ALLQUESTIONSANDSOLUTIONS
TESTBANK:NURSINGA
CONCEPT-BASED
g
APPROACHTO
g
LEARNING,VOLUMESI,
II&III,3RD
g
EDITION,PEARSON
g
EDUCATION
g
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
g
WISHINGYOUSUCCESSA+
,Nursing:AConcept-BasedApproachtoLearningVol.12&3,3e(Pearson) Module 1
g g g g g g g g g g g g g g
g Acid-Base Balance g
TheConceptofAcid-BaseBalance
g g g g
1) A client is brought to the emergency department (ED) after passing out in a local department store.
g g g g g g g g g g g g g g g g
The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse
g g g g g g g g g g g g g g g g g
expect to assess in this client?
g g g g g g
A) Metabolicacidosis g
B) Respiratory alkalosis g
C) Metabolic alkalosis g
D) Respiratoryacidosis
Answer: A
g
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The g g g g g g g g g g g g g g g
bodyrecognizesfastingas starvation and beginsto metabolizeits ownfattyacids into ketones, whichare
g g g g g g g g g g g g g g g g
metabolicacids. Starvationwouldnotresult inrespiratoryacidosisoralkalosisorin metabolic alkalosis.
g g g g g g g g g g g g g g g
B) Aclient whoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
g g g g g g g g g g g g g g g g
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
g g g g g g g g g g g g g g g g
Starvation would not result in respiratory acidosis oralkalosis orin metabolic alkalosis.
g g g g g g g g g g g g g
C) Aclient whoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
g g g g g g g g g g g g g g g g
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
g g g g g g g g g g g g g g g g
Starvation would not result in respiratory acidosis oralkalosis orin metabolic alkalosis.
g g g g g g g g g g g g g
D) Aclient who is fastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
g g g g g g g g g g g g g g g g
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
g g g g g g g g g g g g g g g g
Starvation would not result in respiratory acidosis oralkalosis orin metabolic alkalosis.
g g g g g g g g g g g g g
PageRef:6 g g
Cognitive Level: Analyzing g
ClientNeed/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
g g g g
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
g g g g g g g g g g
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
g g g g g g g g g g
reflects an understanding of human growth and development, pathophysiology, pharmacology,
g g g g g g g g g g
medical management and nursing management across the health-illness continuum,acrosslifespan,
g g g g g g g g g g g
andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science:Relationshipsbetween
g g g g g g g g g g g g
knowledge/scienceand qualityandsafepatient care. |Nursing Process: Assessment
g g g g g g g g g g g
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
g g g g g g
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
g g g g g g g g g g g g
,2) Whichrisk factors exhibited bythe client presenting in theemergencydepartment (ED) would
g g g g g g g g g g g g g
place the client at risk for metabolic acidosis? Select all that apply.
g g g g g g g g g g g g
A) Abdominal fistulas g
B) Chronicobstructivepulmonarydisease g g g
C) Pneumonia
D) Acuterenalfailure g g
E) Hypovolemicshock g
Answer: A, D, E
g g g
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
g g g g g g g g g g g g g g g
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal
g g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumoniaplacethe
g g g g g g g g g g g g
clientatrisk forrespiratoryacidosis with theincreased retention ofcarbon dioxide in the blood.
g g g g g g g g g g g g g g g g
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute renal
g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the
g g g g g g g g g g g g
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
g g g g g g g g g g g g g g b g
C) Metabolicacidosisisrarelyaprimarydisorder. It usuallydevelopsduringthecourseof g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas, whichcan cause excess bicarbonate loss;
g g g g g g g g g g g g
acuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
g g g g g g g g g g
pneumonia place the client at risk for respiratory acidosis with the increased retention of
g g g g g g g g g g g g g g
carbon dioxide inthe blood.
g g g g
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute renal
g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the
g g g g g g g g g g g g
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
g g g g g g g g g g g g g g b g
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute renal
g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the
g g g g g g g g g g g g
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
g g g g g g g g g g g g g g b g
PageRef: 6, 14
g g g
CognitiveLevel: Applying g
ClientNeed/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
g g g g
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
g g g g g g g g g g
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
g g g g g g g g g g
reflects an understanding of human growth and development, pathophysiology, pharmacology,
g g g g g g g g g g
medical management and nursing management across the health-illness continuum,acrosslifespan,
g g g g g g g g g g g
andinall healthcaresettings.|NLNCompetencies: Knowledgeand Science:Relationshipsbetween
g g g g g g g g g g g g
knowledge/scienceand qualityandsafepatient care. |Nursing Process: Assessment
g g g g g g g g g g g
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
g g g g g g
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
g g g g g g g g g g g g
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood gas
g g g g g g g
g
g g g g g g g g g g
g
g
value. The nurse interprets these findings as indicative of which condition?
g g g g g g g g g g g
A) Metabolicacidosis g
B) Respiratory alkalosis g
C) Respiratoryacidosis g
D) Metabolicalkalosis g
Answer: C
g
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is g g g g g g g g g
g
g g g g g g g
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
g
g g g g g g g g g
decreased PaCO2, and normal HCO3.Uncompensatedmetabolicacidosis has a decreased pH, normal
g
g g g g g g g g g g g g
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,normal
g g g g g g g g g g g
PaCO2, and increased HCO3.
g g g g
B) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
g g g g g g g
g
g g g g g g g g
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
g
g g g g g g g g g g
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
g g g g g g g g g g g g g
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
g g g g g g g g g g g
increased HCO3.
g g
C) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
g g g g g g g
g
g g g g g g g g
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
g
g g g g g g g g g g
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
g g g g g g g g g g g g g
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
g g g g g g g g g g g
increased HCO3.
g g
D) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
g g g g g g g
g
g g g g g g g g
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
g
g g g g g g g g g g
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
g g g g g g g g g g g g g
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
g g g g g g g g g g g
increased HCO3.
g g
PageRef:24 g g
Cognitive Level: Analyzing g
ClientNeed/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
g g g g
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
g g g g g g g g g g
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
g g g g g g g g g g
reflects an understanding of human growth and development, pathophysiology, pharmacology,
g g g g g g g g g g
medical management and nursing management across the health-illness continuum,acrosslifespan,
g g g g g g g g g g g
andinall healthcaresettings. |NLNCompetencies: Knowledgeand Science:Relationshipsbetween
g g g g g g g g g g g g g
knowledge/scienceand qualityandsafepatient care. |Nursing Process: Diagnosis
g g g g g g g g g g g
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
g g g g g g
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
g g g g g g g g g g g g
TESTBANK:NURSINGA
CONCEPT-BASED
g
APPROACHTO
g
LEARNING,VOLUMESI,
II&III,3RD
g
EDITION,PEARSON
g
EDUCATION
g
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
g
WISHINGYOUSUCCESSA+
,Nursing:AConcept-BasedApproachtoLearningVol.12&3,3e(Pearson) Module 1
g g g g g g g g g g g g g g
g Acid-Base Balance g
TheConceptofAcid-BaseBalance
g g g g
1) A client is brought to the emergency department (ED) after passing out in a local department store.
g g g g g g g g g g g g g g g g
The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse
g g g g g g g g g g g g g g g g g
expect to assess in this client?
g g g g g g
A) Metabolicacidosis g
B) Respiratory alkalosis g
C) Metabolic alkalosis g
D) Respiratoryacidosis
Answer: A
g
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The g g g g g g g g g g g g g g g
bodyrecognizesfastingas starvation and beginsto metabolizeits ownfattyacids into ketones, whichare
g g g g g g g g g g g g g g g g
metabolicacids. Starvationwouldnotresult inrespiratoryacidosisoralkalosisorin metabolic alkalosis.
g g g g g g g g g g g g g g g
B) Aclient whoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
g g g g g g g g g g g g g g g g
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
g g g g g g g g g g g g g g g g
Starvation would not result in respiratory acidosis oralkalosis orin metabolic alkalosis.
g g g g g g g g g g g g g
C) Aclient whoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
g g g g g g g g g g g g g g g g
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
g g g g g g g g g g g g g g g g
Starvation would not result in respiratory acidosis oralkalosis orin metabolic alkalosis.
g g g g g g g g g g g g g
D) Aclient who is fastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
g g g g g g g g g g g g g g g g
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
g g g g g g g g g g g g g g g g
Starvation would not result in respiratory acidosis oralkalosis orin metabolic alkalosis.
g g g g g g g g g g g g g
PageRef:6 g g
Cognitive Level: Analyzing g
ClientNeed/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
g g g g
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
g g g g g g g g g g
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
g g g g g g g g g g
reflects an understanding of human growth and development, pathophysiology, pharmacology,
g g g g g g g g g g
medical management and nursing management across the health-illness continuum,acrosslifespan,
g g g g g g g g g g g
andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science:Relationshipsbetween
g g g g g g g g g g g g
knowledge/scienceand qualityandsafepatient care. |Nursing Process: Assessment
g g g g g g g g g g g
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
g g g g g g
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
g g g g g g g g g g g g
,2) Whichrisk factors exhibited bythe client presenting in theemergencydepartment (ED) would
g g g g g g g g g g g g g
place the client at risk for metabolic acidosis? Select all that apply.
g g g g g g g g g g g g
A) Abdominal fistulas g
B) Chronicobstructivepulmonarydisease g g g
C) Pneumonia
D) Acuterenalfailure g g
E) Hypovolemicshock g
Answer: A, D, E
g g g
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
g g g g g g g g g g g g g g g
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal
g g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumoniaplacethe
g g g g g g g g g g g g
clientatrisk forrespiratoryacidosis with theincreased retention ofcarbon dioxide in the blood.
g g g g g g g g g g g g g g g g
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute renal
g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the
g g g g g g g g g g g g
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
g g g g g g g g g g g g g g b g
C) Metabolicacidosisisrarelyaprimarydisorder. It usuallydevelopsduringthecourseof g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas, whichcan cause excess bicarbonate loss;
g g g g g g g g g g g g
acuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
g g g g g g g g g g
pneumonia place the client at risk for respiratory acidosis with the increased retention of
g g g g g g g g g g g g g g
carbon dioxide inthe blood.
g g g g
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute renal
g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the
g g g g g g g g g g g g
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
g g g g g g g g g g g g g g b g
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of g g g g g g g g g g g g g
anotherdisease;presence ofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute renal
g g g g g g g g g g g g g
failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the
g g g g g g g g g g g g
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
g g g g g g g g g g g g g g b g
PageRef: 6, 14
g g g
CognitiveLevel: Applying g
ClientNeed/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
g g g g
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
g g g g g g g g g g
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
g g g g g g g g g g
reflects an understanding of human growth and development, pathophysiology, pharmacology,
g g g g g g g g g g
medical management and nursing management across the health-illness continuum,acrosslifespan,
g g g g g g g g g g g
andinall healthcaresettings.|NLNCompetencies: Knowledgeand Science:Relationshipsbetween
g g g g g g g g g g g g
knowledge/scienceand qualityandsafepatient care. |Nursing Process: Assessment
g g g g g g g g g g g
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
g g g g g g
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
g g g g g g g g g g g g
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood gas
g g g g g g g
g
g g g g g g g g g g
g
g
value. The nurse interprets these findings as indicative of which condition?
g g g g g g g g g g g
A) Metabolicacidosis g
B) Respiratory alkalosis g
C) Respiratoryacidosis g
D) Metabolicalkalosis g
Answer: C
g
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is g g g g g g g g g
g
g g g g g g g
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
g
g g g g g g g g g
decreased PaCO2, and normal HCO3.Uncompensatedmetabolicacidosis has a decreased pH, normal
g
g g g g g g g g g g g g
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,normal
g g g g g g g g g g g
PaCO2, and increased HCO3.
g g g g
B) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
g g g g g g g
g
g g g g g g g g
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
g
g g g g g g g g g g
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
g g g g g g g g g g g g g
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
g g g g g g g g g g g
increased HCO3.
g g
C) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
g g g g g g g
g
g g g g g g g g
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
g
g g g g g g g g g g
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
g g g g g g g g g g g g g
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
g g g g g g g g g g g
increased HCO3.
g g
D) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
g g g g g g g
g
g g g g g g g g
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
g
g g g g g g g g g g
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
g g g g g g g g g g g g g
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
g g g g g g g g g g g
increased HCO3.
g g
PageRef:24 g g
Cognitive Level: Analyzing g
ClientNeed/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
g g g g
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
g g g g g g g g g g
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
g g g g g g g g g g
reflects an understanding of human growth and development, pathophysiology, pharmacology,
g g g g g g g g g g
medical management and nursing management across the health-illness continuum,acrosslifespan,
g g g g g g g g g g g
andinall healthcaresettings. |NLNCompetencies: Knowledgeand Science:Relationshipsbetween
g g g g g g g g g g g g g
knowledge/scienceand qualityandsafepatient care. |Nursing Process: Diagnosis
g g g g g g g g g g g
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
g g g g g g
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
g g g g g g g g g g g g
