Medical Surgical Nursing An Integrated Approach 3rd Edition by Lois White -Test Bank

Chapter 11—Assessment and Care for Clients with Acid-Base Disturbances

MULTIPLE CHOICE

1. When an acid and a base react with each other, which substance is formed?
a. atom c. salt
b. ion d. buffer

ANS: C
The chemical reaction of the combination of an acid and a base results in the formation of a salt.

PTS: 1 DIF: Comprehension REF: White (2013)

2. Identify which of these elements determines pH range within the body’s internal environment?
a. bicarbonate c. hydrogen
b. carbon dioxide d. oxygen

ANS: C
The normal body pH range of blood is from 7.35 to 7.45; blood pH above or below this range can cause profound physiologic problems. A blood pH level below 7.35 means that the concentration of hydrogen ions is elevated. A blood pH above 7.45 indicates excessive loss of hydrogen ions, resulting in alkalosis.

PTS: 1 DIF: Comprehension REF: White (2013)

3. The nurse is aware that which of the following results when a decreased concentration of hydrogen ions occurs within body fluids?
a. They become acidic.
b. They become alkaline.
c. Carbon ions are retained.
d. Oxygen ions are released into the blood.

ANS: A
The normal body pH range of blood is from 7.35 to 7.45; blood pH above or below this range can cause profound physiologic problems. A blood pH level below 7.35 means that the concentration of hydrogen ions is elevated, resulting in acidosis, which can cause coma, weak or irregular heartbeat, or severe hypotension. A blood pH above 7.45 indicates excessive loss of hydrogen ions, resulting in alkalosis, with symptoms such as apathy, irritability, delirium, or spasmodic muscle contractions.

PTS: 1 DIF: Comprehension REF: White (2013)

4. When a solution has a pH of less than 7, what is its classification?
a. acid c. neutral
b. base d. buffer

ANS: A
The normal body pH range of blood is from 7.35 to 7.45; blood pH above or below this range can cause profound physiologic problems. A blood pH level below 7.35 means that the concentration of hydrogen ions is elevated, resulting in acidosis.

PTS: 1 DIF: Comprehension REF: White (2013)

5. A client’s blood pH is 7.5. The nurse should recognize that this is considered to be:
a. critically decreased, in need of immediate intervention
b. decreased
c. normal
d. slightly increased

ANS: D
The normal body pH range of blood is from 7.35 to 7.45; blood pH above or below this range can cause profound physiologic problems. A blood pH above 7.45 indicates excessive loss of hydrogen ions, resulting in alkalosis, with symptoms such as apathy, irritability, delirium, or spasmodic muscle contractions.

PTS: 1 DIF: Comprehension REF: White (2013)

6. Which of these buffer systems normally buffers organic acids found in body fluids?
a. bicarbonate c. protein
b. phosphate d. neutral

ANS: B
The phosphate buffer system, composed of sodium monohydrogen phosphate and sodium dihydrogen phosphate, regulates the pH of intracellular fluid and fluid in the kidney tubules by buffering organic acids found in the body.

PTS: 1 DIF: Comprehension REF: White (2013)

7. Which of these body systems regulate acid-base balance within the body?
a. central nervous system and lymphatic system
b. heart and lungs
c. integumentary system and lungs
d. lungs and kidneys

ANS: D
Body pH is maintained by the buffer systems, the respiratory system, and the kidneys. Chloride, the major extracellular anion, functions with sodium to maintain osmotic pressure and aid in maintaining acid-base balance. There is a direct relationship between the values of these electrolytes.

PTS: 1 DIF: Comprehension REF: White (2013)

8. The physician requires more information on the client’s acid-base balance. The nurse anticipates the physician ordering which lab test to measure acid-base balance?
a. arterial blood gases (ABG) c. serum hydrogen level
b. serum carbon-dioxide level d. serum oxygen level

ANS: A
Body pH is maintained by the buffer systems, the respiratory system, and the kidneys. The diagnostic test used to evaluate this effectiveness are arterial blood gases.

PTS: 1 DIF: Comprehension REF: White (2013)

9. The nurse is caring for a client experiencing respiratory alkalosis. Which of these conditions is a causative agent?
a. pneumonia c. anxiety
b. brain injury d. emphysema

ANS: C
A client experiences respiratory alkalosis as a result of hypoxia (decrease in H+ ions). The most common causative agent is anxiety.

PTS: 1 DIF: Comprehension REF: White (2013)

10. Which of these conditions results from a decreased level of carbonic acid from hyperventilation?
a. metabolic acidosis c. respiratory acidosis
b. metabolic alkalosis d. respiratory alkalosis

ANS: D
Respiratory alkalosis is caused by hyperventilation, which can be precipitated by anxiety, fear, pain, fever, rapid mechanical ventilation, hypoxia at high altitudes, or by disease conditions such as brain tumors. In respiratory alkalosis, the blood pH is above 7.45 and the partial carbon dioxide level is less than 35 mmHg.

PTS: 1 DIF: Comprehension REF: White (2013)