📙 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. The major drive for respiration is:

A) Oxygen

B) Carbon dioxide

C) Hydrogen ions

D) Nitrogen

CO₂ levels in the blood stimulate respiratory center in medulla.

2 / 50

2. 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.

3 / 50

3. PaCO₂ is primarily regulated by:

A) Blood pressure

B) Digestive system

C) Kidneys

D) Respiratory rate

The rate and depth of breathing control carbon dioxide levels.

4 / 50

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

A) Uncompensated respiratory acidosis

B) Compensated alkalosis

C) Mixed disorder

D) Metabolic acidosis

Hypoventilation from pain or anesthesia → respiratory acidosis.

5 / 50

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

A) Metabolic alkalosis

B) Uncompensated respiratory alkalosis

C) Mixed acidosis

D) Fully compensated alkalosis

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

6 / 50

6. Hypoventilation leads to:

A) Respiratory alkalosis

B) Hypocapnia

C) Respiratory acidosis

D) Hyperoxygenation

Decreased ventilation retains CO₂ causing respiratory acidosis.

7 / 50

7. Hypoxemia refers to:

A) Low oxygen in blood

B) High HCO₃⁻

C) High CO₂ in blood

D) Decreased hemoglobin

Hypoxemia is decreased oxygen level in the blood.

8 / 50

8. Respiratory acidosis commonly occurs in:

A) Hyperventilation

B) COPD

C) Pulmonary embolism

D) Asthma attack

COPD causes CO₂ retention leading to respiratory acidosis.

9 / 50

9. Which of the following indicates metabolic acidosis?

A) pH 7.45, HCO₃⁻ 26

B) pH 7.25, HCO₃⁻ 18

C) pH 7.48, HCO₃⁻ 30

D) pH 7.50, HCO₃⁻ 28

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

10 / 50

10. What artery is commonly used for ABG sampling?

A) Brachial

B) Carotid

C) Radial

D) Femoral

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

11 / 50

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

A) 100

B) 60

C) 80

D) 70

PaO₂ below 60 mmHg indicates respiratory failure.

12 / 50

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

A) Apnea

B) Hyperventilation

C) Normal breathing

D) Hypoventilation

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

13 / 50

13. Which organ regulates metabolic acid–base balance?

A) Liver

B) Heart

C) Kidneys

D) Lungs

The kidneys control bicarbonate reabsorption and hydrogen ion secretion.

14 / 50

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

A) Metabolic acidosis

B) Respiratory acidosis

C) Mixed disorder

D) Respiratory alkalosis

High pH and low CO₂ indicate respiratory alkalosis.

15 / 50

15. 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.

16 / 50

16. 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).

17 / 50

17. The normal PaO₂ in ABG report is:

A) 110–120 mmHg

B) 60–70 mmHg

C) 50–60 mmHg

D) 80–100 mmHg

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

18 / 50

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

A) Normal metabolism

B) Severe lactic acidosis

C) Adequate perfusion

D) Mild acidosis

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

19 / 50

19. What is the normal range of HCO₃⁻?

A) 28–32 mEq/L

B) 15–18 mEq/L

C) 30–35 mEq/L

D) 22–26 mEq/L

Normal bicarbonate level is 22–26 mEq/L.

20 / 50

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

A) Extubate immediately

B) Reduce FiO₂

C) Stop weaning and provide ventilatory support

D) Continue weaning

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

21 / 50

21. Which ABG value best reflects tissue oxygenation?

A) Lactate

B) HCO₃⁻

C) PaCO₂

D) SaO₂

PaO₂ reflects arterial oxygen; lactate better reflects tissue perfusion.

22 / 50

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

A) Delay analysis

B) Avoid air bubbles

C) Use a venous sample

D) Apply ice immediately

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

23 / 50

23. Kussmaul breathing is seen in:

A) COPD

B) Asthma

C) Emphysema

D) Diabetic ketoacidosis

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

24 / 50

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

A) Mixed alkalosis

B) Mixed acidosis

C) Respiratory acidosis

D) Metabolic acidosis

Both increased bicarbonate and low CO₂ → mixed alkalosis.

25 / 50

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

A) Metabolic alkalosis

B) Fully compensated respiratory acidosis

C) Uncompensated acidosis

D) Mixed acidosis

Indicates fully compensated respiratory acidosis (chronic COPD).

26 / 50

26. In metabolic alkalosis, the lungs compensate by:

A) Decreasing ventilation

B) Producing lactic acid

C) Increasing ventilation

D) Increasing renal acid excretion

The body retains CO₂ through hypoventilation to lower pH.

27 / 50

27. Which test measures oxygen saturation non-invasively?

A) Pulse oximetry

B) Capnography

C) Chest X-ray

D) ABG test

Pulse oximetry uses light to measure SpO₂ without blood draw.

28 / 50

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

A) Respiratory acidosis

B) Compensated alkalosis

C) Mixed acidosis

D) Partially compensated metabolic acidosis

Lactic acidosis from shock → metabolic acidosis with respiratory compensation.

29 / 50

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

A) 40–45 mmHg

B) 25–30 mmHg

C) 50–55 mmHg

D) 30–35 mmHg

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

30 / 50

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

A) PaO₂

B) PaCO₂

C) Bicarbonate only

D) Metabolic component

It shows the amount of base required to normalize pH.

31 / 50

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

A) Respiratory alkalosis

B) Mixed alkalosis

C) Compensated respiratory acidosis

D) Uncompensated metabolic acidosis

Kidneys unable to excrete acid → metabolic acidosis without compensation.

32 / 50

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

A) Increase IV fluids

B) Notify physician

C) Check temperature

D) Administer oxygen

Administering supplemental oxygen restores tissue oxygenation immediately.

33 / 50

33. Oxyhemoglobin dissociation curve shifts to the right when:

A) Low CO₂

B) Alkalosis

C) High CO₂ and temperature

D) Low temperature

Increased CO₂ or temperature decreases oxygen affinity.

34 / 50

34. Which ABG finding is typical in early ARDS?

A) Respiratory acidosis

B) Respiratory alkalosis

C) Metabolic acidosis

D) Mixed acidosis

Early ARDS causes tachypnea → respiratory alkalosis.

35 / 50

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

A) Mixed acidosis

B) Metabolic alkalosis

C) Respiratory acidosis

D) Partially compensated metabolic acidosis

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

36 / 50

36. 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.

37 / 50

37. Which of the following can cause metabolic alkalosis?

A) Kidney failure

B) Diarrhea

C) Prolonged vomiting

D) Shock

Vomiting causes loss of gastric acid leading to alkalosis.

38 / 50

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

A) Decrease FiO₂

B) Give bicarbonate

C) Fluid restriction

D) Administer IV normal saline and potassium

Replace chloride and potassium losses to correct alkalosis.

39 / 50

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

A) 30 seconds

B) 1 minute

C) 2 minutes

D) 5–10 minutes

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

40 / 50

40. What compensatory mechanism occurs in metabolic acidosis?

A) Retention of CO₂

B) Decreased heart rate

C) Hypoventilation

D) Hyperventilation

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

41 / 50

41. Which buffer system acts fastest in the body?

A) Respiratory buffer

B) Chemical buffer

C) Renal buffer

D) Protein buffer

The chemical buffer system works immediately to resist pH changes.

42 / 50

42. Which of the following can cause respiratory alkalosis?

A) Diarrhea

B) Drug overdose

C) Kidney failure

D) Anxiety hyperventilation

Hyperventilation decreases CO₂ causing alkalosis.

43 / 50

43. Which value represents respiratory alkalosis?

A) pH 7.38, PaCO₂ 40

B) pH 7.30, PaCO₂ 55

C) pH 7.20, PaCO₂ 70

D) pH 7.48, PaCO₂ 30

Low PaCO₂ and high pH indicate respiratory alkalosis.

44 / 50

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

A) Mixed acidosis

B) Compensated acidosis

C) Respiratory acidosis

D) Metabolic acidosis

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

45 / 50

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

A) Mixed metabolic acidosis and alkalosis

B) Uncompensated acidosis

C) Mixed respiratory alkalosis

D) Normal ABG

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

46 / 50

46. Which condition shows respiratory acidosis with partial compensation?

A) pH 7.48, PaCO₂ 30

B) pH 7.30, PaCO₂ 55, HCO₃⁻ 28

C) pH 7.25, HCO₃⁻ 22

D) pH 7.38, PaCO₂ 40

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

47 / 50

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

A) Respiratory acidosis

B) Metabolic alkalosis

C) Metabolic acidosis

D) Respiratory alkalosis

High CO₂ and low pH indicate respiratory acidosis.

48 / 50

48. Which organ compensates for respiratory acidosis?

A) Kidneys

B) Lungs

C) Liver

D) Heart

The kidneys retain HCO₃⁻ to neutralize increased CO₂.

49 / 50

49. 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.

50 / 50

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

A) Mixed alkalosis

B) Metabolic acidosis

C) Alkalosis due to hypoxia

D) CO₂ narcosis (respiratory acidosis)

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

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