Ch 26: Fluid, Electrolyte, and Acid-Base Balance
1) Adipose tissue is one of the most hydrated of all tissues in the human body.
FALSE
2) The most abundant cation in intracellular fluid is sodium.
FALSE
3) Electrolytes determine most of the chemical and physical reactions of body fluids.
TRUE
4) Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients.
FALSE
5) The thirst center in the brain is located in the hypothalamus.
TRUE
6) Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus.
TRUE
7) It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions.
FALSE
8) Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration.
TRUE
9) Salts are lost from the body in perspiration, and urine only.
FALSE
10) Excessive loss of water from the extracellular fluid (ECF) leads to a rise in osmotic pressure in the ECF which causes cells to shrink as water leaves by osmosis.
TRUE
11) Although the sodium content of the body may be altered, its concentration in the ECF remains relatively stable because of immediate adjustments in water volume.
TRUE
12) Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.
TRUE
13) When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the distal convoluted tubule.
TRUE
14) Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.
TRUE
15) Some potassium ions are reabsorbed from the kidney filtrate via type A intercalated cells, a unique population of collecting duct cells.
TRUE
16) Aldosterone is secreted in response to low extracellular potassium.
FALSE
17) To remain properly hydrated, water intake must equal water output.
TRUE
18) The main way the kidney regulates potassium ions is to excrete them.
TRUE
19) Atrial natriuretic peptide reduces blood pressure and blood volume by inhibiting nearly all events that promote vasodilation and potassium and water retention.
FALSE
20) Premenstrual edema may be due to enhanced reabsorption of sodium chloride.
TRUE
21) Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal.
TRUE
22) Hypercalcemia causes muscle tetany.
FALSE
23) The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin.
FALSE
24) Calcitonin targets the bones and causes the release of calcium from storage when serum levels are low.
FALSE
25) The normal pH of blood is 7.35-7.45.
TRUE
26) Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism.
TRUE
27) Weak acids are able to act as chemical buffering systems for the body because they only partially dissociate.
TRUE
28) The phosphate buffer system is relatively unimportant for buffering blood plasma.
TRUE
29) The single most important blood buffer system is the bicarbonate buffer system.
TRUE
30) One of the most powerful and plentiful sources of buffers is the protein buffer system.
TRUE
31) As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases.
TRUE
32) Carotid artery and aortic baroreceptors are involved in long term adjustment to total body sodium ion content.
TRUE
33) Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.
TRUE
34) Prolonged hyperventilation can cause alkalosis.
TRUE
35) Thirst is always a reliable indicator of body water need.
FALSE
36) Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS.
TRUE
1) The term hypotonic hydration refers to ________. A) a condition that may result from renal insufficiency or drinking extraordinary amounts of water B) the unpleasant feeling people have after drinking too much liquor C) the feeling one might have after profuse sweating with exertion D) a condition that is caused by high levels of sodium in the extracellular fluid compartment
A
2) When antidiuretic hormone (ADH) levels are low ________. A) nearly all of the filtered water is reabsorbed B) a small volume of concentrated urine is excreted C) most of the water reaching the collecting ducts is not reabsorbed D) aquaporins are inserted into the principal cell apical membranes
C
3) Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? A) erythropoietin B) antidiuretic hormone C) renin D) aldosterone
D
4) Atrial natriuretic peptide (ANP) is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. A) prevent pH changes caused by organic acids B) reduce blood pressure and blood volume by inhibiting sodium and water retention C) enhance atrial contractions D) activate the renin-angiotensin mechanism
B
5) Respiratory acidosis can occur when ________. A) a runner has completed a very long marathon B) a person consumes excessive amounts of antacids C) the kidneys secrete hydrogen ions D) a person's breathing is shallow due to obstruction
D
6) Which of the choices below is NOT an essential role of salts in the body? A) anabolism of lipids B) secretory activity C) neuromuscular activity D) membrane permeability
A
7) Which of the choices below exerts primary control over sodium levels in the body? A) glucocorticoids B) aldosterone C) water levels D) ADH
B
8) The fluid link between the external and internal environment is ________. A) plasma B) cerebrospinal fluid C) interstitial fluid D) intracellular fluid
A
9) In a car accident, Jane suffered a chest injury that resulted in impaired breathing and respiratory acidosis. How will her body compensate for this imbalance? A) kidneys eliminate bicarbonate ions B) kidneys retain bicarbonate ions C) kidneys retain hydrogen ions D) kidneys eliminate carbon dioxide
B
10) Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. A) potassium B) chloride C) bicarbonate D) iron
A
11) Which of the following describes the distribution of sodium and potassium between cells and body fluids? A) little of either in the cells, but large amounts of each 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) K+ mainly in the cells, Na+ in the body fluids
D
12) For bulk flow across capillary walls, ________. A) hydrostatic pressure of the interstitial space returns fluid to the capillary B) fluid runs into lymphatic capillaries that empty into the interstitial space C) hydrostatic pressure of blood forces nearly protein-free plasma out of the blood into the interstitial space D) osmotic pressure of plasma proteins pulls fluid from the capillary into the interstitial space
C
13) The single most important factor influencing potassium ion secretion is ________. A) potassium ion concentration in extracellular fluid B) the pH of the intracellular fluid C) intracellular sodium levels D) the potassium ion content in the renal tubule cells
A
14) The term alkaline reserve is used to describe the ________ buffer system. A) hemoglobin B) protein C) phosphate D) bicarbonate
D
15) A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. A) metabolic acidosis B) respiratory alkalosis C) metabolic alkalosis D) respiratory acidosis
D
16) The movement of fluids between cellular compartments ________. A) always involves filtration B) is regulated by osmotic and hydrostatic forces C) requires active transport D) requires ATP for the transport to take place
B
17) What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? A) atrial natriuretic peptide (ANP) B) antidiuretic hormone (ADH) C) thyroxine D) aldosterone
A
18) Which of the following is NOT a method for regulating the hydrogen ion concentration in blood? A) chemical buffers B) renal mechanisms C) respiratory changes D) diet
D
19) Which of the following is NOT a chemical buffer system? A) phosphate B) bicarbonate C) protein D) nucleic acid
D
20) Which of the following is NOT a trigger for juxtaglomerular granular cells to release renin? A) increased extracellular fluid water levels B) sympathetic stimulation C) decreased stretch of the granular cells of the afferent arterioles D) decreased filtrate NaCl concentration
A
21) 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) Nonelectrolytes are the controlling factor in directing fluid shifts. C) Electrolytes are not as important as proteins in regulating fluid shifts in the body. D) Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.
D
22) Which of the following hormones functions to increase water reabsorption by inserting aquaporins into the principal cell apical membranes? A) aldosterone B) progesterone C) atrial natriuretic peptide D) antidiuretic hormone
D
23) The maintenance of the proper pH of the body fluids may be the result of ________. A) control of the acids produced in the stomach B) the control of respiratory ventilation C) the operation of the various buffer systems in the stomach D) the active secretion of OH- into the filtrate by the kidney tubule cells
B
24) Which of the following is NOT a disorder of water balance? A) hypotonic hydration, in which sodium content is normal but water content is high B) excessive hydration due to excess atrial natriuretic peptide (ANP) secretion 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
B
25) The regulation of sodium ________. A) involves hypothalamic osmoreceptor detection of ion concentration B) is due to specific sodium receptors in the hypothalamus C) is linked to blood pressure D) involves aldosterone, a hormone that increases sodium excretion in the kidneys
C
26) 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) metabolic acidosis B) respiratory alkalosis C) respiratory acidosis D) metabolic alkalosis
A
27) A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? A) metabolic acidosis B) respiratory acidosis C) metabolic alkalosis D) respiratory alkalosis
C
28) One of the major physiological factors that triggers thirst is ________. A) becoming overly agitated B) a rise in plasma osmolality C) drinking caffeinated beverages D) a dry mouth from high temperatures
B
29) 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) There will be a temporary increase in blood volume. B) There will be a shift in the pH of her body fluids to the higher side of the pH scale. C) It will cause a prolonged increase in the osmolality of the blood. D) She will experience hypotension.
A
30) The most important force causing net outward water flow across capillary walls is ________. A) intracellular hydrostatic pressure B) hydrostatic pressure of capillary blood C) hydrostatic pressure of interstitial fluid D) osmotic pressure of plasma proteins
B
31) After completing a marathon on a particularly warm day, Dave consumes four liters of water. Soon after, he begins to feel nauseous and starts vomiting. What is likely happening to Dave? A) hypoproteinemia- unusually low levels of plasma proteins B) obligatory water loss C) dehydration D) hyponatremia- very low extracellular sodium ion concentration
D
32) Mary finds that she regularly retains water at a certain point in the menstrual cycle. Which of the following is chemically similar to aldosterone, and like aldosterone, enhances NaCl reabsorption in the renal tubules? A) follicle-stimulating hormone B) luteinizing hormone C) progesterone D) estrogen
D
33) Nancy is experiencing an acute panic attack. While hyperventilating, she remembers to open a paper bag and breathe into it. What is Nancy trying to prevent? A) respiratory acidosis B) metabolic acidosis C) respiratory alkalosis D) metabolic alkalosis
C
34) If the thyroid and parathyroid glands are surgically removed, which of the following would go out of balance without replacement therapy? A) anion levels B) sodium ion levels C) calcium ion levels D) potassium ion levels
C
35) Insufficient parathyroid hormone production in the body could result in ________. A) muscle weakness B) muscle twitching C) kidney stones D) cardiac arrhythmia
B
36) Molecules that can act reversibly as acids or bases depending upon the pH of their environment are called ________. A) amphoteric B) metabolic C) compensatory D) volatile
A
37) Falling arterial blood pressure promotes ________. A) enhanced sodium ion loss in urine B) vasodilation C) enhanced water loss in urine D) vasoconstriction
D
38) An illness causes Doug to experience severe diarrhea and an accompanying loss of bicarbonate-rich secretions. How can this metabolic acidosis be compensated? A) increased respiratory rate and depth B) increased renin secretion C) hypoventilation D) enhanced sodium ion loss in urine
A