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