Chapter 43: Fluid and Electrolyte Balance

4. In young adults, the percentage of body weight composed of water will average about _____ for males and _____ for females.

60%; 50%

58. In parenteral therapy, it is equally important that both intravenous and subcutaneous solutions be isotonic to plasma.

ANS: F

59. A normal saline solution consists of a 9% solution of NaCl.

ANS: F

6. Intracellular fluids constitute about 50% of body weight.

ANS: F

61. Acidosis can be treated rapidly by the intravenous administration of ammonium chloride.

ANS: F

62. Intracellular fluid is the only fluid that usually contains protein.

ANS: F

65. The total concentration of anions in blood plasma is slightly higher than the total concentration of cations.

ANS: F

66. Milligram percent is the most common unit used to measure electrolyte concentration.

ANS: F

74. A body weight loss of 7% due to dehydration is the most that can be tolerated and still sustain life.

ANS: F

76. Edema can be defined as the presence of an abnormally large amount of intracellular fluid.

ANS: F

77. Fluid tends to be pushed out of the blood vessels at the venous end and reabsorbed at the arterial end.

ANS: F

78. Hydrostatic pressure serves as the chief regulator of water transfer between intracellular and interstitial fluid.

ANS: F

8. The tonicity of a solution is not important when it is administered subcutaneously.

ANS: F

80. A decrease in solute concentration in the extracellular fluid will cause water to leave the cell in an attempt to compensate.

ANS: F

81. Aldosterone and ADH both regulate body fluid by causing absorption of sodium.

ANS: F

82. When chloride is secreted in the urine, it is often linked with sodium.

ANS: F

84. Potassium loss is rarely a problem because it is so well absorbed by the kidney.

ANS: F

85. In severe and prolonged water loss, the initial fluid shift will be from plasma to interstitial fluid.

ANS: F

86. Strenuous physical activity on a hot day can generate as much as 5 L of sweat a day.

ANS: F

87. Extracellular fluid and intracellular fluid can each be reduced to 30% before death from dehydration occurs.

ANS: F

88. Diuretics, used cautiously, can be used to treat hypovolemia.

ANS: F

9. Ingested liquids are the major source of water for the body, followed by water formed from a catabolism, with a smaller amount coming from water in foods.

ANS: F

91. The body tissue with the least amount of water is bone.

ANS: F

93. Calcium has an atomic weight of 40, and a valance of +2. A 5 mg% solution would have a milliequivalence of 1.25.

ANS: F

94. Both a decrease in potassium ions and a decrease in blood pressure will stimulate the release of aldosterone.

ANS: F

98. The most accurate measurement of the body's store of potassium is an arterial blood sample.

ANS: F

10. The principle of fluid balance states that fluid intake normally equals fluid output.

ANS: T

100. Because fat tissue contains the least amount of water of any tissue in the body, obese people tend to have a lower percentage of body water.

ANS: T

101. Extracellular fluid has two main functions—providing a relatively constant internal environment for the cells and transporting materials to and from them.

ANS: T

102. The lungs are a source of water loss for the body.

ANS: T

104. Respiration contributes to the obligatory water loss of the body.

ANS: T

105. Because the GFR is almost constant, the amount of hormone in the blood has the biggest impact on urine volume.

ANS: T

11. Both ADH and aldosterone cause fluid retention.

ANS: T

13. The thirst center is located in the hypothalamus and SFO of the brain.

ANS: T

15. Osmoreceptors are cells able to detect an increase in solute concentration in extracellular fluid caused by water loss.

ANS: T

16. The amounts of antidiuretic hormone and aldosterone secreted determine the amount of water reabsorbed in the tubules.

ANS: T

18. Positive ions of electrolytes are cations and are attracted to a cathode.

ANS: T

19. Urine volume is regulated mainly by hormones secreted by the posterior lobe of the pituitary gland and by the adrenal cortex.

ANS: T

2. Electrolytes are substances that dissociate in solution.

ANS: T

21. The body's major fluid compartments are called the extracellular and intracellular fluid compartments.

ANS: T

23. Thirst is associated with any condition that decreases total volume of body water, such as blood loss or hemorrhage.

ANS: T

24. The most crucial mechanisms for maintaining fluid balance adjust output to intake, as in the aldosterone mechanism and the renin-angiotensin mechanism.

ANS: T

29. Vomiting or diarrhea each may cause fluid and electrolyte output to exceed intake.

ANS: T

30. Chemical similarity predominates between the two extracellular fluids.

ANS: T

31. The only functionally important difference between blood plasma and interstitial fluid is the presence of more protein anions in plasma.

ANS: T

34. Blood hydrostatic pressure tends to force fluid out of capillaries and into interstitial fluid.

ANS: T

36. Milliequivalents serve as an accurate measure of the physiological combining power, or reactivity, of a particular electrolyte solution.

ANS: T

38. The most common cause of edema is generalized venous congestion as a result of heart failure.

ANS: T

4. Plasma, synovial fluid, and cerebrospinal fluid are all examples of extracellular fluid.

ANS: T

40. The plasma membrane separates the intracellular and extracellular fluid compartments.

ANS: T

41. An imbalance of electrolytes between the cells and intercellular areas will cause an imbalance of fluids.

ANS: T

43. A 70-kg (154-lb) adult has a total body sodium pool of approximately 2800 to 3000 mEq.

ANS: T

45. The release of aldosterone can cause an increase in the blood colloid osmotic pressure.

ANS: T

47. Cell breakdown may lead to a potassium deficiency in the body.

ANS: T

48. Hypochloremia is frequently linked to cases of potassium loss.

ANS: T

49. A person who is dehydrated will need replacement of water and electrolytes.

ANS: T

5. The volume of interstitial fluid is greater than the volume of plasma.

ANS: T

50. A continuous movement of sodium occurs between a number of internal secretions, such as saliva, gastric and intestinal secretions, bile, and pancreatic fluid.

ANS: T

52. If the volume of fluid and electrolyte levels inside and outside the cell remains relatively constant, a condition of homeostasis exists.

ANS: T

53. The total charge in a solution of dissolved electrolytes and a solution of dissolved non-electrolytes would both be zero.

ANS: T

55. The dissociated particles of an electrolyte are called ions.

ANS: T

60. Acidosis can be rapidly treated by the intravenous administration of lactate.

ANS: T

63. Whereas sodium is the predominant cation in blood plasma, potassium is the predominant cation in intracellular fluid.

ANS: T

64. Proteins in body fluids are considered anions.

ANS: T

67. Physiologically, the valence of an electrolyte is more important than the number of particles in a solution.

ANS: T

68. The amount of water removed by the kidney as urine is greater than all the other sources of water loss combined.

ANS: T

69. Angiotensin I and angiotensin II increase the secretion of aldosterone.

ANS: T

7. In recent years, Ringer solution has frequently been used instead of normal saline.

ANS: T

70. The skin is one of the areas of the body that contributes to obligatory water loss.

ANS: T

71. ANH assists in the regulation of urine volume.

ANS: T

72. Skin "tenting" is a sign of possible dehydration.

ANS: T

73. When a 6% body weight loss occurs because of dehydration, it causes an increase in pulse rate, body temperature, and respiration rate.

ANS: T

75. If the other three forces that determine fluid movement were unchanged, an increase in blood hydrostatic pressure would cause edema.

ANS: T

79. Colloid pressure is the chief regulator of water transfer between intracellular and interstitial fluid.

ANS: T

83. The total body potassium content may be 1000 times greater than the serum potassium level.

ANS: T

89. Too much potassium can be more dangerous than too little potassium.

ANS: T

90. Cells in the roof of the third ventricle of the brain affect the functioning of the thirst center.

ANS: T

92. Lymph, joint fluid, and the fluid in joint capsules is considered transcellular fluid.

ANS: T

95. Impulses from the subfornical organ stimulates the release of ADH.

ANS: T

96. Starling law of the capillaries explains the balance between fluid lost from the capillaries and fluid reabsorbed by the capillaries.

ANS: T

97. The nephron has the ability to produce almost sodium-free urine.

ANS: T

99. Normal values for total body water as a percentage of body weight will vary from 45% to 75%.

ANS: T

26. In accordance with the physical laws governing filtration and osmosis, which of the following statements is true?

Blood colloid osmotic pressure tends to draw fluid back into the capillaries.

63. In accordance with the physical laws governing filtration and osmosis, which of the following statements is true?

Blood colloid osmotic pressure tends to draw fluid back into the capillaries.

50. Which of the following two forces tend to move fluid into the blood vessel?

Blood colloid pressure and interstitial fluid colloid pressure

28. As related to the Starling law, which of the following is the greatest pressure at the arterial end of the capillaries?

Blood hydrostatic pressure

6. Force that acts to move fluid out of the blood and into the tissue space

Blood hydrostatic pressure

49. Which of the following two forces tend to move fluid out of the blood vessel?

Blood hydrostatic pressure and interstitial fluid colloid pressure

9. Which of the following is NOT a method used for Parenteral administration?

By mouth

30. As related to the Starling law, which of the following has the greatest effect on water reentering the capillaries?

Blood colloid osmotic pressure

33. Which large molecules are retained by the selectively permeable cell membrane?

Proteins

51. The mechanism of action for aldosterone and the mechanism of action for ADH differ because ADH regulates water whereas aldosterone regulates:

sodium.

12. The two factors that determine urine volume are:

the glomerular filtration rate and the rate of water reabsorption by the renal tubules.

66. A solution of sodium (Na+ , atomic weight = 23) and a solution of calcium (Ca2+, atomic weight = 40) have equal mg%. The mEq/L of calcium would be about _____ that of sodium.

twice

64. Osmoreceptors assist in controlling homeostasis of body fluids by:

working in the hypothalamus to trigger a conscious sense of dry mouth and thirst.

2. The total fluid or water content of the human body ranges from _____ of its total weight.

45% to 75%

27. Which of the following is the formula representing the Starling law of capillaries?

(BHP + IFCOP) - (IFHP + BCOP) = EFP

20. The composition of sodium in the blood plasma is equal to _____ mEq/L.

142

65. In patients with severe burn injuries, what mechanism is responsible for the increased risk of hypovolemic shock?

A loss of interstitial fluid causing a drain of blood plasma out of the vessels and into tissue spaces

57. Functionally, total body water can be subdivided into two fluid compartments—plasma and interstitial.

ANS: F

46. The chief means of regulating body sodium levels is through sweat loss.

ANS: F

8. Within the cell

Intracellular

51. Extracellular fluid depletion is the last line of defense against dehydration.

ANS: F

54. A change in electrolyte balance will have little effect on fluid balance.

ANS: F

56. Organic compounds are important sources of electrolytes.

ANS: F

1. Salt and glucose are examples of electrolytes found in the body

ANS: F

103. Angiotensin I is converted to angiotensin II by the liver.

ANS: F

12. The two major factors that determine urine volume are glomerular filtration rate and blood volume.

ANS: F

14. Osmoreceptors associated with thirst are located in the gastrointestinal tract.

ANS: F

17. Because of unknown mechanisms, the secretion of saliva generally increases when there is a decrease in the total volume of body water.

ANS: F

20. If a person takes nothing by mouth for several days, fluid output decreases to zero to compensate and maintain homeostasis.

ANS: F

22. Water is added to the body only through the digestive tract.

ANS: F

25. Mechanisms for controlling water movement between the fluid compartments of the body constitute the slowest-acting fluid balance devices.

ANS: F

26. A person who hyperventilates could lose excessive amounts of water and electrolytes.

ANS: F

27. When compared chemically, interstitial fluid and intercellular fluid are almost identical.

ANS: F

28. When compared chemically, intracellular fluid and plasma are almost identical.

ANS: F

3. In infants, total body water constitutes approximately 40% of body weight.

ANS: F

32. The reactivity or combining power of an electrolyte depends solely on the number of molecular particles present.

ANS: F

33. The milliequivalent is a measure of the weight of an electrolyte.

ANS: F

35. Interstitial fluid contains an appreciable amount of protein anions, whereas blood contains hardly any.

ANS: F

37. Burns, infections, and shock may lead to an increase in plasma proteins, which then causes fluid imbalance.

ANS: F

39. When the sum of the blood hydrostatic pressure and the interstitial fluid colloid osmotic pressure is greater than the sum of the interstitial fluid hydrostatic pressure and the blood colloid osmotic pressure, fluid shifts out of the interstitial fluid and into the blood.

ANS: F

42. A decrease in interstitial fluid sodium concentration will cause an immediate increase in interstitial fluid colloid osmotic pressure.

ANS: F

44. The release of ADH will cause an increase in the reabsorption of sodium and water by the kidney.

ANS: F

57. Which type of tissue has the least amount of water?

Adipose

34. Movement of water and solutes between ECF and ICF spaces is influenced by all of the following except:

All of the above influence movement.

9. An ion with a negative charge

Anion

52. Which of the following is not a cause of hypervolemia?

Ascites

10. An ion with a positive charge

Cation

19. Which of the following electrolytes is not a cation?

Chloride

25. What is the most abundant anion in the extracellular fluid?

Chloride

14. Condition when fluid output exceeds fluid intake and results in a decrease in total body water

Dehydration

15. An abnormally large amount of fluid in the intercellular tissue spaces of the body

Edema

2. Type of compound that dissociates into ions when dissolved in water

Electrolyte

4. Outside the cell

Extracellular

23. What is the most abundant cation in intracellular fluid?

Potassium

12. A serum potassium level substantially above normal

Hyperkalemia

13. An expansion of fluid volume in the body; a fluid volume excess

Hypervolemia

16. Serum potassium levels substantially below normal; a potassium deficit

Hypokalemia

18. A condition of decreased serum sodium concentration below the normal range

Hyponatremia

7. Substance that enters the body through injection and not through the alimentary canal

Parenteral

17. A fluid volume deficit that can lead to a state of dehydration

Hypovolemia

11. Surrounding the cell

Interstitial

1. Force that acts to move fluid out of the tissue space and back into the blood

Interstitial fluid hydrostatic pressure

55. Which of the following is not true of sodium chloride (NaCl)?

It has the same type of bonds as glucose.

61. Which of the following sites of fluid loss can be automatically adjusted according to fluid intake volume?

Kidney

Which of the following sites of fluid loss can be automatically adjusted according to fluid intake volume?

Kidney

36. Which body location is not one that is usually impacted by edema?

Kidneys

8. Which of the following is not one of the seven basic solutions used for parenteral therapy?

Liquid protein

40. Which of the following is not considered a "transcellular fluid"?

Lymph

58. Which of the following is not considered an extracellular fluid?

Lymph, Plasma, The aqueous fluid of the eye, All of the above are considered extracellular fluids.

29. Which of the following statements is(are) not true?

Men have less body water than women do.

5. Unit measuring the number of ionic charges or electrocovalent bonds in a solution; measure of reactivity of a particular electrolyte solution

Milliequivalent

6. Which of the following body fluid compartments has the same volume (percentage of body weight) in the infant, the adult male, and the adult female?

Plasma

21. Which of the following pairs are almost identical when compared chemically?

Plasma and interstitial fluid

56. Which of the following is not true of glucose?

None of the above are true of glucose.

3. Specialized cells in the hypothalamus that detect increased solute concentration in extracellular fluid caused by water loss

Osmoreceptors

1. Which of the following is true of total body water?

Overweight people have lower water content per kilogram of body weight than slender people.

14. Which of the following substances is released by the juxtaglomerular cells?

Renin

59. The subfornical organ is located in what part of the central nervous system?

Roof of the third ventricle of the brain

22. What is the most abundant cation in extracellular fluid?

Sodium

47. With an equal milligram percent in solution, calcium would have a(n) _____ milliequivalent than potassium.

There is not enough information to determine the milliequivalent.

44. If two electrodes charged with a weak current were placed in a solution of NaCl, the positive electrode would attract:

b. anions. c. chloride ions. d. Both B and C are correct.

24. The most important difference between blood plasma and interstitial fluid, when compared chemically, is:

blood contains appreciable amounts of protein anions.

60. Angiotensinogen is converted to angiotensin I in the:

blood.

46. The ion with the least total concentration in body fluids is:

calcium.

43. If two electrodes charged with a weak current were placed in a solution of NaCl, the negative electrode would attract:

cations.

45. If two electrodes charged with a weak current were placed in a solution of NaCl, the positive electrode would attract:

chloride ions.

35. Edema may occur when: sodium is retained in the extracellular fluid as a result of increased aldosterone secretion or after serious renal disease such as acute glomerulonephritis, an increase in capillary blood pressure occurs, a decrease in the concentration of plasma proteins normally retained in the blood occurs.

d. all of the above occur.

39. Aged individuals of either sex may have less total body water because of their:

decreased muscle mass.

10. Parenteral solutions are given to: meet current maintenance needs for nutrients, fluids, and electrolytes, replace past losses, replace concurrent losses (additional losses that are in excess of maintenance needs).

do all of the above.

13. Abnormal conditions that cause fluid and electrolyte output to exceed input include all the following except:

drinking liquids too fast.

5. Cerebrospinal fluid is part of the _____ fluid.

extracellular

62. Cerebrospinal fluid is part of the:

extracellular fluid because it consists mainly of plasma found in blood vessels and interstitial fluids.

11. Water normally leaves the body through _____ exits.

four

54. Potassium-rich foods can be used to treat:

hypokalemia.

53. An intravenous addition of sodium can be used to treat:

hyponatremia.

17. The thirst center, which contains specialized cells called osmoreceptors, is located in the:

hypothalamus.

15. When the adrenal cortex is stimulated to increase its secretion of aldosterone, the first thing that happens is a(n):

increase in the kidney tubule reabsorption of sodium.

37. When the posterior lobe of the pituitary is stimulated to increase its secretion of ADH, the first event to occur is a(n):

increase in the kidney tubule reabsorption of water.

32. Edema is defined as abnormally large amounts of fluid in the:

intercellular spaces.

3. When comparing the volume of the various body fluids, the correct order going from highest to lowest in total volume would be:

intracellular fluid, interstitial fluid, plasma.

16. Juxtaglomerular cells are located in the:

kidney.

38. The major organ that balances sodium and potassium in the body is the:

kidney.

48. Angiotensin I is converted to angiotensin II in the:

lung.

31. When the effective filtration pressure equals zero:

no net transfer of water occurs between blood and interstitial fluid.

41. The body fluid that stays constant as a percentage of body weight throughout life is:

plasma.

7. Ringer solution is often described as normal saline solution modified by the addition of:

potassium and calcium.

42. If two electrodes charged with a weak current were placed in a solution of NaCl, the negative electrode would attract the:

sodium ion.