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TEST BANK FOR NURSING A Il* Il* Il* Il*
CONCEPT-BASED Il* Il*
APPROACH TO LEARNING, Il* Il* Il*
VOLUMES I, II & III, 3RD Il* Il* Il* Il* Il* Il*
EDITION, PEARSON Il* Il*
Il*
Il*
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EDUCATION Il*
Il*
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Il*
Il*
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The Concept of Acid-Base Balance
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Il* Il* Il* Il* Il*
1) A client is brought to the emergency department (ED) after passing out in a local department
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the nurse expect to assess in this client?
Il* Il* Il* Il* Il* Il* Il* Il* Il*
A) Metabolic acidosis Il* Il*
B) Respiratory alkalosis Il* Il*
C) Metabolic alkalosis Il* Il*
D) Respiratory acidosis Il* Il*
Answer: A Il* Il* Il*
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis.
Il* Il* Il*
B) A client who is fasting is at risk for development of metabolic acidosis. The body
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis.
Il* Il* Il*
,C) A client who is fasting is at risk for development of metabolic acidosis. The body
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis.
Il* Il* Il*
D) A client who is fasting is at risk for development of metabolic acidosis. The body
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis. Page Ref: 6
Il* Il* Il* Il* Il* Il*
Cognitive Level: Analyzing Il* Il* Il* Il*
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Il* Il* Il* Il* Il* Il* Il*
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
that reflects an understanding of human growth and development, pathophysiology,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pharmacology, medical management and nursing management across the health-illness
Il* Il* Il* Il* Il* Il* Il* Il* Il*
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Process: Assessment Il* Il*
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
Il* Il* Il* Il* Il* Il* Il* Il* Il*
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
Il*
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
,2) Which risk factors exhibited by the client presenting in the emergency department (ED) would
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for metabolic acidosis? Select all that apply.
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
A) Abdominal fistulas Il* Il*
B) Chronic obstructive pulmonary disease Il* Il* Il* Il*
C) Pneumonia Il*
D) Acute renal failure Il* Il* Il*
E) Hypovolemic shock Il* Il*
Answer: A, D, E Il* Il* Il* Il* Il*
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
dioxide in the blood.
Il* Il* Il* Il* Il*
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood.
Il* Il* Il*
C) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood.
Il* Il* Il*
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood.
Il* Il* Il*
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood. Page Ref: 6, 14
Il* Il* Il* Il* Il* Il* Il*
Cognitive Level: Applying Il* Il* Il* Il*
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Il* Il* Il* Il* Il* Il* Il*
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
that reflects an understanding of human growth and development, pathophysiology,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pharmacology, medical management and nursing management across the health-illness
Il* Il* Il* Il* Il* Il* Il* Il* Il*
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Process: Assessment Il* Il*
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
Il* Il* Il* Il* Il* Il* Il* Il* Il*
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
Il*
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
, 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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gas value. The nurse interprets these findings as indicative of which condition?
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A) Metabolic acidosis Il* Il*
B) Respiratory alkalosis Il* Il*
C) Respiratory acidosis Il* Il*
D) Metabolic alkalosis Il* Il*
Answer: C Il* Il* Il*
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and increased HCO3.
Il* Il* Il* Il* Il* Il*
B) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and increased HCO3.
Il* Il* Il* Il* Il* Il*
C) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and increased HCO3.
Il* Il* Il* Il* Il* Il*
D) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
normal PaCO2, and increased HCO3.
Il* Il* Il* Il* Il* Il*
Page Ref: 24 Il* Il* Il*
Cognitive Level: Analyzing Il* Il* Il* Il*
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Il* Il* Il* Il* Il* Il* Il*
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
that reflects an understanding of human growth and development, pathophysiology,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pharmacology, medical management and nursing management across the health-illness
Il* Il* Il* Il* Il* Il* Il* Il* Il*
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
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Process: Diagnosis
Il* Il* Il*
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
Il* Il* Il* Il* Il* Il* Il* Il* Il*
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
Il*
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
4) The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis.
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Which result indicates that the metabolic alkalosis is compensated?
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A) pH 7.32 Il* Il*
B) PaCO2 18 mmHg Il* Il* Il*
C) HCO3 8 mEq/L Il* Il* Il*
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Il*
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Il*
TEST BANK FOR NURSING A Il* Il* Il* Il*
CONCEPT-BASED Il* Il*
APPROACH TO LEARNING, Il* Il* Il*
VOLUMES I, II & III, 3RD Il* Il* Il* Il* Il* Il*
EDITION, PEARSON Il* Il*
Il*
Il*
Il*
EDUCATION Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
Il*
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The Concept of Acid-Base Balance
Il*
Il* Il* Il* Il* Il*
1) A client is brought to the emergency department (ED) after passing out in a local department
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the nurse expect to assess in this client?
Il* Il* Il* Il* Il* Il* Il* Il* Il*
A) Metabolic acidosis Il* Il*
B) Respiratory alkalosis Il* Il*
C) Metabolic alkalosis Il* Il*
D) Respiratory acidosis Il* Il*
Answer: A Il* Il* Il*
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis.
Il* Il* Il*
B) A client who is fasting is at risk for development of metabolic acidosis. The body
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis.
Il* Il* Il*
,C) A client who is fasting is at risk for development of metabolic acidosis. The body
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis.
Il* Il* Il*
D) A client who is fasting is at risk for development of metabolic acidosis. The body
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones, which
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
metabolic alkalosis. Page Ref: 6
Il* Il* Il* Il* Il* Il*
Cognitive Level: Analyzing Il* Il* Il* Il*
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Il* Il* Il* Il* Il* Il* Il*
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
that reflects an understanding of human growth and development, pathophysiology,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pharmacology, medical management and nursing management across the health-illness
Il* Il* Il* Il* Il* Il* Il* Il* Il*
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Process: Assessment Il* Il*
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
Il* Il* Il* Il* Il* Il* Il* Il* Il*
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
Il*
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
,2) Which risk factors exhibited by the client presenting in the emergency department (ED) would
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for metabolic acidosis? Select all that apply.
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
A) Abdominal fistulas Il* Il*
B) Chronic obstructive pulmonary disease Il* Il* Il* Il*
C) Pneumonia Il*
D) Acute renal failure Il* Il* Il*
E) Hypovolemic shock Il* Il*
Answer: A, D, E Il* Il* Il* Il* Il*
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
dioxide in the blood.
Il* Il* Il* Il* Il*
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood.
Il* Il* Il*
C) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood.
Il* Il* Il*
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood.
Il* Il* Il*
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
the blood. Page Ref: 6, 14
Il* Il* Il* Il* Il* Il* Il*
Cognitive Level: Applying Il* Il* Il* Il*
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Il* Il* Il* Il* Il* Il* Il*
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
that reflects an understanding of human growth and development, pathophysiology,
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
pharmacology, medical management and nursing management across the health-illness
Il* Il* Il* Il* Il* Il* Il* Il* Il*
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il* Il*
Process: Assessment Il* Il*
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
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MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
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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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gas value. The nurse interprets these findings as indicative of which condition?
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A) Metabolic acidosis Il* Il*
B) Respiratory alkalosis Il* Il*
C) Respiratory acidosis Il* Il*
D) Metabolic alkalosis Il* Il*
Answer: C Il* Il* Il*
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
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uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
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decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
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normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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normal PaCO2, and increased HCO3.
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B) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
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uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
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decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
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normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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normal PaCO2, and increased HCO3.
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C) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
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uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
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decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
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normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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normal PaCO2, and increased HCO3.
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D) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
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uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
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decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
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normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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normal PaCO2, and increased HCO3.
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Page Ref: 24 Il* Il* Il*
Cognitive Level: Analyzing Il* Il* Il* Il*
Client Need/Sub: Physiological Integrity: Physiological Adaptation
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Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
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and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
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that reflects an understanding of human growth and development, pathophysiology,
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pharmacology, medical management and nursing management across the health-illness
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continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
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Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
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Process: Diagnosis
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Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
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MNL LO: Analyze the concept of acid-base balance and its application to nursing care.
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4) The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis.
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Which result indicates that the metabolic alkalosis is compensated?
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A) pH 7.32 Il* Il*
B) PaCO2 18 mmHg Il* Il* Il*
C) HCO3 8 mEq/L Il* Il* Il*
