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

Question 1

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

Answer 1

Renin

Question 2

A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between what?

A)Intracellular and extracellular Na⁺
B)Intracellular and extracellular K⁺
C)Intracellular Na⁺ and extracellular K⁺
D)Intracellular K⁺ and extracellular Na⁺

Answer 2

Intracellular and extracellular K⁺

Question 3

How are secretion of antidiuretic hormone (ADH) and the perception of thirst stimulated?

A)Decrease in serum sodium
B)Increase in plasma osmolality
C)Increase in glomerular filtration rate
D)Decrease in osmoreceptor stimulation

Answer 3

Increase in plasma osmolality

Question 4

A patient's blood gases reveal the following findings: pH 7.3; bicarbonate (HCO₃) 27 mEq/L; carbon dioxide (CO₂) 58 mm Hg. What is the interpretation of these gases?

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

Question 5

A patient in the hospital has hypernatremia. What condition should the healthcare professional assess for?

A)Syndrome of inappropriate antidiuretic hormone
B)Hypersecretion of aldosterone
C)Brief bouts of vomiting or diarrhea
D)Excessive diuretic therapy

Question 6

Why does obesity create a greater risk for dehydration in people?

A)Adipose cells contain little water because fat is water repelling.
B)The metabolic rate of obese adults is slower than the rate of lean adults.
C)The rate of urine output of obese adults is higher than in lean adults.
D)The thirst receptors of the hypothalamus do not function effectively.

Question 7

When changes in total body water are accompanied by proportional changes in electrolytes, what type of alteration occurs?

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

Question 8

Thirst activates osmoreceptors following an increase in which blood plasma component?

A)Antidiuretic hormone
B)Aldosterone
C)Hydrostatic pressure
D)Osmotic pressure

Question 9

The pathophysiologic process of edema is related to which mechanism?

A)Sodium depletion
B)Decreased capillary hydrostatic pressure
C)Increased plasma oncotic pressure
D)Lymphatic obstruction

Question 10

At the arterial end of capillaries, why does fluid move from the intravascular space into the interstitial space?

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 11

Venous obstruction is a cause of edema because of an increase in which pressure?

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

Question 12

In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?

A)Oncotic pressure
B)Buffering
C)Net filtration
D)Hydrostatic pressure

Question 13

A student asks about natriuretic peptides. Which statement by the professor is most accurate?

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

Question 14

Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of what?

A)Osmotic forces
B)Plasma oncotic pressure
C)Antidiuretic hormone
D)Hydrostatic forces

Question 15

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

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

Question 16

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

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

Question 17

Why is insulin used to treat hyperkalemia?

A)Stimulates sodium to be removed from the cell in exchange for potassium
B)Binds to potassium to remove it through the kidneys
C)Transports potassium from the blood into the cell along with glucose
D)Breaks down the chemical components of potassium, inactivating it

Question 18

A patient has a serum sodium level of 165 mEq/L. The healthcare professional explains that the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma are caused by what mechanism?

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

Question 19

Why are infants most susceptible to significant losses in total body water?

A)High body surface-to-body size ratio
B)Slow metabolic rate
C)Kidneys are not mature enough to counter fluid losses
D)Inability to communicate adequately when he or she is thirsty

Question 20

What does vomiting-induced metabolic alkalosis cause?

A)Retained sodium to bind with the chloride
B)Hydrogen to move into the cell and exchange with potassium
C)Retention of bicarbonate to maintain the anion balance
D)Hypoventilation to compensate for the metabolic alkalosis

Question 21

Which statements regarding total body water (TBW) are true? (Select all that apply.)

A)During childhood, TBW slowly decreases in relationship to body weight.
B)Gender has no influence on TBW until old age.
C)Men tend to have greater TBW as a result of their muscle mass.
D)Estrogen plays a role in female TBW.
E)Older adults experience a decrease in TBW as a result of decreased muscle mass.

Question 22

A third of the body's fluid is contained in the extracellular interstitial fluid spaces that include what? (Select all that apply.)

A)Urine
B)Intraocular fluids
C)Lymph
D)Blood plasma
E)Sweat

Question 23

In hyperkalemia, what change occurs to the cells' resting membrane potential?

A)Hypopolarization
B)Hyperexcitability
C)Depolarization
D)Repolarization

Question 24

Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO₃) and carbonic acid (H₂CO₃) exist in what ratio?

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

Question 25

An imbalance of potassium can produce which dysfunctions? (Select all that apply.)

A)Weakness of skeletal muscles
B)Cardiac dysrhythmias
C)Smooth muscle atony
D)Visual impairment
E)Hearing loss

Question 26

A healthcare provider notes that tapping the patient's facial nerve leads to lip twitching. What electrolyte value is correlated with this finding?

A)K⁺: 2.8 mEq/L
B)K⁺: 5.4 mEq/L
C)Ca⁺⁺: 8.2 mg/dL
D)Ca⁺⁺: 12.9 mg/dL

Question 27

A healthcare professional is caring for four patients. Which patient should the professional assess for hypermagnesemia as a priority?

A)Hepatitis
B)Renal failure
C)Trauma to the hypothalamus
D)Pancreatitis

Question 28

A patient's serum potassium level is 2.7 mEq/L. Which clinical manifestations does the healthcare professional assess for? (Select all that apply.)

A)Paralytic ileus
B)Sinus bradycardia
C)Atrioventricular block
D)Dry mucous membranes
E)Tetany

Question 29

Where is two thirds of the body's water found?

A)Interstitial fluid spaces
B)Vascular system
C)Intracellular fluid compartments
D)Intraocular fluids

Question 30

A patient is admitted to the hospital with dehydration. For which signs or symptoms would the healthcare professional assess? (Select all that apply.)

A)Moist mucous membranes
B)Weak pulses
C)Tachycardia
D)Polyuria
E)Weight loss

Question 31

A patient is admitted with hyponatremia. For which clinical manifestations would the healthcare professional assess? (Select all that apply.)

A)Headache
B)Seizures
C)Paranoia
D)Confusion
E)Lethargy

Question 32

A healthcare professional is caring for four patients. Which patient should the professional assess for hyperkalemia?

A)Hyperparathyroidism
B)Vomiting
C)Renal failure
D)Hyperaldosteronism

Question 33

A patient has a history of excessive use of magnesium-containing antacids and aluminum-containing antacids. What lab value does the healthcare professional correlate to this behavior?

A)Magnesium 1.8 mg/dL
B)Phosphate 1.9 mg/dL
C)Sodium 149 mEq/L
D)Potassium 2.5 mEq/L

Question 34

What are the causes of hypocalcemia? (Select all that apply.)

A)Repeated blood administration
B)Pancreatitis
C)Decreased reabsorption of calcium
D)Hyperparathyroidism
E)Kidney stones

Question 35

A patient's chart indicates Kussmaul respirations. The student asks the healthcare professional what this is caused by. What response by the professional is most accurate?

A)Anxiety leads to Kussmaul respirations and is a cause of respiratory acidosis.
B)A compensatory measure is needed to correct metabolic acidosis.
C)Diabetic ketoacidosis is leading to metabolic acidosis.
D)More oxygen is necessary to compensate for respiratory acidosis.

Question 36

A healthcare professional just administered a large dose of insulin to a patient. Which electrolyte value should the professional monitor as a priority?

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

Question 37

A patient's electrocardiogram (ECG) shows tall, peaked T waves. What lab value or assessment would the healthcare professional correlate with this finding?

A)Positive Chvostek sign
B)Serum potassium 6.7 mEq/L
C)Nausea and vomiting
D)Serum sodium 138 mEq/L

Question 38

A patient has been diagnosed with hypercalcemia. Which manifestations does the healthcare professional assess for? (Select all that apply.)

A)Diarrhea
B)Calcium-based kidney stones
C)ECG showing narrow T waves
D)Lethargy
E)Bradycardia

Question 39

Why does increased capillary hydrostatic pressure result in edema?

A)Losses or diminished production of plasma albumin
B)Inflammation resulting from an immune response
C)Blockage within the lymphatic channel system
D)Sodium and water retention

Question 40

Which groups are at risk for fluid imbalance? (Select all that apply.)

A)Women
B)Infants
C)Men
D)Obese persons
E)Older adults

Question 41

The calcium and phosphate balance is influenced by which three substances? (Select all that apply.)

A)Parathyroid hormone
B)Vasopressin
C)Thyroid hormone
D)Calcitonin
E)Vitamin D