Chapter 26 Fluid, Electrolyte, and Acid-Base Balance

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1

Dissociate in water

A) Intracellular
B) Interstitial
C) Nonelectrolytes
D) Extracellular
E) Electrolytes

E) Electrolytes

2

Do not dissociate

A) Intracellular
B) Interstitial
C) Nonelectrolytes
D) Extracellular
E) Electrolytes

C) Nonelectrolytes

3

The fluid compartments outside the cell

A) Intracellular
B) Interstitial
C) Nonelectrolytes
D) Extracellular
E) Electrolytes

D) Extracellular

4

Fluid compartments located within the cell.

A) Intracellular
B) Interstitial
C) Nonelectrolytes
D) Extracellular
E) Electrolytes

A) Intracellular

5

Spaces between cell.

A) Intracellular
B) Interstitial
C) Nonelectrolytes
D) Extracellular
E) Electrolytes

B) Interstitial

6

Magnesium excess.

A) Hyperkalemia
B) Hypermagnesemia
C) Hypernatremia
D) Hypocalcemia
E) Hyponatremia

B) Hypermagnesemia

7

Calcium depletion.

A) Hyperkalemia
B) Hypermagnesemia
C) Hypernatremia
D) Hypocalcemia
E) Hyponatremia

D) Hypocalcemia

8

Sodium excess.

A) Hyperkalemia
B) Hypermagnesemia
C) Hypernatremia
D) Hypocalcemia
E) Hyponatremia

C) Hypernatremia

9

Potassium excess.

A) Hyperkalemia
B) Hypermagnesemia
C) Hypernatremia
D) Hypocalcemia
E) Hyponatremia

A) Hyperkalemia

10

Sodium depletion.

A) Hyperkalemia
B) Hypermagnesemia
C) Hypernatremia
D) Hypocalcemia
E) Hyponatremia

E) Hyponatremia

11

An atypical accumulation of fluid in the interstitial space.

A) Hypoproteinemia
B) Edema
C) Aldosterone
D) Hyponatremia
E) Addison's disease

B) Edema

12

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

A) Hypoproteinemia
B) Edema
C) Aldosterone
D) Hyponatremia
E) Addison's disease

A) Hypoproteinemia

13

A disorder entailing deficient mineralocorticoid hormone production by the adrenal cortex.

A) Hypoproteinemia
B) Edema
C) Aldosterone
D) Hyponatremia
E) Addison's disease

E) Addison's disease

14

Regulates sodium ion concentrations in the extracellular fluid.

A) Hypoproteinemia
B) Edema
C) Aldosterone
D) Hyponatremia
E) Addison's disease

C) Aldosterone

15

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

A) Hypoproteinemia
B) Edema
C) Aldosterone
D) Hyponatremia
E) Addison's disease

D) Hyponatremia

16

Sodium ions are highest in ________.
A) interstitial fluid
B) blood plasma
C) intracellular fluid

B) blood plasma

17

Potassium ions are highest in ________.
A) interstitial fluid
B) blood plasma
C) intracellular fluid

C) intracellular fluid

18

Phosphate ions are highest in ________.
A) interstitial fluid
B) blood plasma
C) intracellular fluid

C) intracellular fluid

19

Bicarbonate ions are highest in ________.
A) interstitial fluid
B) blood plasma
C) intracellular fluid

A) interstitial fluid

20

Proteins are highest in ________.
A) interstitial fluid
B) blood plasma
C) intracellular fluid

C) intracellular fluid

21

True/False Questions
Adipose tissue is one of the most hydrated of all tissues in the human body

False

22

True/False Questions
The most abundant cation in intracellular fluid is sodium.

False

23

True/False Questions
Electrolytes determine most of the chemical and physical reactions of the body

True

24

True/False Questions
Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients.

False

25

True/False Questions
The thirst center in the brain is located in the hypothalamus

True

26

True/False Questions
Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus

True

27

True/False Questions
It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions.

False

28

True/False Questions
Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration

True

29

True/False Questions
Salts are lost from the body in perspiration, feces, and urine

True

30

True/False Questions
Hypoproteinemia reflects a condition of unusually high levels of plasma proteins and causes tissue edema.

False

31

True/False Questions
Although the sodium content of the body may be altered, its concentration in the ECF remains stable because of immediate adjustments in water volume.

True

32

True/False Questions
Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.

True

33

True/False Questions
When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the collecting tube

True

34

True/False Questions
Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.

True

35

True/False Questions
Pressure diuresis decreases blood volume and blood pressure

True

36

True/False Questions
Aldosterone is secreted in response to low extracellular potassium

False

37

True/False Questions
To remain properly hydrated, water intake must equal water output

True

38

True/False Questions
The main way the kidney regulates potassium ions is to excrete them

True

39

True/False Questions
Atrial natriuretic peptide reduces blood pressure and blood volume by inhibiting nearly all events that promote vasodilation and potassium and water retention.

False

40

True/False Questions
Premenstrual edema may be due to enhanced reabsorption of sodium chloride.

True

41

True/False Questions
Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal.

True

42

True/False Questions
Hypercalcemia causes muscle tetany

False

43

True/False Questions
The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin.

False

44

True/False Questions
Calcitonin targets the bones and causes the release of calcium from storage when serum levels are low.

False

45

True/False Questions
The normal pH of blood is 7.35-7.45.

True

46

True/False Questions
Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism

True

47

True/False Questions
Weak acids are able to act as chemical buffering systems for the body because they partially dissociate.

True

48

True/False Questions
The phosphate buffer system is relatively unimportant for buffering blood plasma

True

49

True/False Questions
The single most important blood buffer system is the bicarbonate buffer system

True

50

True/False Questions
One of the most powerful and plentiful sources of buffers is the protein buffer system.

True

51

True/False Questions
As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases.

True

52

True/False Questions
Regulation of the acid-base system is accomplished mainly through respiratory control, and the kidneys also play a small role

False

53

True/False Questions
Severe damage to the respiratory system rarely will result in acid-base imbalances.

False

54

True/False Questions
Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.

True

55

True/False Questions
Prolonged hyperventilation can cause alkalosis.

True

56

True/False Questions
Thirst is always a reliable indicator of body water need.

False

57

True/False Questions
Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS.

True

58

The body’s water volume is closely tied to the level of which of the following ions?
A) calcium ions
B) potassium ions
C) hydrogen ions
D) sodium ions

D) sodium ions

59

The term hypotonic hydration refers to ________.
A) the feeling one might have after a long swim
B) the unpleasant feeling people have after drinking too much liquor
C) a condition that may result from renal insufficiency or drinking extraordinary amounts of water
D) a condition that is caused by high levels of sodium in the extracellular fluid compartment

C) a condition that may result from renal insufficiency or drinking extraordinary amounts of water

60

Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________.
A) tissue edema
B) extreme weight loss
C) extreme weight gain
D) nerve damage

A) tissue edema

61

Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid?
A) antidiuretic hormone
B) erythropoietin
C) aldosterone
D) renin

C) aldosterone

62

Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this hormone is to ________.
A) enhance atrial contractions
B) activate the renin-angiotensin mechanism
C) prevent pH changes caused by organic acids
D) reduce blood pressure and blood volume by inhibiting sodium and water retention

D) reduce blood pressure and blood volume by inhibiting sodium and water retention

63

Respiratory acidosis can occur when ________.
A) a person consumes excessive amounts of antacids
B) a person's breathing is shallow due to obstruction
C) a runner has completed a very long marathon
D) the kidneys secrete hydrogen ions

B) a person's breathing is shallow due to obstruction

64

Which of the following two organs function as the most important physiological buffer systems?
A) the lungs and the kidneys
B) the adrenal glands and the testes
C) the thyroid gland and the heart
D) the stomach and the liver

A) the lungs and the kidneys

65

Which of the choices below is not an essential role of salts in the body?
A) neuromuscular activity
B) membrane permeability
C) secretory activity
D) anabolism of proteins

D) anabolism of proteins

66

Which of the choices below exerts primary control over sodium levels in the body?
A) ADH
B) aldosterone
C) water levels
D) glucocorticoids

B) aldosterone

67

The fluid link between the external and internal environment is ________.
A) plasma
B) intracellular fluid
C) interstitial fluid
D) cerebrospinal fluid

A) plasma

68

Newborn infants have a relatively higher ________ content in their ECF than do adults.
A) iron
B) sodium
C) magnesium
D) bicarbonate

B) sodium

69

Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid.
A) iron
B) chloride
C) potassium
D) magnesium

C) potassium

70

Which of the following describes the distribution of sodium and potassium between cells and body fluids?
A) K+ mainly in the cells, Na+ in the body fluids
B) Na+ mainly in the cells, K+ in the body fluids
C) equal amounts of each ion in the cells and body fluids
D) little of either in the cells, but large amounts of each in the body fluids

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

71

Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________.
A) inefficient kidneys
B) comparatively low metabolic rates
C) low rate of insensible water loss
D) low daily rate of fluid exchange

A) inefficient kidneys

72

The single most important factor influencing potassium ion secretion is ________.
A) the potassium ion content in the renal tubule cells
B) the pH of the ICF
C) intracellular sodium levels
D) potassium ion concentration in blood plasma

D) potassium ion concentration in blood plasma

73

The term alkaline reserve is used to describe the ________ buffer system.
A) phosphate
B) hemoglobin
C) bicarbonate
D) protein

C) bicarbonate

74

A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________.
A) respiratory acidosis
B) respiratory alkalosis
C) metabolic acidosis
D) metabolic alkalosis

A) respiratory acidosis

75

The movement of fluids between cellular compartments ________.
A) requires active transport
B) is regulated by osmotic and hydrostatic forces
C) requires ATP for the transport to take place
D) involves filtration

B) is regulated by osmotic and hydrostatic forces

76

What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention?
A) ADH
B) aldosterone
C) atrial natriuretic peptide
D) thyroxine

C) atrial natriuretic peptide

77

Which of the following is not a method for regulating the hydrogen ion concentration in blood?
A) chemical buffer systems
B) diet
C) respiratory changes
D) renal mechanism

B) diet

78

Which of the following is not a chemical buffer system?
A) bicarbonate
B) phosphate
C) nucleic acid
D) protein

C) nucleic acid

79

Extracellular fluid in the human body is composed of all of the following except ________.
A) lymph and interstitial fluid
B) blood plasma
C) cerebrospinal fluid
D) glucose

D) glucose

80

Which of the following statements is true regarding fluid shifts?
A) Nonelectrolytes are the controlling factor in directing fluid shifts.
B) Electrolytes are not as important as proteins in regulating fluid shifts in the body.
C) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.
D) There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.

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

81

Which of the following hormones is important in stimulating water conservation in the kidneys?
A) aldosterone
B) thymosin
C) antidiuretic hormone
D) atrial natriuretic peptide

C) antidiuretic hormone

82

The maintenance of the proper pH of the body fluids may be the result of ________.
A) the control of respiratory ventilation
B) the operation of the various buffer systems in the stomach
C) the active secretion of OH- into the filtrate by the kidney tubule cells
D) control of the acids produced in the stomach

A) the control of respiratory ventilation

83

Which of the following is not a disorder of water balance?
A) excessive hydration due to excess ADH secretion
B) hypotonic hydration, in which sodium content is normal but water content is high
C) edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure
D) excess water in interstitial spaces due to a low level of plasma proteins

A) excessive hydration due to excess ADH secretion

84

The regulation of sodium ________.
A) is due to specific sodium receptors in the hypothalamus
B) is linked to blood pressure
C) involves aldosterone, a hormone that increases sodium excretion in the kidneys
D) involves hypothalamic osmoreceptor detection of ion concentration

B) is linked to blood pressure

85

Select the correct statement about renal mechanisms of acid-base balance.
A) The kidneys are not able to excrete phosphoric acid.
B) Excreted hydrogen ions are unbound in the filtrate.
C) Kidney tubule cells are able to synthesize bicarbonate ion.
D) The kidneys are the most important mechanism for eliminating all bicarbonate ions.

C) Kidney tubule cells are able to synthesize bicarbonate ion.

86

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?
A) respiratory acidosis
B) metabolic acidosis
C) metabolic alkalosis
D) respiratory alkalosis

B) metabolic acidosis

87

A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis?
A) respiratory acidosis
B) metabolic acidosis
C) metabolic alkalosis
D) respiratory alkalosis

C) metabolic alkalosis

88

One of the major physiological factors that triggers thirst is ________.
A) a dry mouth from high temperatures
B) becoming overly agitated
C) drinking caffeinated beverages
D) a rise in plasma osmolality

D) a rise in plasma osmolality

89

Annie has just eaten a large order of heavily salted french fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology?
A) It will increase the osmolality of the blood.
B) There will be a temporary increase in blood volume.
C) She will experience hypotension.
D) There will be a shift in the pH of her body fluids to the higher side of the pH scale.

B) There will be a temporary increase in blood volume.

90

The most important force causing net water flow across capillary walls is ________.
A) osmotic pressure of plasma proteins
B) hydrostatic pressure of capillary blood
C) hydrostatic pressure of interstitial fluid
D) intracellular hydrostatic pressure

B) hydrostatic pressure of capillary blood

91

Which of the following does not depend on the presence of electrolytes?
A) membrane polarity
B) neuromuscular excitability
C) maintenance of osmotic relations between cells and ECF
D) amount of body fat

D) amount of body fat

92

The regulation of potassium balance ________.
A) is not linked to sodium balance
B) includes renal secretion, but never absorption
C) is accomplished mainly by hepatic mechanisms
D) involves aldosterone-induced secretion of potassium

D) involves aldosterone-induced secretion of potassium

93

________ occurs when carbon dioxide is eliminated faster than it is produced

Respiratory alkalosis

94

The female hormone ________ seems to decrease sodium reabsorption, thus promoting sodium and water loss by the kidney.

Progesterone

95

The preferred intracellular negative ion is ________.

Hydrogen Phosphate

96

The most important ECF buffer of HCl is ________.

Sodium Bicarbonate

97

The most important hormone that regulates calcium ions in the body is ________.

PTH (parathyroid hormone)

98

Molecules that can act reversibly as acids or bases depending upon the pH of their environment are called ________.

Amphoteric

99

The breakdown of phosphorus-containing proteins releases ________ acid.

Phosphoric

100

Arterial blood pH below 7.35 is called ________.

Acidemia or Acidosis

101

________ reduces blood pressure and volume by inhibiting nearly all events that promote vasoconstriction and the retention of sodium ions and water.

Atrial natriuretic peptide