ALLQUESTIONSANDSOLUTIONS
TESTBANK:NURSINGA
CONCEPT-BASED
c
APPROACHTO
c
LEARNING,VOLUMESI,
II&III,3RD
c
EDITION,PEARSON
c
EDUCATION
c
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
c
WISHINGYOUSUCCESSA+
,Nursing:AConcept-BasedApproachtoLearningVol. 12&3,3e(Pearson) Module 1
c c c c c c c c c c c c c c
c Acid-Base Balance c
TheConcept ofAcid-BaseBalance
c c c c
1) A client is brought to the emergency department (ED) after passing out in a local department store.
c c c c c c c c c c c c c c c c
The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse
c c c c c c c c c c c c c c c c c
cexpect to assess in this client?
c c c c c
A) Metabolicacidosis c
B) Respiratory alkalosis c
C) Metabolic alkalosis c
D) Respiratoryacidosis
Answer: A
c
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
c c c c c c c c c c c c c c c
calkalosis.
B) Aclient who is fastingisat risk fordevelopment of metabolicacidosis. Thebodyrecognizes
c c c c c c c c c c c c c c c
cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
c c c c c c c c c c c c c c c
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
c c c c c c c c c c c c c c
C) Aclient who is fastingis at risk fordevelopment of metabolicacidosis. Thebodyrecognizes
c c c c c c c c c c c c c c c
cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
c c c c c c c c c c c c c c c
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
c c c c c c c c c c c c c c
D) Aclient who is fastingisat risk fordevelopment of metabolicacidosis. Thebodyrecognizes
c c c c c c c c c c c c c c
cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
c c c c c c c c c c c c c c c
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
c c c c c c c c c c c c c c
PageRef: 6 c c
Cognitive Level: Analyzing c
Client Need/Sub: Physiological Integrity: Physiological Adaptation
c c c c
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,andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
c c c c c c c c c c c c
between knowledge/science and quality and safe patient care. |Nursing Process: Assessment
c c c c c c c c c c c c
Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
c c c c c c c c c c c c
,2) Which risk factors exhibited bythe client presenting in the emergencydepartment (ED)
c c c c c c c c c c c c
cwould place the client at risk for metabolic acidosis? Select all that apply.
c c c c c c c c c c c c
A) Abdominal fistulas c
B) Chronicobstructive pulmonarydisease c c
C) Pneumonia
D) Acuterenalfailure c c
E) Hypovolemic
cshock Answer: A, c
D, E
c c
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;
c c c c c c c c c c c c c
cacute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
c c c c c c c c c c
cpneumoniaplacetheclientatrisk forrespiratoryacidosis with theincreased retention ofcarbon
c c c c c c c c c c c c c c
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
c c c c c c c c c c
cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
c c c c c c c c c c c c c c c b
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;
c c c c c c c c c c c c
acuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
c c c c c c c c c c
pneumonia place the client at risk for respiratory acidosis with the increased retention of
c c c c c c c c c c c c c c
carbon dioxide inthe blood.
c c c c
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
c c c c c c c c c c
cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
c c c c c c c c c c c c c c c b
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
c c c c c c c c c c
cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
c c c c c c c c c c c c c c c b
cblood.
PageRef: 6, 14
c c c
CognitiveLevel: Applying c
Client Need/Sub: Physiological Integrity: Physiological Adaptation
c c c c
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, andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
c c c c c c c c c c c c
between knowledge/science and qualityand safe patient care. |Nursing Process: Assessment
c c c c c c c c c c c c
Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
c c c c c c c c c c c c
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
c c c c c c c c c c c c c c c c c c c
cgas value. The nurse interprets these findings as indicative of which condition?
c c c c c c c c c c c
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
c c c c c c c c c c c c c c c c c
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
c c c c c c c c c c
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c c c
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,normal
c c c c c c c c c c c
PaCO2, and increased HCO3.
c c c c
B) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
c c c c c c c c c c c c c c c c
crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
c c c c c c c c c
cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c
cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
c c c c c c c c c c
cnormalPaCO2, and increased HCO3. c c c
C) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
c c c c c c c c c c c c c c c c
crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
c c c c c c c c c
cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c
cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
c c c c c c c c c c
cnormalPaCO2, and increased HCO3. c c c
D) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
c c c c c c c c c c c c c c c c
crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
c c c c c c c c c
cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c
cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
c c c c c c c c c c
cnormalPaCO2, and increased HCO3. c c c
PageRef: 24 c c
Cognitive Level: Analyzing c
Client Need/Sub: Physiological Integrity: Physiological Adaptation
c c c c
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
c c c c c c c c c c c c
Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
c c c c c c c c c c c c
TESTBANK:NURSINGA
CONCEPT-BASED
c
APPROACHTO
c
LEARNING,VOLUMESI,
II&III,3RD
c
EDITION,PEARSON
c
EDUCATION
c
ALLCHAPTERSQUESTIONSANDANSWERSFOR
REVISION
c
WISHINGYOUSUCCESSA+
,Nursing:AConcept-BasedApproachtoLearningVol. 12&3,3e(Pearson) Module 1
c c c c c c c c c c c c c c
c Acid-Base Balance c
TheConcept ofAcid-BaseBalance
c c c c
1) A client is brought to the emergency department (ED) after passing out in a local department store.
c c c c c c c c c c c c c c c c
The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse
c c c c c c c c c c c c c c c c c
cexpect to assess in this client?
c c c c c
A) Metabolicacidosis c
B) Respiratory alkalosis c
C) Metabolic alkalosis c
D) Respiratoryacidosis
Answer: A
c
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
c c c c c c c c c c c c c c c
calkalosis.
B) Aclient who is fastingisat risk fordevelopment of metabolicacidosis. Thebodyrecognizes
c c c c c c c c c c c c c c c
cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
c c c c c c c c c c c c c c c
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
c c c c c c c c c c c c c c
C) Aclient who is fastingis at risk fordevelopment of metabolicacidosis. Thebodyrecognizes
c c c c c c c c c c c c c c c
cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
c c c c c c c c c c c c c c c
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
c c c c c c c c c c c c c c
D) Aclient who is fastingisat risk fordevelopment of metabolicacidosis. Thebodyrecognizes
c c c c c c c c c c c c c c
cfasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
c c c c c c c c c c c c c c c
acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic alkalosis.
c c c c c c c c c c c c c c
PageRef: 6 c c
Cognitive Level: Analyzing c
Client Need/Sub: Physiological Integrity: Physiological Adaptation
c c c c
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,andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
c c c c c c c c c c c c
between knowledge/science and quality and safe patient care. |Nursing Process: Assessment
c c c c c c c c c c c c
Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
c c c c c c c c c c c c
,2) Which risk factors exhibited bythe client presenting in the emergencydepartment (ED)
c c c c c c c c c c c c
cwould place the client at risk for metabolic acidosis? Select all that apply.
c c c c c c c c c c c c
A) Abdominal fistulas c
B) Chronicobstructive pulmonarydisease c c
C) Pneumonia
D) Acuterenalfailure c c
E) Hypovolemic
cshock Answer: A, c
D, E
c c
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;
c c c c c c c c c c c c c
cacute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
c c c c c c c c c c
cpneumoniaplacetheclientatrisk forrespiratoryacidosis with theincreased retention ofcarbon
c c c c c c c c c c c c c c
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
c c c c c c c c c c
cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
c c c c c c c c c c c c c c c b
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;
c c c c c c c c c c c c
acuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
c c c c c c c c c c
pneumonia place the client at risk for respiratory acidosis with the increased retention of
c c c c c c c c c c c c c c
carbon dioxide inthe blood.
c c c c
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
c c c c c c c c c c
cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
c c c c c c c c c c c c c c c b
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
c c c c c c c c c c
cplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide in the
c c c c c c c c c c c c c c c b
cblood.
PageRef: 6, 14
c c c
CognitiveLevel: Applying c
Client Need/Sub: Physiological Integrity: Physiological Adaptation
c c c c
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, andin all healthcaresettings. |NLNCompetencies: Knowledgeand Science: Relationships
c c c c c c c c c c c c
between knowledge/science and qualityand safe patient care. |Nursing Process: Assessment
c c c c c c c c c c c c
Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
c c c c c c c c c c c c
, 3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
c c c c c c c c c c c c c c c c c c c
cgas value. The nurse interprets these findings as indicative of which condition?
c c c c c c c c c c c
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
c c c c c c c c c c c c c c c c c
uncompensatedrespiratoryacidosis.UncompensatedrespiratoryalkalosishasanincreasedpH,
c c c c c c c c c c
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c c c
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,normal
c c c c c c c c c c c
PaCO2, and increased HCO3.
c c c c
B) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
c c c c c c c c c c c c c c c c
crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
c c c c c c c c c
cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c
cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
c c c c c c c c c c
cnormalPaCO2, and increased HCO3. c c c
C) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
c c c c c c c c c c c c c c c c
crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
c c c c c c c c c
cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c
cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
c c c c c c c c c c
cnormalPaCO2, and increased HCO3. c c c
D) IfthepHisdecreased and thePaCO2is increased with anormal HCO3, it isuncompensated
c c c c c c c c c c c c c c c c
crespiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
c c c c c c c c c
cPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
c c c c c c c c c c c
cPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
c c c c c c c c c c
cnormalPaCO2, and increased HCO3. c c c
PageRef: 24 c c
Cognitive Level: Analyzing c
Client Need/Sub: Physiological Integrity: Physiological Adaptation
c c c c
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
c c c c c c c c c c c c
Learning Outcome: 1.2.Differentiate alterations inacid-basebalance.
c c c c c c
MNLLO:Analyzetheconcept of acid-basebalanceand its application to nursingcare.
c c c c c c c c c c c c
