ALLQUESTIONSANDSOLUTIONS
TESTBANK:NURSINGA
CONCEPT-BASED
APPROACHTO
LEARNING,VOLUMESI,
II&III,3RD
EDITION,PEARSON
EDUCATION
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
WISHINGYOUSUCCESSA+
,Nursing: A Concept-Based Approach to Learning Vol. 1 2 & 3, 3e (Pearson)
Module 1 Acid-Base Balance
The Concept of Acid-Base Balance
1) A client is brought to the emergency department (ED) after passing out in a local department
store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would
the nurse expect to assess in this client?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratoryacidosis
Answer: A
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The
bodyrecognizes 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 alkalosis or 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 alkalosis or 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 alkalosis or in metabolic
alkalosis.
D) A client who is fasting is at risk for development of metabolic acidosis. The bodyrecognizes
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 alkalosis or in metabolic
alkalosis.
Page Ref: 6
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
carethat reflects an understanding of human growth and development, pathophysiology,
pharmacology, medical management and nursing management across the health-illness
continuum, across lifespan, and in all healthcare 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.
MNLLO: Analyze the concept of acid-base balance and its application to nursing care.
,2) Whichrisk factors exhibited bythe client presenting intheemergencydepartment (ED)
would place the client at risk for metabolic acidosis? Select all that apply.
A) Abdominal fistulas
B) Chronicobstructivepulmonarydisease
B
C) Pneumonia
D) Acuterenalfailure
E) Hypovolemicshock
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
placetheclient at risk forrespiratoryacidosis with theincreased retention ofcarbon dioxide in the
blood.
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
anotherdisease;presence ofabdominal fistulas,whichcan cause excess bicarbonateloss; acute
B
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 acidosisis rarely aprimarydisorder. It usuallydevelopsduringthecourseof
B
anotherdisease; presence ofabdominalfistulas, which can cause excess bicarbonate loss;
acuterenal 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 inthe blood.
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
anotherdisease;presence ofabdominal fistulas,whichcan cause excess bicarbonateloss; acute
B
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.
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
anotherdisease;presence ofabdominal fistulas,whichcan cause excess bicarbonateloss; acute
B
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.
PageRef: 6, 14
CognitiveLevel: Applying
Client Need/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
B
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
reflects an understanding of human growth and development, pathophysiology, pharmacology,
medical management and nursing management across the health-illness continuum,across
lifespan, andinall healthcaresettings.|NLNCompetencies: Knowledgeand Science:
Relationshipsbetween knowledge/scienceand qualityandsafepatient care. |Nursing Process:
Assessment
Learning Outcome: 1.2.Differentiatealterationsin acid-basebalance.
B B
MNLLO: Analyzetheconcept of acid-basebalanceand its application to nursingcare.
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
gas value. The nurse interprets these findings as indicative of which condition?
A) Metabolicacidosis
B) Respiratory alkalosis
C) Respiratoryacidosis
D) Metabolicalkalosis
Answer: C
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
decreased PaCO2, and normal HCO3. Uncompensatedmetabolicacidosishas adecreased pH,
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased
pH,normal PaCO2, and increased HCO3.
B) IfthepHis decreased and thePaCO2 isincreased with anormal HCO3, itisuncompensated
B B
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,
normalPaCO2, and increased HCO3.
C) IfthepHis decreasedandthePaCO2 isincreased withanormal HCO3, it is uncompensated
B B
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,
normalPaCO2, and increased HCO3.
D) IfthepHis decreasedandthePaCO2 isincreased withanormal HCO3, itisuncompensated
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,
normalPaCO2, and increased HCO3.
PageRef:24
Cognitive Level: Analyzing
Client Need/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
B
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
reflects an understanding of human growth and development, pathophysiology, pharmacology,
medical management and nursing management across the health-illness continuum,across
lifespan,and in all healthcaresettings. |NLNCompetencies: Knowledgeand Science:
B
Relationshipsbetween knowledge/scienceand qualityandsafepatient care. |Nursing Process:
Diagnosis
Learning Outcome: 1.2.Differentiatealterationsin acid-basebalance.
B B
MNLLO: Analyzetheconcept of acid-basebalanceand its application to nursingcare.
B
TESTBANK:NURSINGA
CONCEPT-BASED
APPROACHTO
LEARNING,VOLUMESI,
II&III,3RD
EDITION,PEARSON
EDUCATION
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
WISHINGYOUSUCCESSA+
,Nursing: A Concept-Based Approach to Learning Vol. 1 2 & 3, 3e (Pearson)
Module 1 Acid-Base Balance
The Concept of Acid-Base Balance
1) A client is brought to the emergency department (ED) after passing out in a local department
store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would
the nurse expect to assess in this client?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratoryacidosis
Answer: A
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The
bodyrecognizes 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 alkalosis or 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 alkalosis or 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 alkalosis or in metabolic
alkalosis.
D) A client who is fasting is at risk for development of metabolic acidosis. The bodyrecognizes
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 alkalosis or in metabolic
alkalosis.
Page Ref: 6
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
carethat reflects an understanding of human growth and development, pathophysiology,
pharmacology, medical management and nursing management across the health-illness
continuum, across lifespan, and in all healthcare 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.
MNLLO: Analyze the concept of acid-base balance and its application to nursing care.
,2) Whichrisk factors exhibited bythe client presenting intheemergencydepartment (ED)
would place the client at risk for metabolic acidosis? Select all that apply.
A) Abdominal fistulas
B) Chronicobstructivepulmonarydisease
B
C) Pneumonia
D) Acuterenalfailure
E) Hypovolemicshock
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
placetheclient at risk forrespiratoryacidosis with theincreased retention ofcarbon dioxide in the
blood.
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
anotherdisease;presence ofabdominal fistulas,whichcan cause excess bicarbonateloss; acute
B
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 acidosisis rarely aprimarydisorder. It usuallydevelopsduringthecourseof
B
anotherdisease; presence ofabdominalfistulas, which can cause excess bicarbonate loss;
acuterenal 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 inthe blood.
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
anotherdisease;presence ofabdominal fistulas,whichcan cause excess bicarbonateloss; acute
B
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.
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
anotherdisease;presence ofabdominal fistulas,whichcan cause excess bicarbonateloss; acute
B
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.
PageRef: 6, 14
CognitiveLevel: Applying
Client Need/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
B
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
reflects an understanding of human growth and development, pathophysiology, pharmacology,
medical management and nursing management across the health-illness continuum,across
lifespan, andinall healthcaresettings.|NLNCompetencies: Knowledgeand Science:
Relationshipsbetween knowledge/scienceand qualityandsafepatient care. |Nursing Process:
Assessment
Learning Outcome: 1.2.Differentiatealterationsin acid-basebalance.
B B
MNLLO: Analyzetheconcept of acid-basebalanceand its application to nursingcare.
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
gas value. The nurse interprets these findings as indicative of which condition?
A) Metabolicacidosis
B) Respiratory alkalosis
C) Respiratoryacidosis
D) Metabolicalkalosis
Answer: C
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
decreased PaCO2, and normal HCO3. Uncompensatedmetabolicacidosishas adecreased pH,
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased
pH,normal PaCO2, and increased HCO3.
B) IfthepHis decreased and thePaCO2 isincreased with anormal HCO3, itisuncompensated
B B
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,
normalPaCO2, and increased HCO3.
C) IfthepHis decreasedandthePaCO2 isincreased withanormal HCO3, it is uncompensated
B B
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,
normalPaCO2, and increased HCO3.
D) IfthepHis decreasedandthePaCO2 isincreased withanormal HCO3, itisuncompensated
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,
normalPaCO2, and increased HCO3.
PageRef:24
Cognitive Level: Analyzing
Client Need/Sub: PhysiologicalIntegrity:PhysiologicalAdaptation
B
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
reflects an understanding of human growth and development, pathophysiology, pharmacology,
medical management and nursing management across the health-illness continuum,across
lifespan,and in all healthcaresettings. |NLNCompetencies: Knowledgeand Science:
B
Relationshipsbetween knowledge/scienceand qualityandsafepatient care. |Nursing Process:
Diagnosis
Learning Outcome: 1.2.Differentiatealterationsin acid-basebalance.
B B
MNLLO: Analyzetheconcept of acid-basebalanceand its application to nursingcare.
B
