Based Approach to
Learning, Vol 1
5th Edition
Pearson
TEST BANK
Includes All Modules (1 to 21)
**Answers Included
, Nursing: A Concept Based
Approach to Learning,
Vol 1, 5th Edition by
Pearson
Test Bank
Module 1: Acid-Base Balance
Module 2: Cellular Regulation
Module 3: Comfort
Module 4: Digestion
Module 5: Elimination
Module 6: Fluids and Electrolytes
Module 7: Health, Wellness, and Illness
Module 8: Immunity
Module 9: Infection
Module 10: Inflammation
Module 11: Intracranial Regulation
Module 12: Metabolism
Module 13: Mobility
Module 14: Nutrition
Module 15: Oxygenation
Module 16: Perfusion
Module 17: Perioperative Care
Module 18: Sensory Perception
Module 19: Sexuality
Module 20: Thermoregulation
Module 21: Tissue Integrity
,N u r s i n g : A C o n c e p t - B a s e d A p p r o a c h t o L e a r n i n g Vo l . 1, 5 e
(Pearson) Module 1 Acid-Base Balance
The Concept of Acid-Base Balance
1) A client who has been fasting and has ketones in the urine is brought to the emergency department
(ED) unconscious. 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 faJy acids into ketones, which are
metabolic acids.
B) Respiratory alkalosis involves an imbalance in the respiratory and metabolic processes of the body. It
is caused by hyperventilation. Causes of respiratory alkalosis include anxiety, pain, stress, thyrotoxicosis,
fever, infection, excessive heat, high altitudes, or an overdose of aspirin.
C) Metabolic alkalosis involves an imbalance in the metabolic processes of the body. It is caused by a
decrease in hydrogen ions, a decrease in chloride ions, or an increase in bicarbonate. Metabolic alkalosis
can also be caused by excessive vomiting, excessive use of loop diuretics, and excessive use of sodium
bicarbonate.
D) Respiratory acidosis involves an imbalance in the respiratory and metabolic processes of the body. It is
caused by a decreased respiratory rate, a decreased inhaled and exhaled volume of air, or blockage of the
respiratory passageways. Causes of respiratory acidosis include overdose of a narcotic drug, lung
diseases, or aspiration of a foreign body blocking an airway.
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 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN
Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe
patient care. | Nursing Process: Assessment | CJMM: Analyze Cues
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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, 2) The nurse is caring for a client in the emergency department. Which health condition will the nurse
suspect that increases the client's risk for metabolic acidosis? Select all that apply.
A) Abdominal fistulas
B) Chronic obstructive pulmonary disease
C) Pneumonia
D) Chronic 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 condition such as an abdominal fistula which can cause the loss of bicarbonate from the intestine.
B) Chronic obstructive pulmonary disease places the client at risk for respiratory acidosis with the
increased retention of carbon dioxide in the blood.
C) Pneumonia places 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
condition such as chronic renal failure. In this health problem, the kidneys are unable to excrete a normal
amount of hydrogen ions in the urine. This results in an excessive amount of hydrogen ions in the blood,
which produces metabolic acidosis.
E) Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another
condition such as hypovolemic shock. With a severe blood loss, there is a lack of blood flow throughout
the body and a lack of oxygen in every cell. Adenosine triphosphate (ATP) must produce energy
anaerobically without the presence of oxygen; lactic acid is a by-product. This produces systemic lactic
acidosis, a type of metabolic acidosis.
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 Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN
Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe
patient care. | Nursing Process: Assessment | CJMM: Analyze Cues
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
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