Chapter 26:Fluid, Electrolyte, and Acid-Base Balance

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1

Which of the following is NOT a chemical buffer system?

A) Nucleic Acid

B) Bicarbonate

C) Protein

D) Phosphate

A) Nucleic Acid

2

Metabolic Acidosis

Possibly caused by severe diarrhea or untreated diabetes mellitus

3

Respiratory Alkalosis

Possibly caused by asthma, pneumonia, or a severe panic attack

4

Respiratory Acidosis

Possibly occurring with emphysema, extreme obesity, or narcotic overdose

5

Metabolic Alkalosis

possibly caused by vomiting, use of diuretics, or use of antacids.

6

Which of the following is NOT a risk factor for dehydration?

A) inefficient kidneys

B) vomiting

C) a high rate of insensible water loss

D) increased muscle mass

D) Increased muscle mass

7

T/F: The most abundant cation in intracellular fluid is potassium.

TRUE

8
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In order to buffer a strong acid into a weak acid, which has a less dramatic effect on pH, what chemical should be used as the buffer?

Weak base

9

A patient is discovered to have a strange craving for iron objects. To try to determine the cause, her physician decides to order tests to determine if this patient might have some type of ______.

Anemia

10

Which hormone raises blood calcium levels?

PTH (parathyroid hormone)

11

The body's water volume is closely tied to a powerful water "magnet." What magnet is referred to here?

ionic Sodium

12

The most important renal mechanism for regulating acid-base balance of the blood involves __________.

maintaing HCO3- balance

13

Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________.

insufficient kidneys

14
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What is the hallmark of hypotonic hydration?

hyponatremia

15

What is the driving force for water intake?

Thirst

16
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What accounts for the route through which most fluid is lost in a day?

Urine

17

The fluid link between the external and internal environment is ________.

Plasma

18

Which of the following is the only logical explanation for why hypocalcemia increases neuromuscular excitability and causes muscle tetany?

A) Low plasma calcium ion concentration decreases the release of calcium ions from the sarcoplasmic reticulum.

B) Low plasma calcium ion concentration decreases the rate of exocytosis of synaptic vesicles.

C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated.

D) Low plasma calcium ion concentration increases the likelihood of acetic acid and choline being formed in the synaptic cleft when a neuron is stimulated to the threshold level.

C) Low plasma calcium ion concentration increases the permeability of neuron membranes to sodium ions, thereby causing depolarization that in turn increases the likelihood of action potentials being generated.

19

The regulation of potassium balance ________.

involves aldosterone-induced secretion of patassium

20

Which of the choices below is not an essential role of salts in the body?

A) membrane permeability

B) anabolism of lipids

C) neuromuscular activity

D) secretory activity

B) Anabolism of lipids

21
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What is the most common cation found in the interstitial fluid?

Na+ (sodium)

22

Which of the following is an electrolyte?

A) glucose

B) potassium

C) phospholipid

D) cholesterol

B) potassium

23

Sodium ions are highest in ___.

Blood Plasma

24

Potassium ions are highest in ___.

Intracellular fluid

25

Phosphate ions are highest in ___.

Intracellular fluid

26

bicarbonate ions are highest in ___.

Interstitial fluid

27

Proteins are highest in ___.

Intracellular fluid

28

Electrolytes

Dissociate in water

29

Nonelectrolytes

Do NOT dissociate in water

30

Extracellular

The fluid compartments outside the cell

31

Intracellular

Fluid compartments located within the cell

32

Interstitial

Spaced between cells

33

Newborn infants have a relatively higher ________ content in their ECF than do adults.

Sodium

34

Which of the following would NOT be expected to lead to edema?

A) incompetent venous valves

B) hyponatremia

C) inflammation

D) hypoproteinemia

B) Hyponatremia

35
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Which of the following regulates the secretion of K+ into the filtrate?

A) Aldosterone

B) Parathyroid Hormone (PTH)

C) Antidiuretic Hormone (ADH)

D) Atrial Natriuretic Peptide (ANP)

A) Aldosterone

36

A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. Which side of the heart failed, and how did this cause edema?

The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.

37

One of the major physiological factors that triggers thirst is ________.

a rise in plasma osmolality

38

What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention?

Atrial Natriuretic Peptide (ANP)

39

Which of the following creates the greatest osmotic pressure?

A) glucose

B) KCl

C) NaCl

D) MgCl2

D) MgCl2

40

Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid?

A) antidiuretic hormone

B) renin

C) erythropoietin

D) aldosterone

D) Aldosterone

41
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What is the most abundant intracellular cation?

K+

42
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Select the person in the following list who would have the highest percentage of water in his or her body.

A) a 25-year-old male of average weight

B) a 25-year-old overweight female

C) a 6-month-old baby boy

D) a 80-year-old man of average weight

C) a 6-month-old baby boy

43
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Which of the following is NOT involved in triggering the thirst mechanism?

A) osmoreceptors detect increased osmolality

B) increase in blood pressure

C) decrease in blood volume

D) dry mouth

B) Increase in blood pressre

44

Which age group most commonly has fluid, electrolyte, and acid-base balance issues?

A) Young Adults

B) Infants

C) Growing children

D) The elderly

B) infants

45
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Which of the following conditions promotes edema?

A) Diabetes Mellitus

B) Hyponatremia

C) hypoproteinemia

D) Hemorrhage

C) hypoproteinemia

46

Which of the following abnormalities would not be observed in a patient who has Addison's disease?

A) elevated blood plasma potassium level

B) hypertension

C) hyponatremia

D) decreased plasma chloride level

B) hypertension

**Hypertension (abnormally high blood pressure) is typically caused by restricting blood flow by vasoconstriction or abnormally high fluid volume in the blood. Water balance is regulated by anti-diuretic hormone secreted from the posterior pituitary.

47
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What results from increased levels of aldosterone?

A) increased K+ reabsorption

B) increased Ca2+ reabsorption

C) increased Na+ reabsorption

D) decreased Na+ reabsorption

C) increased Na+ reabsorption

48

Under normal circumstances, most water is lost in __________.

Urine

49

What type of water imbalance increases the amount of fluid in all compartments?

Hypotonic hydration

50

Which of the following does NOT serve as a source of acids in the body?

A) Fat metabolism

B) Ingested foods

C) Aerobic breakdown of glucose

D) CO2 in the blood

C) Aerobic breakdown of glucose

51

The maintenance of the proper pH of the body fluids may be the result of ________.

the control of respiratory ventilation

52

Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely?

metabolic acidosis

53

The single most important factor influencing potassium ion secretion is ___.

potassium ion concentration in blood plasma

54
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In a given day, what is the typical value for water intake?

2500 ml

55
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What receptors does the brain use to detect changes in osmolality?

Osmoreceptors

56

After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. What was the reason of her complaint, and what has caused this problem?

Respiratory alkalosis caused by hyperventilation. Claire was breathing faster and deeper due to stress.

57

The primary buffer of the extracellular fluid (ECF) is the ___.

bicarbonate buffer system

58

Which of the following statements is true regarding fluid shifts?

A) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.

B) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

C) Nonelectrolytes are the controlling factor in directing fluid shifts.

D) Electrolytes are not as important as proteins in regulating fluid shifts in the body.

B) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.

59

A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________.

Respiratory Acidosis

60

Which of the following is not a trigger for juxtaglomerular granular cells to release renin?

A) sympathetic stimulation

B) increased extracellular fluid water levels

C) decreased filtrate

D) NaCl concentration decreased stretch due to decreased blood pressure

B) Increased extracellular fluid water levels

61
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This chemical equation shows the reaction of a strong acid and weak base in the bicarbonate buffer system. Provide the products of the following reaction. HCl + NaHCO3 -->

H2CO3 + NaCl

62

Which buffer system if the most abundant in the body?

Protein

63

Edema

An atypical accumulation of fluid in the interstitial space

64

Hypoproteinemia

A condition of unusually low levels of plasma proteins resulting in tissue edema

65

Addisons Disease

A disorder entailing deficient mineralocortocoid hormone production by the adrenal cortex

66

Aldosterone

Regulates sodium ion concentrations in the extracellular fluid

67

Hyponatermia

A condition due to excessive water intake that results in net osmosis into tissue cells. This leads to severe metabolic disturbances.

68

Which of the following does not depend on the presence of electrolytes?

A) amount of body fat

B) membrane polarity

C) maintenance of osmotic relations between cells and ECF

D) neuromuscular excitability

A) Amount of body fat

69
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What hormone helps to maintain extracellular fluid (ECF) osmolality when concentrations become too high?

Antidiuretic hormone (ADH)

70

The regulation of sodium ________.

is linked to blood pressure

71
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What is the most abundant intracellular anion?

HPO4 2-

72
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What is the most important trigger for aldosterone release?

A) decreased sodium ion concentration in the extracellular fluids (ECF)

B) renin-angiotensin-aldosterone mechanism

C) increased osmolality of the extracellular fluids (ECF)

D) decreased K+ concentration in the extracellular fluids (ECF)

B) renin-angiotensin-aldosterone mechanism

73

Which of the following is not a disorder of water balance?

A) excessive hydration due to excess ANP secretion

B) excess water in interstitial spaces due to a low level of plasma proteins

C) hypotonic hydration, in which sodium content is normal but water content is high

D) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure

A) excessive hydration due to excess ANP secretion

74

Hypermagnesemia

Magnesium excess

75

Hypocalcemia

Calcium depletion

76

Hypernatremia

Sodium excess

77

Hyperkalemia

potassium excess

78

Hyponatremia

Sodium depletion

79

Which of the following is NOT a hormone involved in water and electrolyte balance?

A) thyroxine

B) atrial natriuretic peptide

C) ADH

D) aldosterone

A) Thyroxine

80
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How much water is generated per day from cellular metabolism?

250 ml

81

Which of the following describes the distribution of sodium and potassium between cells and body fluids?

A) equal amounts of each ion in the cells and body fluids

B) little of either in the cells, but large amounts of each in the body fluids

C) Na+ mainly in the cells, K+ in the body fluids

D) K+ mainly in the cells, Na+ in the body fluids

D) K+ mainly in the cells, Na+ in the body fluids

82

PTH (parathyroid hormone) acts on the ___ to ___ Ca2+ reabsorption.

Space 1. DCT

Space 2. increase

83

T/F: Potassium balance is controlled mainly by renal mechanisms.

TRUE

84
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Starvation would cause which of the following acid-base conditions? Also, determine what type of compensation (metabolic or respiratory) there would be.

Metabolic acidosis with respiratory compensation

85
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A patient is admitted to the hospital with the following plasma values: pH = 7.2, pCO2 = 55 mmHg, and HCO= 30 mEq/L. What is the acid base imbalance?

respiratory acidosis with metabolic compensation

86
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A patient is admitted to the hospital with the following plasma values: pH = 7.5, pCO2 = 45 mmHg, and HCO = 30 mEq/L. What is the acid-base imbalance?

Metabolic alkalosis with no compensation

87
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A patient is admitted to the hospital with the following plasma values: pH = 7.2, pCO2 = 25 mmHg, and HCO = 18 mEq/L. What is the acid base imbalance?

Metabolic acidosis with respiratory compensation

88
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Diarrhea can lead to which acid/base disturbance? Assuming compensation, would it be a metabolic or respiratory compensation?

Metabolic acidosis with respiratory compensation

89
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Emphysema can lead to which acid/base disturbance? What would be the compensation?

Respiratory acidosis; kidneys will retain more HCO3 and excrete H+

90

What solute in body fluids determines most of their chemical and physical reactions?

Electrolytes

91
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Of the three buffering mechanisms in the body, which is the strongest?

Renal System

92
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The bicarbonate buffer system is one of the chemical buffer systems of the body. How would the bicarbonate buffer system work is Sodium hydroxide were added to a solution?

A hydrogen on carbonic acid would dissociate and join the hydroxyl group on the base to form water and sodium bicarbonate

93
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The respiratory system is one of the 3 systems that regulate acid-base balance in the body. How does it work to decrease an acidosis?

Carbonic acid is broken down into water and CO2; the CO2 is then exhaled.

94
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In respiratory acidosis the kidney would do which of the following?

A) The kidney would reabsorb bicarbonate and secrete hydrogen ions.

B) The kidney would increase excretion of both bicarbonate and hydrogen ions.

C) The kidney will reabsorb both bicarbonate and hydrogen ions. When it reabsorbs the hydrogen ion, it also generates more bicarbonate ions.

A) The kidney would reabsorb bicarbonate and secrete hydrogen ions.

95
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Ingesting too much antacid would cause which of the following acid-base disturbances?

Metabolic alkalosis

96
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Vomiting would cause which type of acid-base disturbance?

Metabolis Alkalosis

97
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Severe anxiety would cause which type of acid-base disturbance? What would be the compensation?

Respiratory alkalosis

kidneys would excrete HCO3

98
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Which chemical buffer system is the only important system in the extracellular fluid (ECF) that resists short-term changes in pH?

bicarbonate buffer system

99

A decrease in blood CO2 levels leads to __________.

an increase in blood pH

100

The fluid that bathes the cells found in tissues is called __________.

Interstitial Fluid

101

The term alkaline reserve is used to describe the ________ buffer system.

bicarbonate

102

Which of the choices below exerts primary control over sodium levels in the body?

A) aldosterone

B) water levels

C) glucocorticoids

D) ADH

A) Aldosterone

103
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Where is the majority of water stored in the human body?

Intracellular Fluid (ICF) Compartment

104

A patient's anxiety caused her to develop respiratory alkalosis. What breathing technique did the nurse recommend, and why?

The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease.

105

Respiratory acidosis can occur when ________.

a person's breathing is shallow due to obstruction


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