Quiz 50: The Cellular Environment: Fluids and Electrolytes, Acids and Bases
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1. Infants are most susceptible to significant losses in total body water because of an infant’s:
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
2. Obesity creates a greater risk for dehydration in people because:
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 the rate of output of lean adults.
d. The thirst receptors of the hypothalamus do not function effectively.
3. 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 c. Respiratory acidosis
b. Metabolic acidosis d. Metabolic alkalosis
4. Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of:
a. Osmotic forces c. Antidiuretic hormone
b. Plasma oncotic pressure d. Hydrostatic forces
5. In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
a. Oncotic pressure c. Net filtration
b. Buffering d. Hydrostatic pressure
6. Venous obstruction is a cause of edema because of an increase in which pressure?
a. Capillary hydrostatic c. Capillary oncotic
b. Interstitial hydrostatic d. Interstitial oncotic
7. 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.
8. Low plasma albumin causes edema as a result of a reduction in which pressure?
a. Capillary hydrostatic c. Plasma oncotic
b. Interstitial hydrostatic d. Interstitial oncotic
9. Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by a(n):
a. Decrease in serum sodium c. Increase in glomerular filtration rate
b. Increase in plasma osmolality d. Decrease in osmoreceptor stimulation
10. Thirst activates osmoreceptors by an increase in which blood plasma?
a. Antidiuretic hormone c. Hydrostatic pressure
b. Aldosterone d. Osmotic pressure
11. It is true that natriuretic peptides:
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.
12. When changes in total body water are accompanied by proportional changes in electrolytes, what type of alteration occurs?
a. Isotonic c. Hypotonic
b. Hypertonic d. Normotonic
13. Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?
a. Angiotensin I c. Aldosterone
b. Angiotensin II d. Renin
14. What mechanism can cause hypernatremia?
a. Syndrome of inappropriate antidiuretic hormone
b. Hypersecretion of aldosterone
c. Brief bouts of vomiting or diarrhea
d. Excessive diuretic therapy
15. What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma in hypernatremia?
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. High sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain.
d. High sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell.
16. Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes:
a. Retained sodium to bind with the chloride
b. Hydrogen to move into the cell and exchange with potassium to maintain cation balance
c. Retention of bicarbonate to maintain the anion balance
d. Hypoventilation to compensate for the metabolic alkalosis
17. 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
18. Insulin is used to treat hyperkalemia because it:
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 to the cell along with glucose.
d. Breaks down the chemical components of potassium, causing it to be no longer effective.
19. A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between:
a. Intracellular and extracellular Na+ c. Intracellular Na+ and extracellular K+
b. Intracellular and extracellular K+ d. Intracellular K+ and extracellular Na+
20. 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 c. Potassium
b. Sodium d. Magnesium
21. Causes of hyperkalemia include:
a. Hyperparathyroidism and malnutrition
b. Vomiting and diarrhea
c. Renal failure and Addison disease
d. Hyperaldosteronism and Cushing disease
22. In hyperkalemia, what change occurs to the cells’ resting membrane potential?
a. Hypopolarization c. Depolarization
b. Hyperexcitability d. Repolarization
23. 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
24. It is true that Kussmaul respirations indicate:
a. Anxiety is a cause of respiratory acidosis.
b. A compensatory measure is needed to correct metabolic acidosis.
c. Diabetic ketoacidosis is the cause of the metabolic acidosis.
d. More oxygen is necessary to compensate for respiratory acidosis.
25. Chvostek and Trousseau signs indicate which electrolyte imbalance?
a. Hypokalemia c. Hypocalcemia
b. Hyperkalemia d. Hypercalcemia
26. An excessive use of magnesium-containing antacids and aluminum-containing antacids can result in:
a. Hypomagnesemia c. Hyponatremia
b. Hypophosphatemia d. Hypokalemia
27. The most common cause of hypermagnesemia is:
a. Hepatitis c. Trauma to the hypothalamus
b. Renal failure d. Pancreatitis
28. Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in a ratio of:
a. 20:1 c. 10:2
b. 1:20 d. 10:5
29. Which arterial pH will initiate the formation of ammonium (NH4) from ammonia (NH3), referred to as academia, in the tubular lumen of the kidney?
a. 7.25 c. 7.55
b. 7.35 d. 7.65
30. Two thirds of the body’s water is found in its:
a. Interstitial fluid spaces c. Intracellular fluid compartments
b. Vascular system d. Intraocular fluids
31. It is true that when insulin is administered:
a. The Na+, K+–ATPase pump is turned off.
b. Potassium is moved out of muscle cells.
c. The liver increases its potassium levels.
d. Glucose transport is impaired.
32. Increased capillary hydrostatic pressure results in edema because of:
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
33. The existence of hyperkalemia is likely to result in which changes to a person’s electrocardiogram (ECG)?
a. Flattened U waves c. Depressed ST segments
b. Peaked T waves d. Peaked P waves
34. Which groups are at risk for fluid imbalance? (Select all that apply.)
d. Obese persons
e. Older adults
35. Dehydration can cause which result? (Select all that apply.)
a. Moist mucous membranes
b. Weak pulses
e. Weight loss
36. Causes of hypocalcemia include: (Select all that apply.)
a. Repeated blood administration
c. Decreased reabsorption of calcium
e. Kidney stones
37. The electrolyte imbalance called hyponatremia exhibits which clinical manifestations? (Select all that apply.)
38. The electrolyte imbalance hypercalcemia exhibits which clinical manifestations? (Select all that apply.)
b. Calcium based kidney stones
c. ECG showing narrow T waves
39. The electrolyte imbalance hypokalemia exhibits which clinical manifestations? (Select all that apply.)
a. Paralytic ileus
b. Sinus bradycardia
c. Atrioventricular block
d. Dry mucous membranes
40. A third of the body’s fluid is contained in the extracellular interstitial fluid spaces that include: (Select all that apply.)
b. Intraocular fluids
d. Blood plasma
41. An imbalance of potassium can produce which dysfunctions? (Select all that apply.)
a. Weakness skeletal muscles
b. Cardiac dysrhythmias
c. Smooth muscle atony
d. Visual impairment
e. Hearing loss
42. 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.
Match the electrolytes with the corresponding descriptions. Terms may be used more than once.
______ A. Sodium
______ B. Chloride
______ C. Potassium
______ D. Magnesium
______ E. Phosphate
43. Regulates osmolality in the extracellular fluid (ECF) space.
44. Is inversely related to HCO3 concentration.
45. Is a major determinant of resting membrane potential.
46. An intracellular metabolic form is adenosine triphosphate (ATP).
47. Changes in hydrogen ion concentration affect this electrolyte.