Stuvia.com - The Marketplace to Buy and Sell your Study Material
b b b b b b b b b b
NURSING A CONCEPT-BASED
b b
APPROACH TO LEARNING 4TH
b b b b
EDITIONPEARSONEDUCATION TEST
b b b b
BANK
b
Downloaded by: Crate |
b b b b Want to earn $1.236
b b b
Distribution of this document is illegal
b b b b b extra per year?
b b
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
b b b b b b b b b b
Nursing: A Concept-Based Approach to Learning Vol. 1 & 2, 4e (Pearson)
b b b b b b b b b b b
Module 1 Acid-Base Balance
b b b
The Concept of Acid-Base Balance
b b b b
1) A client who has been fasting and has ketones in the urine is brought to the emergency
b b b b b b b b b b b b b b b b
department (ED) unconscious. Which acid-base imbalance would the nurse expect to assess in this
b b b b b b b b b b b b b b
client?
b
A) Metabolic acidosis b
B) Respiratory alkalosis b
C) Metabolic alkalosis b
D) Respiratoryacidosis b
Answer: A
b b
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The body
b b b b b b b b b b b b b b b b
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
b b b b b b b b b b b b b b b b
metabolic acids.
b b
B) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
b b b b b b b b b b b b b b b
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
b b b b b b b b b b b b b b b b
acids. Starvation would not result in respiratory alkalosis.
b b b b b b b b
C) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
b b b b b b b b b b b b b b b
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
b b b b b b b b b b b b b b b b
acids. Starvation would not result in metabolic alkalosis.
b b b b b b b b
D) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
b b b b b b b b b b b b b b b
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
b b b b b b b b b b b b b b b b
acids. Starvation would not result in respiratory acidosis.
b b b b b b b b
Page Ref: 5 b b
Cognitive Level: Analyzing b b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
b b b b b b b b b b
processes. | AACN Domains and Competencies: 2.4 Diagnose actual or potential health problems
b b b b b b b b b b b b b
and needs. | NLN Competencies: Knowledge and Science: Relationships between
b b b b b b b b b b
knowledge/science and quality and safe patient care. | Nursing Process: Assessment
b b b b b b b b b b b
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
b b b b b b b b
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
b b b b b b b b b b b b b b
https://www.stuvia.com/
Downloaded by: Crate | b b b b Want to earn $1.236
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Distribution of this document is illegal b b b b b extra per year? b b
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2) The nurse is caring for a client in the emergency department. Which factors will the nurse
b b b b b b b b b b b b b b b
identify that increase the client's risk for metabolic acidosis? Select all that apply.
b b b b b b b b b b b b b
A) Abdominal fistulas b
B) Chronic obstructive pulmonary disease b b b
C) Pneumonia
D) Chronic renal failure b b
E) Hypovolemicshock b
Answer: A, D, E
b b b b
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the
b b b b b b b b b b b b b
course of another condition such as an abdominal fistula which can cause the loss of bicarbonate from
b b b b b b b b b b b b b b b b b
the intestine.
b b
B) Chronic obstructive pulmonary disease places the client at risk for respiratory acidosis with the
b b b b b b b b b b b b b
increased retention of carbon dioxide in the blood.
b b b b b b b b
C) Pneumonia places the client at risk for respiratory acidosis with the increased retention of
b b b b b b b b b b b b b
carbon dioxide in the blood.
b b b b b
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
b b b b b b b b b b b b b b
condition such as chronic renal failure. In this health problem, the kidneys are unable to excrete a
b b b b b b b b b b b b b b b b b
normal amount of hydrogen ions in the urine. This results in an excessive amount of hydrogen ions
b b b b b b b b b b b b b b b b b
in the blood, which produces metabolic acidosis.
b b b b b b b
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
b b b b b b b b b b b b b b
condition such as hypovolemic shock. With a severe blood loss, there is a lack of blood flow
b b b b b b b b b b b b b b b b b
throughout the body and a lack of oxygen in every cell. Adenosine triphosphate (ATP) must produce
b b b b b b b b b b b b b b b b
energy anaerobically without the presence of oxygen; lactic acid is a by-product. This produces
b b b b b b b b b b b b b b
systemic lactic acidosis, a type of metabolic acidosis.
b b b b b b b b
Page Ref: 5-6 b b
Cognitive Level: Applying b b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
b b b b b b b b b b
processes. | AACN Domains and Competencies: 2.4 Diagnose actual or potential health problems
b b b b b b b b b b b b b
and needs. | NLN Competencies: Knowledge and Science: Relationships between
b b b b b b b b b b
knowledge/science and quality and safe patient care. | Nursing Process: Assessment
b b b b b b b b b b b
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
b b b b b b b b
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
b b b b b b b b b b b b b b
https://www.stuvia.com/
Downloaded by: Crate | b b b b Want to earn $1.236 b b b
Distribution of this document is illegal b b b b b extra per year? b b
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
b b b b b b b b b b
3) A client with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3
b b b b b b b
b
b b b b b b b b b b
arterial blood gas value. Which condition will the nurse associate with these values?
b
b b b b b b b b b b b b
A) Metabolic acidosis b
B) Respiratory alkalosis b
C) Respiratory acidosis b
D) Metabolicalkalosis b
Answer: C
b b
Explanation: A) Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
b b b b b b b b b b b
decreased HCO3.
b b
B) Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, and normal b b b b b b b b b b
HCO3.
b
C) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
b b b b b b b
b
b b b b b b b b
respiratory acidosis.
b b
D) Uncompensated metabolic alkalosis has an increased pH, normal PaCO2, and increased b b b b b b b b b b
HCO3.
b
Page Ref: 7
b b
Cognitive Level: Analyzing b b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
b b b b b b b b b b
processes. | AACN Domains and Essential Competencies: 2.4 Diagnose actual or potential health
b b b b b b b b b b b b b
problems and needs. | NLN Competencies: Knowledge and Science: Relationships between
b b b b b b b b b b b
knowledge/science and quality and safe patient care. | Nursing Process: Assessment Learning
b b b b b b b b b b b b
Outcome: 1.2. Differentiate alterations in acid-base balance.
b b b b b b b
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
b b b b b b b b b b b b b b
https://www.stuvia.com/
Downloaded by: Crate | b b b b Want to earn $1.236
b b b
Distribution of this document is illegal b b b b b extra per year?
b b
b b b b b b b b b b
NURSING A CONCEPT-BASED
b b
APPROACH TO LEARNING 4TH
b b b b
EDITIONPEARSONEDUCATION TEST
b b b b
BANK
b
Downloaded by: Crate |
b b b b Want to earn $1.236
b b b
Distribution of this document is illegal
b b b b b extra per year?
b b
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
b b b b b b b b b b
Nursing: A Concept-Based Approach to Learning Vol. 1 & 2, 4e (Pearson)
b b b b b b b b b b b
Module 1 Acid-Base Balance
b b b
The Concept of Acid-Base Balance
b b b b
1) A client who has been fasting and has ketones in the urine is brought to the emergency
b b b b b b b b b b b b b b b b
department (ED) unconscious. Which acid-base imbalance would the nurse expect to assess in this
b b b b b b b b b b b b b b
client?
b
A) Metabolic acidosis b
B) Respiratory alkalosis b
C) Metabolic alkalosis b
D) Respiratoryacidosis b
Answer: A
b b
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The body
b b b b b b b b b b b b b b b b
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
b b b b b b b b b b b b b b b b
metabolic acids.
b b
B) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
b b b b b b b b b b b b b b b
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
b b b b b b b b b b b b b b b b
acids. Starvation would not result in respiratory alkalosis.
b b b b b b b b
C) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
b b b b b b b b b b b b b b b
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
b b b b b b b b b b b b b b b b
acids. Starvation would not result in metabolic alkalosis.
b b b b b b b b
D) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
b b b b b b b b b b b b b b b
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are metabolic
b b b b b b b b b b b b b b b b
acids. Starvation would not result in respiratory acidosis.
b b b b b b b b
Page Ref: 5 b b
Cognitive Level: Analyzing b b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
b b b b b b b b b b
processes. | AACN Domains and Competencies: 2.4 Diagnose actual or potential health problems
b b b b b b b b b b b b b
and needs. | NLN Competencies: Knowledge and Science: Relationships between
b b b b b b b b b b
knowledge/science and quality and safe patient care. | Nursing Process: Assessment
b b b b b b b b b b b
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
b b b b b b b b
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
b b b b b b b b b b b b b b
https://www.stuvia.com/
Downloaded by: Crate | b b b b Want to earn $1.236
b b b
Distribution of this document is illegal b b b b b extra per year? b b
, Stuvia.com - The Marketplace to Buy and Sell your Study Material b b b b b b b b b b
2) The nurse is caring for a client in the emergency department. Which factors will the nurse
b b b b b b b b b b b b b b b
identify that increase the client's risk for metabolic acidosis? Select all that apply.
b b b b b b b b b b b b b
A) Abdominal fistulas b
B) Chronic obstructive pulmonary disease b b b
C) Pneumonia
D) Chronic renal failure b b
E) Hypovolemicshock b
Answer: A, D, E
b b b b
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the
b b b b b b b b b b b b b
course of another condition such as an abdominal fistula which can cause the loss of bicarbonate from
b b b b b b b b b b b b b b b b b
the intestine.
b b
B) Chronic obstructive pulmonary disease places the client at risk for respiratory acidosis with the
b b b b b b b b b b b b b
increased retention of carbon dioxide in the blood.
b b b b b b b b
C) Pneumonia places the client at risk for respiratory acidosis with the increased retention of
b b b b b b b b b b b b b
carbon dioxide in the blood.
b b b b b
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
b b b b b b b b b b b b b b
condition such as chronic renal failure. In this health problem, the kidneys are unable to excrete a
b b b b b b b b b b b b b b b b b
normal amount of hydrogen ions in the urine. This results in an excessive amount of hydrogen ions
b b b b b b b b b b b b b b b b b
in the blood, which produces metabolic acidosis.
b b b b b b b
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
b b b b b b b b b b b b b b
condition such as hypovolemic shock. With a severe blood loss, there is a lack of blood flow
b b b b b b b b b b b b b b b b b
throughout the body and a lack of oxygen in every cell. Adenosine triphosphate (ATP) must produce
b b b b b b b b b b b b b b b b
energy anaerobically without the presence of oxygen; lactic acid is a by-product. This produces
b b b b b b b b b b b b b b
systemic lactic acidosis, a type of metabolic acidosis.
b b b b b b b b
Page Ref: 5-6 b b
Cognitive Level: Applying b b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
b b b b b b b b b b
processes. | AACN Domains and Competencies: 2.4 Diagnose actual or potential health problems
b b b b b b b b b b b b b
and needs. | NLN Competencies: Knowledge and Science: Relationships between
b b b b b b b b b b
knowledge/science and quality and safe patient care. | Nursing Process: Assessment
b b b b b b b b b b b
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
b b b b b b b b
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
b b b b b b b b b b b b b b
https://www.stuvia.com/
Downloaded by: Crate | b b b b Want to earn $1.236 b b b
Distribution of this document is illegal b b b b b extra per year? b b
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
b b b b b b b b b b
3) A client with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3
b b b b b b b
b
b b b b b b b b b b
arterial blood gas value. Which condition will the nurse associate with these values?
b
b b b b b b b b b b b b
A) Metabolic acidosis b
B) Respiratory alkalosis b
C) Respiratory acidosis b
D) Metabolicalkalosis b
Answer: C
b b
Explanation: A) Uncompensated metabolic acidosis has a decreased pH, normal PaCO2, and
b b b b b b b b b b b
decreased HCO3.
b b
B) Uncompensated respiratory alkalosis has an increased pH, decreased PaCO2, and normal b b b b b b b b b b
HCO3.
b
C) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
b b b b b b b
b
b b b b b b b b
respiratory acidosis.
b b
D) Uncompensated metabolic alkalosis has an increased pH, normal PaCO2, and increased b b b b b b b b b b
HCO3.
b
Page Ref: 7
b b
Cognitive Level: Analyzing b b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and
b b b b b b b b b b
processes. | AACN Domains and Essential Competencies: 2.4 Diagnose actual or potential health
b b b b b b b b b b b b b
problems and needs. | NLN Competencies: Knowledge and Science: Relationships between
b b b b b b b b b b b
knowledge/science and quality and safe patient care. | Nursing Process: Assessment Learning
b b b b b b b b b b b b
Outcome: 1.2. Differentiate alterations in acid-base balance.
b b b b b b b
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
b b b b b b b b b b b b b b
https://www.stuvia.com/
Downloaded by: Crate | b b b b Want to earn $1.236
b b b
Distribution of this document is illegal b b b b b extra per year?
b b
