Test Bank Complete_
Clinical Nursing Skills: A Concept-Based Approach
3rd Edition, (Vol. 1), (Vol. 2) & (Vol. 3); (2025)
By Barbara Callahan
All Modules 1-21| All Exemplar| Latest Edition With Well Detailed Answers| Grade A+
From: [Bestmaxsolutions.Stuvia
,Module 1: Acid-Base Balance ------------------------------------------------------------------------------------- 6
The Concept Of Acid-Base Balance --------------------------------------------------------------------------------------6
Exemplar 1.A: Metabolic Acidosis ----------------------------------------------------------------------------------------------- 35
Exemplar 1.B: Metabolic Alkalosis ---------------------------------------------------------------------------------------------- 62
Exemplar 1.C: Respiratory Acidosis --------------------------------------------------------------------------------------------- 90
Exemplar 1.D: Respiratory Alkalosis ------------------------------------------------------------------------------------------- 118
Module 2: Cellular Regulation -------------------------------------------------------------------------------- 147
The Concept Of Cellular Regulation --------------------------------------------------------------------------------- 147
Exemplar 2.A: Cancer -------------------------------------------------------------------------------------------------------------- 159
Exemplar 2.B: Anemia ------------------------------------------------------------------------------------------------------------- 171
Exemplar 2.C: Breast Cancer ----------------------------------------------------------------------------------------------------- 183
Exemplar 2.D: Colorectal Cancer ----------------------------------------------------------------------------------------------- 195
Exemplar 2.E: Leukemia ---------------------------------------------------------------------------------------------------------- 208
Exemplar 2.F: Lung Cancer ------------------------------------------------------------------------------------------------------- 220
Exemplar 2.G: Prostate Cancer ------------------------------------------------------------------------------------------------- 232
Exemplar 2.H: Sickle Cell Disease----------------------------------------------------------------------------------------------- 244
Exemplar 2.I: Skin Cancer -------------------------------------------------------------------------------------------------------- 256
Module 3: Comfort ---------------------------------------------------------------------------------------------- 269
The Concept Of Comfort ------------------------------------------------------------------------------------------------ 269
Exemplar 3.A: Acute And Chronic Pain --------------------------------------------------------------------------------------- 284
Exemplar 3.B: End-Of-Life Care ------------------------------------------------------------------------------------------------- 296
Exemplar 3.C: Fatigue ------------------------------------------------------------------------------------------------------------- 309
Exemplar 3.D: Fibromyalgia ----------------------------------------------------------------------------------------------------- 321
Exemplar 3.E: Sleep - Rest Disorders ------------------------------------------------------------------------------------------ 332
Module 4: Digestion --------------------------------------------------------------------------------------------- 345
The Concept Of Digestion ---------------------------------------------------------------------------------------------- 345
Exemplar 4.A: Gastroesophageal Reflux Disease--------------------------------------------------------------------------- 361
Exemplar 4.B: Hepatitis ----------------------------------------------------------------------------------------------------------- 374
Exemplar 4.C: Malabsorption Disorders -------------------------------------------------------------------------------------- 387
Exemplar 4.D: Pancreatitis ------------------------------------------------------------------------------------------------------- 400
Exemplar 4.E: Pyloric Stenosis -------------------------------------------------------------------------------------------------- 413
Module 5: Elimination ------------------------------------------------------------------------------------------ 426
The Concept Of Elimination ------------------------------------------------------------------------------------------- 426
Exemplar 5.A: Benign Prostatic Hyperplasia -------------------------------------------------------------------------------- 442
Exemplar 5.B: Bladder Incontinence And Retention ---------------------------------------------------------------------- 453
Exemplar 5.C: Bowel Incontinence, Constipation, And Impaction ----------------------------------------------------- 465
Exemplar 5.D: Urinary Calculi --------------------------------------------------------------------------------------------------- 477
Module 6: Fluids And Electrolytes --------------------------------------------------------------------------- 489
The Concept Of Fluids And Electrolytes ---------------------------------------------------------------------------- 489
Exemplar 6.A: Fluid And Electrolyte Imbalance ---------------------------------------------------------------------------- 505
Exemplar 6.B: Acute Kidney Injury --------------------------------------------------------------------------------------------- 517
Exemplar 6.C: Chronic Kidney Disease ---------------------------------------------------------------------------------------- 527
,Module 7: Health, Wellness, Illness, And Injury --------------------------------------------------------- 540
The Concept Of Health, Wellness, Illness, And Injury --------------------------------------------------------------------- 540
Exemplar 7.A: Physical Fitness And Exercise -------------------------------------------------------------------------------- 556
Exemplar 7.B: Oral Health -------------------------------------------------------------------------------------------------------- 568
Exemplar 7.C: Normal Sleep - Rest Patterns --------------------------------------------------------------------------------- 581
Module 8: Immunity -------------------------------------------------------------------------------------------- 594
The Concept Of Immunity ---------------------------------------------------------------------------------------------- 594
Exemplar 8.A: HIV/AIDS ---------------------------------------------------------------------------------------------------------- 610
Exemplar 8.B: Hypersensitivity ------------------------------------------------------------------------------------------------- 622
Exemplar 8.C: Rheumatoid Arthritis ------------------------------------------------------------------------------------------- 634
Exemplar 8.D: Systemic Lupus Erythematosus ----------------------------------------------------------------------------- 646
Module 9: Infection---------------------------------------------------------------------------------------------- 659
The Concept Of Infection ----------------------------------------------------------------------------------------------- 659
Exemplar 9.A: Cellulitis ----------------------------------------------------------------------------------------------------------- 675
Exemplar 9.B: Conjunctivitis ----------------------------------------------------------------------------------------------------- 687
Exemplar 9.C: Influenza ----------------------------------------------------------------------------------------------------------- 699
Exemplar 9.D: Otitis Media ------------------------------------------------------------------------------------------------------ 708
Exemplar 9.E: Pneumonia -------------------------------------------------------------------------------------------------------- 716
Exemplar 9.F: Sepsis --------------------------------------------------------------------------------------------------------------- 725
Exemplar 9.G: Tuberculosis ------------------------------------------------------------------------------------------------------ 732
Exemplar 9.H: Urinary Tract Infection ---------------------------------------------------------------------------------------- 740
Module 10: Inflammation-------------------------------------------------------------------------------------- 749
The Concept Of Inflammation ---------------------------------------------------------------------------------------- 749
Exemplar 10.A: Appendicitis----------------------------------------------------------------------------------------------------- 758
Exemplar 10.B: Gallbladder Disease ------------------------------------------------------------------------------------------- 765
Exemplar 10.C: Inflammatory Bowel Disease ------------------------------------------------------------------------------- 772
Exemplar 10.D: Nephritis --------------------------------------------------------------------------------------------------------- 780
Exemplar 10.E: Peptic Ulcer Disease------------------------------------------------------------------------------------------- 787
Module 11: Intracranial Regulation ------------------------------------------------------------------------- 795
The Concept Of Intracranial Regulation ---------------------------------------------------------------------------- 795
Exemplar 11.A: Increased Intracranial Pressure ---------------------------------------------------------------------------- 805
Exemplar 11.B: Seizure Disorders ---------------------------------------------------------------------------------------------- 812
Exemplar 11.C: Traumatic Brain Injury---------------------------------------------------------------------------------------- 819
Module 12: Metabolism ---------------------------------------------------------------------------------------- 828
The Concept Of Metabolism------------------------------------------------------------------------------------------- 828
Exemplar 12.A: Type 1 Diabetes Mellitus ------------------------------------------------------------------------------------ 837
Exemplar 12.B: Type 2 Diabetes Mellitus ------------------------------------------------------------------------------------ 845
Exemplar 12.C: Liver Disease ---------------------------------------------------------------------------------------------------- 852
Exemplar 12.D: Osteoporosis --------------------------------------------------------------------------------------------------- 859
Exemplar 12.E: Thyroid Disease ------------------------------------------------------------------------------------------------ 866
Module 13: Mobility--------------------------------------------------------------------------------------------- 874
, The Concept Of Mobility ----------------------------------------------------------------------------------------------- 874
Exemplar 13.A: Back Problems-------------------------------------------------------------------------------------------------- 882
Exemplar 13.B: Fractures --------------------------------------------------------------------------------------------------------- 889
Exemplar 13.C: Hip Fractures ---------------------------------------------------------------------------------------------------- 895
Exemplar 13.D: Multiple Sclerosis --------------------------------------------------------------------------------------------- 908
Exemplar 13.E: Osteoarthritis --------------------------------------------------------------------------------------------------- 915
Exemplar 13.F: Parkinson Disease --------------------------------------------------------------------------------------------- 921
Exemplar 13.G: Spinal Cord Injury --------------------------------------------------------------------------------------------- 928
Module 14: Nutrition-------------------------------------------------------------------------------------------- 935
The Concept Of Nutrition ---------------------------------------------------------------------------------------------- 935
Exemplar 14.A: Obesity ----------------------------------------------------------------------------------------------------------- 943
Module 15: Oxygenation --------------------------------------------------------------------------------------- 950
The Concept Of Oxygenation ------------------------------------------------------------------------------------------ 950
Exemplar 15.A: Acute Respiratory Distress Syndrome-------------------------------------------------------------------- 958
Exemplar 15.B: Asthma ----------------------------------------------------------------------------------------------------------- 965
Exemplar 15.C: Chronic Obstructive Pulmonary Disease ----------------------------------------------------------------- 971
Exemplar 15.D: Cystic Fibrosis -------------------------------------------------------------------------------------------------- 978
Exemplar 15.E: Respiratory Syncytial Virus/Bronchiolitis---------------------------------------------------------------- 984
Exemplar 15.F: Sudden Infant Death Syndrome ---------------------------------------------------------------------------- 991
Module 16: Perfusion ------------------------------------------------------------------------------------------- 999
The Concept Of Perfusion ---------------------------------------------------------------------------------------------- 999
Exemplar 16.A: Cardiomyopathy --------------------------------------------------------------------------------------------- 1008
Exemplar 16.B: Congenital Heart Defects ---------------------------------------------------------------------------------- 1015
Exemplar 16.C: Coronary Artery Disease ----------------------------------------------------------------------------------- 1023
Exemplar 16.D: Deep Venous Thrombosis --------------------------------------------------------------------------------- 1030
Exemplar 16.E: Disseminated Intravascular Coagulation -------------------------------------------------------------- 1037
Exemplar 16.F: Heart Failure -------------------------------------------------------------------------------------------------- 1044
Exemplar 16.G Hypertension -------------------------------------------------------------------------------------------------- 1052
Exemplar 16.H: Hypertensive Disorders Of Pregnancy ----------------------------------------------------------------- 1059
Exemplar 16.I: Life-Threatening Dysrhythmias --------------------------------------------------------------------------- 1066
Exemplar 16.J: Peripheral Vascular Disease ------------------------------------------------------------------------------- 1073
Exemplar 16.K: Pulmonary Embolism --------------------------------------------------------------------------------------- 1080
Exemplar 16.L: Shock ------------------------------------------------------------------------------------------------------------ 1087
Exemplar 16.M: Stroke ---------------------------------------------------------------------------------------------------------- 1097
Module 17: Perioperative Care ------------------------------------------------------------------------------ 1106
The Concept Of Perioperative Care --------------------------------------------------------------------------------- 1106
Module 18. Sensory Perception ----------------------------------------------------------------------------- 1120
The Concept Of Sensory Perception -------------------------------------------------------------------------------- 1120
Exemplar 18.A: Hearing Impairment ---------------------------------------------------------------------------------------- 1133
Exemplar 18.B: Diseases Of The Eye ----------------------------------------------------------------------------------------- 1143
Exemplar 18.C: Eye Injuries ---------------------------------------------------------------------------------------------------- 1154
Exemplar 18.D: Peripheral Neuropathy ------------------------------------------------------------------------------------ 1164
,Module 19: Sexuality ------------------------------------------------------------------------------------------- 1175
The Concept Of Sexuality --------------------------------------------------------------------------------------------- 1175
Exemplar 19.A: Family Planning ---------------------------------------------------------------------------------------------- 1188
Exemplar 19.B: Menopause --------------------------------------------------------------------------------------------------- 1198
Exemplar 19.C: Menstrual Dysfunction ------------------------------------------------------------------------------------- 1208
Exemplar 19.D: Sexual Dysfunctions ---------------------------------------------------------------------------------------- 1218
Exemplar 19.E: Sexually Transmitted Infections ------------------------------------------------------------------------- 1227
Module 20: Thermoregulation------------------------------------------------------------------------------- 1237
The Concept Of Thermoregulation --------------------------------------------------------------------------------- 1237
Exemplar 20.A: Hyperthermia------------------------------------------------------------------------------------------------- 1247
Exemplar 20.B: Hypothermia -------------------------------------------------------------------------------------------------- 1255
Module 21: Tissue Integrity ---------------------------------------------------------------------------------- 1263
The Concept Of Tissue Integrity ------------------------------------------------------------------------------------- 1263
Exemplar 21.A: Burns ----------------------------------------------------------------------------------------------------------- 1272
Exemplar 21.B: Pressure Injuries --------------------------------------------------------------------------------------------- 1279
Exemplar 21.C: Wound Healing ----------------------------------------------------------------------------------------------- 1287
,Module 1: Acid-Base Balance
The Concept Of Acid-Base Balance
Barbara Callahan: Clinical Nursing Skills: A Concept-Based Approach 3rd Edition, (Vol. 1), (Vol. 2) & (Vol. 3) Test Bank
MULTIPLE CHOICE
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.
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) 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
Clinical Nursing Skills: A Concept-Based Approach
3rd Edition, (Vol. 1), (Vol. 2) & (Vol. 3); (2025)
By Barbara Callahan
All Modules 1-21| All Exemplar| Latest Edition With Well Detailed Answers| Grade A+
From: [Bestmaxsolutions.Stuvia
,Module 1: Acid-Base Balance ------------------------------------------------------------------------------------- 6
The Concept Of Acid-Base Balance --------------------------------------------------------------------------------------6
Exemplar 1.A: Metabolic Acidosis ----------------------------------------------------------------------------------------------- 35
Exemplar 1.B: Metabolic Alkalosis ---------------------------------------------------------------------------------------------- 62
Exemplar 1.C: Respiratory Acidosis --------------------------------------------------------------------------------------------- 90
Exemplar 1.D: Respiratory Alkalosis ------------------------------------------------------------------------------------------- 118
Module 2: Cellular Regulation -------------------------------------------------------------------------------- 147
The Concept Of Cellular Regulation --------------------------------------------------------------------------------- 147
Exemplar 2.A: Cancer -------------------------------------------------------------------------------------------------------------- 159
Exemplar 2.B: Anemia ------------------------------------------------------------------------------------------------------------- 171
Exemplar 2.C: Breast Cancer ----------------------------------------------------------------------------------------------------- 183
Exemplar 2.D: Colorectal Cancer ----------------------------------------------------------------------------------------------- 195
Exemplar 2.E: Leukemia ---------------------------------------------------------------------------------------------------------- 208
Exemplar 2.F: Lung Cancer ------------------------------------------------------------------------------------------------------- 220
Exemplar 2.G: Prostate Cancer ------------------------------------------------------------------------------------------------- 232
Exemplar 2.H: Sickle Cell Disease----------------------------------------------------------------------------------------------- 244
Exemplar 2.I: Skin Cancer -------------------------------------------------------------------------------------------------------- 256
Module 3: Comfort ---------------------------------------------------------------------------------------------- 269
The Concept Of Comfort ------------------------------------------------------------------------------------------------ 269
Exemplar 3.A: Acute And Chronic Pain --------------------------------------------------------------------------------------- 284
Exemplar 3.B: End-Of-Life Care ------------------------------------------------------------------------------------------------- 296
Exemplar 3.C: Fatigue ------------------------------------------------------------------------------------------------------------- 309
Exemplar 3.D: Fibromyalgia ----------------------------------------------------------------------------------------------------- 321
Exemplar 3.E: Sleep - Rest Disorders ------------------------------------------------------------------------------------------ 332
Module 4: Digestion --------------------------------------------------------------------------------------------- 345
The Concept Of Digestion ---------------------------------------------------------------------------------------------- 345
Exemplar 4.A: Gastroesophageal Reflux Disease--------------------------------------------------------------------------- 361
Exemplar 4.B: Hepatitis ----------------------------------------------------------------------------------------------------------- 374
Exemplar 4.C: Malabsorption Disorders -------------------------------------------------------------------------------------- 387
Exemplar 4.D: Pancreatitis ------------------------------------------------------------------------------------------------------- 400
Exemplar 4.E: Pyloric Stenosis -------------------------------------------------------------------------------------------------- 413
Module 5: Elimination ------------------------------------------------------------------------------------------ 426
The Concept Of Elimination ------------------------------------------------------------------------------------------- 426
Exemplar 5.A: Benign Prostatic Hyperplasia -------------------------------------------------------------------------------- 442
Exemplar 5.B: Bladder Incontinence And Retention ---------------------------------------------------------------------- 453
Exemplar 5.C: Bowel Incontinence, Constipation, And Impaction ----------------------------------------------------- 465
Exemplar 5.D: Urinary Calculi --------------------------------------------------------------------------------------------------- 477
Module 6: Fluids And Electrolytes --------------------------------------------------------------------------- 489
The Concept Of Fluids And Electrolytes ---------------------------------------------------------------------------- 489
Exemplar 6.A: Fluid And Electrolyte Imbalance ---------------------------------------------------------------------------- 505
Exemplar 6.B: Acute Kidney Injury --------------------------------------------------------------------------------------------- 517
Exemplar 6.C: Chronic Kidney Disease ---------------------------------------------------------------------------------------- 527
,Module 7: Health, Wellness, Illness, And Injury --------------------------------------------------------- 540
The Concept Of Health, Wellness, Illness, And Injury --------------------------------------------------------------------- 540
Exemplar 7.A: Physical Fitness And Exercise -------------------------------------------------------------------------------- 556
Exemplar 7.B: Oral Health -------------------------------------------------------------------------------------------------------- 568
Exemplar 7.C: Normal Sleep - Rest Patterns --------------------------------------------------------------------------------- 581
Module 8: Immunity -------------------------------------------------------------------------------------------- 594
The Concept Of Immunity ---------------------------------------------------------------------------------------------- 594
Exemplar 8.A: HIV/AIDS ---------------------------------------------------------------------------------------------------------- 610
Exemplar 8.B: Hypersensitivity ------------------------------------------------------------------------------------------------- 622
Exemplar 8.C: Rheumatoid Arthritis ------------------------------------------------------------------------------------------- 634
Exemplar 8.D: Systemic Lupus Erythematosus ----------------------------------------------------------------------------- 646
Module 9: Infection---------------------------------------------------------------------------------------------- 659
The Concept Of Infection ----------------------------------------------------------------------------------------------- 659
Exemplar 9.A: Cellulitis ----------------------------------------------------------------------------------------------------------- 675
Exemplar 9.B: Conjunctivitis ----------------------------------------------------------------------------------------------------- 687
Exemplar 9.C: Influenza ----------------------------------------------------------------------------------------------------------- 699
Exemplar 9.D: Otitis Media ------------------------------------------------------------------------------------------------------ 708
Exemplar 9.E: Pneumonia -------------------------------------------------------------------------------------------------------- 716
Exemplar 9.F: Sepsis --------------------------------------------------------------------------------------------------------------- 725
Exemplar 9.G: Tuberculosis ------------------------------------------------------------------------------------------------------ 732
Exemplar 9.H: Urinary Tract Infection ---------------------------------------------------------------------------------------- 740
Module 10: Inflammation-------------------------------------------------------------------------------------- 749
The Concept Of Inflammation ---------------------------------------------------------------------------------------- 749
Exemplar 10.A: Appendicitis----------------------------------------------------------------------------------------------------- 758
Exemplar 10.B: Gallbladder Disease ------------------------------------------------------------------------------------------- 765
Exemplar 10.C: Inflammatory Bowel Disease ------------------------------------------------------------------------------- 772
Exemplar 10.D: Nephritis --------------------------------------------------------------------------------------------------------- 780
Exemplar 10.E: Peptic Ulcer Disease------------------------------------------------------------------------------------------- 787
Module 11: Intracranial Regulation ------------------------------------------------------------------------- 795
The Concept Of Intracranial Regulation ---------------------------------------------------------------------------- 795
Exemplar 11.A: Increased Intracranial Pressure ---------------------------------------------------------------------------- 805
Exemplar 11.B: Seizure Disorders ---------------------------------------------------------------------------------------------- 812
Exemplar 11.C: Traumatic Brain Injury---------------------------------------------------------------------------------------- 819
Module 12: Metabolism ---------------------------------------------------------------------------------------- 828
The Concept Of Metabolism------------------------------------------------------------------------------------------- 828
Exemplar 12.A: Type 1 Diabetes Mellitus ------------------------------------------------------------------------------------ 837
Exemplar 12.B: Type 2 Diabetes Mellitus ------------------------------------------------------------------------------------ 845
Exemplar 12.C: Liver Disease ---------------------------------------------------------------------------------------------------- 852
Exemplar 12.D: Osteoporosis --------------------------------------------------------------------------------------------------- 859
Exemplar 12.E: Thyroid Disease ------------------------------------------------------------------------------------------------ 866
Module 13: Mobility--------------------------------------------------------------------------------------------- 874
, The Concept Of Mobility ----------------------------------------------------------------------------------------------- 874
Exemplar 13.A: Back Problems-------------------------------------------------------------------------------------------------- 882
Exemplar 13.B: Fractures --------------------------------------------------------------------------------------------------------- 889
Exemplar 13.C: Hip Fractures ---------------------------------------------------------------------------------------------------- 895
Exemplar 13.D: Multiple Sclerosis --------------------------------------------------------------------------------------------- 908
Exemplar 13.E: Osteoarthritis --------------------------------------------------------------------------------------------------- 915
Exemplar 13.F: Parkinson Disease --------------------------------------------------------------------------------------------- 921
Exemplar 13.G: Spinal Cord Injury --------------------------------------------------------------------------------------------- 928
Module 14: Nutrition-------------------------------------------------------------------------------------------- 935
The Concept Of Nutrition ---------------------------------------------------------------------------------------------- 935
Exemplar 14.A: Obesity ----------------------------------------------------------------------------------------------------------- 943
Module 15: Oxygenation --------------------------------------------------------------------------------------- 950
The Concept Of Oxygenation ------------------------------------------------------------------------------------------ 950
Exemplar 15.A: Acute Respiratory Distress Syndrome-------------------------------------------------------------------- 958
Exemplar 15.B: Asthma ----------------------------------------------------------------------------------------------------------- 965
Exemplar 15.C: Chronic Obstructive Pulmonary Disease ----------------------------------------------------------------- 971
Exemplar 15.D: Cystic Fibrosis -------------------------------------------------------------------------------------------------- 978
Exemplar 15.E: Respiratory Syncytial Virus/Bronchiolitis---------------------------------------------------------------- 984
Exemplar 15.F: Sudden Infant Death Syndrome ---------------------------------------------------------------------------- 991
Module 16: Perfusion ------------------------------------------------------------------------------------------- 999
The Concept Of Perfusion ---------------------------------------------------------------------------------------------- 999
Exemplar 16.A: Cardiomyopathy --------------------------------------------------------------------------------------------- 1008
Exemplar 16.B: Congenital Heart Defects ---------------------------------------------------------------------------------- 1015
Exemplar 16.C: Coronary Artery Disease ----------------------------------------------------------------------------------- 1023
Exemplar 16.D: Deep Venous Thrombosis --------------------------------------------------------------------------------- 1030
Exemplar 16.E: Disseminated Intravascular Coagulation -------------------------------------------------------------- 1037
Exemplar 16.F: Heart Failure -------------------------------------------------------------------------------------------------- 1044
Exemplar 16.G Hypertension -------------------------------------------------------------------------------------------------- 1052
Exemplar 16.H: Hypertensive Disorders Of Pregnancy ----------------------------------------------------------------- 1059
Exemplar 16.I: Life-Threatening Dysrhythmias --------------------------------------------------------------------------- 1066
Exemplar 16.J: Peripheral Vascular Disease ------------------------------------------------------------------------------- 1073
Exemplar 16.K: Pulmonary Embolism --------------------------------------------------------------------------------------- 1080
Exemplar 16.L: Shock ------------------------------------------------------------------------------------------------------------ 1087
Exemplar 16.M: Stroke ---------------------------------------------------------------------------------------------------------- 1097
Module 17: Perioperative Care ------------------------------------------------------------------------------ 1106
The Concept Of Perioperative Care --------------------------------------------------------------------------------- 1106
Module 18. Sensory Perception ----------------------------------------------------------------------------- 1120
The Concept Of Sensory Perception -------------------------------------------------------------------------------- 1120
Exemplar 18.A: Hearing Impairment ---------------------------------------------------------------------------------------- 1133
Exemplar 18.B: Diseases Of The Eye ----------------------------------------------------------------------------------------- 1143
Exemplar 18.C: Eye Injuries ---------------------------------------------------------------------------------------------------- 1154
Exemplar 18.D: Peripheral Neuropathy ------------------------------------------------------------------------------------ 1164
,Module 19: Sexuality ------------------------------------------------------------------------------------------- 1175
The Concept Of Sexuality --------------------------------------------------------------------------------------------- 1175
Exemplar 19.A: Family Planning ---------------------------------------------------------------------------------------------- 1188
Exemplar 19.B: Menopause --------------------------------------------------------------------------------------------------- 1198
Exemplar 19.C: Menstrual Dysfunction ------------------------------------------------------------------------------------- 1208
Exemplar 19.D: Sexual Dysfunctions ---------------------------------------------------------------------------------------- 1218
Exemplar 19.E: Sexually Transmitted Infections ------------------------------------------------------------------------- 1227
Module 20: Thermoregulation------------------------------------------------------------------------------- 1237
The Concept Of Thermoregulation --------------------------------------------------------------------------------- 1237
Exemplar 20.A: Hyperthermia------------------------------------------------------------------------------------------------- 1247
Exemplar 20.B: Hypothermia -------------------------------------------------------------------------------------------------- 1255
Module 21: Tissue Integrity ---------------------------------------------------------------------------------- 1263
The Concept Of Tissue Integrity ------------------------------------------------------------------------------------- 1263
Exemplar 21.A: Burns ----------------------------------------------------------------------------------------------------------- 1272
Exemplar 21.B: Pressure Injuries --------------------------------------------------------------------------------------------- 1279
Exemplar 21.C: Wound Healing ----------------------------------------------------------------------------------------------- 1287
,Module 1: Acid-Base Balance
The Concept Of Acid-Base Balance
Barbara Callahan: Clinical Nursing Skills: A Concept-Based Approach 3rd Edition, (Vol. 1), (Vol. 2) & (Vol. 3) Test Bank
MULTIPLE CHOICE
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.
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) 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
