Practice Question
A nurse is caring for a client who has metabolic acidosis. Which assessment finding is a possible cause for this condition? (Select all that apply.)
Answer Choices:
Correct Answer:
Hyperkalemia
Rationale:
✅ 1. Hyperkalemia – Possible Cause
✨ Hyperkalemia is associated with metabolic acidosis because hydrogen ions (H⁺) shift into cells while potassium ions (K⁺) shift out, increasing serum potassium.
✨ This ion exchange happens when the body is acidotic and can also worsen the acidosis by altering renal acid excretion.
✨ In conditions like renal failure, the kidneys cannot eliminate acids effectively, causing both potassium and hydrogen ions to accumulate.
✨ Reduced ability to excrete H⁺ contributes directly to the development or worsening of metabolic acidosis.
✨ Thus, hyperkalemia is both a result and a contributing cause of metabolic acidosis.
✅ 2. Salicylate Toxicity – Possible Cause
🔥 Salicylate toxicity increases metabolic rate and triggers excess production of organic acids such as lactic acid.
🔥 These acids accumulate and lower serum bicarbonate (HCO₃⁻), leading to metabolic acidosis.
🔥 Salicylates disrupt oxidative phosphorylation, producing even more acid byproducts.
🔥 They also interfere with renal bicarbonate reabsorption, which further decreases buffering capacity.
🔥 This condition often produces a mixed acid–base disorder, with early respiratory alkalosis followed by metabolic acidosis.
❌ 3. Hyperventilation – Not a Cause
🚫 Hyperventilation removes excessive carbon dioxide (CO₂) from the bloodstream, causing respiratory alkalosis, not metabolic acidosis.
🚫 As CO₂ levels fall, carbonic acid decreases and pH rises into the alkaline range.
🚫 This process does not generate metabolic acids or reduce serum bicarbonate.
🚫 Hyperventilation is commonly linked to anxiety, pain, or hypoxemia, not metabolic imbalance.
🚫 Therefore, hyperventilation is not associated with the development of metabolic acidosis.
❌ 4. Nausea and Vomiting – Not a Cause
❌ Vomiting causes loss of hydrochloric acid (HCl) from the stomach, which leads to metabolic alkalosis, the opposite of metabolic acidosis.
❌ Loss of acid results in elevated serum bicarbonate, increasing blood pH.
❌ Vomiting does not contribute to the retention of metabolic acids.
❌ Resulting fluid loss may impair renal perfusion, reducing acid excretion and worsening alkalosis.
❌ Therefore, nausea and vomiting are not causes of metabolic acidosis.
❌ 5. Overuse of Antacids – Not a Cause
⚠️ Overuse of antacids introduces excess alkaline substances such as bicarbonate, leading to metabolic alkalosis.
⚠️ Increased HCO₃⁻ raises pH and reduces overall acidity in the bloodstream.
⚠️ Impaired kidney perfusion may limit bicarbonate excretion, worsening alkalosis.
⚠️ This does not increase production or retention of metabolic acids.
⚠️ Therefore, antacid overuse is associated with alkalosis—not metabolic acidosis.etabolic acidosis.
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This question is from Custom NUR1211 Midterm November 2025 which contains 85 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Medical-Surgical
- Answer Choices: 5