ALLQUESTIONSANDSOLUTIONS
TESTBANK:NURSINGA
CONCEPT-BASED
r
APPROACHTO
r
LEARNING,VOLUMESI,
II&III,3RD
r
EDITION,PEARSON
r
EDUCATION
r
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
r
WISHINGYOUSUCCESSA+
,Nursing:AConcept-BasedApproachtoLearningVol.12&3,3e(Pearson) Module 1
r r r r r r r r r r r r r r
r Acid-Base Balance r
TheConceptofAcid-BaseBalance
r r r r
1) A client is brought to the emergency department (ED) after passing out in a local department store.
r r r r r r r r r r r r r r r r
The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse
r r r r r r r r r r r r r r r r r
expect to assess in this client?
r r r r r r
A) Metabolicacidosis r
B) Respiratoryalkalosis r
C) Metabolicalkalosis r
D) Respiratoryacidosis
Answer: A
r
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The r r r r r r r r r r r r r r r
bodyrecognizesfastingas starvation and beginstometabolizeits ownfattyacids into ketones, whichare
r r r r r r r r r r r r r r r r
metabolicacids.Starvationwouldnotresultinrespiratoryacidosisoralkalosisorin metabolic alkalosis.
r r r r r r r r r r r r r r r
B) Aclientwhoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
r r r r r r r r r r r r r r r r
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
r r r r r r r r r r r r r r r r
Starvationwouldnotresultinrespiratoryacidosisoralkalosisorinmetabolic alkalosis.
r r r r r r r r r r r r r
C) Aclient whoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
r r r r r r r r r r r r r r r r
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
r r r r r r r r r r r r r r r r
Starvationwouldnotresultinrespiratoryacidosisoralkalosisorinmetabolic alkalosis.
r r r r r r r r r r r r r
D) Aclient whois fastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
r r r r r r r r r r r r r r r
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
r r r r r r r r r r r r r r r r
Starvationwouldnotresultinrespiratoryacidosisoralkalosisorinmetabolic alkalosis.
r r r r r r r r r r r r r
PageRef:6 r r
Cognitive Level: Analyzing r
ClientNeed/Sub: Physiological Integrity:Physiological Adaptation
r r r r
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
r r r r r r r r r r
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
r r r r r r r r r r
reflects an understanding of human growth and development, pathophysiology, pharmacology,
r r r r r r r r r r
medical management and nursing management across the health-illness continuum,acrosslifespan,
r r r r r r r r r r r
andinallhealthcaresettings. |NLNCompetencies:Knowledgeand Science:Relationshipsbetween
r r r r r r r r r r r r
knowledge/scienceandqualityandsafepatientcare.|Nursing Process: Assessment
r r r r r r r r r r r
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
r r r r r r
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
r r r r r r r r r r r r
,2) Whichrisk factors exhibited bythe client presenting in theemergencydepartment (ED)
r r r r r r r r r r r r
would place the client at risk for metabolic acidosis? Select all that apply.
r r r r r r r r r r r r r
A) Abdominal fistulas r
B) Chronicobstructive pulmonarydisease r r
C) Pneumonia
D) Acuterenalfailure r r
E) Hypovolemic
shock Answer:
r A, r
D, E
r r
Explanation: A) Metabolic acidosis is rarely a primarydisorder. It usually develops during the course r r r r r r r r r r r r r r
ofanotherdisease; presence ofabdominal fistulas, which can cause excess bicarbonate loss; acute
r r r r r r r r r r r r r r
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumoniaplace
r r r r r r r r r r r r
theclientatriskforrespiratoryacidosiswiththeincreased retentionofcarbon dioxide in the blood.
r r r r r r r r r r r r r r r r r
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;acute renal
r r r r r r r r r r r r r
failure; and hypovolemicshock. Chronicobstructivepulmonarydiseaseand pneumonia place the
r r r r r r r r r r r r
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
r r r r r r r r r r r r r r b r
C) Metabolicacidosisisrarelyaprimarydisorder.It usuallydevelopsduringthecourseof r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;
r r r r r r r r r r r r
acuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
r r r r r r r r r r
pneumonia place the client at risk for respiratoryacidosis with the increased retention of carbon
r r r r r r r r r r r r r r r
dioxide inthe blood.
r r r
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;acute renal
r r r r r r r r r r r r r
failure; and hypovolemicshock. Chronicobstructivepulmonarydiseaseand pneumonia place the
r r r r r r r r r r r r
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
r r r r r r r r r r r r r r b r
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;acute renal
r r r r r r r r r r r r r
failure; and hypovolemicshock. Chronicobstructivepulmonarydiseaseand pneumonia place the
r r r r r r r r r r r r
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
r r r r r r r r r r r r r r b r
PageRef:6, 14 r r r
CognitiveLevel: Applying r
ClientNeed/Sub: Physiological Integrity: Physiological Adaptation
r r r r
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and r r r r r r r r r r
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
r r r r r r r r r r
reflects an understanding of human growth and development, pathophysiology, pharmacology,
r r r r r r r r r r
medical management and nursing management across the health-illness continuum,acrosslifespan,
r r r r r r r r r r r
andinallhealthcaresettings.|NLNCompetencies:Knowledgeand Science:Relationshipsbetween
r r r r r r r r r r r r
knowledge/scienceandqualityandsafepatientcare.|Nursing Process: Assessment
r r r r r r r r r r r
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance. r r r r r r
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare. r r r r r r r r r r r r
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
r r r r r r r
r
r r r r r r r r r r
r
gas value. The nurse interprets these findings as indicative of which condition?
r
r r r r r r r r r r r
A) Metabolicacidosis r
B) Respiratoryalkalosis r
C) Respiratory acidosis r
D) Metabolicalkalosis
Answer: C
r
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is r r r r r r r r r
r
r r r r r r r
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
r
r r r r r r r r r
decreasedPaCO2,andnormalHCO3.UncompensatedmetabolicacidosishasadecreasedpH, normal
r
r r r r r r r r r r r r
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,normal
r r r r r r r r r r r
PaCO2, and increased HCO3.
r r r r
B) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
r r r r r r r
r
r r r r r r r r
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
r
r r r r r r r r r r
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
r r r r r r r r r r r r r
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
r r r r r r r r r r r
increased HCO3.
r r
C) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
r r r r r r r
r
r r r r r r r r
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
r
r r r r r r r r r r
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
r r r r r r r r r r r r r
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
r r r r r r r r r r r
increased HCO3.
r r
D) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
r r r r r r r
r
r r r r r r r r
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
r
r r r r r r r r r r
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
r r r r r r r r r r r r r
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
r r r r r r r r r r r
increased HCO3.
r r
PageRef:24 r r
Cognitive Level: Analyzing r
ClientNeed/Sub: Physiological Integrity:Physiological Adaptation
r r r r
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
r r r r r r r r r r
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
r r r r r r r r r r
reflects an understanding of human growth and development, pathophysiology, pharmacology,
r r r r r r r r r r
medical management and nursing management across the health-illness continuum,acrosslifespan,
r r r r r r r r r r r
andinallhealthcaresettings.|NLNCompetencies:Knowledgeand Science:Relationshipsbetween
r r r r r r r r r r r r r
knowledge/scienceandqualityandsafepatientcare. |Nursing Process: Diagnosis
r r r r r r r r r r r
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
r r r r r r
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
r r r r r r r r r r r r
TESTBANK:NURSINGA
CONCEPT-BASED
r
APPROACHTO
r
LEARNING,VOLUMESI,
II&III,3RD
r
EDITION,PEARSON
r
EDUCATION
r
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
r
WISHINGYOUSUCCESSA+
,Nursing:AConcept-BasedApproachtoLearningVol.12&3,3e(Pearson) Module 1
r r r r r r r r r r r r r r
r Acid-Base Balance r
TheConceptofAcid-BaseBalance
r r r r
1) A client is brought to the emergency department (ED) after passing out in a local department store.
r r r r r r r r r r r r r r r r
The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse
r r r r r r r r r r r r r r r r r
expect to assess in this client?
r r r r r r
A) Metabolicacidosis r
B) Respiratoryalkalosis r
C) Metabolicalkalosis r
D) Respiratoryacidosis
Answer: A
r
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The r r r r r r r r r r r r r r r
bodyrecognizesfastingas starvation and beginstometabolizeits ownfattyacids into ketones, whichare
r r r r r r r r r r r r r r r r
metabolicacids.Starvationwouldnotresultinrespiratoryacidosisoralkalosisorin metabolic alkalosis.
r r r r r r r r r r r r r r r
B) Aclientwhoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
r r r r r r r r r r r r r r r r
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
r r r r r r r r r r r r r r r r
Starvationwouldnotresultinrespiratoryacidosisoralkalosisorinmetabolic alkalosis.
r r r r r r r r r r r r r
C) Aclient whoisfastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
r r r r r r r r r r r r r r r r
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
r r r r r r r r r r r r r r r r
Starvationwouldnotresultinrespiratoryacidosisoralkalosisorinmetabolic alkalosis.
r r r r r r r r r r r r r
D) Aclient whois fastingisat risk fordevelopment ofmetabolicacidosis. Thebodyrecognizes fasting
r r r r r r r r r r r r r r r
as starvation and begins to metabolize its own fatty acids into ketones, which are metabolicacids.
r r r r r r r r r r r r r r r r
Starvationwouldnotresultinrespiratoryacidosisoralkalosisorinmetabolic alkalosis.
r r r r r r r r r r r r r
PageRef:6 r r
Cognitive Level: Analyzing r
ClientNeed/Sub: Physiological Integrity:Physiological Adaptation
r r r r
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
r r r r r r r r r r
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
r r r r r r r r r r
reflects an understanding of human growth and development, pathophysiology, pharmacology,
r r r r r r r r r r
medical management and nursing management across the health-illness continuum,acrosslifespan,
r r r r r r r r r r r
andinallhealthcaresettings. |NLNCompetencies:Knowledgeand Science:Relationshipsbetween
r r r r r r r r r r r r
knowledge/scienceandqualityandsafepatientcare.|Nursing Process: Assessment
r r r r r r r r r r r
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
r r r r r r
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
r r r r r r r r r r r r
,2) Whichrisk factors exhibited bythe client presenting in theemergencydepartment (ED)
r r r r r r r r r r r r
would place the client at risk for metabolic acidosis? Select all that apply.
r r r r r r r r r r r r r
A) Abdominal fistulas r
B) Chronicobstructive pulmonarydisease r r
C) Pneumonia
D) Acuterenalfailure r r
E) Hypovolemic
shock Answer:
r A, r
D, E
r r
Explanation: A) Metabolic acidosis is rarely a primarydisorder. It usually develops during the course r r r r r r r r r r r r r r
ofanotherdisease; presence ofabdominal fistulas, which can cause excess bicarbonate loss; acute
r r r r r r r r r r r r r r
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumoniaplace
r r r r r r r r r r r r
theclientatriskforrespiratoryacidosiswiththeincreased retentionofcarbon dioxide in the blood.
r r r r r r r r r r r r r r r r r
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;acute renal
r r r r r r r r r r r r r
failure; and hypovolemicshock. Chronicobstructivepulmonarydiseaseand pneumonia place the
r r r r r r r r r r r r
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
r r r r r r r r r r r r r r b r
C) Metabolicacidosisisrarelyaprimarydisorder.It usuallydevelopsduringthecourseof r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;
r r r r r r r r r r r r
acuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
r r r r r r r r r r
pneumonia place the client at risk for respiratoryacidosis with the increased retention of carbon
r r r r r r r r r r r r r r r
dioxide inthe blood.
r r r
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;acute renal
r r r r r r r r r r r r r
failure; and hypovolemicshock. Chronicobstructivepulmonarydiseaseand pneumonia place the
r r r r r r r r r r r r
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
r r r r r r r r r r r r r r b r
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of r r r r r r r r r r r r r
anotherdisease;presenceofabdominalfistulas,whichcancauseexcessbicarbonateloss;acute renal
r r r r r r r r r r r r r
failure; and hypovolemicshock. Chronicobstructivepulmonarydiseaseand pneumonia place the
r r r r r r r r r r r r
client at risk for respiratory acidosis with the increased retention of carbon dioxide in the blood.
r r r r r r r r r r r r r r b r
PageRef:6, 14 r r r
CognitiveLevel: Applying r
ClientNeed/Sub: Physiological Integrity: Physiological Adaptation
r r r r
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and r r r r r r r r r r
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
r r r r r r r r r r
reflects an understanding of human growth and development, pathophysiology, pharmacology,
r r r r r r r r r r
medical management and nursing management across the health-illness continuum,acrosslifespan,
r r r r r r r r r r r
andinallhealthcaresettings.|NLNCompetencies:Knowledgeand Science:Relationshipsbetween
r r r r r r r r r r r r
knowledge/scienceandqualityandsafepatientcare.|Nursing Process: Assessment
r r r r r r r r r r r
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance. r r r r r r
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare. r r r r r r r r r r r r
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
r r r r r r r
r
r r r r r r r r r r
r
gas value. The nurse interprets these findings as indicative of which condition?
r
r r r r r r r r r r r
A) Metabolicacidosis r
B) Respiratoryalkalosis r
C) Respiratory acidosis r
D) Metabolicalkalosis
Answer: C
r
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is r r r r r r r r r
r
r r r r r r r
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
r
r r r r r r r r r
decreasedPaCO2,andnormalHCO3.UncompensatedmetabolicacidosishasadecreasedpH, normal
r
r r r r r r r r r r r r
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,normal
r r r r r r r r r r r
PaCO2, and increased HCO3.
r r r r
B) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
r r r r r r r
r
r r r r r r r r
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
r
r r r r r r r r r r
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
r r r r r r r r r r r r r
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
r r r r r r r r r r r
increased HCO3.
r r
C) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
r r r r r r r
r
r r r r r r r r
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
r
r r r r r r r r r r
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
r r r r r r r r r r r r r
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
r r r r r r r r r r r
increased HCO3.
r r
D) IfthepHisdecreasedandthePaCO2isincreased withanormalHCO3,itisuncompensated
r r r r r r r
r
r r r r r r r r
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2,
r
r r r r r r r r r r
and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
r r r r r r r r r r r r r
decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normalPaCO2, and
r r r r r r r r r r r
increased HCO3.
r r
PageRef:24 r r
Cognitive Level: Analyzing r
ClientNeed/Sub: Physiological Integrity:Physiological Adaptation
r r r r
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
r r r r r r r r r r
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
r r r r r r r r r r
reflects an understanding of human growth and development, pathophysiology, pharmacology,
r r r r r r r r r r
medical management and nursing management across the health-illness continuum,acrosslifespan,
r r r r r r r r r r r
andinallhealthcaresettings.|NLNCompetencies:Knowledgeand Science:Relationshipsbetween
r r r r r r r r r r r r r
knowledge/scienceandqualityandsafepatientcare. |Nursing Process: Diagnosis
r r r r r r r r r r r
LearningOutcome: 1.2.Differentiatealterationsinacid-basebalance.
r r r r r r
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
r r r r r r r r r r r r
