Deck 2: Fluid, Electrolyte, and Acid-Base Imbalances

Question 1

When many excess hydrogen ions accumulate in the blood, what happens to serum pH? The pH:

A) decreases.
B) increases.
C) remains constant.
D) varies based on metabolism.

Answer 1

decreases.

Question 2

Choose the correct proportion of water to body weight to be expected in a healthy male adult's body:

A) 30%
B) 45%
C) 60%
D) 70%

Answer 2

60%

Question 3

What is the slowest but most effective control for acid-base balance?

A) Respiratory system
B) Buffer systems in the blood
C) Kidneys
D) Brain

Answer 3

Kidneys

Question 4

Which of the following would result from a deficit of plasma proteins?

A) Increased osmotic pressure
B) Decreased osmotic pressure
C) Increased hydrostatic pressure
D) Decreased hydrostatic pressure

Question 5

Which of the following is the primary cation in the extracellular fluid?

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

Question 6

In which of the following processes is phosphate ion NOT a major component?

A) Bone metabolism
B) Metabolic processes involving adenosine triphosphate (ATP)
C) Blood clotting
D) Acid-base balance

Question 7

Which of the following would cause edema?

A) Decreased capillary hydrostatic pressure
B) Increased capillary osmotic pressure
C) Decreased capillary permeability
D) Increased capillary permeability

Question 8

Which of the following results from hypocalcemia?
1) Low serum phosphate levels
2) Nausea and constipation
3) Skeletal muscle twitch and spasms
4) Weak cardiac contractions

A) 1, 2
B) 1, 4
C) 2, 3
D) 3, 4

Question 9

Which of the following would likely be related to an elevated hematocrit reading?

A) Fluid excess
B) Fluid deficit
C) Increased sodium level
D) Decreased erythrocytes

Question 10

Which of the following is essential in order to maintain serum pH within normal range?

A) Carbonic acid and bicarbonate ion must be present in equal quantities.
B) All excess carbonic acid must be excreted by the kidneys.
C) The concentration of bicarbonate ion must remain constant.
D) The ratio of carbonic acid to bicarbonate ion must be 1:20.

Question 11

Insensible fluid loss refers to water lost through:

A) perspiration only.
B) feces only.
C) perspiration and expiration.
D) urine and feces.

Question 12

Which of the following would be considered normal serum pH?

A) 4.5-8
B) 7.0
C) 7.4
D) 8

Question 13

When the osmotic pressure of the blood is elevated above normal, water would shift from the:

A) blood into the cells.
B) interstitial compartment into the cells.
C) interstitial compartment into the blood.
D) cells into the interstitial compartment.

Question 14

Choose the correct proportion of blood (to body weight) in an adult male's body:

A) 30%
B) 20%
C) 10%
D) 4%

Question 15

Choose the correct effect of increased parathyroid hormone.

A) Increased movement of calcium ions into the bones
B) Increased activation of vitamin D
C) Increased absorption of calcium from the digestive tract
D) Decreased reabsorption of calcium in the kidneys

Question 16

Which of the following is a common cause of hyponatremia?

A) Loss of the thirst mechanism
B) Excessive sweating
C) Excessive aldosterone secretion
D) Prolonged period of rapid, deep respirations

Question 17

Which of the following terms refers to a combination of decreased circulating blood volume combined with excess fluid in a body cavity?

A) Dehydration
B) Third-spacing
C) Hypovolemia
D) Water retention

Question 18

Which of the following is a typical sign of dehydration?

A) Rapid, strong pulse
B) Low hematocrit
C) Increased urine output
D) Rough oral mucosa

Question 19

Which of the following is a common effect of both hypokalemia and hyperkalemia?

A) Skeletal muscle twitch and cramps
B) Oliguria
C) Elevated serum pH
D) Cardiac arrhythmias

Question 20

Which of the following causes tetany?

A) Increased permeability of nerve membranes due to low serum calcium
B) Excess calcium ions in skeletal muscle due to excess parathyroid hormone (PTH)
C) Excess calcium ions inside somatic nerves as a result of neoplasms
D) Increased stimulation of the nerves in the cerebral cortex

Question 21

The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance of the carbonic acid and bicarbonate ion levels are controlled by the:

A) liver and pancreas.
B) lungs and kidneys.
C) lungs and plasma proteins.
D) kidneys and bone marrow.

Question 22

One of the factors involved in the increased need for water in infants is:

A) proportionally smaller body surface area.
B) higher metabolic rate.
C) smaller respiratory capacity.
D) greater surface area of exposed mucous membranes.

Question 23

Which serum value indicates decompensated metabolic acidosis?

A) pH is below normal range
B) pH is above normal range
C) Bicarbonate level decreases
D) Bicarbonate level increases

Question 24

An anxiety attack often causes hyperventilation leading to:

A) increased PCO₂.
B) decreased PCO₂.
C) respiratory acidosis.
D) metabolic acidosis.

Question 25

Which is the correct effect on the body of abnormally slow respirations?

A) Increased carbonic acid
B) Decreased carbonic acid
C) Increased bicarbonate ion
D) Decreased bicarbonate ion

Question 26

Compensation mechanisms in the body for dehydration would include:

A) increased antidiuretic hormone (ADH).
B) decreased aldosterone.
C) slow, strong heart contraction.
D) peripheral vasodilation.

Question 27

Which acid-base imbalance results from impaired expiration due to emphysema?

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

Question 28

Prolonged diarrhea results in:

A) loss of fluid and bicarbonate ions, leading to metabolic acidosis.
B) increased fluid and serum bicarbonate ions, leading to metabolic acidosis.
C) loss of chloride ions only, leading to metabolic alkalosis.
D) surplus bicarbonate ions, leading to respiratory alkalosis.

Question 29

In the initial stage, vomiting results in:

A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory alkalosis.
D) None of the above

Question 30

What is the effect on blood serum when excessive lactic acid accumulates in the body?

A) Bicarbonate ion levels decrease
B) Bicarbonate ion levels increase
C) Carbonic acid levels increase
D) pH increases

Question 31

Which two ions are most important for acid-base balance in the body?

A) K+, Na+
B) Cl- and HCO₃-
C) Ca++, Na+
D) Na+, Cl-

Question 32

Which condition is likely to cause metabolic acidosis?

A) Slow, shallow respirations
B) Prolonged diarrhea
C) Mild vomiting
D) Excessive fluid in the body

Question 33

Strenuous physical exercise on a hot day is likely to result in:

A) hypokalemia.
B) hypernatremia.
C) hyperchloremia.
D) hypovolemia.

Question 34

What would a serum pH of 7.33 in a patient with kidney disease indicate?

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

Question 35

Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic patient. Not all options are used in the answers.
1) Serum pH decreases
2) Serum bicarbonate decreases
3) PC_O2 decreases
4) Respiration decreases
5) Respiration increases
6) Serum pH increases
7) Urine pH decreases

A) 1, 3, 7, 4, 2, 6
B) 5, 2, 7, 3, 4, 1
C) 2, 1, 5, 3, 7, 6
D) 3, 1, 2, 5, 7, 6

Question 36

Which of the following is a manifestation of respiratory alkalosis?

A) Bradycardia and deep rapid breathing
B) Drowsiness and general lethargy
C) Increased nervous system irritability
D) Decreased urine pH

Question 37

A prolonged state of metabolic acidosis often leads to:

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

Question 38

The direct effects of acidosis are manifested primarily in the functioning of the:

A) Digestive system
B) Urinary system
C) Nervous system
D) Respiratory system

Question 39

In patients with impaired expiration associated with emphysema, effective compensation for the acid-base imbalance would be:

A) increased rate and depth of respiration.
B) decreased rate and depth of respiration.
C) increased urine pH and decreased serum bicarbonate.
D) decreased urine pH and increased serum bicarbonate.

Question 40

Compensation for respiratory system depression due to anesthesia and sedation would be:

A) decreased reabsorption of bicarbonate ions in the kidneys.
B) increased secretion of hydrogen ions into the filtrate.
C) increased respiratory rate and depth.
D) increased renin secretion.

Question 41

In the blood and extracellular fluids, hypernatremia refers to:

A) a deficient sodium level.
B) an excess phosphate level.
C) an excess sodium level.
D) an excessively low phosphate level.

Question 42

What are the three mechanisms that control or compensate for serum pH?

A) Hypothalamus, metabolic changes by digestive system, lymphatic system filtration
B) Buffer pairs in blood, change in kidney excretion rate, change in respiration rate
C) Neural feedback, increase in heart rate, decrease in calcium intake
D) Modification of water intake, increased capillary permeability, decrease in blood volume

Question 43

Hypokalemia refers to a condition in which the serum has a very low level of which ion?

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

Question 44

Alkalosis increases irritability and spontaneous stimulation of nerves by:

A) blocking normal nerve conduction.
B) increasing the permeability of nerve membranes.
C) blocking movement of calcium ions.
D) decreasing phosphate ion levels.

Question 45

Increased milk and/or antacid intake can contribute to development of "milk-alkali syndrome," which can cause which of the following?

A) Hyponatremia
B) Hyperkalemia
C) Hypercalcemia
D) Hypovolemia

Question 46

The control center for thirst is located in the:

A) kidneys.
B) thalamus.
C) medulla.
D) hypothalamus.

Question 47

Which statements apply to atrial natriuretic peptide?
1) It is secreted by heart muscle cells.
2) It is a hormone secreted by the kidneys.
3) It helps to control water and sodium balance.
4) It is released in response to low blood pressure.

A) 1, 3
B) 1, 4
C) 2, 3
D) 2, 4

Question 48

Serum potassium levels are affected by:
1) ADH.
2) aldosterone.
3) serum H+ levels.
4) insulin levels.

A) 2 only
B) 1, 2
C) 1, 3
D) 2, 3, 4
E) 1, 2, 3

Question 49

Which of the following is the primary control of serum Na? levels?

A) ADH
B) Aldosterone
C) Serum H+ levels
D) serum K+ levels

Question 50

Hypocalcemia causes weak cardiac contractions because:

A) permeability of nerve membranes increases.
B) insufficient calcium ions are available for muscle contraction.
C) low phosphate ion levels prevent muscle contraction.
D) excessive amounts of calcium are stored in cardiac muscle.