Deck 3: The Cellular Environment: Fluids and Electrolytes, Acids and Bases

Question 1

Water movement between the intracellular fluid compartment and the extracellular compartment is primarily a function of:

A)osmotic forces.
B)plasma oncotic pressure.
C)antidiuretic hormone.
D)hydrostatic forces.

Answer 1

osmotic forces.

Question 2

How does the body reestablish equilibrium when solute is added to extracellular fluid making it hypertonic?

A)Water is drawn from the extracellular space to the intracellular space.
B)Sodium is drawn from the extracellular space to the intracellular space.
C)Sodium is drawn from the intracellular space to the extracellular space.
D)Water is drawn from the intracellular space to the extracellular space.

Answer 2

Water is drawn from the intracellular space to the extracellular space.

Question 3

Insulin and glucose can be given to correct hyperkalemia.

Answer 3

True

Question 4

________ alterations occur when changes in TBW are accompanied by proportional changes in electrolytes.

A)Isotonic
B)Hypertonic
C)Hypotonic
D)Normotonic

Question 5

Loss of sodium and gain of water can cause hyponatremia.

Question 6

Retention of sodium and water is a cause of edema because of an increase in which pressure?

A)Capillary hydrostatic pressure
B)Interstitial hydrostatic pressure
C)Capillary oncotic pressure
D)Interstitial oncotic pressure

Question 7

Why are obese people at greater risk for dehydration than lean people?

A)Because adipose cells contain little water; fat is water repelling
B)Because the metabolic rate of obese adults is slower than lean adults
C)Because the rate of urine output of obese adults is higher than lean adults
D)Because the thirst receptors of the hypothalamus do not function effectively

Question 8

Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by a(n):

A)decrease in serum sodium.
B)increase in plasma osmolality.
C)increase in glomerular filtration rate.
D)decrease in osmoreceptor stimulation.

Question 9

What is the action of natriuretic peptides?

A)They decrease blood pressure and increase sodium and water excretion.
B)They increase blood pressure and decrease sodium and water excretion.
C)They increase heart rate and decrease potassium excretion.
D)They decrease heart rate and increase potassium excretion.

Question 10

Infants have the highest overall percentage of body water.

Question 11

Movement of water from the ICF to the ECF is primarily accomplished by active transport.

Question 12

Which groups are at risk for fluid imbalance?

A)Older adults, thin women, and infants
B)Infants, children, and obese persons
C)Thin women, obese persons, and older adults
D)Obese persons, older adults, and infants

Question 13

When buffers, such as carbonic acid-bicarbonate, absorb excessive H⁺ (acid) or OH- (base), a significant change in the plasma pH results.

Question 14

The two main intracellular fluid (ICF) compartments are the interstitial fluid contained in the nucleus and the intravascular fluid contained in the cell body.

Question 15

When thirst is experienced, how are osmoreceptors activated?

A)By an increase in the antidiuretic hormone secreted into the plasma
B)By an increase in aldosterone secreted into the plasma
C)By an increase in the hydrostatic pressure of the plasma
D)By an increase in the osmotic pressure of the plasma

Question 16

Proteins are primarily an intracellular buffer.

Question 17

Hypokalemia as well as hyperkalemia can cause muscle weakness.

Question 18

Why are infants susceptible to significant losses in total body water (TBW)?

A)Because more than half of an infant's body weight is water
B)Because infants have a slow metabolic rate
C)Because an infant's kidneys are not mature enough to counter fluids losses
D)Because they are unable communicate adequately when they are thirsty

Question 19

Low plasma albumin causes edema as a result of a reduction in which pressure?

A)Capillary hydrostatic pressure
B)Interstitial hydrostatic pressure
C)Capillary oncotic pressure
D)Interstitial oncotic pressure

Question 20

At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the:

A)interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.
B)capillary hydrostatic pressure is higher than the capillary oncotic pressure.
C)interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
D)capillary oncotic pressure is lower than the interstitial hydrostatic pressure.

Question 21

During acidosis, the body compensates for the increase in hydrogen ions in the blood by shifting hydrogen ions into the cell in exchange for which electrolyte?

A)Oxygen
B)Sodium
C)Potassium
D)Magnesium

Question 22

Chvostek sign and Trousseau sign indicate:

A)hypokalemia.
B)hyperkalemia.
C)hypocalcemia.
D)hypercalcemia.

Question 23

How is insulin used to treat hyperkalemia?

A)Insulin stimulates sodium to be removed from the cell in exchange for potassium.
B)Insulin binds to potassium to remove it through the kidneys.
C)Insulin transports potassium from the blood to the cell along with glucose.
D)Insulin breaks down the chemical components of potassium so that it is no longer effective.

Question 24

Excessive use of magnesium- and aluminum-containing laxatives can result in:

A)hypomagnesemia.
B)hypophosphatemia.
C)hyponatremia.
D)hypokalemia.

Question 25

How does the loss of chloride during vomiting cause metabolic alkalosis?

A)Loss of chloride stimulates the release of aldosterone, which causes the retained sodium to bind with the chloride.
B)Loss of chloride causes hydrogen to move into the cell and exchange with potassium to maintain cation balance.
C)Loss of chloride causes retention of bicarbonate to maintain the anion balance.
D)Loss of chloride causes hypoventilation to compensate for the metabolic alkalosis.

Question 26

What is the significance of deep, rapid breathing (Kussmaul respirations) in metabolic acidosis?

A)It indicates that anxiety, with rapid breathing, is a cause of respiratory acidosis.
B)It indicates the excessive carbon dioxide is exhaled to compensate for metabolic acidosis.
C)It indicates that diabetic ketoacidosis is the cause of the metabolic acidosis.
D)It indicates that more oxygen is necessary to compensate for respiratory acidosis.

Question 27

What are causes of hyperkalemia?

A)Hyperparathyroidism and malnutrition
B)Vomiting and diarrhea
C)Renal failure and Addison disease
D)Hyperaldosteronism and Cushing disease

Question 28

What initiates the formation of ammonium (NH₄) from ammonia (NH₃) in the tubular lumen of the kidney?

A)Arterial pH of 7.25
B)Arterial pH of 7.35
C)Arterial pH of 7.55
D)Arterial pH of 7.65

Question 29

What mechanisms cause hypernatremia?

A)Syndrome of inappropriate antidiuretic hormone (SIADH)
B)Cushing disease and hyperaldosteronism
C)Prolonged vomiting or diarrhea
D)Excessive diuretic therapy

Question 30

What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma in hypernatremia?

A)The high sodium in the blood vessels pulls water out of brain cells into the blood vessels, causing brain cells to shrink.
B)The high sodium in the brain cells pulls water out of blood vessels into the brain cells, causing them to swell.
C)The high sodium in the blood vessels pulls potassium out of brain cells, which slows the synapses within the brain.
D)The high sodium in the blood vessels draws chloride into the brain cells followed by water, causing brain cells to swell.

Question 31

Which are causes of hypocalcemia?

A)Repeated blood administration or pancreatitis
B)Kidney stones and immobility
C)Decreased resorption of calcium and phosphate from bone
D)Hyperparathyroidism and bone metastasis

Question 32

In hyperkalemia, cardiac rhythm changes are a direct result of:

A)cardiac cell hypopolarization.
B)cardiac cell hyperexcitability.
C)depression of the sinoatrial (SA) node.
D)cardiac cell repolarization.

Question 33

How does SIADH cause excess water?

A)The increase in antidiuretic hormone causes retention of sodium that retains excessive water in the renal tubules.
B)The decrease in antidiuretic hormone increases serum glucose, which binds to water.
C)The decrease in antidiuretic hormone prevents the renal tubules from reabsorbing water.
D)The increase in antidiuretic hormone causes retention of water in the renal tubules.

Question 34

Hypermagnesemia is usually caused by:

A)hepatitis.
B)renal failure.
C)trauma to the hypothalamus.
D)pancreatitis.

Question 35

Which are indications of dehydration?

A)Decreased hemoglobin and hematocrit
B)Muscle weakness and decreased deep tendon reflexes
C)Tachycardia and weight loss
D)Polyuria and hyperventilation

Question 36

The calcium and phosphate balance is influenced by which three substances?

A)Parathyroid hormone, vasopressin, and vitamin D
B)Parathyroid hormone, calcitonin, and vitamin D
C)Thyroid hormone, vasopressin, and vitamin A
D)Thyroid hormone, calcitonin, and vitamin A

Question 37

Physiologic pH is maintained around 7.4 because bicarbonate (HCO₃) and carbonic acid (H₂CO₃) exist in a ratio of:

A)20:1.
B)1:20.
C)10:2.
D)10:5.

Question 38

A patient has a long history of smoking.He has blood studies done because he is very tired, is short of breath, and just does not feel well.His blood gases reveal the following findings: pH, 7.3; HCO₃ 27 mEq/L; CO₂, 58 mmHg.What is the interpretation of these gases?

A)Respiratory alkalosis
B)Metabolic acidosis
C)Respiratory acidosis
D)Metabolic alkalosis

Question 39

Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?

A)Angiotensin I
B)Angiotensin II
C)Aldosterone
D)Renin

Question 40

What is a major determinant of the resting membrane potential necessary for transmission of nerve impulses?

A)The ratio between intracellular Na⁺ and extracellular sodium
B)The ratio between intracellular K⁺ and extracellular potassium
C)The ratio between intracellular Na⁺ and extracellular K⁺
D)The ratio between intracellular K⁺ and extracellular Na⁺

Question 41

Match each electrolyte imbalance with its clinical manifestations.
Absent bowel sounds, skeletal muscle weakness, bradycardia

A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia

Question 42

Match the electrolytes with the corresponding descriptions. Terms may be used more than once.
An intracellular metabolic form is ATP

A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate

Question 43

Match the electrolytes with the corresponding descriptions. Terms may be used more than once.
Changes in hydrogen ion concentration affect this electrolyte

A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate

Question 44

Match the electrolytes with the corresponding descriptions. Terms may be used more than once.
Inversely related to HCO₃ concentration

A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate

Question 45

Match the electrolytes with the corresponding descriptions. Terms may be used more than once.
Major determinant of resting membrane potential

A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate

Question 46

Match each electrolyte imbalance with its clinical manifestations.
Hypotension, fever, tachycardia

A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia

Question 47

Match each electrolyte imbalance with its clinical manifestations.
Depression, confusion, irritability, increased reflexes, tetany

A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia

Question 48

Match each electrolyte imbalance with its clinical manifestations.
Confusion, irritability, depression, headache, seizures

A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia

Question 49

Match each electrolyte imbalance with its clinical manifestations.
Fatigue, weakness, kidney stones, varying degrees of heart block

A)Hyponatremia
B)Hypernatremia
C)Hypercalcemia
D)Hypokalemia
E)Hypomagnesemia

Question 50

Match the electrolytes with the corresponding descriptions. Terms may be used more than once.
Regulation of osmolality

A)Sodium
B)Chloride
C)Potassium
D)Magnesium
E)Phosphate