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