Deck 4: Fluids and Electrolytes, Acids and Bases

Question 1

A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor. Further testing indicates that the tumor secretes ADH. Which of the following would be expected to result from this condition ?

A) Increased urine osmolality
B) Decreased blood volume
C) Increased plasma osmolality
D) Increased urine output

Answer 1

Increased urine osmolality

Question 2

A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the physician orders fluid replacement. The nurse administers a hypertonic IV solution. Which of the following would be expected?

A) His symptoms would subside quickly
B) Increased intracellular fluid volume
C) Decreased extracellular fluid volume
D) Intracellular dehydration

Answer 2

Intracellular dehydration

Question 3

Natriuretic hormones affect the balance of:

A) calcium.
B) sodium.
C) magnesium.
D) potassium.

Answer 3

sodium.

Question 4

A 70-year-old male with chronic renal failure presents with edema. Which of the following is the most likely cause of this condition?

A) Increased capillary oncotic pressure
B) Increased interstitial oncotic pressure
C) Increased capillary hydrostatic pressure
D) Increased interstitial hydrostatic pressure

Question 5

Water movement between the intracellular and extracellular fluid compartments is determined by:

A) osmotic forces.
B) plasma oncotic pressure.
C) antidiuretic hormone.
D) buffer systems.

Question 6

Which of the following conditions would decrease oncotic pressure in the capillaries?

A) High protein diet
B) Liver failure
C) Low blood pressure
D) Low blood glucose

Question 7

Secretion of antidiuretic hormone (ADH) is stimulated by:

A) increased serum potassium.
B) increased plasma osmolality.
C) decreased renal blood flow.
D) generalized edema.

Question 8

Elderly individuals are at a higher risk for developing dehydration because they have:

A) a higher total body water volume.
B) a decreased lean body mass.
C) a decreased intravascular volume.
D) an increased tendency towards developing edema.

Question 9

Secretion of aldosterone results in:

A) decreased plasma osmolality.
B) increased serum potassium levels.
C) increased blood volume.
D) localized edema.

Question 10

A 10-year-old male is brought to the ER because he is incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as:

A) localized edema.
B) generalized edema.
C) pitting edema.
D) lymphedema.

Question 11

A 52-year-old diabetic male presents to the ER with lethargy, confusion, and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Which of the following is most likely to occur?

A) Hypo-osmolar hyponatremia
B) Hypertonic hyponatremia
C) Decreased urine formation
D) Decreased extracellular fluid osmolality

Question 12

Hyperkalemia causes:

A) an increase in resting membrane potential with increased excitability of cardiac muscle.
B) a decrease in resting membrane potential with increased excitability of cardiac muscle.
C) an increase in resting membrane potential with decreased excitability of cardiac muscle.
D) a decrease in resting membrane potential with decreased excitability of cardiac muscle.

Question 13

A 35-year-old male weights 70 kg. Approximately how much of this weight is intracellular fluid?

A) 5 L
B) 10 L
C) 28 L
D) 42 L

Question 14

The most common cause of pure water deficit is:

A) renal water loss.
B) hyperventilation.
C) sodium loss.
D) insufficient water intake.

Question 15

An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid movement into the interstitial space?

A) Increase capillary oncotic pressure
B) Increase interstitial hydrostatic pressure
C) Decrease capillary hydrostatic pressure
D) Increase interstitial oncotic pressure

Question 16

Hyperlipidemia and hyperglycemia are associated with:

A) hypernatremia.
B) hypertonic hyponatremia.
C) hypokalemia.
D) acidosis.

Question 17

Blood plasma is referred to as:

A) intracellular fluid.
B) extracellular fluid.
C) interstitial fluid.
D) intravascular fluid.

Question 18

A 25-year-old male is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which of the following would be expected to accompany this condition?

A) Decreased blood volume
B) Decreased blood K⁺ levels
C) Increased urine Na⁺ levels
D) Increased renin secretion

Question 19

Which of the following conditions is the most significant risk factor for developing hypernatremia?

A) Vomiting
B) Diuretic use
C) Dehydration
D) Hypoaldosteronism

Question 20

Water balance is closely related to _____ balance.

A) potassium
B) chloride
C) bicarbonate
D) sodium

Question 21

Causes of respiratory acidosis include:

A) vomiting.
B) hyperventilation.
C) pneumonia.
D) an increase in noncarbonic acids.

Question 22

A 19-year-old male presents to his physician complaining of restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemic. Which of the following could have caused his condition?

A) Primary hyperaldosteronism
B) Acidosis
C) Insulin secretion
D) Alkalosis

Question 23

Which of the following conditions is commonly associated with hyperkalemia and metabolic acidosis?

A) Hypermetabolism
B) Pulmonary disorders
C) Cushing syndrome
D) Renal failure

Question 24

Which of the following would most likely cause hypochloremia?

A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Increased bicarbonate

Question 25

Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of:

A) 20/1.
B) 1/20.
C) 10/2.
D) 10/5.

Question 26

Acute compensation for metabolic acidosis includes:

A) kidney excretion of H⁺.
B) hyperventilation.
C) CO₂ retention.
D) aldosterone secretion.

Question 27

Chronic compensation for respiratory acidosis includes:

A) kidney excretion of H⁺.
B) kidney excretion of HCO₃^-.
C) prolonged exhalations to blow off CO₂.
D) protein buffering.

Question 28

One cause of metabolic alkalosis is:

A) retention of metabolic acids.
B) hypoaldosteronism.
C) excessive loss of Cl^-.
D) hyperventilation.

Question 29

A 60-year-old female is diagnosed with hyperkalemia. Which of the following would be an expected symptom?

A) Weak pulse
B) Excessive thirst
C) Oliguria
D) Constipation

Question 30

Which of the following buffer pairs is considered the major plasma buffering system?

A) NaCl/KPO₄
B) HCO₃/H₂CO₃
C) HPO₄/H₂PO₄
D) NH₃/NH₄

Question 31

Regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:

A) buffer systems.
B) kidneys.
C) lungs.
D) liver.

Question 32

A 55-year-old female presents to her physician complaining of dizziness, confusion, and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO₂, and slightly decreased HCO₃^-. Which of the following is the most likely diagnosis?

A) Respiratory alkalosis with renal compensation
B) Respiratory acidosis with renal compensation
C) Metabolic alkalosis with respiratory compensation
D) Metabolic acidosis with respiratory compensation

Question 33

A 54-year-old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feelings. Lab results reveal decreased pH, increased CO₂, and normal bicarbonate ion. The most likely diagnosis is:

A) respiratory alkalosis.
B) metabolic acidosis.
C) respiratory acidosis.
D) metabolic alkalosis.

Question 34

Long-term potassium deficits result in damage to the:

A) central nervous system.
B) lungs.
C) kidneys.
D) gastrointestinal tract.

Question 35

A 42-year-old female presents to her physician complaining of muscle weakness and cardiac abnormalities. Laboratory tests indicate that she is hypokalemic. Which of the following could be the cause of her condition?

A) Respiratory acidosis
B) Constipation
C) Hypoglycemia
D) Primary hyperaldosteronism

Question 36

Which of the following would result in hyperkalemia?

A) Excess aldosterone
B) Acute acidosis
C) Insulin
D) Alkalosis