(27) Fluids, Electrolytes, and Acid Base Balance

28) Water accounts for approximately ________ percent of the body weight in an adult male. A) 60 B) 50 C) 80 D) 75 E) 40

A) 60

53) The normal pH range for body fluids is ________ to _______: A)7.35; 7.45 B) 7; 7.35 C) 7 7.45 D) 0.9; 0.95

A) 7.35; 7.45

33) Which hormone affects the osmotic concentration? A) ADH B) BNP C) Natriuretic peptide D) ANP E) Aldosterone

A) ADH

31) Which hormone is released by cardiac muscle in response to abnormal stretching of the heart walls? A) ANP B) BNP C) Aldosterone D) ADH E) A and B

A) ANP

54) When the pH falls below 7.35, a state of ________ exists. A) Acidosis B) Alkalosis C) Ketosis

A) Acidosis

43) In which case is the pH lower? A) After hypoventilating B) After hyperventilating

A) After hypoventilating

29) Which hormone plays a role in determining the rate of sodium absorption and potassium loss? A) Aldosterone B) BNP C) Natriuretic peptide D) ADH E) ANP

A) Aldosterone

49) A (n) ________ consists of a combination of a weak acid and its dissociation products. A) Buffer system B) Osmosis C) Filtration D) Cardiovascular system

A) Buffer system

30) Exchange among subdivisions of ECF occurs primarily in the: A) Capillaries. B) Veins. C) Arteries. D) Tissues. E) Muscles.

A) Capillaries.

48) All of the homeostatic mechanisms that monitor and adjust the composition of body fluids respond to changes in the ______: A) ECF B) ICF C) Plasma D) Lymph E) CSF

A) ECF

56) _______ are ions released through the dissociation of inorganic compounds. A) Electrolytes B) Oxygen C) CO2

A) Electrolytes

51) A (n) ________ acid is an acid that does not leave solution once it is produced. A) Fixed B) Volatile C) Both D) Neither

A) Fixed

38) Renal failure can result in: A) Hyperkalemia. B) Decreased urea. C) Hypokalemia. D) Hyponatremia. E) None of the above

A) Hyperkalemia.

57) if you were walking across the Sahara Desert with an empty canteen, the amount of ADH secreted would most likely: A) Increase. B) Decrease. C) Stay the same. D) Have no effect.

A) Increase.

42) Dehydration will cause A) Increased thirst. B) Decreased concentration of sodium ions in the ECF. C) Decreased secretion of ADH. D) Decreased levels of aldosterone. E) Fluid to shift from the ECF to the ICF.

A) Increased thirst.

15) Each of the following statements concerning chloride ions is true, except that: A) Large amounts of chloride ions are lost each day in the urine. B) Chloride ion concentrations in the ICF are usually low. C) Chloride ions are absorbed along the digestive tract in the company of sodium ions. D) Chloride ions are lost in perspiration. E) Chloride ions are the most abundant anions in the ECF.

A) Large amounts of chloride ions are lost each day in the urine.

47) The principal ions in extracellular fluid are ___, ___, and ___. A) Na, Cl, HCO3- B) Na, Cl, K C) Na, K, HCO3- D) K, Cl, PO4- E) K, PO4-, Fe

A) Na, Cl, HCO3-

52) ____ Acids are participants in or by-products of cellular metabolism. A) Organic B) Non organic C) Both D) Neither

A) Organic

16) The primary role of the carbonic acid-bicarbonate buffer system is to: A) Prevent pH changes caused by organic and fixed acids. B) Buffer stomach acid. C) Buffer the urine. D) Increase the amount of carbonic acid during ventilation. E) Buffer carbonic acid formed by carbon dioxide.

A) Prevent pH changes caused by organic and fixed acids.

58) Giving a hypertonic I.V solution to a patient may cause too much fluid to be: A) Pulled from the cells into the bloodstream, which may cause the cells to shrink. B) Pulled out of the bloodstream into the cells. C) Pushed out of the bloodstream into the extravascular spaces. D) Pulled from the cells into the bloodstream, which may cause the cells to increase in size.

A) Pulled from the cells into the bloodstream, which may cause the cells to shrink.

21) A person with emphysema will exhibit signs of: A) Respiratory acidosis. B) Respiratory alkalosis. C) Metabolic acidosis. D) Metabolic alkalosis.

A) Respiratory acidosis.

69) When the hormone Aldosterone is secreted, the kidneys reabsorb: A) Sodium. B) Potassium. C) Magnesium. D) Calcium.

A) Sodium.

7) Antidiuretic hormone A) Stimulates water conservation by the kidneys. B) Results in the loss of more urine from the bladder. C) Causes the kidneys to produce a large volume of urine. D) Is secreted by the anterior pituitary gland in response to changes in blood osmolarity. E) Stimulates the kidneys to retain sodium ions.

A) Stimulates water conservation by the kidneys.

39) Which of the following is greater? A) The amount of ADH released when blood osmolarity is high B) The amount of ADH released when blood osmolarity is low

A) The amount of ADH released when blood osmolarity is high

50) A (n) ________ acid is an acid that can leave solution and enter the atmosphere. A) Volatile B) Nonvolatile C) Both D) Neither

A) Volatile

34) Approximately ________ liters of peritoneal fluid are produced and reabsorbed each day. A) 10 B) 7 C) 9 D) 15 E) 20

B) 7 liters

66) Water intoxication can be caused by: A) Administering too much hypertonic fluid. B) Administering too much hypotonic fluid . C) Encouraging fluid intake. D) Administering too much isotonic fluid

B) Administering too much hypotonic fluid .

When the pH rises above 7.45, a state of ____ exists. A) Acidosis B) Alkalosis C) Ketosis

B) Alkalosis

32) You are caring for a patient who has been vomiting and having diarrhea for the past five days. You suspect that his electrolyte levels are: A) Normal B) Decreased C) Elevated D) Noncritical

B) Decreased

59) Older adults are at increased risk for electrolyte imbalances because, with age, the kidneys have: A) Increased Glomerular filtration rate. B) Fewer functioning Nephrons. C) Increased ability to concentrate urine. D) Increased blood flow.

B) Fewer functioning Nephrons.

62) If your patient is breathing rapidly his body is attempting to: A) Retain carbon dioxide. B) Get rid of excess carbon dioxide. C) Improve the buffering ability of bicarbonate. D) Produce more carbonic acid

B) Get rid of excess carbon dioxide.

41) Factors that increase the secretion of antidiuretic hormone include all of the following, except: A) Water deprivation. B) Increased concentration of potassium ions in the ICF. C) Increased concentration of sodium ions in the ECF. D) Increased osmolarity of the ECF. E) Decreased renal blood flow.

B) Increased concentration of potassium ions in the ICF.

63) If your patient has a higher-than-normal pH (alkalosis), you would expect to also see: A) High Paco2 and high bicarbonate. B) Low Paco2 and high bicarbonate. C) Low bicarbonate and high Paco0. D) Low Paco2 and low bicarbonate.

B) Low Paco2 and high bicarbonate.

60) PCO2 level indicates the effectiveness of: A) Kidney function. B) Lung ventilation. C) Phosphate buffers. D) Bicarbonate buffers.

B) Lung ventilation

64) The laboratory reports the following ABG results for your pa¬tient; pH, 7:33; Paco2, 40 mm Hg; and bicarbonate, 20mEq/L. You interpret these results as: A) Respiratory acidosis. B) Metabolic acidosis. C) Respiratory alkalosis. D) Metabolic alkalosis.

B) Metabolic acidosis.

8) Aldosterone: A) Is secreted in response to elevated levels of sodium in the blood. B) Promotes sodium retention in the kidneys. C) Increases the concentration of sodium in urine. D) Functions in pH regulation. E) Helps decrease blood volume. (little effect on blood volume)

B) Promotes sodium retention in the kidneys.

18) Hypoventilation would cause: A) Respiratory alkalosis. B) Respiratory acidosis. C) Metabolic alkalosis. D) Metabolic acidosis.

B) Respiratory acidosis.

23) A mountain climber at high altitude may lose consciousness as the result of: A) Respiratory acidosis. B) Respiratory alkalosis. C) Metabolic acidosis. D) Metabolic alkalosis.

B) Respiratory alkalosis.

OMITTED 45) What effect would a decrease in pH have on the amount of potassium ions in the urine? A) No effect on the amount of potassium in the urine B) An increase in the amount of potassium in the urine C) A decrease in the amount of potassium in the urine

C) A decrease in the amount of potassium in the urine

68) Increased serum sodium levels cause thirst and the release of: A) Potassium into the cells. B) Fluid into the interstitium. C) ADH into the bloodstream D) Aldosterone into the kidneys.

C) ADH into the bloodstream

9) Atrial natriuretic peptide does all of the following, except that it: A) Reduces thirst. B) Promotes diuresis. C) Blocks the release of glucocorticoids during the stress response. D) Blocks the release of aldosterone. E) Blocks the release of ADH.

C) Blocks the release of glucocorticoids during the stress response.

67) In addition to its responsibility for fluid balance, sodium is also responsible for: A) Good eyesight and vitamin balance. B) Bone structure. C) Impulse transmission. D) Muscle mass.

C) Impulse transmission.

44) When the pH of the extracellular fluid declines, the: A) Kidneys reabsorb less water. B) pH of the urine decrease. C) Kidneys secrete more potassium ions. D) Kidneys excrete more sodium ions. E) Kidneys excrete more bicarbonate ions.

C) Kidneys secrete more potassium ions.

22) A person with chronic diabetes will exhibit signs of: A) Respiratory acidosis. B) Respiratory alkalosis. C) Metabolic acidosis. D) Metabolic alkalosis.

C) Metabolic acidosis.

25) A person with nephritis (an inflammation of the kidneys) will show symptoms of: A) Respiratory acidosis. B) Respiratory alkalosis. C) Metabolic acidosis. D) Metabolic alkalosis.

C) Metabolic acidosis.

17) Acidosis can cause all of the following, except: A) Cardiac arrhythmias. B) Kidney failure. C) Peripheral vasoconstriction. D) Coma and death. E) Heart failure.

C) Peripheral vasoconstriction.

6) Consuming a meal high in salt will: A) Activate the renin-angiotensin mechanism. B) Cause hypotension. C) Result in a temporary increase in blood volume. D) Decrease thirst. E) Drastically increase the osmolarity of the blood.

C) Result in a temporary increase in blood volume.

35) The most common problems with electrolyte balance are caused by an imbalance between gains and losses of: A) Chlorine ions. B) Magnesium ions. C) Sodium ions. D) Calcium ions. E) Potassium ions.

C) Sodium ions.

When large amts of pure water are consumed, a) Osmolarities of the two compartments are slightly lower b) the volume of the ECF decreases c) a fluid shift occurs and the volume of the ICF decreases d) the ECF becomes hypertonic to the ICF e) The volume of the ICF increases

a) osmolarities of the two compartments are slightly lower

Intracellular fluid (ICF) is found in: a) the cells of the body b) Lymph c) Blood vessels d) the interstitial space e) the cerebrospinal fluid

a) the cells of the body

The amount of potassium secreted by the kidneys is regulated by: a) cortisol b) Atrial Natriuretic factor c) aldosterone d) parathormone e) ADH

c) aldosterone

The principal cation in the ICF is: a) Sodium b) Calcium c) magnesium d) potassium e) chloride

d) potassium

Excess potassium ion is eliminated from the body by: a) the spleen b) sweating c) the liver d) the digestive system e) the kidneys

e) the kidneys

19. In response to respiratory alkalosis, the a. respiratory rate increases. b. tidal volume increases. c. kidneys conserve bicarbonate. d. kidneys secrete more hydrogen ions. e. kidneys retain more hydrogen ions.

e. kidneys retain more hydrogen ions.

10) When the level of sodium ion in extracellular fluid decreases, A) A person experiences an increased thirst. B) More ADH is released. C) There is an increase in the level of aldosterone. D) There is an increase in the level of atrial natriuretic factor. E) Osmoreceptors are stimulated

C) There is an increase in the level of aldosterone.

27) Which hormone stimulates the thirst mechanism? A) Aldosterone B) Natriuretic peptide C) BNP D) ADH E) ANP

D) ADH

70) Magnesium is an important electrolyte because it: A) Helps control urine volume. B) Promotes the production of growth hormone. C) Promotes bone growth and strength. D) Assists in neuromuscular transmission.

D) Assists in neuromuscular transmission.

40) Secretion of potassium into the urine is: A) Increased with elevated levels of ADH. B) Minimal because humans ingest very little potassium. C) Decreased by aldosterone. D) Associated with the reabsorption of sodium from the distal tubules and collecting ducts. E) Increased in the presence of atrial natriuretic peptide.

D) Associated with the reabsorption of sodium from the distal tubules and collecting ducts.

36) The higher the plasma concentration of aldosterone, the more efficiently the kidney will: A) Secrete greater amounts of ADH. B) Retain potassium ions. C) Stimulate urinary water loss. D) Conserve sodium ions. E) All of the above

D) Conserve sodium ions.

46) In response to a rapid increase of organic acids in the body, you would expect to observe all of the following, except A) Increased heart rate. B) Increased alveolar ventilation. C) Decreased blood pH. D) Decreased respiration rate. E) Increased blood pressure.

D) Decreased respiration rate.

65) A colleague hands you these ABG results: pH, 7.52; Paco2, 47 mm Hg; and bicarbonate, 36mEq/L. You interpret these results as: A) Normal. B) Respiratory acidosis. C) Respiratory alkalosis with respiratory compensation. D) Metabolic alkalosis with respiratory compensation.

D) Metabolic alkalosis with respiratory compensation.

20) Prolonged vomiting can result in: A) Respiratory acidosis. B) Respiratory alkalosis. C) Metabolic acidosis. D) Metabolic alkalosis.

D) Metabolic alkalosis.

24) A person who chronically consumes large amounts of antacids may risk: A) Respiratory acidosis. B) Respiratory alkalosis. C) Metabolic acidosis. D) Metabolic alkalosis.

D) Metabolic alkalosis.

11) When the amount of sodium ion in extracellular fluid increases, A) There is a decreased thirst. B) Aldosterone secretion increases. C) ADH secretion decreases. D) Osmoreceptors are stimulated. E) There is an increase in the volume of urine produced.

D) Osmoreceptors are stimulated.

61) The kidneys respond to acid-base disturbances by: A) Adjusting Paco2 levels. B) Producing phosphate buffers. C) Producing protein buffers. D) excreting or reabsorbing hydrogen or bicarbonate

D) excreting or reabsorbing hydrogen or bicarbonate

37) Angiotensin II produces a coordinated elevation in the ECF volume by: A) Causing the release of ADH. B) Triggering the production and secretion of aldosterone. C) Stimulating thirst. D) A and B E) A, B, and C

E) A, B, and C

26) To survive, humans must maintain a normal volume and composition of: A) Body fluids. B) ECF. C) Plasma. D) ICF. E)` All of the above

E)` All of the above

Ca+ reabsorption by the kidneys is promoted by the hormone: a) Calcitonin b) Calcitriol c) Cortisol d) ADH e) Aldosterone

b) Calcitriol

When water is lost but electrolytes are retained,: a) both the ECF and ICF become more dilute b) Osmosis moves water from the ICF to the ECF c) There is an increase in the volume of the ICF d) the osmolarity of the ECF falls e) both A and D

b) Osmosis moes water from the ICF to the ECF

The components of extracellular fluid (ECF) include: a) Interstitial fluid b) CSF c) blood plasma & lymph d) all the above e) A and B only

d) all the above