Test Bank For Nursing A Concept Based Approach to Learning 3rd Edition Pearson Education

ALLQUESTIONSANDSOLUTIONS


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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c Acid-Base Balance c




TheConcept ofAcid-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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cexpect to assess in this client?
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A) Metabolicacidosis c




B) Respiratory alkalosis c




C) Metabolic alkalosis c




D) Respiratoryacidosis
Answer: A
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Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The c c c c c c c c c c c c c c c




cbodyrecognizes fastingas starvation and begins to metabolizeits ownfattyacids into ketones, which c c c c c c c c c c c c c c




aremetabolicacids. Starvation wouldnot result in respiratoryacidosis oralkalosis orin metabolic
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calkalosis.
B) Aclient who is fastingisat risk fordevelopment of metabolicacidosis. Thebodyrecognizes
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cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
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acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
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C) Aclient who is fastingis at risk fordevelopment of metabolicacidosis. Thebodyrecognizes
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cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
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acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
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D) Aclient who is fastingisat risk fordevelopment of metabolicacidosis. Thebodyrecognizes
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cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
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acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
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PageRef: 6 c c




Cognitive Level: Analyzing c




Client Need/Sub: Physiological Integrity: Physiological Adaptation
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Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
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cprocesses. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
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creflects an understanding of human growth and development, pathophysiology, pharmacology,
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cmedical management and nursing management across the health-illness continuum,across
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lifespan,andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
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between knowledge/science and quality and safe patient care. |Nursing Process: Assessment
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Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
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MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
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,2) Which risk factors exhibited bythe client presenting in the emergencydepartment (ED)
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cwould place the client at risk for metabolic acidosis? Select all that apply.
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A) Abdominal fistulas c




B) Chronicobstructive pulmonarydisease c c




C) Pneumonia
D) Acuterenalfailure c c




E) Hypovolemic
cshock Answer: A, c




D, E
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Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the c c c c c c c c c c c c c




ccourse of another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss;
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cacute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
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cpneumoniaplacetheclientatrisk forrespiratoryacidosis with theincreased retention ofcarbon
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cdioxide in the blood. c c c




B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of c c c c c c c c c c c c c




canotherdisease;presenceofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute c c c c c c c c c c c




crenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
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cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
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cblood.
C) Metabolicacidosis is rarely aprimarydisorder. It usuallydevelops duringthe courseof c c c c c c c c c c c c c




anotherdisease; presence of abdominal fistulas, which can 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 c c c c c c c c c c c c c




canotherdisease;presenceofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute c c c c c c c c c c c




crenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
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cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
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cblood.
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of c c c c c c c c c c c c c




canotherdisease;presenceofabdominal fistulas,whichcan causeexcess bicarbonateloss; acute c c c c c c c c c c c




crenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
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cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
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cblood.
PageRef: 6, 14
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CognitiveLevel: Applying c




Client Need/Sub: Physiological Integrity: Physiological Adaptation
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Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
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cprocesses. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
c c c c c c c c c




creflects an understanding of human growth and development, pathophysiology, pharmacology,
c c c c c c c c c




cmedical management and nursing management across the health-illness continuum,across
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lifespan, andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
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between knowledge/science and qualityand safe patient care. |Nursing Process: Assessment
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Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c




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
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cgas value. The nurse interprets these findings as indicative of which condition?
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A) Metabolicacidosis c




B) Respiratory alkalosis c




C) Respiratory acidosis c




D) Metabolicalkalosis
cAnswer: C
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
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uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
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decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis 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) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
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crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
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cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
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cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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cnormalPaCO2, and increased HCO3. c c c




C) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
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crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
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cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
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cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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cnormalPaCO2, and increased HCO3. c c c




D) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
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crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
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cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
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cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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cnormalPaCO2, and increased HCO3. c c c




PageRef: 24 c c




Cognitive Level: Analyzing c




Client Need/Sub: Physiological Integrity: Physiological Adaptation
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Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
c c c c c c c c c c




cprocesses. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered carethat
c c c c c c c c c




creflects an understanding of human growth and development, pathophysiology, pharmacology,
c c c c c c c c c




cmedical management and nursing management across the health-illness continuum,across
c c c c c c c c c




lifespan,andinallhealthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
c c c c c c c c c c c c c




between knowledge/science and qualityand safe patient care. |Nursing Process: Diagnosis
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Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c




MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
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