ALL QUESTIONS AND SOLUTIONS
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TESTBANK:NURSINGA b b
CONCEPT-BASED
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APPROACH TO
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LEARNING,VOLUMESI, b
II & III, 3RD b b b b
EDITION, PEARSON b
EDUCATION b
ALL CHAPTERS QUESTIONS AND ANSWERS FOR
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REVISION b
WISHINGYOUSUCCESSA+ b b b
,Nursing: A Concept-Based Approach to Learning Vol. 1 2 & 3, 3e (Pearson)
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Module 1 Acid-Base Balance
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The Concept of Acid-Base Balance
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1) A client is brought to the emergency department (ED) after passing out in a local department
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bstore. The client has been fasting and has ketones in the urine. Which acid-base imbalance would
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the nurse expect to assess in this client?
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A) Metabolic acidosis b
B) Respiratory alkalosis b
C) Metabolic alkalosis b
D) Respiratory acidosis b
Answer: A
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Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The
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bbody recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones,
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which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
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metabolic alkalosis.
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B) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
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fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
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bmetabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic
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balkalosis.
C) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
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fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
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bmetabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic
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balkalosis.
D) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
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fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
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bmetabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic
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balkalosis.
Page Ref: 6 b b
Cognitive Level: Analyzing b b
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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band processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered
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bcarethat reflects an understanding of human growth and development, pathophysiology,
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bpharmacology, medical management and nursing management across the health-illness
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bcontinuum, 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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bProcess: Assessment b
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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,2) Which risk factors exhibited by the client presenting in the emergency department (ED) would
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place the client at risk for metabolic acidosis? Select all that apply.
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A) Abdominal fistulas b
B) Chronic obstructive pulmonary disease b b b
C) Pneumonia
D) Acute renal failure b b
E) Hypovolemic shock b
Answer: A, D, E
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Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the
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bcourse of another disease; presence of abdominal fistulas, which can cause excess bicarbonate
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bloss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
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bpneumonia place the client at risk for respiratory acidosis with the increased retention of carbon
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dioxide in the blood.
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B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
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banother disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
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renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
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bplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide
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binthe blood.
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C) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
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banother disease; presence of abdominal fistulas, which can cause excess bicarbonate loss;
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bacuterenal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
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bpneumonia place the client at risk for respiratory acidosis with the increased retention of
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bcarbon dioxide inthe blood.
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D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
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banother disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
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renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
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bplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide
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binthe blood.
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E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
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banother disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
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renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
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bplace the client at risk for respiratory acidosis with the increased retention of carbon dioxide
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binthe blood.
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Page Ref: 6, 14
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Cognitive Level: Applying b b
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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band processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered
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bcarethat reflects an understanding of human growth and development, pathophysiology,
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bpharmacology, medical management and nursing management across the health-illness
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bcontinuum, 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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bProcess: Assessment b
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 b
B) Respiratory alkalosis b
C) Respiratory acidosis b
D) Metabolic alkalosis b
Answer: C
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Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
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buncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
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bdecreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
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bnormal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased
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bpH,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 uncompensated
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respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
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bPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
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bPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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bnormalPaCO2, and increased HCO3.
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C) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
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respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
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bPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
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bPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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bnormalPaCO2, and increased HCO3.
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D) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
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respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
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bPaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
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bPaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
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bnormalPaCO2, and increased HCO3.
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Page Ref: 24 b b
Cognitive Level: Analyzing b b
Client Need/Sub: Physiological Integrity: Physiological Adaptation
b b b b b
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
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band processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered
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bcarethat reflects an understanding of human growth and development, pathophysiology,
b b b b b b b b b b
bpharmacology, medical management and nursing management across the health-illness
b b b b b b b b
bcontinuum, 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
b b b b b b b b b b b b
bProcess: Diagnosis b
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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