Deck 25: Water, Electrolyte, and Acid-Base Balance

Question 1

Hyperventilation is most likely to cause

A) a blood pH higher than 7.45.
B) diuresis.
C) edema.
D) acidosis.

Answer 1

A

Question 2

Which of the following is most likely to occur when output is less than intake?

A) Dehydration
B) Edema
C) Hypovolemia
D) Polyuria

Answer 2

Edema

Question 3

Most body water is located within which space?

A) Interstitial
B) Intravascular
C) Intracellular
D) Transcellular

Answer 3

Intracellular

Question 4

Water and chloride usually follow the movement of which cation?

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

Question 5

Kaliuresis refers to the urinary loss of

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

Question 6

Which of the following forms the greatest extracellular fluid compartment?

A) Lymph
B) Interstitial
C) Plasma
D) Transcellular

Question 7

Which of the following is true about interstitial fluid,plasma,lymph,and transcellular fluid?

A) Contain no electrolytes
B) Protein-free fluids
C) Classified as extracellular
D) pH less than 6 (highly acidic)

Question 8

Excess diuresis is most likely to cause

A) edema.
B) overhydration.
C) blood volume depletion.
D) acidosis.

Question 9

Which of the following is descriptive of normal saline?

A) Distilled water
B) 0.9% sodium chloride
C) Highly acidic
D) Contains albumin

Question 10

Poor skin turgor is most indicative of

A) cystitis.
B) acidosis.
C) edema.
D) dehydration.

Question 11

Which of the following is not a function of the lungs?

A) Oxygenation of blood
B) Excretion of carbon dioxide
C) Secretion of aldosterone and the regulation of Na+
D) Regulation of blood pH

Question 12

Which of the following is not true of extracellular fluid?

A) Most body water is extracellular.
B) Plasma is extracellular fluid.
C) Transcellular fluid is extracellular.
D) There is more interstitial fluid than intravascular fluid.

Question 13

Which of the following is most likely to occur when output exceeds intake?

A) Diuresis
B) Polyuria
C) Hematuria
D) Dehydration

Question 14

Which of the following can be defined as an H⁺ donor?

A) Ion
B) Tincture
C) Acid
D) Bicarbonate

Question 15

Hypoventilation is most likely to cause

A) acidosis.
B) edema.
C) renal excretion of bicarbonate.
D) hypokalemia.

Question 16

K⁺

A) is a cation.
B) is an acid.
C) neutralizes H+.
D) is the chief extracellular cation.

Question 17

Bicarbonate (HCO₃-)is considered an anion because it

A) contains hydrogen.
B) contains carbon.
C) contains oxygen.
D) carries a negative charge.

Question 18

Which of the following acts as a base?

A) H+
B) OH-
C) Calcium ion
D) Gastric juice

Question 19

Metabolic acidosis,such as diabetic ketoacidosis,is most likely to cause

A) hypoventilation.
B) Kussmaul respirations.
C) the renal excretion of bicarbonate.
D) the renal retention of H+.

Question 20

Which fluid compartment is located between the cells and is also called tissue fluid?

A) Lymph
B) Plasma
C) Interstitial
D) Transcellular

Question 21

Hyperkalemia refers to an increase in the blood levels of which ion?

A) Hydrogen
B) Bicarbonate
C) Calcium
D) Potassium

Question 22

Which ion determines the resting membrane potential of nerve and muscle?

A) Sodium
B) Calcium
C) Hydrogen
D) Potassium

Question 23

Most diuretics increase urine production by blocking the effects of which cation?

A) Calcium
B) Bicarbonate
C) Chloride
D) Sodium

Question 24

Which of the following is most likely to develop in an anxious hyperventilating patient?

A) Respiratory acidosis
B) Alkalosis
C) A decrease in plasma pH
D) Ketoacidosis

Question 25

Which hormone stimulates the kidneys to reabsorb calcium and to excrete phosphate?

A) ADH
B) Aldosterone
C) Parathyroid hormone
D) Erythropoietin

Question 26

What does urinary specific gravity measure?

A) Plasma H+ concentration
B) Hydration status of the body
C) Plasma potassium
D) The buffering capacity of the blood

Question 27

Which of the following is characteristic of acidosis?

A) pH of 7.55
B) A decrease in the concentration of hydrogen ion in the blood
C) Urinary excretion of bicarbonate
D) pH less than 7.35

Question 28

A patient is admitted with severe emphysema and a PO₂ of 85.He also has a blood pH of 7.25 and a serum bicarbonate of 40 mEq/liter.Which of the following is the accurate description?

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

Question 29

Retention of which ion causes water retention and edema formation?

A) Potassium
B) Hydrogen
C) Sodium
D) Bicarbonate

Question 30

Which of the following is a buffer pair?

A) PTH, aldosterone
B) ADH, ANF
C) HCO3-, H2CO3
D) Sodium, potassium

Question 31

More than 99% of which cation is stored in the bones and teeth?

A) Potassium
B) Hydrogen
C) Chloride
D) Calcium

Question 32

Which ion determines pH?

A) Sodium
B) Hydrogen
C) Bicarbonate
D) Potassium

Question 33

Which of the following is most likely to develop in a patient who hypoventilates because of a chronic respiratory disease,such as emphysema?

A) Kussmaul respirations
B) A decrease in the plasma concentration of hydrogen ion
C) An increase in plasma pH
D) Acidosis

Question 34

Which group is incorrect?

A) Cations: sodium, potassium, calcium
B) Acid-base imbalances: acidosis, alkalosis
C) Lines of defense against acid-base imbalance: buffers, lungs, kidneys
D) Transcellular fluids: aqueous humor, cerebrospinal fluid, plasma

Question 35

Which hormone causes the kidneys to retain sodium and to excrete potassium?

A) ADH
B) Erythropoietin
C) Aldosterone
D) PTH

Question 36

Which condition is caused by vomiting stomach contents?

A) Hyperkalemia
B) Hypernatremia and blood volume expansion
C) Hypocalcemic tetany
D) Alkalosis

Question 37

Which of the following is the chief extracellular cation?

A) Chloride
B) Calcium
C) Sodium
D) Potassium

Question 38

Respiratory rate is most sensitive to the effects of which ion?

A) Na⁺
B) K⁺
C) H⁺
D) Cl^-

Question 39

Which of the following anions buffers H⁺?

A) Ca2⁺
B) HCO3^-
C) Na⁺
D) K⁺

Question 40

Which condition stimulates Kussmaul respirations?

A) Respiratory acidosis
B) Respiratory alkalosis
C) Ketoacidosis
D) Hypocalcemic tetany

Question 41

Which group is incorrect?

A) Anions: bicarbonate, chloride, phosphate
B) Lines of defense against acid-base imbalance: buffers, lungs, kidneys
C) Transcellular fluids: aqueous humor, cerebrospinal fluid, synovial fluid
D) Hormones: aldosterone, ADH, ANP, urea

Question 42

An unconscious diabetic patient with a blood sugar of 450 mg/dL has an elevated temperature and is experiencing Kussmaul respirations.You suspect that

A) he is excreting large amounts of bicarbonate in his urine.
B) his PO2 is normal or high-normal.
C) his blood pH is 7.25.
D) Two of the above are true.

Question 43

Which of the following is least descriptive of dehydration?

A) Tenting
B) Anasarca
C) Hypovolemia
D) Concentrated plasma

Question 44

Which of the following best indicates the role of albumin in water balance?

A) Blocks the renal reabsorption of Na+
B) Enhances the renal excretion of K+
C) Maintains plasma oncotic pressure
D) "Plugs up" capillary pores, keeping water in the plasma

Question 45

Which of the following is the trigger for the release of ADH?

A) Decreased blood volume
B) Renin
C) Dehydration
D) More than one of the above are true.

Question 46

The determination of daily weights is used to monitor

A) serum K+.
B) diuretic therapy.
C) concentration of plasma protein.
D) pH.

Question 47

A change of pH from 7.40 to 7.25

A) is indicative of expanded blood volume.
B) is indicative of alkalosis.
C) reflects an increase in the amount of H+ in the blood.
D) is within normal limits.

Question 48

Which group is incorrect?

A) Ions: sodium, potassium, calcium, bicarbonate, chloride
B) Lines of defense against acid-base imbalance: buffers, lungs, kidneys
C) Extracellular fluid: intravascular, interstitial, transcellular
D) Substances that are normally found in a sample of urine: urea, creatinine, glucose

Question 49

Plasma oncotic pressure

A) is caused primarily by salt (sodium chloride).
B) "pulls" water into the capillaries from the interstitium.
C) pushes water out of the capillaries into the interstitium.
D) increases the flow of lymph.

Question 50

A patient with pulmonary edema is receiving furosemide (Lasix),a kaliuretic diuretic.He has lost 6.6 lb over a 48-hr period.Which statement is true?

A) His urinary output has decreased.
B) He has lost water weight.
C) He will become hyperkalemic if the furosemide is continued.
D) The loss of 6.6 lb causes "tenting."

Question 51

Hypocalcemia is most likely to

A) cause blood volume expansion (hypervolemia).
B) be treated with IV potassium.
C) cause tetany.
D) be caused by excess parathyroid hormone activity.

Question 52

A patient with pulmonary edema is receiving furosemide (Lasix),a kaliuretic diuretic.He has lost 6.6 lb over a 48-hr period.Which of the following statements is true?

A) He is probably hyperkalemic secondary to the diuretic therapy.
B) He has lost 12 L of water.
C) His skin is "tenting."
D) He has lost 3 L of water.

Question 53

Which of the following is most likely to cause acidosis?

A) Persistent vomiting
B) Accumulation of plasma H+
C) Renal loss of albumin
D) Diuresis

Question 54

Third spacing

A) is caused by aggressive diuretic therapy.
B) describes a severe state of hypovolemia and dehydration.
C) involves only the interstitial space.
D) can result in an abnormal accumulation of large amounts of water.

Question 55

Aldosterone

A) is released in response to hypovolemia.
B) causes Na+ excretion.
C) causes K+ reabsorption.
D) determines the permeability of the collecting duct to water.

Question 56

Which of the following is (are)true of Na⁺?

A) Is the chief extracellular anion
B) Helps regulate extracellular volume
C) Is regulated by ADH
D) All of the above

Question 57

A drug that decreases the synthesis of aldosterone

A) decreases blood pressure.
B) causes hypernatremia.
C) causes hypokalemia.
D) does all of the above.

Question 58

Hyperkalemia

A) refers to an elevated serum calcium level.
B) generally develops in response to declining renal function.
C) is often caused by a kaliuretic diuretic.
D) is caused by excess aldosterone.

Question 59

Which of the following is an example of metabolic acidosis with a respiratory compensation?

A) Morphine overdose and diuresis
B) Persistent vomiting and hypoventilation
C) Ketoacidosis and Kussmaul respirations
D) Hypocalcemic tetany and hyperventilation

Question 60

Which of the following is most likely to happen when fatty acids are broken down rapidly and incompletely?

A) The plasma pH decreases, causing metabolic alkalosis.
B) The patient hypoventilates in an attempt to correct the pH disturbance.
C) Ketoacids are produced, causing metabolic acidosis.
D) The plasma [H⁺] decreases.

Question 61

Which of the following conditions is most apt to decrease glomerular filtration rate (GFR)?

A) Overhydration
B) Hypotension
C) Administration of a diuretic for the treatment of edema
D) Water intoxication

Question 62

Which of the following is true of hyperkalemia?

A) Also causes blood volume expansion and hypertension
B) Refers to an elevation in serum potassium
C) Is most often due to impaired respiratory function
D) Is due to an accumulation of urea in the blood

Question 63

Which of the following is most apt to cause a hypocalcemic tetany?

A) Hyperventilation
B) Rapid and excess fat catabolism
C) Metabolic acidosis
D) pH < 7.35

Question 64

An osmotic diuresis is most commonly caused by

A) ketonuria.
B) albuminuria.
C) glucosuria.
D) hypoglycemia.

Question 65

A deficiency of ADH,called diabetes insipidus,is characterized by

A) glucosuria and an osmotic diuresis.
B) polyuria and polydipsia.
C) Kussmaul respirations and hyperventilation.
D) edema formation and sodium retention.

Question 66

A drug that blocks the renal reabsorption of sodium

A) decreases the renal excretion of Na+.
B) increases the amount of urine.
C) decreases the excretion of bicarbonate.
D) always increases the reabsorption of K+.

Question 67

Excessive secretion of ADH,as occurs with head injury,is most likely to cause

A) tenting.
B) blood volume expansion.
C) diuresis.
D) hypernatremia.

Question 68

Which of the following is a pH descriptive of ketoacidosis?

A) 7.50
B) pH > 7.45
C) 14.0
D) 7.25

Question 69

Under which condition will the renal reabsorption of bicarbonate increase?

A) As a compensatory mechanism for respiratory acidosis
B) Whenever blood pH exceeds 7.45
C) As a compensatory mechanism for metabolic alkalosis
D) Whenever a person hyperventilates

Question 70

This anion is an important part of a major buffer pair and therefore plays an important role in acid-base regulation.

A) Na+
B) Bicarbonate
C) HCO3-
D) More than one of the above are true.

Question 71

A patient is ventilating at a rate of 8 to 10 respirations/min,having been heavily medicated for pain.Which of the following is true? The patient is (may)

A) develop a respiratory acidosis.
B) experiencing Kussmaul respirations.
C) experiencing diuresis.
D) likely to develop a metabolic alkalosis.

Question 72

Where does most of the body's acid come from?

A) It is reabsorbed from the urine by the kidneys.
B) Metabolic reactions within the body
C) Ingestion of fruit juices
D) Ingestion of a variety of sources of bicarbonate

Question 73

Which of the following conditions is most apt to cause a dilutional hyponatremia?

A) Excess ingestion of water
B) Dehydration
C) Hypotension
D) Diaphoresis

Question 74

Generally speaking the movement of Na+ determines the

A) blood pH.
B) blood glucose.
C) secretion of PTH.
D) movement of water.

Question 75

Which of the following is true about these percentages: 60% and 28%? They represent the amount of

A) water eliminated as urine and through the skin and lungs.
B) Na+ and K+ reabsorbed by the kidneys in response to aldosterone.
C) water ingested through moist food and metabolism.
D) Na+ and K+ reabsorbed in response to ADH secretion.

Question 76

Which of the following is true of dehydration?

A) Is characterized by poor skin turgor and "tenting"
B) Is accompanied by an decrease in urine specific gravity
C) Causes a shift of water from the vasculature into the interstitium
D) Is generally treated with a diuretic

Question 77

With carbon dioxide retention,CO? + H?O $\rightarrow$

A) H₂O₂.
B) H⁺ + HCO₃^-.
C) bicarbonate.
D) H₂O + H₂O.