Deck 6: Fluid, Electrolyte, and Acid-Base Homeostasis

Question 1

Insensible water losses are those that occur as the result of water that is lost in:

A) urine.
B) breathing and sweating.
C) urine and bowel movements.
D) vomitus and bowel movements.

Answer 1

B

Question 2

Which of the following statements is true as it relates to acid-base balance?

A) Renal mechanisms for correcting an acid-base imbalance are less rapid than respiratory mechanisms, but they continue to function until pH has been returned to a normal or near-normal range.
B) pH provides an accurate measure of serum bicarbonate and carbonic acid levels.
C) The acid-base buffer systems of the body consist of a weak acid and strong base.
D) The body uses respiratory compensatory mechanisms to prevent large changes in pH resulting from respiratory disease.

Answer 2

A

Question 3

Which of the following is the highest priority for meeting the needs of a patient who presents with a 3-day history of vomiting and diarrhea, blood pressure of 85/60 mm Hg, heart rate of 105 beats/min, and temperature of 99°F?

A) Finding the source of infection
B) Preventing nutritional deficit
C) Replacing fluid loss
D) Relieving nausea

Answer 3

C

Question 4

Reduced capillary osmotic pressure can be caused by:

A) dehydration.
B) low concentration of plasma proteins.
C) increased hydrostatic pressure in the veins draining the capillaries.
D) edema.

Question 5

Which of the following signs would indicate a fluid deficit?

A) Acute weight loss and increase in blood pressure
B) Tachycardia, acute weight loss, weakness, and dry mucous membranes
C) Physical weakness, weight gain, bradycardia, and decreased urine output
D) Dry fissured tongue, rapid respirations, weight gain, and confusion or delirium

Question 6

Aldosterone's main effect is the regulation of:

A) sodium.
B) water.
C) chloride.
D) potassium.

Question 7

In which of the following data would acidosis be more likely?

A) Serum sodium level of 130 mEq/L
B) Serum sodium level of 150 mEq/L
C) Serum potassium level of 6.2 mEq/L
D) Serum potassium level of 3.5 mEq/L

Question 8

Which of the following patients should be evaluated first?

A) 76-year-old female admitted 3 days ago with pneumonia; most recent blood gases are pH 7.35, PaO₂ of 90, HCO₃ of 35, and PaCO₂ of 29
B) 48-year-old male admitted yesterday with kidney stones complaining of pain of a 5 on a 0-10 scale
C) 52-year-old female admitted yesterday with acute renal failure; most recent lab results are pH of 7.3, PaO₂ of 94, HCO₃ of 15, PaCO₂ of 44, K of 6.1, Na of 148, and osmolality of 369
D) 59-year-old male admitted 2 days ago with stage III bronchogenic carcinoma complaining of nausea and pain of a 6 on a 0-10 scale

Question 9

Which of the following would be appropriate treatment for a patient on a ventilator with respiratory alkalosis, a low CO₂, and normal sodium bicarbonate?

A) Increase the respiratory rate on the ventilator
B) Administer sodium bicarbonate IV
C) Decrease the respiratory rate on the ventilator
D) Administer dialysis

Question 10

Classify the following arterial blood gas: pH = 7.35, PaCO₂ = 50 mm Hg, HCO₃^- = 29 mEq/L.

A) Compensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Compensated metabolic acidosis
D) Partially compensated metabolic acidosis

Question 11

Classify the following arterial blood gas: pH = 7.52, PaCO₂ = 30 mm Hg, HCO₃^- = 24 mEq/L.

A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis

Question 12

Which of the following would be used to treat severe hyperkalemia?

A) Angiotensin-converting enzyme
B) Lactated Ringer's
C) Arginine HCL
D) Insulin and Dextrose 50%

Question 13

What fluid and electrolyte changes will occur in a patient with diabetes and a very high blood glucose?

A) Hyperkalemia develops.
B) Water shifts by osmosis from the cells into the extracellular fluid (ECF).
C) Water shifts by osmosis from the extracellular fluid into the cells.
D) Equal amounts of water move from the cells into the ECF and from the ECF into the cells, and thus, there is no net change in the water content of either the cells or the ECF.
E) Hyperkalemia develops, and water shifts by osmosis from the cells into the extracellular fluid (ECF).

Question 14

Respiratory acidosis occurs most commonly in:

A) uncontrolled diabetes mellitus.
B) renal insufficiency.
C) emphysema.
D) potassium depletion.

Question 15

Which of the following compensatory mechanisms occur when osmolality increases?

A) Inhibition of thirst mechanism
B) Stimulation of thirst mechanism
C) Suppression of antidiuretic hormone
D) Inhibition of aldosterone

Question 16

A patient with decompensated heart failure with reduced ejection fraction has edema and shortness of breath. The patient has hyponatremia. Which of the following is the most likely cause of the hyponatremia?

A) Coexisting high triglycerides
B) Antidiuretic hormone imbalances
C) Thirst mechanism is impaired, leading to reduction in sodium intake
D) An excess of water is retained, causing a dilutional hyponatremia

Question 17

A patient just ran a marathon in extreme heat and is diagnosed with dehydration. What is an expected finding in the urine-specific gravity?

A) It will be normal.
B) It will be low.
C) It will be high.
D) It will be indeterminate.

Question 18

A patient with a history of angina and hypertension is getting a preoperative evaluation for a knee replacement. His preoperative history and physical examination revealed no abnormalities. The preoperative labs, however, reveal a serum potassium level of 5.9 mEq/L. The next intervention would be to:

A) withhold potassium in all intravenous fluids during the surgery.
B) draw another serum potassium level.
C) administer insulin and D50.
D) prescribe Kayexalate.

Question 19

Which serum value can cause an abnormal total calcium levels and, if known, should be used to calculate a corrected serum calcium level?

A) Phosphorus
B) Bicarbonate
C) Sodium
D) Albumin

Question 20

In which scenario is hypercalcemia likely?

A) A 55-year-old who is an alcoholic
B) A woman diagnosed with hyperparathyroidism
C) A 40-year-old man with pancreatitis
D) A 60-year-old woman with heart failure who is on diuretics