it slowly. This helps prevent the risk of causing cardiac arrest, which is a sudden stop in the heart's pumping function. Potassium plays a role in maintaining the heart's rhythm, but if too much is given too quickly, it can disrupt the heart's electrical activity and lead to a dangerous condition.
19. In hypoalbuminemia there is:
a. Increase in extra cellular fluid
b. Decrease in extra cellular fluid
c. Increase in intracellular fluid
d. Decrease in intracellular fluid
Answer: a. Increase in extra cellular fluid
Description:When giving potassium through methods like injections or IVs (parenteral preparation), it's important to administer it slowly. This helps prevent the risk of causing cardiac arrest, which is a sudden stop in the heart's pumping function. Potassium plays a role in maintaining the heart's rhythm, but if too much is given too quickly, it can disrupt the heart's electrical activity and lead to a dangerous condition.
20. Poorly controlled diabetes with blood sugar of 450 mg% is associated with:
a. Hyponatremia
b. Hypernatremia
c. Hypokalemia
d. Hypomagnesemia
Answer: a. Hyponatremia
Description:Glucose produces a drop in the serum sodium concentration by a factor of 1.6 mEq/L for each 100mg/dL increase in serum glucose greater than 100mg/dL.
21. Hypokalemia causes death due to:
a. Diastolic arrest
b. Bidirectional Tachycardia
c. Respiratory insufficiency
d. Systolic arrest
Answer: c. Respiratory insufficiency
Description:Hypokalemia can cause death due to respiratory insufficiency. Potassium is essential for proper muscle function, including the muscles used for breathing. When potassium levels are too low (hypokalemia), it can lead to weakness in the respiratory muscles, making it difficult for a person to breathe effectively. Severe hypokalemia can even lead to respiratory failure, where the lungs can't provide enough oxygen to the body. So, the correct answer is option c: Respiratory insufficiency.
22. Important nursing intervention while caring for a client with dilutional hyponatremia includes:
a. Fluid restriction
b. Provide isotonic saline
c. Administer potassium as ordered by physician
d. Provide NG feed
Answer: a. Fluid restriction
Description:An important nursing intervention while caring for a client with dilutional hyponatremia is fluid restriction. Dilutional hyponatremia occurs when there's an imbalance of water and sodium levels in the body, leading to low sodium concentration in the blood. To address this, it's important to limit the intake of fluids to avoid further diluting the sodium levels. So, the correct answer is option a: Fluid restriction.
23. All are used for management for hypernatremia except:
a. 5% dextrose in water
b. Indomethacin
c. Nil by mouth
d. N/2 in 5% dextrose
Answer: c. Nil by mouth
Description:All the options mentioned are used for managing hypernatremia except "Nil by mouth." Hypernatremia is a condition where there's an excessive amount of sodium in the blood. To treat it, various approaches are taken to lower sodium levels. Options a, b, and d suggest ways to address hypernatremia, such as using specific intravenous fluids and medications. However, "Nil by mouth" means not allowing the patient to consume any food or fluids orally. This approach wouldn't be suitable for managing hypernatremia, as the goal is to restore the body's electrolyte balance through controlled fluid intake. So, the correct answer is option c: Nil by mouth.
24. Most common cause of hypernatremia?
a. Sweating
b. Carcinoid syndrome
c. Primary hypodipsia
d. Renal losses
Answer: d. Renal losses
Description:The most common cause of hypernatremia, which is having too much sodium in the blood, is "renal losses." This means that the kidneys are not properly regulating the balance of water and sodium, leading to an increase in sodium levels. The kidneys normally help maintain this balance, but if they are not functioning correctly, it can result in higher sodium concentrations in the blood.
25. A convulsion during diarrhea is because of?
a. Hypokalemia
b. Hyponatremia
c. Hyperkalemia
d. Hypernatremia
Answer: b. Hyponatremia
Description:A convulsion during diarrhea is often caused by "hyponatremia." Hyponatremia is a condition where there's a lower-than-normal level of sodium in the blood. Diarrhea can lead to the loss of not only fluids but also important electrolytes, including sodium. When sodium levels drop significantly, it can disrupt the balance of electrolytes in the body, affecting nerve and muscle function. This disruption can potentially lead to convulsions or seizures.
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