A&P II Exam 4 Chapter 26: Fluid, Electrolyte, and Acid-Base Balance
Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________. A) nerve damage B) tissue edema C) confusion D) extreme weight loss
B) tissue edema
Which of the following does NOT impact how much sodium is reabsorbed? A) aldosterone B) transport maximum of the renal proximal tubule C) estrogen D) atrial natriuretic peptide
B) transport maximum of the renal proximal tubule
Under normal circumstances, most water is lost in __________. A) feces B) urine C) sweat D) insensible losses via skin and lungs
B) urine
In a given day, what is the typical value for water intake? A) 250 mL B) 1500 ml C) 2500 ml D) 750 ml
C) 2500 ml
PTH (parathyroid hormone) acts on the __________ to __________ Ca2+ reabsorption. A) liver; decrease B) bones; decrease C) DCT; increase D) large intestine; increase
C) DCT; increase
This chemical equation shows the reaction of a strong acid and weak base in the bicarbonate buffer system. Provide the products of the following reaction. HCl + NaHCO3 --> A) NaOH + NaH2PO4 B) NaHCO3 + H2O C) H2CO3 + NaCl D) NaH2PO4 + NaCl
C) H2CO3 + NaCl
What is the most abundant intracellular anion? A) Na+ B) Cl- C) HPO4 2- D) K+
C) HPO4 2-
What is the most abundant intracellular cation? A) Na+ B) Cl- C) K+ D) HPO42-
C) K+
Which chemical buffer system is the only important system in the extracellular fluid (ECF) that resists short-term changes in pH? A) phosphate buffer system B) protein buffer system C) bicarbonate buffer system D) physiological buffering systems
C) bicarbonate buffer system
What results from increased levels of aldosterone? A) decreased Na+ reabsorption B) increased K+ reabsorption C) increased Na+ reabsorption D) increased Ca2+ reabsorption
C) increased Na+ reabsorption
The fluid that bathes the cells found in tissues is called __________. A) plasma B) intracellular fluid C) interstitial fluid D) electrolytic fluid
C) interstitial fluid
Which of the following is not a chemical buffer system? A) bicarbonate B) phosphate C) nucleic acid D) protein
C) nucleic acid
Which of the following is an electrolyte? A) glucose B) cholesterol C) potassium D) phospholipid
C) potassium
What is the most important trigger for aldosterone release? A) increased osmolality of the extracellular fluids (ECF) B) decreased K+ concentration in the extracellular fluids (ECF) C) renin-angiotensin-aldosterone mechanism D) decreased sodium ion concentration in the extracellular fluids (ECF)
C) renin-angiotensin-aldosterone mechanism
What is the effect of hyperventilation on pH? A) metabolic acidosis B) metabolic alkalosis C) respiratory alkalosis D) respiratory acidosis
C) respiratory alkalosis
Hypersecretion of aldosterone results in hypokalemia, which causes hyperpolarization of neurons; this in turn results in ______. A) increased speed of sodium-potassium pump activity in order to compensate for the reduced concentration of potassium ions B) decreased plasma membrane permeability to potassium ions C) the need for a stronger than normal stimulus in order to trigger an action potential D) a craving for more salt in the diet
C) the need for a stronger than normal stimulus in order to trigger an action potential To trigger an action potential cells must reach threshold (critical electrical value required to open voltage-gated ion channels). If the membrane potential is hyperpolarized and falls below normal resting membrane potential, then more cations must enter the cytoplasm for the cell to reach threshold.
In order to buffer a strong acid into a weak acid, which has a less dramatic effect on pH, what chemical should be used as the buffer? A) salt B) weak acid C) weak base D) water
C) weak base
Which of the following creates the greatest osmotic pressure? A) NaCl B) MgCl2 C) glucose D) H3PO4
D) H3PO4
What is the most common cation found in the interstitial fluid? A) K+ B) HPO42- C) Cl- D) Na+
D) Na+
The regulation of sodium ________. A) involves hypothalamic osmoreceptor detection of ion concentration B) involves aldosterone, a hormone that increases sodium excretion in the kidneys C) is due to specific sodium receptors in the hypothalamus D) is linked to blood pressure
D) is linked to blood pressure
What receptors does the brain use to detect changes in osmolality? A) chemoreceptors B) thermoreceptors C) baroreceptors D) osmoreceptors
D) osmoreceptors
The fluid link between the external and internal environment is ________. A) intracellular fluid B) cerebrospinal fluid C) interstitial fluid D) plasma
D) plasma
The single most important factor influencing potassium ion secretion is ________. A) intracellular sodium levels B) the potassium ion content in the renal tubule cells C) the pH of the ICF D) potassium ion concentration in blood plasma
D) potassium ion concentration in blood plasma
What is the driving force for water intake? A) ADH B) aldosterone C) glucose concentration D) thirst
D) thirst
What type of water imbalance increases the amount of fluid in all compartments? A) hypotonic hydration B) edema C) dehydration D) inflammation
A) hypotonic hydration
The role of ADH is to __________. A) increase water reabsorption B) produce dilute urine C) decrease water reabsorption D) lower blood pressure
A) increase water reabsorption
Which of the following is not a trigger for juxtaglomerular granular cells to release renin? A) increased extracellular fluid water levels B) decreased filtrate NaCl concentration C) sympathetic stimulation D) decreased stretch due to decreased blood pressure
A) increased extracellular fluid water levels
Where is the majority of water stored in the human body? A) intracellular fluid (ICF) compartment B) interstitial fluid (IF) C) extracellular fluid (ECF) compartment D) plasma
A) intracellular fluid (ICF) compartment
Which organs are the ultimate acid-base regulatory organs? A) kidneys B) lungs C) cardiovascular organs D) GI tract organs
A) kidneys
The most important renal mechanism for regulating acid-base balance of the blood involves __________. A) maintaining HCO3- balance. B) maintaining phosphate balance C) maintaining water balance D) maintaining CO2 balance
A) maintaining HCO3- balance.
A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? A) metabolic alkalosis B) metabolic acidosis C) respiratory alkalosis D) respiratory acidosis
A) metabolic alkalosis
Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. A) reduce blood pressure and blood volume by inhibiting sodium and water retention B) prevent pH changes caused by organic acids C) enhance atrial contractions D) activate the renin-angiotensin mechanism
A) reduce blood pressure and blood volume by inhibiting sodium and water retention
A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. A) respiratory acidosis B) metabolic acidosis C) respiratory alkalosis D) metabolic alkalosis
A) respiratory acidosis
Newborn infants have a relatively higher ________ content in their ECF than do adults. A) sodium B) magnesium C) bicarbonate D) iron
A) sodium
The body's water volume is closely tied to the level of which of the following ions? A) sodium ions B) hydrogen ions C) potassium ions D) calcium ions
A) sodium ions
The maintenance of the proper pH of the body fluids may be the result of ________. A) the control of respiratory ventilation B) the active secretion of OH- into the filtrate by the kidney tubule cells C) the operation of the various buffer systems in the stomach D) control of the acids produced in the stomach
A) the control of respiratory ventilation
Which of the following is NOT a hormone involved in water and electrolyte balance? A) thyroxine B) ADH C) aldosterone D) atrial natriuretic peptide
A) thyroxine
What accounts for the route through which most fluid is lost in a day? A) urine B) insensible loss through skin and lungs C) feces D) sweat
A) urine
How much water is generated per day from cellular metabolism? A) 750 ml B) 250 ml C) 1500 ml D) 2500 ml
B) 250 ml
Which hormone raises blood calcium levels? A) aldosterone B) PTH C) ADH D) calcitonin
B) PTH
Respiratory acidosis can occur when ________. A) a runner has completed a very long marathon B) a person's breathing is shallow due to obstruction C) the kidneys secrete hydrogen ions D) a person consumes excessive amounts of antacids
B) a person's breathing is shallow due to obstruction
The term alkaline reserve is used to describe the ________ buffer system. A) protein B) bicarbonate C) phosphate D) hemoglobin
B) bicarbonate
The primary buffer of the extracellular fluid (ECF) is the __________. A) protein buffer system B) bicarbonate buffer system C) phosphate buffer system D) sodium-potassium buffer system
B) bicarbonate buffer system
Which of the following is not a method for regulating the hydrogen ion concentration in blood? A) chemical buffer systems B) diet C) renal mechanism D) respiratory changes
B) diet
Which of the following is not a disorder of water balance? A) hypotonic hydration, in which sodium content is normal but water content is high B) excessive hydration due to excess ANP secretion C) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure D) excess water in interstitial spaces due to a low level of plasma proteins
B) excessive hydration due to excess ANP secretion
Which of the following abnormalities would not be observed in a patient who has Addison's disease? A) elevated plasma potassium level B) hypertension C) hyponatremia D) decreased plasma chloride level
B) hypertension Hypertension (abnormally high blood pressure) is typically caused by restricting blood flow by vasoconstriction or abnormally high fluid volume in the blood. Water balance is regulated by anti-diuretic hormone secreted from the posterior pituitary.
Which of the following is NOT involved in triggering the thirst mechanism? A) decrease in blood volume B) increase in blood pressure C) dry mouth D) osmoreceptors detect increased osmolality
B) increase in blood pressure
Which of the following is NOT a risk factor for dehydration? A) a high rate of insensible water loss B) increased muscle mass C) vomiting D) inefficient kidneys
B) increased muscle mass
Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________. A) low daily rate of fluid exchange B) inefficient kidneys C) comparatively low metabolic rates D) low rate of insensible water loss
B) inefficient kidneys
The regulation of potassium balance ________. A) includes renal secretion, but never absorption B) involves aldosterone-induced secretion of potassium C) is not linked to sodium balance D) is accomplished mainly by hepatic mechanisms
B) involves aldosterone-induced secretion of potassium
The body's water volume is closely tied to a powerful water "magnet." What magnet is referred to here? A) water level in the intracellular compartment B) ionic sodium C) ionic potassium D) water level in the extracellular compartment
B) ionic sodium
The movement of fluids between cellular compartments ________. A) requires ATP for the transport to take place B) is regulated by osmotic and hydrostatic forces C) involves filtration D) requires active transport
B) is regulated by osmotic and hydrostatic forces
Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely? A) respiratory acidosis B) metabolic acidosis C) respiratory alkalosis D) metabolic alkalosis
B) metabolic acidosis
Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. A) chloride B) potassium C) iron D) bicarbonate
B) potassium
Which buffer system is the most abundant in the body? A) hydrogen B) protein C) phosphate D) carbonic acid-bicarbonate
B) protein
The most common cause of acid-base imbalance is __________. A) metabolic acidosis B) respiratory acidosis C) respiratory alkalosis D) metabolic alkalosis
B) respiratory acidosis
What is the most common cause of acid-base imbalance? A) metabolic acidosis B) respiratory acidosis C) metabolic alkalosis D) respiratory alkalosis
B) respiratory acidosis
Which of the following conditions promotes edema? A) hypoproteinemia B) diabetes mellitus C) hemorrhage D) hyponatremia
A) hypoproteinemia
Which of the following statements is true regarding fluid shifts? A) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts. B) Nonelectrolytes are the controlling factor in directing fluid shifts. C) Electrolytes are not as important as proteins in regulating fluid shifts in the body. D) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.
A) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.
Which of the following describes the distribution of sodium and potassium between cells and body fluids? A) K+ mainly in the cells, Na+ in the body fluids B) equal amounts of each ion in the cells and body fluids C) Na+ mainly in the cells, K+ in the body fluids D) little of either in the cells, but large amounts of each in the body fluids
A) K+ mainly in the cells, Na+ in the body fluids
After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. What is the diagnosis, and what has caused this problem? A) Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood. B) Respiratory acidosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood. C) Respiratory acidosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing slower and shallower to raise the oxygen levels in her blood. D) Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing slower and shallower to raise the oxygen levels in her blood.
A) Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood.
Select the person in the following list who would have the highest percentage of water in his or her body. A) a 6-month-old baby boy B) a 25-year-old overweight female C) a 80-year-old man of average weight D) a 25-year-old male of average weight
A) a 6-month-old baby boy
Total body water is not a function of which of the following? A) amount of water ingested B) body mass C) age D) amount of body fat
A) amount of water ingested
Which of the following hormones is important in stimulating water conservation in the kidneys? A) antidiuretic hormone B) progesterone C) aldosterone D) atrial natriuretic peptide
A) antidiuretic hormone
What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? A) atrial natriuretic peptide B) ADH C) aldosterone D) thyroxine
A) atrial natriuretic peptide
The most important force causing net water flow across capillary walls is ________. A) hydrostatic pressure of capillary blood B) intracellular hydrostatic pressure C) osmotic pressure of plasma proteins D) hydrostatic pressure of interstitial fluid
A) hydrostatic pressure of capillary blood
What is the hallmark of hypotonic hydration? A) hyponatremia B) hypoproteinemia C) hypernatremia D) hypercalcemia
A) hyponatremia
Which of the following would NOT be expected to lead to edema? A) hyponatremia B) incompetent venous valves C) hypoproteinemia D) inflammation
A) hyponatremia
Which of the following is the only logical explanation for why hypocalcemia increases neuromuscular excitability and causes muscle tetany? A) Low plasma calcium ion concentration decreases the release of calcium ions from the sarcoplasmic reticulum. B) Low plasma calcium ion concentration decreases the rate of exocytosis of synaptic vesicles. C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated. D) Low plasma calcium ion concentration increases the likelihood of acetic acid and choline being formed in the synaptic cleft when a neuron is stimulated to the threshold level.
C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated. Sodium and calcium are cations, and so loss of positive charge in the extracellular fluid would increase membrane permeability to all cations, including sodium. Recall that the efflux (outward movement) of sodium causes depolarization.
A patient's anxiety caused her to develop respiratory alkalosis. What breathing technique did the nurse recommend, and why? A) The nurse instructed the patient to breathe faster and deeper. This will increase the patient's blood levels of carbon dioxide by eliminating less carbon dioxide from the lungs, resulting in a decrease in the blood pH. B) The nurse instructed the patient to breathe more shallowly. This will decrease the patient's blood levels of carbon dioxide by eliminating more carbon dioxide from the lungs, resulting in a decrease in the blood pH. C) The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease. D) The nurse instructed the patient to breathe faster and deeper. This will decrease the patient's blood levels of carbon dioxide by eliminating more carbon dioxide from the lungs, resulting in a decrease in the blood pH.
C) The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease.
One of the major physiological factors that triggers thirst is ________. A) becoming overly agitated B) a dry mouth from high temperatures C) a rise in plasma osmolality D) drinking caffeinated beverages
C) a rise in plasma osmolality
Which of the following does NOT serve as a source of acids in the body? A) CO2 in the blood B) fat metabolism C) aerobic breakdown of glucose D) ingested foods
C) aerobic breakdown of glucose
Which of the choices below exerts primary control over sodium levels in the body? A) glucocorticoids B) water levels C) aldosterone D) ADH
C) aldosterone
Which of the following regulates the secretion of K+ into the filtrate? A) atrial natriuretic peptide (ANP) B) parathyroid hormone (PTH) C) aldosterone D) antidiuretic hormone
C) aldosterone
A decrease in blood CO2 levels leads to __________. A) a drop in blood pH B) an increase in carbonic acid C) an increase in blood pH D) an increased respiratory rate
C) an increase in blood pH
What hormone helps to maintain extracellular fluid (ECF) osmolality when concentrations become too high? A) parathyroid hormone (PTH) B) angiotensin II C) antidiuretic hormone (ADH) D) aldosterone
C) antidiuretic hormone (ADH)
A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. Which side of the heart failed, and how did this cause edema? A) The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the pulmonary circulation, leading to edema. B) The left side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the systemic circulation caused pooling of blood in the pulmonary circulation, leading to edema. C) The left side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the systemic circulation caused pooling of blood in the systemic circulation, leading to edema. D) The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.
D) The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.
Annie has just eaten a large order of heavily salted french fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology? A) There will be a shift in the pH of her body fluids to the higher side of the pH scale. B) She will experience hypotension. C) It will cause a prolonged increase in the osmolality of the blood. D) There will be a temporary increase in blood volume.
D) There will be a temporary increase in blood volume.
The term hypotonic hydration refers to ________. A) the feeling one might have after profuse sweating with exertion B) the unpleasant feeling people have after drinking too much liquor C) a condition that is caused by high levels of sodium in the extracellular fluid compartment D) a condition that may result from renal insufficiency or drinking extraordinary amounts of water
D) a condition that may result from renal insufficiency or drinking extraordinary amounts of water
Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? A) renin B) erythropoietin C) antidiuretic hormone D) aldosterone
D) aldosterone
Which of the following does not depend on the presence of electrolytes? A) membrane polarity B) neuromuscular excitability C) maintenance of osmotic relations between cells and ECF D) amount of body fat
D) amount of body fat
Which of the choices below is not an essential role of salts in the body? A) secretory activity B) membrane permeability C) neuromuscular activity D) anabolism of lipids
D) anabolism of lipids
A patient is discovered to have a strange craving for iron objects. To try to determine the cause, her physician decides to order tests to determine if this patient might have some type of ______. A) hypothyroidism B) diabetes C) acidosis D) anemia
D) anemia Anemia is a condition where red blood cells have an abnormally low oxygen carrying capacity. This capacity depends on the iron content within the hemoglobin molecule.
What solute in body fluids determines most of their chemical and physical reactions? A) glucose B) nonelectrolytes C) water D) electrolytes
D) electrolytes
Which age group most commonly has fluid, electrolyte, and acid-base balance issues? A) growing children B) young adults C) the elderly D) infants
D) infants
A 13-year-old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64 inches. She admits to frequent self-induced vomiting and abuse of laxatives. She was treated on the medical unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as evidenced by mild puffiness and bloating. Why did she get these symptoms? A) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed kidney failure, and the kidneys are no longer absorbing fluid correctly. B) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed kidney failure, and the kidneys are no longer absorbing electrolytes correctly. C) The abuse of laxatives and self-induced vomiting caused her to be chronically electrolyte depleted. She developed a compensatory increased production of aldosterone. D) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid depleted. She developed a compensatory increased production of ADH. E) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH.
E) The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH.
A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3- is 20 mEq/L. A medical history reveals that this patient is a chronic alcoholic. What diagnosis would you give, and what prognosis? A) The pH and bicarbonate levels and the history of alcoholism indicate metabolic alkalosis. The patient will require dialysis to remove the bicarbonate ions. B) The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will require dialysis to remove the bicarbonate ions. C) The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will go into a coma and death soon follows. D) The pH and bicarbonate levels and the history of alcoholism indicate respiratory alkalosis. The patient will require dialysis to remove the bicarbonate ions. E) The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.
E) The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.
