📙 WBHRB স্টাফ নার্স CBT টেস্ট – 7 ( Medical Surgical Nurshing -1 ABG )

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বিষয়ঃ 📙 WBHRB স্টাফ নার্স CBT টেস্ট – 7

🧮 কুইজ: 📙 WBHRB স্টাফ নার্স CBT টেস্ট – 7

🧮 মোট প্রশ্ন: 50 টি

⏱ সময়সীমা: 60 Minute

❌ নেগেটিভ : -0.5 প্রতি প্রশ্নে

⚠️ কুইজ শেষ হলে স্বয়ংক্রিয়ভাবে রেজাল্ট দেখতে পাবেন।

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📙 WBHRB স্টাফ নার্স CBT টেস্ট – 7

1 / 50

1. Respiratory failure is defined when PaO₂ < ___ mmHg:

A) 100

B) 70

C) 80

D) 60

PaO₂ below 60 mmHg indicates respiratory failure.

2 / 50

2. Which organ compensates for respiratory acidosis?

A) Heart

B) Lungs

C) Liver

D) Kidneys

The kidneys retain HCO₃⁻ to neutralize increased CO₂.

3 / 50

3. Kussmaul breathing is seen in:

A) Asthma

B) Emphysema

C) COPD

D) Diabetic ketoacidosis

Deep, rapid breathing in diabetic ketoacidosis to blow off CO₂.

4 / 50

4. Which condition shows respiratory acidosis with partial compensation?

A) pH 7.30, PaCO₂ 55, HCO₃⁻ 28

B) pH 7.38, PaCO₂ 40

C) pH 7.25, HCO₃⁻ 22

D) pH 7.48, PaCO₂ 30

Elevated PaCO₂, low pH, and slightly raised HCO₃⁻ indicate partial renal compensation.

5 / 50

5. Which of the following can cause respiratory alkalosis?

A) Anxiety hyperventilation

B) Drug overdose

C) Kidney failure

D) Diarrhea

Hyperventilation decreases CO₂ causing alkalosis.

6 / 50

6. Hypoxemia refers to:

A) Low oxygen in blood

B) High HCO₃⁻

C) Decreased hemoglobin

D) High CO₂ in blood

Hypoxemia is decreased oxygen level in the blood.

7 / 50

7. A COPD patient on high O₂ develops pH 7.25, PaCO₂ 80 mmHg — what’s happening?

A) Mixed alkalosis

B) Alkalosis due to hypoxia

C) Metabolic acidosis

D) CO₂ narcosis (respiratory acidosis)

Excess O₂ suppresses hypoxic drive → CO₂ retention → respiratory acidosis.

8 / 50

8. Respiratory acidosis commonly occurs in:

A) Hyperventilation

B) Asthma attack

C) Pulmonary embolism

D) COPD

COPD causes CO₂ retention leading to respiratory acidosis.

9 / 50

9. In sepsis with multiorgan failure, lactate 6 mmol/L indicates what?

A) Adequate perfusion

B) Normal metabolism

C) Severe lactic acidosis

D) Mild acidosis

High lactate = tissue hypoxia and poor perfusion — needs urgent correction.

10 / 50

10. Which ABG value best reflects tissue oxygenation?

A) Lactate

B) PaCO₂

C) SaO₂

D) HCO₃⁻

PaO₂ reflects arterial oxygen; lactate better reflects tissue perfusion.

11 / 50

11. In metabolic acidosis, the expected respiratory compensation is:

A) Hyperventilation

B) Apnea

C) Normal breathing

D) Hypoventilation

Rapid, deep breathing (Kussmaul) lowers CO₂ and raises pH.

12 / 50

12. A patient with ARDS shows PaO₂ 50 mmHg on FiO₂ 0.8. What does the PaO₂/FiO₂ ratio indicate?

A) Mild ARDS

B) Severe ARDS

C) Moderate ARDS

D) Normal oxygenation

50 / 0.8 = 62.5 → indicates severe ARDS (<100).

13 / 50

13. What artery is commonly used for ABG sampling?

A) Brachial

B) Femoral

C) Carotid

D) Radial

The radial artery is preferred for easy access and collateral circulation.

14 / 50

14. Which ABG finding is typical in early ARDS?

A) Respiratory acidosis

B) Respiratory alkalosis

C) Mixed acidosis

D) Metabolic acidosis

Early ARDS causes tachypnea → respiratory alkalosis.

15 / 50

15. Hypoventilation leads to:

A) Hypocapnia

B) Hyperoxygenation

C) Respiratory alkalosis

D) Respiratory acidosis

Decreased ventilation retains CO₂ causing respiratory acidosis.

16 / 50

16. In diabetic ketoacidosis with vomiting, which ABG pattern may appear?

A) Mixed metabolic acidosis and alkalosis

B) Mixed respiratory alkalosis

C) Uncompensated acidosis

D) Normal ABG

Metabolic acidosis (DKA) + metabolic alkalosis (vomiting) → near-normal pH.

17 / 50

17. A patient in cardiac arrest shows pH 7.10, PaCO₂ 60 mmHg, HCO₃⁻ 12 mEq/L — interpretation?

A) Metabolic acidosis

B) Respiratory acidosis

C) Compensated acidosis

D) Mixed acidosis

Combined respiratory and metabolic acidosis due to hypoventilation and lactic acidosis.

18 / 50

18. A patient with pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 34 mEq/L — what is the disorder?

A) Mixed acidosis

B) Metabolic acidosis

C) Mixed alkalosis

D) Respiratory acidosis

Both increased bicarbonate and low CO₂ → mixed alkalosis.

19 / 50

19. Which value represents respiratory alkalosis?

A) pH 7.38, PaCO₂ 40

B) pH 7.20, PaCO₂ 70

C) pH 7.48, PaCO₂ 30

D) pH 7.30, PaCO₂ 55

Low PaCO₂ and high pH indicate respiratory alkalosis.

20 / 50

20. What is the normal range of HCO₃⁻?

A) 28–32 mEq/L

B) 22–26 mEq/L

C) 30–35 mEq/L

D) 15–18 mEq/L

Normal bicarbonate level is 22–26 mEq/L.

21 / 50

21. A post-op patient has pH 7.33, PaCO₂ 48 mmHg, HCO₃⁻ 24 mEq/L — what’s the likely cause?

A) Compensated alkalosis

B) Metabolic acidosis

C) Mixed disorder

D) Uncompensated respiratory acidosis

Hypoventilation from pain or anesthesia → respiratory acidosis.

22 / 50

22. A patient on ventilator has pH 7.60, PaCO₂ 20 mmHg, HCO₃⁻ 22 mEq/L — what’s the cause?

A) Metabolic alkalosis

B) Respiratory alkalosis

C) Mixed acidosis

D) Normal ABG

Excess ventilation removes too much CO₂ → respiratory alkalosis.

23 / 50

23. In ABG, what does HCO₃⁻ represent?

A) Oxygen saturation

B) Hydrogen ion

C) Carbon dioxide

D) Bicarbonate

HCO₃⁻ indicates the metabolic component controlled by kidneys.

24 / 50

24. Which of the following indicates metabolic acidosis?

A) pH 7.45, HCO₃⁻ 26

B) pH 7.25, HCO₃⁻ 18

C) pH 7.50, HCO₃⁻ 28

D) pH 7.48, HCO₃⁻ 30

Low pH and low HCO₃⁻ indicate metabolic acidosis due to acid accumulation.

25 / 50

25. In a patient with metabolic alkalosis due to diuretics, what is the best treatment?

A) Give bicarbonate

B) Decrease FiO₂

C) Fluid restriction

D) Administer IV normal saline and potassium

Replace chloride and potassium losses to correct alkalosis.

26 / 50

26. During ventilator weaning, pH 7.28, PaCO₂ 60 mmHg, HCO₃⁻ 27 mEq/L — what should be done?

A) Stop weaning and provide ventilatory support

B) Extubate immediately

C) Continue weaning

D) Reduce FiO₂

High CO₂ and low pH indicate fatigue → patient not ready for weaning.

27 / 50

27. After an arterial puncture, the nurse should apply pressure for:

A) 1 minute

B) 2 minutes

C) 30 seconds

D) 5–10 minutes

Firm pressure prevents hematoma or bleeding due to high arterial pressure.

28 / 50

28. Which condition shows both high PaCO₂ and high HCO₃⁻ with normal pH?

A) Mixed acidosis

B) Fully compensated respiratory acidosis

C) Uncompensated acidosis

D) Metabolic alkalosis

Indicates fully compensated respiratory acidosis (chronic COPD).

29 / 50

29. Oxyhemoglobin dissociation curve shifts to the right when:

A) High CO₂ and temperature

B) Low CO₂

C) Low temperature

D) Alkalosis

Increased CO₂ or temperature decreases oxygen affinity.

30 / 50

30. Which test measures oxygen saturation non-invasively?

A) Capnography

B) Pulse oximetry

C) ABG test

D) Chest X-ray

Pulse oximetry uses light to measure SpO₂ without blood draw.

31 / 50

31. PaCO₂ is primarily regulated by:

A) Kidneys

B) Respiratory rate

C) Blood pressure

D) Digestive system

The rate and depth of breathing control carbon dioxide levels.

32 / 50

32. A head injury patient on ventilator: pH 7.52, PaCO₂ 28 mmHg, HCO₃⁻ 24 mEq/L — interpretation?

A) Uncompensated respiratory alkalosis

B) Mixed acidosis

C) Metabolic alkalosis

D) Fully compensated alkalosis

Hyperventilation reduces CO₂ → respiratory alkalosis, may decrease cerebral perfusion.

33 / 50

33. What compensatory mechanism occurs in metabolic acidosis?

A) Retention of CO₂

B) Hypoventilation

C) Hyperventilation

D) Decreased heart rate

The lungs increase ventilation to blow off CO₂ and raise pH.

34 / 50

34. What compensatory mechanism occurs in metabolic acidosis?

A) Increased respiratory rate

B) Decreased respiratory rate

C) Hypoventilation

D) Renal H⁺ retention

Lungs hyperventilate (Kussmaul breathing) to blow off CO₂.

35 / 50

35. What is the nurse’s first step when PaO₂ is critically low?

A) Administer oxygen

B) Notify physician

C) Increase IV fluids

D) Check temperature

Administering supplemental oxygen restores tissue oxygenation immediately.

36 / 50

36. A trauma patient with blood loss shows pH 7.30, PaCO₂ 30 mmHg, HCO₃⁻ 15 mEq/L — interpretation?

A) Respiratory acidosis

B) Mixed acidosis

C) Partially compensated metabolic acidosis

D) Compensated alkalosis

Lactic acidosis from shock → metabolic acidosis with respiratory compensation.

37 / 50

37. The major drive for respiration is:

A) Nitrogen

B) Carbon dioxide

C) Hydrogen ions

D) Oxygen

CO₂ levels in the blood stimulate respiratory center in medulla.

38 / 50

38. In renal failure, pH 7.25, PaCO₂ 40 mmHg, HCO₃⁻ 15 mEq/L — what does this indicate?

A) Respiratory alkalosis

B) Uncompensated metabolic acidosis

C) Compensated respiratory acidosis

D) Mixed alkalosis

Kidneys unable to excrete acid → metabolic acidosis without compensation.

39 / 50

39. A patient with PaCO₂ 55 mmHg and pH 7.30 likely has:

A) Metabolic acidosis

B) Metabolic alkalosis

C) Respiratory alkalosis

D) Respiratory acidosis

High CO₂ and low pH indicate respiratory acidosis.

40 / 50

40. A patient with pH 7.50, PaCO₂ 28 mmHg has:

A) Respiratory acidosis

B) Respiratory alkalosis

C) Metabolic acidosis

D) Mixed disorder

High pH and low CO₂ indicate respiratory alkalosis.

41 / 50

41. In ABG, Base excess (BE) indicates:

A) PaO₂

B) Bicarbonate only

C) Metabolic component

D) PaCO₂

It shows the amount of base required to normalize pH.

42 / 50

42. In metabolic alkalosis, the lungs compensate by:

A) Decreasing ventilation

B) Producing lactic acid

C) Increasing renal acid excretion

D) Increasing ventilation

The body retains CO₂ through hypoventilation to lower pH.

43 / 50

43. Which of the following can cause metabolic alkalosis?

A) Prolonged vomiting

B) Shock

C) Kidney failure

D) Diarrhea

Vomiting causes loss of gastric acid leading to alkalosis.

44 / 50

44. Which nursing action is essential before collecting an ABG sample?

A) Avoid air bubbles

B) Use a venous sample

C) Apply ice immediately

D) Delay analysis

Ensuring the patient’s oxygen delivery and avoiding air bubbles in the syringe are critical for accuracy.

45 / 50

45. Which organ regulates metabolic acid–base balance?

A) Liver

B) Kidneys

C) Lungs

D) Heart

The kidneys control bicarbonate reabsorption and hydrogen ion secretion.

46 / 50

46. Which buffer system acts fastest in the body?

A) Chemical buffer

B) Renal buffer

C) Protein buffer

D) Respiratory buffer

The chemical buffer system works immediately to resist pH changes.

47 / 50

47. What is the primary goal of ventilator adjustment in ARDS patients?

A) Prevent barotrauma and maintain oxygenation

B) Increase FiO₂ to 100% always

C) Avoid PEEP

D) Decrease tidal volume drastically

Maintain adequate oxygenation while preventing barotrauma.

48 / 50

48. A patient in septic shock shows pH 7.18, PaCO₂ 30 mmHg, HCO₃⁻ 12 mEq/L — what is the disorder?

A) Partially compensated metabolic acidosis

B) Respiratory acidosis

C) Metabolic alkalosis

D) Mixed acidosis

Sepsis causes lactic acidosis → metabolic acidosis with partial respiratory compensation.

49 / 50

49. A patient with high intracranial pressure (ICP) should maintain PaCO₂ at what level?

A) 30–35 mmHg

B) 40–45 mmHg

C) 50–55 mmHg

D) 25–30 mmHg

Mild hypocapnia (PaCO₂ 30–35 mmHg) helps reduce ICP by vasoconstriction.

50 / 50

50. The normal PaO₂ in ABG report is:

A) 80–100 mmHg

B) 60–70 mmHg

C) 110–120 mmHg

D) 50–60 mmHg

PaO₂ measures oxygen level in arterial blood. Normal is 80–100 mmHg.

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