Electrolytes Question #58


The nurse is caring for a client with exacerbation of COPD who is in respiratory acidosis. Which finding indicates that the client is experiencing compensation?


  1. Increased breathing to excrete carbon dioxide
    • Rationale:
  2. Decreased breathing to retain carbon dioxide
    • Rationale:
  3. Bicarbonate retained by the kidneys
    • Rationale:
  4. Bicarbonate excreted by the kidneys
    • Rationale:



The correct answer is C. In chronic respiratory acidosis, the body promotes acid excretion through the kidneys (through renal ammoniagenesis in the proximal convoluted tubules; see image below), which enhances bicarbonate retention. Respiratory rate change does not affect respiratory acidosis. Excretion of bicarbonate would exacerbate the acidosis.

NCLEX TIP: Using critical thinking is recommended when reading priority questions. Recognizing key words in the answer choices will allow you to know how to choose the correct answer for the question. Go through each answer choice and decide is it: Maslow’s hierarchy, safety-related, or following the nursing process (ADPIE). Never complete a nursing action that is outside the scope of practice.

Learning Outcomes

Test Taking Tip

Video Rationale