TEST BANK Nursing A Concept-Based Approach to Learning, Volume I, II & III 4th Edition

TEST BANK Nursing A Concept-Based Approach to Learning, Volume I, II & III 4th Edition DOWNLOAD THE FULL VERSION AT: Nursing: A Concept-Based Approach to Learning Vol. 1 & 2, 4e (Pearson) Module 1 Acid-Base Balance The Concept of Acid-Base Balance A client who has been fasting and has ketones in the urine is brought to the emergency department (ED) unconscious. Which acid-base imbalance would the nurse expect to assess in this client? Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Answer: A Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in respiratory alkalosis. A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in metabolic alkalosis. A client who is fasting is at risk for development of metabolic acidosis. The body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic acids. Starvation would not result in respiratory acidosis. Page Ref: 5 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing Process: Assessment Learning Outcome: 1.2. Differentiate alterations in acid-base balance. MNL LO: Analyze the concept of acid-base balance and its application to nursing care. DOWNLOAD THE FULL VERSION AT: The nurse is caring for a client in the emergency department. Which factors will the nurse identify that increase the client's risk for metabolic acidosis? Select all that apply. Abdominal fistulas Chronic obstructive pulmonary disease Pneumonia Chronic renal failure Hypovolemic shock Answer: A, D, E Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another condition such as an abdominal fistula which can cause the loss of bicarbonate from the intestine. Chronic obstructive pulmonary disease places the client at risk for respiratory acidosis withthe increased retention of carbon dioxide in the blood. Pneumonia places the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood. Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another condition such as chronic renal failure. In this health problem, the kidneys are unable toexcrete a normal amount of hydrogen ions in the urine. This results in an excessive amount of hydrogen ions in the blood, which produces metabolic acidosis. Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another condition such as hypovolemic shock. With a severe blood loss, there is a lack of blood flow throughout the body and a lack of oxygen in every cell. Adenosine triphosphate (ATP) must produce energy anaerobically without the presence of oxygen; lactic acid is a by-product. This produces systemic lactic acidosis, a type of metabolic acidosis. Page Ref: 5-6 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Domains and Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing Process: Assessment Learning Outcome: 1.2. Differentiate alterations in acid-base balance. MNL LO: Analyze the concept of acid-base balance and its application to nursing care. DOWNLOAD THE FULL VERSION AT: A client with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 arterial blood gas value. Which condition will the nurse associate with these values? Metabolic acidosis Respiratory alkalosis Respiratory acidosis Metabolic alkalosis Answer: C Explanation: A) Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and decreased HCO3. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, and normal HCO3. If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Uncompensated metabolic alkalosis has an increased pH, normal PaCO2, and increased HCO3. Page Ref: 7 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Domains and Essential Competencies: 2.4 Diagnose actual or potential health problems and needs. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing Process: Assessment Learning Outcome: 1.2. Differentiate alterations in acid-base balance. MNL LO: Analyze the concept of acid-base balance and its application to nursing care.