TEST BANK FOR NURSING A CONCEPT-BASED APPROACH TO LEARNING, 11 TH EDITION VOLUMES I, II & III WITH UPGRADED QUESTIONS AND ANSWERS

TEST BANK FOR NURSING A CONCEPT-BASED APPROACH TO LEARNING, 11 TH EDITION VOLUMES I, II & III WITH UPGRADED QUESTIONS AND ANSWERS MNL LO: Analyze the concept of acid-base balance and its application to nursing care.  Which risk factors exhibited by the client presenting in the emergency department (ED) would place the client at risk for metabolic acidosis? Select all that apply. a. Abdominal fistulas b. Chronic obstructive pulmonary disease c. Pneumonia d. Acute renal failure e. Hypovolemic shock Answer: A, D, E Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood. a. Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood. b. Metabolic acidosis is rarely a primary disorder. It usually develops during the course of anotherdisease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood. c. Metabolic acidosis is rarely a primary disorder. It usually develops during the course of anotherdisease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood. d. Metabolic acidosis is rarely a primary disorder. It usually develops during the course of anotherdisease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood. Page Ref:6, 14 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 Essential Competencies: IX.3. Implement holistic, patient-centered care that reflectsan understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in allhealthcare settings. | 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 theconcept of acid-base balance and its application to nursing care.  A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood gasvalue. The nurse interprets thesefindings as indicativeof which condition? a. Metabolic acidosis b. Respiratory alkalosis c. Respiratory acidosis d. Metabolic alkalosis Answer: C Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal PaCO2,and increased HCO3. a. If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, andnormal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal PaCO2, and increased HCO3. b. If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, andnormal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal PaCO2, and increased HCO3. c. If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, andnormal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal PaCO2, and increased HCO3. Page Ref: 24 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 Essential Competencies: IX.3. Implement holistic, patient-centered care that reflectsan understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in allhealthcare settings. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing Process: Diagnosis Learning Outcome: 1.2. Differentiate alterations in acid-base balance.  A client is brought to the emergency department (ED) after passing out in a local departmentstore. The client has been fasting and has ketones in the urine. Which acid-base imbalance would thenurse expect to assess in this client? a. Metabolic acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. 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. Starvation would not result in respiratory acidosisor alkalosisor in metabolic alkalosis. B) 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 or alkalosisor in metabolic alkalosis. C) 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 or alkalosisor in metabolic alkalosis. D) 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 or alkalosisor in metabolic alkalosis. Page Ref:6 Cognitive Level: Analyzing Client Need/Sub: Physiological Integrity: Physiological Adaptation