PATH CH 25: Acid-Base Homeostasis and Imbalances

The major buffer in the extracellular fluid is a. hemoglobin. b. albumin. c. bicarbonate. d. phosphate.

c. bicarbonate.

Respiratory acidosis is associated with a. increased carbonic acid. b. hypokalemia. c. increased neuromuscular excitability. d. increased pH.

a. increased carbonic acid.

Uncompensated metabolic alkalosis would result in a. increased pH, increased HCO3-. b. increased pH, decreased HCO3-. c. decreased pH, increased HCO3-. d. decreased pH, decreased HCO3-.

a. increased pH, increased HCO3-.

Respiratory alkalosis is caused by a. hyperventilation. b. pneumonia. c. chest muscle weakness. d. pulmonary edema.

a. hyperventilation. Hyperventilation causes respiratory alkalosis due to loss of carbonic acid.

The body compensates for metabolic alkalosis by a. hypoventilation. b. decreasing arterial carbon dioxide.c. increasing bicarbonate ion excretion.d. hyperventilation.

a. hypoventilation. In metabolic alkalosis the lungs compensate by hypoventilation to conserve CO2 in the body.

The finding of ketones in the blood suggests that a person may have a. metabolic acidosis. b. metabolic alkalosis. c. respiratory acidosis. d. respiratory alkalosis.

a. metabolic acidosis. Ketones are produced from breakdown of fat in the body as a result of starvation or lack of ability to utilize glucose in diabetes mellitus. Ketoacids in the blood indicate a very high ketone level in the body, which leads to metabolic acidosis.

Fully compensated respiratory acidosis is demonstrated by a. pH 7.36, PaCO255, HCO3- 36. b. pH 7.45, PaCO240, HCO3- 28. c. pH 7.26, PaCO260, HCO3- 26. d. pH 7.40, PaCO240, HCO3- 24.

a. pH 7.36, PaCO255, HCO3- 36.

Which acid are the kidneys unable to excrete? a. Metabolic b. Carbonic c. Bicarbonate d. Ammonia

b. Carbonic

Early manifestations of a developing metabolic acidosis include a. coma. b. headache. c. muscle cramps. d. short and shallow respirations.

b. headache.

A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician? a. pH in high part of normal range, PaO2 normal, PaCO2 normal, bicarbonate normal b. pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high c. pH in low part of normal range, PaO2 normal, PaCO2 low, bicarbonate low d. pH in low part of normal range, PaO2 normal, PaCO2 normal, bicarbonate normal

b. pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high

A person with acute hypoxemia may hyperventilate and develop a. respiratory acidosis. b. respiratory alkalosis. c. metabolic alkalosis. d. metabolic acidosis.

b. respiratory alkalosis. Hyperventilation causes much carbonic acid to be blown off, resulting in respiratory alkalosis.

A 3 year old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment? a. Slow, shallow breathing, belligerence, hyperexcitability b. Slow, shallow breathing, numbness and tingling around his mouth c. Rapid, deep breathing, lethargy, abdominal pain d. Rapid, deep breathing, tremors, elevated blood pressure

c. Rapid, deep breathing, lethargy, abdominal pain

The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who a. is in the diuretic phase of acute renal failure. b. has had hypokalemia for over a week. c. has had diarrhea for over a week. d. has newly diagnosed Cushing syndrome.

c. has had diarrhea for over a week. Diarrhea causes increased excretion of the base bicarbonate, which can lead to metabolic acidosis

If an individual has a fully compensated metabolic acidosis, the blood pH is a. high. b. low. c. in the normal range. d. either high or low, depending on the type of compensation.

c. in the normal range.

Diarrhea causes a. respiratory acidosis. b. respiratory alkalosis. c. metabolic acidosis. d. metabolic alkalosis.

c. metabolic acidosis. Diarrhea causes metabolic acidosis as the intestinal fluids are rich in bicarbonate ions.

Renal compensation for respiratory acidosis is evidenced by a. decreased carbon dioxide. b. elevated carbon dioxide. c. decreased bicarbonate ion concentration. d. elevated bicarbonate ion concentration.

d. elevated bicarbonate ion concentration.

Metabolic alkalosis is often accompanied by a. hypernatremia. b. hyponatremia. c. hyperkalemia. d. hypokalemia.

d. hypokalemia

Emesis causes a. respiratory acidosis. b. respiratory alkalosis. c. metabolic acidosis. d. metabolic alkalosis.

d. metabolic alkalosis. Emesis causes metabolic alkalosis as the stomach is a major reservoir for acids.

Two primary acid-base disorders that are present independently are referred to as a. metabolic acidosis. b. metabolic alkalosis. c. respiratory alkalosis. d. mixed acid-base imbalance.

d. mixed acid-base imbalance.

The ________ system compensates for metabolic acidosis and alkalosis. a. gastrointestinal b. renal c. cardiovascular d. respiratory

d. respiratory When metabolic acids are out of balance, the respiratory system compensates for the altered pH by adjusting the amount of carbon dioxide in the blood.

Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of a. carbonic acid deficit. b. metabolic acid deficit. c. metabolic acidosis. d. carbonic acid excess.

b. metabolic acid deficit.

Diarrhea and other lower intestinal fluid losses will contribute to a. metabolic alkalosis. b. metabolic acidosis. c. respiratory acidosis. d. mixed acid-base disorders.

b. metabolic acidosis.

A person who experiences a panic attack and develops hyperventilation symptoms may experience a. neuromuscular depression. b. anxiety acidosis. c. numbness and tingling in the extremities. d. acute compensatory metabolic acidosis.

c. numbness and tingling in the extremities. Numbness and tingling in the extremities occurs in alkalosis due to increased neuromuscular irritability

The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L demonstrates a. metabolic acidosis. b. respiratory acidosis. c. respiratory alkalosis. d. mixed alkalosis.

c. respiratory alkalosis.

Causes of metabolic acidosis include a. hyperventilation. b. massive blood transfusion. c. tissue anoxia. d. hypoventilation.

c. tissue anoxia. Tissue anoxia can cause metabolic acidosis due to lactic acid production during anaerobic metabolism.

Respiratory acidosis may be caused by a. hyperventilation. b. massive blood transfusion. c. tissue hypoxia. d. hypoventilation.

d. hypoventilation.