Deck 7: Acid Base Balance

Question 1

What does the chemical formula (OH-)represent?

A) hydroxide ion
B) hydrogen ion
C) bicarbonate ion
D) phosphate ion

Answer 1

A

Question 2

Which of the follwoing are components of the chemical buffer system?
I)Carbonic-acid buffer system
II)Phosphate buffer system
III)Protein buffer system

A) I, II, and III
B) I only
C) I and II only
D) I and III only

Answer 2

A

Question 3

Which of the following are examples of weak acids?
I)Acetic acid
II)Hydrochloric acid
III)Carbonic acid

A) I and III only
B) II only
C) I, II, and III
D) II and III only

Answer 3

A

Question 4

What is the normal pH range for venous blood?

A) 7.30-7.40
B) 7.40-7.50
C) 7.25-7.35
D) 7.35-7.45

Question 5

Which of the following is defined as a proton donor?

A) acid
B) base
C) buffer
D) protein

Question 6

What does an arterial pH of 7.30 indicate?

A) acidosis or acidemia
B) alkalosis or alkalemia
C) normal arterial value
D) insufficient information to assess

Question 7

What is the term for substance that dissociates completely in water to liberate all of the H+?

A) strong acid
B) weak acid
C) strong base
D) weak base

Question 8

What substances are released when carbonic acid dissociates?

A) bicarbonate ions and H+
B) bicarbonate ions and OH-
C) bicarbonate ions and proteins
D) bicarbonate ions and water

Question 9

What is the first line of defense in acid-base regulation?

A) chemical buffer system
B) respiratory system
C) renal system
D) hepatic system

Question 10

How would the pH of pure water be expressed?

A) 10 ^-7 mol/L
B) 7 ^-10 mol/L
C) 0
D) 10⁷ mol/L

Question 11

Under normal conditions,what is the ratio between bicarbonate ions and H₂CO₃ in arterial blood?

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

Question 12

What directly relates to the acidity of a solution ?

A) concentration of free protons
B) concentration of bound protons
C) concentration of free electrons
D) concentration of bound anions

Question 13

What does an arterial pH of 7.48 indicate?

A) alkalosis or aklalemia
B) acidosis or acidemia
C) normal pH
D) insufficient information to assess

Question 14

Under normal conditions what does pK equal?

A) 6.1
B) 20.1
C) 4.1
D) 5.1

Question 15

Which of the following are considered to be weak bases?
I)Bicarbonate ion
II)Sodium Hydroxide
III)Magnesium Hydroxide

A) I only
B) I, II, and III
C) II and III only
D) I and III only

Question 16

What is defined as the negative logarithm of the hydrogen ion concentration?

A) pH
B) HCO₃-
C) acid
D) buffer

Question 17

What is the normal range for pH of arterial blood?

A) 7.35-7.45
B) 7.30-7.40
C) 7.45-7.55
D) 7.20-7.30

Question 18

What is defined as a proton acceptor?

A) base
B) acid
C) buffer
D) protein

Question 19

What is the term for the ability of an acid-base mixture to resist sudden changes in pH?

A) buffer action
B) ionization rate
C) dissociation coefficient
D) ionization coefficient

Question 20

What is the body's most effective acid-base balance monitor and regulator?

A) renal system
B) respiratory system
C) pons
D) peripheral chemoreceptors

Question 21

What are the primary components of the phosphate buffer system?
I)sodium salts of dihydrogen phosphate
II)sodium salts of monohydrogen phosphate
III)sodium salts of trihydrogen phosphate

A) I and II only
B) I, II, and III
C) I only
D) II and III only

Question 22

Which system has up to two times the buffering power of all of the chemical buffering systems combined?

A) respiratory system
B) renal system
C) gastric buffering system
D) hepatic buffering system

Question 23

When chronic ventilatory failure with complete renal compensation is present,which of the following will be within normal limits?
I)PaCO₂
II)pH
III)HCO₃-

A) II only
B) I , II, and III
C) I and II only
D) II and III only

Question 24

What is the body's most abundant buffering system?

A) protein buffer system
B) phosphate buffer system
C) carbonic acid-bicarbonate buffer system
D) hepatic buffering system

Question 25

In the H-H equation,what value can be substituted for carbonic acid?

A) PCO₂ x 0.03
B) PCO₂ x 0.301
C) PCO₂ x 0.003
D) PCO₂ x 3

Question 26

If the pH is 7.60 and the PaCO₂ is 20 mmHg,what would the HCO₃- equal if the "rule of thumb" is applied?

A) 20 mEq/L
B) 24 mEq/L
C) 26 mEq/L
D) 28 mEq/L

Question 27

What percentage ofthe buffering power of body fluids is found in intercellular proteins?

A) 75%
B) 50%
C) 25%
D) 10%

Question 28

What is the term for the situation that exists when the volume of CO₂ eliminated from the lungs is less than the volume of CO₂ produced at the tissue cells?

A) hypoventilation
B) hyperventilation
C) hypoperfusion
D) hyperperfusion

Question 29

When acute ventilatory failure with complete partial renal compensation is present,which of the following would be true?

A) PCO₂ above normal range, pH within normal range, HCO₃ above normal range
B) PCO₂ above normal range, pH below normal range, HCO₃- within normal range
C) PCO₂ above normal range, pH below normal range, HCO₃-above normal range
D) PCO₂ above normal, pH within normal range, HCO₃ below normal range

Question 30

Which of the following conditions are associated with chronic ventilatory failure?
I)COPD
II)Histoplasmosis
III)Kyphoscoliosis
IV)Chronic tuberculosis

A) I, II, III, and IV
B) I only
C) I, II, and III only
D) I and IV only

Question 31

In relationship to acid-base balance,which molecules can be amphoteric?

A) protein molecules
B) phosphate molecules
C) hydoxyl molecules
D) bicarbonate molecules

Question 32

When partially compensated respiratory acidosis is present,which of the following would be true?

A) PCO₂ above normal range, pH below normal range, HCO₃-above normal range
B) PCO₂ above normal range, pH below normal range, HCO₃- within normal range
C) PCO₂ above normal range, pH within normal range, HCO₃ within normal range
D) PCO₂ above normal, pH within normal range, HCO₃ below normal range

Question 33

When acute ventilatory failure is present,which of the following would be true?

A) PCO₂ above normal range, pH below normal range, HCO₃- within normal range
B) PCO₂ above normal range, pH below normal range, HCO₃-above normal range
C) PCO₂ above normal range, pH within normal range, HCO₃ within normal range
D) PCO₂ above normal, pH within normal range, HCO₃ below normal range

Question 34

If the bicarbonate to carbonic acid ratio is 30 and the log of 30 equals 1.48),what would the pH equal?

A) pH would be 7.58
B) pH would be 7.48
C) pH would be 7.148
D) insufficent information to calculate

Question 35

If the bicarbonate to carbonic acid ratio is 15 and the log 15 equals 1.176),what would the pH equal?

A) pH would be 7.28
B) pH would be 7.18
C) pH would be 7.58
D) insufficent information to calculate

Question 36

What is another term for acute respiratory acidosis?

A) acute ventilatory failure
B) acute alveolar hyperventilation
C) chronic alveolar hyperventilation
D) chronic ventilatory failure

Question 37

How does the ability of carbonic acid in changing the blood pH compare to that of the bicarbonate ion?

A) twenty times more powerful
B) one-twentieth as powerful
C) six times more powerful
D) one-sixth as powerful

Question 38

Which of the following systems are capable of eliminating fixed acids?
I)Phosphate buffer system
II)Protein buffer system
III)Respiratory system
IV)Renal system

A) IV only
B) III and IV only
C) I and II only
D) I, II, and IV only

Question 39

Compared to the carbonic acid-bicarbonate buffering system in extracellular fluid,how effective is the phosphate buffering sytem?

A) about one-sixth as effective
B) about 6 times more effective
C) about twice as effective
D) about half as effective

Question 40

Which of the following systems are capable of regulating alkaline substances in the blood and restoring chemical buffers used in managing the H+ levels in extracellular fluids?
I)Phosphate buffer system
II)Protein buffer system
III)Respiratory system
IV)Renal system

A) IV only
B) III only
C) I and II only
D) III and IV only

Question 41

What is an alternate term for acute alveolar hyperventilation?

A) respiratory alkalosis
B) respiratory acidosis
C) metabolic acidosis
D) metabolic alkalosis

Question 42

When acute alveolar hyperventilation is present,which of the following would occur?

A) PaCO₂ is below normal limits, pH is above normal limits, and HCO₃- is within normal limits
B) PaCO₂ is below normal limits and pH and HCO₃- are within normal limits
C) PaCO₂ is below normal limits, pH is above normal, and HCO₃- is above normal limits
D) PaCO₂, pH and HCO₃ are all below normal limits

Question 43

When chronic alveolar hyperventialtion is completely compensated,which of the following would occur?

A) PaCO₂ will be lower than normal, pH will be within normal range, and HCO₃- will be lower than normal
B) PaCO₂ will be lower than normal, pH will be higher than normal normal range, and HCO₃- will be lower than normal
C) PaCO₂ will be lower than normal, pH will be lower than normal range, and HCO₃- will be lower than normal
D) PaCO₂ and pH will be within normal limits and HCO₃ will be below normal

Question 44

What is the alternate name of the acid base abnormality resulting from a decreased HCO₃-?

A) hyperchloremic metabolic alkalosis
B) hypernatremic metabolic alkalosis
C) hyperchloremic metabolic acidosis
D) hypernatremic metabolic acidosis

Question 45

Why does a patient with CO poisoning have cherry red skin coloring instead of cyanosis?

A) CO rapidly fills sites on the hemoglobin where oxygen normally attaches. The high level of carboxyhemoglobin and saturated hemoglobin results in the red coloration
B) CO poisons the hemoglobin and chemical alters the erythrocyte making it incapable of carrying oxygen. The red color is due to compensatory polycythemia which occurs immediately.
C) CO causes the hemoglobin molecule to break apart. The red coloration is from the hemoglobin fragments under the skin
D) Patients with CO posioning hyperventilate so the red coloration is due to the increased WOB

Question 46

Which of the following are causes of metabolic acidosis?
I)Diabetic ketoacidosis
II)Salicylate intoxication
III)Severe diarrhea
IV)Renal failure

A) I, II, III, and IV
B) I, II and III only
C) I and III only
D) II and III only

Question 47

What of the following can be used to determine the underlying cause of metabolic acidosis?

A) anion gap
B) ABG
C) urinalysis
D) liver enzyme panel

Question 48

What are the most commonly measured anions in the anion gap?

A) chloride and bicarbonate
B) sodium and chloride
C) bicarbonate and sodium
D) bicarbonate and potassium

Question 49

What is the normal range for the anion gap (in mEq/L)?

A) 9-14
B) 5-8
C) 15-18
D) 18-21

Question 50

Which of the following are associated with acute alveolar hyperventilation with hypoxemia?
I)Pneumonia
II)Pulmonary Edema
III)ARDS
IV)Pain,anxiety and fear

A) I, II, and III
B) I , II, III, and IV
C) I, II and III only
D) II, III, and IV only

Question 51

What changes would you expect in acid base balance in acute metabolic acidosis?

A) pH and HCO₃- below normal
B) pH would be below normal range and HCO₃- would be normal
C) pH would be below normal and HCO₃- would be above normal limits
D) pH and HCO₃- would be above normal limits

Question 52

Which of the following would occur in partially compensated metabolic acidosis?

A) pH, PaCO₂, and HCO₃- would be below normal limits
B) pH would be normal and PaCO₂ and HCO₃- would be below normal limits
C) pH would be above normal limits and PaCO₂ and HCO₃- would be below normal range
D) pH would be above normal limits, PaCO₂ would be above normal range, and HCO₃- would be below normal range

Question 53

What acid base abnormality would be expected in third trimester pregnancy?

A) chronic alveolar hyperventilation
B) acute alveolar hyperventilation
C) acute ventilatory failure
D) chronic ventilatory failure

Question 54

What does an anion gap of 18 mEq/L indicate?

A) metabolic acidosis
B) metabolic alkalosis
C) respiratory acidosis
D) lab error

Question 55

Which of the following can cause acute ventilatory failure?
I)Guillian-Barre syndrome
II)General anesthesia
III)Head trauma
IV)Myasthenia gravis

A) I, II, III, and IV
B) I and IV only
C) II and III only
D) I, II, and IV only

Question 56

What is the fourth leading cause of death in the USA?

A) COPD
B) cardiovascular disease
C) cancer
D) diabetes

Question 57

What is the most common cause of acute respiratory alkalosis?

A) hypoxemia
B) pain
C) fear and anxiety
D) pneumothorax

Question 58

Which acid base abnormality is suspected when a patient presents with Kussmaul's breathing and a fruity breath odor?

A) metabolic acidosis
B) metabolic alkalosis
C) respiratory acidosis
D) respiratory alkalosis

Question 59

What is the most common cause of an elevated anion gap?

A) accumulation of fixed acids in the blood
B) depletion of fixed acids from the blood
C) hypoventilation
D) hyperventilation

Question 60

How does the body correct for alveolar hyperventilation?

A) metabolic acidosis
B) metabolic alkalosis
C) respiatory acidosis
D) It can't without the adminsitartion of supplemental oxygen

Question 61

Which acid base abnormality would likely occur in a patient with acute ventilatory failure who has a complete cardiac and respiratory arrest?

A) combined metabolic and respiratory acidosis
B) metabolic acidosis
C) respiratory acidosis
D) combined metabolic and respiratory alkalosis

Question 62

Which acid-base abnormality would be present if the ABG revealed a pH of 7.52,PaCO₂ 42,and HCO₃- of 30 mEq/L?

A) metabolic alkalosis
B) metabolic acidosis
C) respiratory alkalosis
D) combined respiratory and metabolic alkalosis

Question 63

Which acid base abnormality is present if the base excess is calculated to be -9 mEq/L?

A) metabolic acidosis
B) metabolic alkalosis
C) respiratory acidosis
D) respiratory alkalosis

Question 64

Which acid base abnormality is present if the ABG revealed a pH of 7.63,PaCO₂ of 27 mmHg,and HCO₃- of 31 mEq/L?

A) combined metabolic and respiratory alkalosis
B) combined metabolic and respiratory acidosis
C) metabolic alkalosis
D) respiratory alkalosis

Question 65

A semi-conscious patient with a severe asthma episode continues to deteriorate clinically in ER and does not respond to treatment.Which acid base abnormality would you expect to be present?

A) combined metabolic and respiratory acidosis
B) respiratory acidosis
C) metabolic acidosis
D) respiratory alkalosis

Question 66

Which acid base abnormality results from hypokalemia?

A) metabolic alkalosis
B) metabolic acidosis
C) combined metabolic and respiratory acidosis
D) combined metabolic and respiratory alkalosis

Question 67

Which of the following are causes of metabolic alkalosis?
I)Hypochloremia
II)Excessive vomiting
III)Severe diarrhea
IV)Diuretic therapy

A) I, II, and IV only
B) I, II, III, and IV
C) II and III only
D) I, II, and III only

Question 68

What is the interpretation of the acid base status for the following ABG: pH 7.08.PaCO₂ 75 mmHg,HCO₃- 20 mEq/L

A) combined metabolic and respiratory acidosis
B) combined metabolic and respiratory alkalosis
C) acute metabolic acidosis
D) acute respiratory acidosis