Deck 44: Acid Base Balance

Question 1

Which of the following ratios of base bicarbonate to carbonic acid will maintain a normal pH?

A) 3:1
B) 5:1
C) 10:1
D) 20:1

Answer 1

D

Question 2

Hydrogen ions are continually entering the body fluids through:

A) acidic ketone bodies.
B) phosphoric acids.
C) carbonic acids.
D) all of the above.

Answer 2

D

Question 3

Potassium salts of hemoglobin are important in buffering _____ acid.

A) lactic
B) carbonic
C) sulfuric
D) phosphoric

Answer 3

B

Question 4

An increase in respiratory rate would result in a decrease in all of the following except:

A) carbon dioxide.
B) acidity.
C) pH.
D) hydrogen ions.

Question 5

Which of the following would have the greatest concentration of hydrogen ions?

A) pH 2
B) pH 6
C) pH 8
D) pH 10

Question 6

Which of the following is considered a powerful physiological buffering system of the body?

A) Skin
B) Liver
C) Kidney
D) Intestine

Question 7

In the body, nonvolatile acids, or fixed acids, are buffered mainly by:

A) hemoglobin.
B) sodium hydroxide.
C) sodium bicarbonate.
D) plasma proteins.

Question 8

In acidosis, the renal tubule excretion of hydrogen ions:

A) decreases.
B) increases.
C) does not change.
D) decreases only when potassium ion excretion increases.

Question 9

Which of the following is a true statement?

A) Arterial blood has a higher hydrogen ion concentration than venous blood.
B) Venous blood has a higher pH than arterial blood.
C) Arterial blood has an average pH of 7.41.
D) Venous blood has a lower hydrogen ion concentration than arterial blood.

Question 10

The pH of the blood is maintained at approximately:

A) 7.1.
B) 7.2.
C) 7.3.
D) 7.4.

Question 11

Ketone bodies are associated with cellular metabolism of:

A) fats.
B) carbohydrates.
C) proteins.
D) vitamins.

Question 12

The regulation of acid-base balance in the body fluids refers to the control of _____ ion concentration.

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

Question 13

The most acidic substance in the body is:

A) stomach acid.
B) saliva.
C) blood.
D) cerebrospinal fluid.

Question 14

Prolonged hyperventilation tends to:

A) produce alkalosis.
B) decrease blood pH.
C) produce acidosis.
D) stimulate increased production of carbonic acid.

Question 15

Which of the following types of acids would be produced as a result of glucose catabolism?

A) Acetoacetic
B) Phosphoric
C) Lactic
D) Sulfuric

Question 16

Which of the following would indicate a neutral solution?

A) pH 7
B) pH 6
C) pH 8
D) pH 10

Question 17

An example of a physiological buffer system (with a delayed response time) would be the _____ system.

A) respiratory response
B) protein buffer
C) bicarbonate buffer
D) phosphate buffer

Question 18

A solution with pH of 7 would contain _____ times the number of hydrogen ions as a solution with a pH of 8.

A) 2
B) 3
C) 5
D) 10

Question 19

If the pH of the blood were 7.23, it would be

A) within the normal range.
B) slightly more acidic than normal.
C) slightly more basic than normal.
D) much more basic than normal.

Question 20

Which of the following is (are) classified as an acid-forming food?

A) Meat
B) Eggs
C) Poultry
D) All of the above

Question 21

A decrease in blood pH:

A) accelerates the renal tubule excretion of ammonia.
B) causes a decrease in the renal tubule excretion of ammonia.
C) produces an increase in the pH of the urine through the chloride shift.
D) has no effect on the renal tubule excretion of ammonia (because of respiratory compensations).

Question 22

Hyperkalemia may have a major effect on which of the following?

A) Gastrointestinal tract
B) Heart
C) Kidney
D) Liver

Question 23

If the blood pH decreases below normal, the kidney tubules secrete _____ urine.

A) fewer hydrogen ions from blood to
B) more hydrogen ions from blood to
C) more sodium ions into the
D) Both A and C will occur.

Question 24

A solution with a pH of 6 would have _____ ions than a solution with a pH of 4.

A) more hydrogen
B) fewer hydrogen
C) fewer hydroxide
D) Both A and C are correct.

Question 25

Which of these is not an acid-forming element?

A) Chloride
B) Potassium
C) Sulfur
D) Phosphorus

Question 26

Which of the following is considered a direct acid-forming food?

A) Citrus fruit
B) Vinegar
C) Cranberries
D) All of the above are considered direct acid-forming foods

Question 27

When the renal tubules reabsorb sodium ions, they normally exchange (secrete) which of the following?

A) Potassium ions
B) Chloride ions
C) Hydrogen
D) Either potassium or hydrogen

Question 28

When the kidney secretes hydrogen ions, it primarily reabsorbs _____ ions.

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

Question 29

A solution with a hydrogen ion concentration of 1 × 10-¹ per liter would have a pH of:

A) 10.
B) -1.
C) 1.
D) none of the above.

Question 30

Hyperventilation can result in loss of consciousness because:

A) oxygen levels become too high.
B) oxygen levels become too low.
C) carbon dioxide levels are elevated.
D) of alkalosis.

Question 31

For the body to maintain an acid-base balance, which of the following is (are) necessary?

A) Buffering
B) Respirations
C) Urine secretion
D) All of the above

Question 32

Carbonic acid results primarily from the metabolism of:

A) glucose.
B) amino acids.
C) fats.
D) ribonucleotides.

Question 33

A solution with a hydrogen ion concentration of 1 × 10-⁴ per liter would be a(n):

A) acid.
B) base.
C) neutral solution.
D) There is not enough information to determine the type of solution it would be.

Question 34

Which of the following is not a base-forming element?

A) Chlorine
B) Potassium
C) Sodium
D) Magnesium

Question 35

A decrease in blood pH below normal tends to:

A) stimulate increased respirations.
B) produce hypoventilation.
C) stimulate a compensatory increase in blood hydrogen ion concentration through the respiratory system.
D) do both B and C.

Question 36

A solution with a pH of 6 would have a hydrogen ion concentration of _____ per liter.

A) 0.000006
B) 0.0000001
C) 0.000001
D) None of the above is correct.

Question 37

Beta-hydroxybutyric acid results from the metabolism of:

A) glucose.
B) amino acids.
C) fats.
D) ribonucleotides.

Question 38

Which of these is true about the metabolism of glucose?

A) Aerobic metabolism produces lactic acid.
B) Anaerobic metabolism produces lactic acid.
C) Anaerobic metabolism produces carbonic acid.
D) Both A and C are true about the metabolism of glucose.

Question 39

Which of the following would be important in treating metabolic alkalosis?

A) Chloride ions
B) Bicarbonate ions
C) Sodium ions
D) Potassium ions

Question 40

The more hydrogen ions excreted by the renal tubules, the:

A) more alkaline the urine.
B) more potassium ions excreted.
C) fewer potassium ions excreted.
D) lower the pH of the blood becomes.

Question 41

Which of the following is most basic?

A) Oven cleaner
B) Baking soda
C) Household ammonia
D) Great Salt Lake water

Question 42

How is the renal tubule excretion of ammonia involved in maintaining the acid-base balance?

A) An increase in blood pH accelerates tubule excretion of both hydrogen and ammonia. A decrease in blood pH produces the opposite effects, thus maintaining pH balance.
B) A decrease in blood pH accelerates tubule excretion of both hydrogen and ammonia. An increase in blood pH produces the opposite effects, thus maintaining pH balance.
C) Renal tubule excretion of ammonia causes the combining of hydrogen to form ammonium ions that decrease the blood bicarbonate buffer pair ratio.
D) Ammonia excreted by renal tubules has no effect on acid-base balance.

Question 43

Respiratory acidosis is also:

A) carbonic acid excess.
B) carbonic acid deficit.
C) bicarbonate excess.
D) bicarbonate deficit.

Question 44

The functioning of the Na-K pump transport mechanism falls by 50% if the pH:

A) falls by 1 unit.
B) falls by 2 units.
C) falls by 3 units.
D) rises by 1 unit.

Question 45

If NaOH were buffered by H-HCO₃, what would not occur?

A) Concentration of NaHCO3 would increase.
B) Water would be formed.
C) The number of hydroxide ions would greatly increase.
D) All of the above would occur.

Question 46

Which of the following is not a weak acid?

A) Hemoglobin
B) Oxyhemoglobin
C) Proteins
D) Na2HPO4

Question 47

An abnormal change in pH in the body could disrupt the functioning of:

A) enzymes.
B) cell membrane receptors.
C) hemoglobin.
D) all of the above.

Question 48

If HCl were buffered by NaHCO₃, the formation of _____ would not occur.

A) NaCl
B) water
C) H-HCO3
D) All of the above would occur.

Question 49

In the body, which of the following substances might be used to buffer a strong base such as NaOH?

A) H₂CO₃
B) KHCO3
C) Proteins
D) None of the above

Question 50

Toxic accumulation of acidic ketone bodies is a common complication of untreated:

A) kidney disease.
B) diabetes mellitus.
C) respiratory distress syndrome.
D) deficiency of carbonic anhydrase in the blood.

Question 51

Sulfuric acid results from the metabolism of:

A) glucose.
B) amino acids.
C) fats.
D) ribonucleotides.

Question 52

The most rapidly acting buffer system in the body is the _____ buffering system.

A) chemical
B) respiratory
C) kidney
D) Both physiological buffering systems act with equal speed and are faster than the chemical.

Question 53

Which of the following statements is true?

A) Hypoventilation can cause alkalosis.
B) Hyperventilation can cause acidosis.
C) Hyperventilation can cause a drop in pH.
D) Hypoventilation can cause a drop in pH.

Question 54

If NaOH were buffered by H-HCO₃, what would occur?

A) There would be a slight drop in pH.
B) There would be a large drop in pH.
C) There would be a slight rise in pH.
D) There would be a large rise in pH.

Question 55

The respiratory center is stimulated if the:

A) amount of carbon dioxide in arterial blood increases.
B) amount of carbon dioxide in venous blood increases.
C) pH of the blood goes above 7.41.
D) Any of the above will stimulate the respiratory center.

Question 56

If HCl were buffered by NaHCO₃, what would occur?

A) There would be a slight rise in pH.
B) There would be a large drop in pH.
C) There would be a slight drop in pH.
D) There would be a large rise in pH.

Question 57

The biological activity of phosphofructokinase (an important enzyme in anaerobic respiration) falls by 90% if the pH:

A) falls by 1 unit.
B) falls by 0.5 units.
C) falls by 0.1 units.
D) rises by 1 unit.

Question 58

Phosphoric acid accumulates when what is broken down in the body?

A) Fats
B) Amino acids
C) Ribonucleotides
D) Carbohydrates

Question 59

In the body, which of the following substances might be used to buffer a strong acid such as HCl?

A) H₂CO₃
B) Hemoglobin
C) NaHCO3
D) None of the above

Question 60

The numerical value of pH represents the:

A) hydrogen ion concentration squared.
B) negative logarithm of the hydrogen ion concentration.
C) logarithm of the hydrogen ion concentration.
D) square root of the hydrogen ion concentration.

Question 61

A decrease in blood pH:

A) accelerates the renal tubule ion exchange mechanisms.
B) causes a decrease in the renal tubule excretion of ammonia.
C) has no effect on the renal tubule excretion of ammonia (because of respiratory compensations).
D) produces an increase in the pH of the urine through the chloride shift.

Question 62

How does the body respond if respiratory mechanisms are unable to stop a pH shift?

A) A renal physiological buffer system involving the excretion of either an acid or alkaline urine will be initiated within 24 hours.
B) Bicarbonate buffers immediately combine with any added acid or alkali that enters the body fluids, thus preventing drastic changes in pH.
C) Phosphate buffers immediately combine with any added acid or alkali that enters the body fluids, thus preventing drastic changes in pH.
D) Protein buffers immediately combine with any added acid or alkali that enters the body fluids, thus preventing drastic changes in pH.

Question 63

Which of the following would be important in treating metabolic alkalosis?

A) Increasing bicarbonate ions
B) Increasing chloride ions
C) Decreasing potassium ions
D) Decreasing sodium ions

Question 64

Which of the following type(s) of acids would be produced as a result of glucose catabolism?

A) Acetoacetic and lactic
B) Lactic
C) Phosphoric and sulfuric
D) Sulfuric

Question 65

A man was advised to acidify his urine to help reduce the development of kidney stones. To accomplish that, he has been drinking a large glass of grapefruit juice every day. Which of the following explains why this is ineffective and gives a food choice that will make his urine acidic?

A) Grapefruit juice is not acid forming when metabolized; cranberry juice is acid forming and will acidify his blood, resulting in a decreased urine pH.
B) Grapefruit juice is not acid forming when metabolized; orange juice is acid forming and will acidify his blood, resulting in a decreased urine pH.
C) Grapefruit juice will acidify both blood and urine, thereby balancing the urine pH; beet juice will change the pH in the urine.
D) Grapefruit juice is not acid forming when metabolized; a calcium carbonate tablet will acidify his blood resulting in a decreased urine pH.

Question 66

Kidney tubule base bicarbonate reabsorption and hydrogen ion excretion both tend to:

A) acidify blood by creating alkaline urine.
B) alkalinize blood by acidifying urine.
C) increase blood pH, which accelerates tubule excretion of both hydrogen and ammonia.
D) decrease blood pH, which reduces tubule excretion of both hydrogen and ammonia.

Question 67

The kidney gets rid of excess hydrogen ions by the process of filtration.

Question 68

Which statement best outlines the reason hyperventilation can result in loss of consciousness?

A) Hyperventilation eliminates too little CO₂, causes an increase in blood H₂CO₃ and consequently in blood H+, and thereby may produce acidosis.
B) Increases in oxygen ion concentration above a certain level depress the central nervous system and, therefore, produce such symptoms as disorientation and coma.
C) Decreases in hydrogen ion concentration above a certain level depress the central nervous system and, therefore, produce such symptoms as disorientation and coma.
D) Increases in hydrogen ion concentration above a certain level depress the central nervous system and, therefore, produce such symptoms as disorientation and coma.

Question 69

If the blood pH decreases below normal, the kidney tubules secrete:

A) fewer hydrogen ions from blood to urine.
B) more hydrogen ions from blood to urine.
C) more sodium ions into the urine.
D) Both A and C are correct.

Question 70

Stomach acid is the most alkaline substance in the body.

Question 71

The respiratory center becomes stimulated if the:

A) amount of carbon dioxide in arterial blood increases, so more CO₂ is exhaled, thus lowering the blood pH.
B) amount of carbon dioxide in venous blood increases to retain more CO₂, thus lowering the blood pH.
C) pH of the blood goes above 7.41.
D) All of the above occur if the respiratory center becomes stimulated.

Question 72

CO₂ entering venous blood gives it a slightly lower pH than arterial blood.

Question 73

A blood pH of 7.1 indicates the body is more acidic than normal.

Question 74

A pregnant patient who has been experiencing repeated vomiting episodes is admitted to the hospital by her obstetrician. After a series of tests determines that she is suffering from metabolic alkalosis, the physician orders intravenous administration of normal saline. How will this help the patient?

A) It will reduce the vomiting episodes.
B) The chloride ions of the solution will replace the acidic ions and relieve the acidic excess responsible for her condition.
C) The chloride ions of the solution will replace bicarbonate ions and relieve the bicarbonate excess responsible for her condition.
D) The sodium ions of the solution will introduce more bicarbonate ions and relieve the bicarbonate shortage responsible for her condition.

Question 75

A rare but very serious complication of metformin therapy is:

A) hyperkalemia.
B) lactic acidosis.
C) uncompensated acidosis.
D) uncompensated alkalosis.

Question 76

A minor bladder infection is often the result of urine not being acidic enough. Which of the following actions could correct this problem?

A) Drinking orange juice
B) Eating large amounts of high-protein foods such as meat, fish, poultry, and eggs, which are acid forming
C) Eating fruits and vegetables
D) Eating foods rich in acids, such as cranberries and rhubarb

Question 77

Some athletes engage in a technique called bicarbonate loading that is said to counteract the lactic acid buildup. This practice raises concerns because excess bicarbonate intake:

A) can trigger fluid and electrolyte imbalances, which may lead to metabolic acidosis.
B) can trigger fluid and electrolyte imbalances, which may lead to metabolic alkalosis.
C) may lead to uncompensated acidosis.
D) may lead to "acid blood."

Question 78

Susan has been experiencing prolonged hypoventilation. If not treated soon, Susan may develop what condition?

A) Prolonged hypoventilation may decrease blood pH enough to produce acidosis.
B) Prolonged hypoventilation may increase blood pH enough to produce alkalosis.
C) Prolonged hypoventilation may reduce the renal tubule ion exchange mechanisms.
D) Prolonged hypoventilation may lead to hyperkalemia.

Question 79

Why are metabolic and respiratory acidosis treated by the intravenous infusion of solutions containing sodium lactate?

A) The infused lactate ions are metabolized by the liver cells and converted to sodium ions, which help replace the depleted sodium reserves required to restore acid-base balance.
B) The infused lactate ions are metabolized by the liver cells and converted to potassium ions, which help restore the depleted potassium reserves required to restore acid-base balance.
C) The infused lactate ions are metabolized by the liver cells and converted to carbonic acid, which helps restore the depleted bicarbonate reserves required to restore acid-base balance.
D) The infused lactate ions are metabolized by the liver cells and converted to bicarbonate ions, which help restore the depleted bicarbonate reserves required to restore acid-base balance.

Question 80

Why does arterial blood have a lower hydrogen ion concentration than venous blood?

A) More carbon dioxide remains in the arterial blood leaving the lung capillaries, causing an increase in the amount of carbonic acid and the number of hydrogen ions.
B) Because there are more red blood cells in arteries than veins, the arterial blood has a greater ability to carry fewer hydrogen ions.
C) Less carbon dioxide remains in the arterial blood leaving the lung capillaries, causing a reduction in the amount of carbonic acid and the number of hydrogen ions.
D) The carbon dioxide diffuses out of the venous blood as it moves through the lung capillaries. Therefore, more carbon dioxide remains in the arterial blood leaving the lung capillaries, causing a decrease in the number of hydrogen ions.