Chapter 30 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

Chapter 30 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nurse notices that a patient in the intensive care unit has lost muscle mass and tone in his arms and legs. The nurse would attribute this loss to changes in which process?

1. Energy
2. Catabolism
3. Adenosine triphosphate
4. Anabolism

Correct Answer: 2

Rationale 1: Energy is the ability of the body to do work and is measured in calories. It is not directly associated with the loss of muscle mass in this patient.

Rationale 2: Catabolism is the process by which complex nutrients and body tissues are broken down into more basic elements such as glucose, fatty acids, and amino acids for the purpose of liberating energy necessary to maintain bodily functions. The patient in the intensive care unit has lost muscle tone which is evidence of catabolism of body tissues.

Rationale 3: Adenosine triphosphate is a source of energy in the body. It is not directly associated with the loss of muscle mass in this patient.

Rationale 4: Anabolism is the process of cell synthesis which builds body tissues.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-1

 

Question 2

Type: MCSA

A patient who is being mechanically ventilated is demonstrating respiratory acidosis. The nurse suspects that which metabolic process is malfunctioning?

1. Anaerobic metabolism
2. Catabolism
3. Aerobic metabolism
4. Anabolism

Correct Answer: 3

Rationale 1: Anaerobic metabolism occurs in the absence of oxygen; however, the patient is being mechanically ventilated so oxygen should be present.

Rationale 2: Catabolism is the process by which complex nutrients and body tissues are broken down into more basic elements such as glucose, fatty acids, and amino acids for the purpose of liberating energy necessary to maintain bodily functions. It is not associated with development of respiratory acidosis in this patient.

Rationale 3: Aerobic metabolism forms adenosine triphosphate through the Krebs cycle. The byproducts of this metabolism are carbon dioxide and water. Carbon dioxide and water normally are harmless and easily excreted from the body; however, excess retention of either of these substances can result in acid–base and fluid excess problems.

Rationale 4: Anabolism is the process of cell synthesis which builds body tissues and would not result in respiratory acidosis in this patient.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-1

 

Question 3

Type: MCSA

A patient’s blood oxygen level is measured to be 78%. The nurse implements interventions to improve this level to avoid development of which situation?

1. Anabolism
2. Catabolism
3. Anaerobic metabolism
4. Aerobic metabolism

Correct Answer: 3

Rationale 1: Anabolism is the process of cell synthesis which builds body tissues.

Rationale 2: Catabolism is the process by which complex nutrients and body tissues are broken down into more basic elements such as glucose, fatty acids, and amino acids for the purpose of liberating energy necessary to maintain bodily functions.

Rationale 3: Anaerobic metabolism is partially a compensatory mechanism that allows energy production to proceed whenever energy demands exceed the oxygen supply, such as during exercise. Anaerobic metabolism, however, is intended only to be temporary and cannot sustain life indefinitely.

Rationale 4: Aerobic metabolism occurs in the presence of oxygen and is the normal state.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-1

 

Question 4

Type: MCSA

It has been calculated that a patient in the intensive care unit needs 1800 calories each day to sustain normal metabolic functioning. The nurse calculates that which number of calories is needed to sustain central nervous system functioning?

1. 1440 calories
2. 360 calories
3. 900 calories
4. 720 calories

Correct Answer: 2

Rationale 1: The central nervous system will not require this many calories.

Rationale 2: Central nervous system functions require about 20 percent of the energy expenditure. The patient’s daily needs are 1800 calories. Twenty percent of this number of calories is 360 calories.

Rationale 3: The central nervous system will not require this number of calories for normal function.

Rationale 4: The central nervous system will not require this number of calories for normal function.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 30-1