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

Module 37: Collaboration
The Concept of Collaboration

Module 38: Communication
The Concept of Communication
38.A Groups and Group Communication
38.B Therapeutic Communication
38.C Documentation
38.D Reporting

Module 39: Managing Care
The Concept of Managing Care
39.A Case Management
39.B Cost-Effective Care
39.C Delegation
39.D Leadership and Management

Module 40: Professionalism
The Concept of Professionalism
40.A Commitment to Profession
40.B Work Ethic

Module 41: Teaching and Learning
The Concept of Teaching and Learning
41.A Patient/Consumer Education

PART V: HEALTHCARE DOMAIN

Module 42: Accountability
The Concept of Accountability
42.A Competence
42.B Professional Development

Module 43: Advocacy
The Concept of Advocacy
43.A Environmental Quality

Module 44: Ethics
The Concept of Ethics
44.A Morality
44.B Ethical Dilemmas
44.C Patient Rights

Module 45: Evidence-Based Practice
The Concept of Evidence-Based Practice

Module 46: Healthcare Systems
The Concept of Healthcare Systems
46.A Emergency Preparedness

Module 47: Health Policy
The Concept of Health Policy

Module 48: Informatics
The Concept of Informatics
48.A Clinical Decision Support Systems
48.B Individual Information at Point of Care

Module 49: Legal Issues
The Concept of Legal Issues
49.A Nurse Practice Acts
49.B Advance Directives
49.C Health Insurance Portability and Accountability Act
49.D Mandatory Reporting
49.E Risk Management

Module 50: Quality Improvement
The Concept of Quality Improvement

Module 51: Safety
The Concept of Safety
51.A Health Promotion and Injury Prevention Across the Lifespan
51.B Patient Safety
51.C Nurse Safety

Nursing: A Concept-Based Approach to Learning Vol. 1 & 2, 3e (Pearson)
Module 1 Acid-Base Balance

The Concept of Acid-Base Balance
1) A client is brought to the emergency department (ED) after passing out in a local department
store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would
the nurse expect to assess in this client?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis
Answer: A
Explanation: A) A client who is fasting is at risk for development of metabolic acidosis. The
body recognizes fasting as starvation and begins to metabolize its own fatty acids into ketones,
which are metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in
metabolic alkalosis.
B) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic
alkalosis.
C) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic
alkalosis.
D) A client who is fasting is at risk for development of metabolic acidosis. The body recognizes
fasting as starvation and begins to metabolize its own fatty acids into ketones, which are
metabolic acids. Starvation would not result in respiratory acidosis or alkalosis or in metabolic
alkalosis.
Page Ref: 6
Cognitive Level: Analyzing
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
that reflects an understanding of human growth and development, pathophysiology,
pharmacology, medical management and nursing management across the health-illness
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Process: Assessment
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.

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Copyright © 2019 Pearson Education, Inc.

2) Which risk factors exhibited by the client presenting in the emergency department (ED) would
place the client at risk for metabolic acidosis? Select all that apply.
A) Abdominal fistulas
B) Chronic obstructive pulmonary disease
C) Pneumonia
D) Acute renal failure
E) Hypovolemic shock
Answer: A, D, E
Explanation: A) Metabolic acidosis is rarely a primary disorder. It usually develops during the
course of another disease; presence of abdominal fistulas, which can cause excess bicarbonate
loss; acute renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and
pneumonia place the client at risk for respiratory acidosis with the increased retention of carbon
dioxide in the blood.
B) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
the blood.
C) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
the blood.
D) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
the blood.
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of
another disease; presence of abdominal fistulas, which can cause excess bicarbonate loss; acute
renal failure; and hypovolemic shock. Chronic obstructive pulmonary disease and pneumonia
place the client at risk for respiratory acidosis with the increased retention of carbon dioxide in
the blood.
Page Ref: 6, 14
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
that reflects an understanding of human growth and development, pathophysiology,
pharmacology, medical management and nursing management across the health-illness
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Process: Assessment
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.

3

Copyright © 2019 Pearson Education, Inc.

3) A child with acute asthma has a PaCO2 of 48 mmHg, a pH of 7.31, and a normal HCO3 blood
gas value. The nurse interprets these findings as indicative of which condition?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Respiratory acidosis
D) Metabolic alkalosis
Answer: C
Explanation: A) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is
uncompensated respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH,
decreased PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH,
normal PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH,
normal PaCO2, and increased HCO3.
B) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal
PaCO2, and increased HCO3.
C) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal
PaCO2, and increased HCO3.
D) If the pH is decreased and the PaCO2 is increased with a normal HCO3, it is uncompensated
respiratory acidosis. Uncompensated respiratory alkalosis has an increased pH, decreased
PaCO2, and normal HCO3. Uncompensated metabolic acidosis has a decreased pH, normal
PaCO2, and decreased HCO3. Uncompensated metabolic alkalosis has an increased pH, normal
PaCO2, and increased HCO3.
Page Ref: 24
Cognitive Level: Analyzing
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
that reflects an understanding of human growth and development, pathophysiology,
pharmacology, medical management and nursing management across the health-illness
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Process: Diagnosis
Learning Outcome: 1.2. Differentiate alterations in acid-base balance.
MNL LO: Analyze the concept of acid-base balance and its application to nursing care.