Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1)
The single most important factor influencing potassium ion secretion is ________.
1)
A)
intracellular sodium levels
B)
potassium ion concentration in blood plasma
C)
the potassium ion content in the renal tubule cells
D)
the pH of the ICF
2)
Which of the following statements is true regarding fluid shifts?
2)
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.
3)
The maintenance of the proper pH of the body fluids may be the result of ________.
3)
A)
control of the acids produced in the stomach
B)
the active secretion of OH– into the filtrate by the kidney tubule cells
C)
the control of respiratory ventilation
D)
the operation of the various buffer systems in the stomach
4)
The fluid link between the external and internal environment is ________.
4)
A)
interstitial fluid
B)
plasma
C)
cerebrospinal fluid
D)
intracellular fluid
5)
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?
5)
A)
metabolic acidosis
B)
metabolic alkalosis
C)
respiratory acidosis
D)
respiratory alkalosis
6)
Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this
hormone is to ________.
6)
A)
reduce blood pressure and blood volume by inhibiting sodium and water retention
B)
activate the renin–angiotensin mechanism
C)
prevent pH changes caused by organic acids
D)
enhance atrial contractions
7)
Respiratory acidosis can occur when ________.
7)
A)
a person consumes excessive amounts of antacids
B)
the kidneys secrete hydrogen ions
C)
a person’s breathing is shallow due to obstruction
D)
a runner has completed a very long marathon
8)
The regulation of potassium balance ________.
8)
A)
is accomplished mainly by hepatic mechanisms
B)
involves aldosterone–induced secretion of potassium
C)
includes renal secretion, but never absorption
D)
is not linked to sodium balance
9)
Which of the choices below exerts primary control over sodium levels in the body?
9)
A)
aldosterone
B)
glucocorticoids
C)
ADH
D)
water levels
10)
Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often
characterized by ________.
10)
A)
confusion
B)
extreme weight loss
C)
tissue edema
D)
nerve damage
11)
Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the
intracellular fluid.
11)
A)
chloride
B)
potassium
C)
bicarbonate
D)
iron
12)
One of the major physiological factors that triggers thirst is ________.
12)
A)
drinking caffeinated beverages
B)
a dry mouth from high temperatures
C)
becoming overly agitated
D)
a rise in plasma osmolality
13)
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?
13)
A)
It will cause a prolonged increase in the osmolality of the blood.
B)
There will be a shift in the pH of her body fluids to the higher side of the pH scale.
C)
There will be a temporary increase in blood volume.
D)
She will experience hypotension.
14)
Which of the following is not a chemical buffer system?
14)
A)
protein
B)
nucleic acid
C)
phosphate
D)
bicarbonate
15)
Which of the following hormones is important in stimulating water conservation in the kidneys?
15)
A)
antidiuretic hormone
B)
progesterone
C)
atrial natriuretic peptide
D)
aldosterone
16)
The regulation of sodium ________.
16)
A)
is linked to blood pressure
B)
is due to specific sodium receptors in the hypothalamus
C)
involves aldosterone, a hormone that increases sodium excretion in the kidneys
D)
involves hypothalamic osmoreceptor detection of ion concentration
17)
Total body water is not a function of which of the following?
17)
A)
amount of body fat
B)
body mass
C)
age
D)
amount of water ingested
18)
What hormone reduces blood pressure and blood volume by inhibiting nearly all events that
promote vasoconstriction and sodium ion and water retention?
18)
A)
thyroxine
B)
atrial natriuretic peptide
C)
ADH
D)
aldosterone
19)
A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or
emphysema indicates ________.
19)
A)
metabolic alkalosis
B)
metabolic acidosis
C)
respiratory alkalosis
D)
respiratory acidosis
20)
Which of the following hormones is important in the regulation of sodium ion concentrations in the
extracellular fluid?
20)
A)
renin
B)
aldosterone
C)
antidiuretic hormone
D)
erythropoietin
21)
Which of the choices below is not an essential role of salts in the body?
21)
A)
anabolism of lipids
B)
membrane permeability
C)
secretory activity
D)
neuromuscular activity
22)
Which of the following is not a trigger for juxtaglomerular granular cells to release renin?
22)
A)
sympathetic stimulation
B)
decreased filtrate NaCl concentration
C)
increased extracellular fluid water levels
D)
decreased stretch due to decreased blood pressure
23)
Which of the following is not a method for regulating the hydrogen ion concentration in blood?
23)
A)
chemical buffer systems
B)
respiratory changes
C)
renal mechanism
D)
diet
24)
The most important force causing net water flow across capillary walls is ________.
24)
A)
hydrostatic pressure of interstitial fluid
B)
osmotic pressure of plasma proteins
C)
hydrostatic pressure of capillary blood
D)
intracellular hydrostatic pressure
25)
A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is
the likely diagnosis?
25)
A)
respiratory alkalosis
B)
metabolic alkalosis
C)
respiratory acidosis
D)
metabolic acidosis
26)
The term hypotonic hydration refers to ________.
26)
A)
a condition that may result from renal insufficiency or drinking extraordinary amounts of
water
B)
a condition that is caused by high levels of sodium in the extracellular fluid compartment
C)
the unpleasant feeling people have after drinking too much liquor
D)
the feeling one might have after profuse sweating with exertion
27)
The movement of fluids between cellular compartments ________.
27)
A)
is regulated by osmotic and hydrostatic forces
B)
requires ATP for the transport to take place
C)
requires active transport
D)
involves filtration
28)
Which of the following is not a disorder of water balance?
28)
A)
edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure
B)
excessive hydration due to excess ANP secretion
C)
excess water in interstitial spaces due to a low level of plasma proteins
D)
hypotonic hydration, in which sodium content is normal but water content is high
29)
The body‘s water volume is closely tied to the level of which of the following ions?
29)
A)
sodium ions
B)
calcium ions
C)
hydrogen ions
D)
potassium ions
30)
Problems with fluid, electrolyte, and acid–base balance are particularly common in infants because
of their ________.
30)
A)
inefficient kidneys
B)
low daily rate of fluid exchange
C)
low rate of insensible water loss
D)
comparatively low metabolic rates
31)
The term alkaline reserve is used to describe the ________ buffer system.
31)
A)
hemoglobin
B)
phosphate
C)
protein
D)
bicarbonate
32)
Newborn infants have a relatively higher ________ content in their ECF than do adults.
32)
A)
iron
B)
magnesium
C)
bicarbonate
D)
sodium
33)
Which of the following describes the distribution of sodium and potassium between cells and body
fluids?
33)
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)
K+ mainly in the cells, Na+ in the body fluids
D)
equal amounts of each ion in the cells and body fluids
34)
Which of the following does not depend on the presence of electrolytes?
34)
A)
membrane polarity
B)
amount of body fat
C)
maintenance of osmotic relations between cells and ECF
D)
neuromuscular excitability
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
35)
The most important physiological buffer systems are the lungs and ________.
35)
36)
The electrolyte deficiency condition where the individual may crave substances like clay,
chalk, starch or burnt match tips is called ________.
36)
37)
The female hormone ________ seems to decrease sodium reabsorption, thus promoting
sodium and water loss by the kidney.
37)
38)
Molecules that can act reversibly as acids or bases depending upon the pH of their
environment are called ________.
38)
39)
How does the respiratory system influence the buffer systems of the body?
39)
40)
When does a person experience greater thirst, during periods when ADH release is elicited
or during periods when aldosterone release is elicited?
40)
41)
What is the effect of acidosis on the body? Of alkalosis?
41)
42)
Parathyroid hormone regulates ________ ions in the body.
42)
43)
Respiratory alkalosis occurs when carbon dioxide is eliminated ________ than it is
produced.
43)
44)
Acidosis occurs when arterial blood pH is below ________.
44)
45)
Identify and describe the operation of the three major chemical buffers of the body.
45)
46)
Describe the influence of rising PTH levels on bone, the small intestine, and the kidneys.
46)
47)
Why would an infant with colic be suffering from respiratory alkalosis?
47)
48)
The breakdown of phosphorus–containing proteins releases ________ acid.
48)
49)
When the blood becomes hypertonic (too many solutes), ADH is released. What is the
effect of ADH on the kidney tubules?
49)
50)
Describe the mechanisms by which the kidneys remove hydrogen ions from the body.
50)
51)
What provides the shortest–term mechanism for preventing acid–base imbalances in the
body? The longest–term mechanism?
51)
TRUE/FALSE. Write ‘T’ if the statement is true and ‘F’ if the statement is false.
52)
Premenstrual edema may be due to enhanced reabsorption of sodium chloride.
52)
53)
Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems.
53)
54)
Salts are lost from the body in perspiration, and urine only.
54)
55)
Calcitonin targets the bones and causes the release of calcium from storage when serum levels are
low.
55)
56)
Hypercalcemia causes muscle tetany.
56)
57)
Some potassium ions are reabsorbed from the kidney filtrate via type A intercalated cells.
57)
58)
Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes
insipidus.
58)
59)
Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of
the CNS.
59)
60)
As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion
concentration of the blood decreases.
60)
61)
The most abundant cation in intracellular fluid is sodium.
61)
62)
Aldosterone is secreted in response to low extracellular potassium.
62)
63)
The single most important blood buffer system is the bicarbonate buffer system.
63)
64)
One of the most powerful and plentiful sources of buffers is the protein buffer system.
64)
65)
Weak acids are able to act as chemical buffering systems for the body because they partially
dissociate.
65)
66)
When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the distal
convoluted tubule.
66)
67)
Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient.
67)
68)
Adipose tissue is one of the most hydrated of all tissues in the human body.
68)
69)
Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion.
69)
70)
The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin.
70)
71)
The normal pH of blood is 7.35–7.45.
71)
72)
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.
72)
73)
To remain properly hydrated, water intake must equal water output.
73)
74)
Solutes, regardless of size, are able to move freely between compartments because water carries
them along the osmotic gradients.
74)
75)
Most acidic substances (hydrogen ions) originate as by–products of cellular metabolism.
75)
76)
The main way the kidney regulates potassium ions is to excrete them.
76)
77)
Carotid artery and aortic baroreceptors are involved in long term adjustment to total body sodium
ion content.
77)
78)
Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed
dehydration.
78)
79)
The phosphate buffer system is relatively unimportant for buffering blood plasma.
79)
80)
Thirst is always a reliable indicator of body water need.
80)
81)
Prolonged hyperventilation can cause alkalosis.
81)
82)
Hypoproteinemia reflects a condition of unusually high levels of plasma proteins and causes tissue
edema.
82)
83)
Electrolytes determine most of the chemical and physical reactions of body fluids.
83)
84)
The thirst center in the brain is located in the hypothalamus.
84)
85)
Atrial natriuretic peptide reduces blood pressure and blood volume by inhibiting nearly all events
that promote vasodilation and potassium and water retention.
85)
86)
Heavy consumption of salt substitutes high in potassium can present a serious clinical problem
when aldosterone release is not normal.
86)
87)
It is impossible to overhydrate because people need as much water as they can drink to carry out
ordinary body functions.
87)
MATCHING. Choose the item in column 2 that best matches each item in column 1.
Match the following:
88)
Potassium excess.
88)
A)
Hyperkalemia
Match the following:
89)
Spaces between cells.
89)
A)
Interstitial
Match the following:
90)
Possibly caused by vomiting, use of
diuretics, or use of antacids
A)
Metabolic alkalosis
90)
Match the following:
91)
Calcium depletion.
91)
A)
Hypocalcemia
13
Match the following:
92)
Regulates sodium ion concentrations
in the extracellular fluid.
93)
An atypical accumulation of fluid in
the interstitial space.
A)
Edema
92)
93)
Match the electrolyte composition for the following:
94)
Potassium ions are highest in
________.
A)
intracellular fluid
94)
Match the following:
95)
Possibly occurring with emphysema,
extreme obesity, or narcotic overdose
A)
Respiratory acidosis
95)
Match the following:
96)
Sodium excess.
A)
Hypernatremia
96)
Match the following:
97)
A condition due to excessive water
intake that results in net osmosis into
tissue cells. This leads to severe
metabolic disturbances.
A)
Hyponatremia
97)
Match the following:
98)
Sodium depletion.
98)
A)
Hyponatremia
Match the electrolyte composition for the following:
99)
Proteins are highest in ________.
A)
intracellular fluid
99)
Match the following:
100)
Do not dissociate.
100)
A)
Nonelectrolytes
Match the electrolyte composition for the following:
101)
Bicarbonate ions are highest in
________.
102)
Phosphate ions are highest in
________.
A)
intracellular fluid
101)
102)
Match the following:
103)
Dissociate in water.
104)
Fluid compartments located within the
cell.
105)
The fluid compartments outside the
cell.
A)
Intracellular
B)
Extracellular
C)
Electrolytes
104)
105)
Match the following:
106)
Magnesium excess.
106)
A)
Hypermagnesemia
Match the following:
107)
A condition of unusually low levels of
plasma proteins resulting in tissue
edema.
108)
A disorder entailing deficient
mineralocorticoid hormone
production by the adrenal cortex.
A)
Addison’s disease
B)
Hypoproteinemia
107)
108)
Match the electrolyte composition for the following:
109)
Sodium ions are highest in ________.
109)
A)
blood plasma
Match the following:
110)
Possibly caused by severe diarrhea or
untreated diabetes mellitus
B)
111)
Possibly caused by asthma,
pneumonia, or a severe panic attack
A)
Respiratory alkalosis
110)
111)
ESSAY. Write your answer in the space provided or on a separate sheet of paper.
112)
Helen is a 62–year–old smoker. Her physician has diagnosed her as having emphysema that has caused her to
hypoventilate. Surprisingly, when her blood pH is checked, it is 7.40. Why?
103)
113)
A patient’s anxiety caused her to develop respiratory alkalosis. The nurse instructs the patient to take some slow
deep breaths. Explain why this would be effective.
114)
After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help.
The clinic’s diagnosis is respiratory alkalosis. What has caused this problem?
115)
A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3– is 20 mEq/L.
What diagnosis would you give and what prognosis? A medical history reveals that this patient is a chronic
alcoholic.
116)
A 13–year–old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64
inches. She admits to frequent self–induced vomiting and abuse of laxatives. She was treated on the medical
unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as
evidenced by mild puffiness and bloating. Explain these symptoms.
117)
A pregnant woman complains to her doctor that her ankles and feet stay swollen all of the time. She is very
worried about this. As her doctor, what would you tell her?
118)
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. A symptom of heart failure is generalized edema. Explain the
finding of generalized edema in heart failure.
Answer Key
Testname: C26
17
Answer Key
Testname: C26
45)
The bicarbonate buffer system (carbonic acid plus sodium bicarbonate) acts to tie up the hydrogen ions released by a
strong acid, thus converting it to a weaker acid, which lowers the pH only slightly. For a strong base, the carbonic acid
will be forced to donate more H+ to tie up the OH– released by the base, with the net result of replacement of a strong
base by a weak one. The pH rise is very small. The phosphate buffer system, composed of the sodium salts of
dihydrogen phosphate and monohydrogen phosphate, acts in a similar fashion to the bicarbonate system. NaH2PO4
acts as a weak acid; Na2HPO4 acts as a weak base. Hydrogen ions released by strong acids are tied up in weak acids;
strong bases are converted to weak bases. Amino acids of the protein buffer system release H+ when the pH begins to
rise by dissociating carboxyl groups, or bind hydrogen ions with amine groups to form NH3+ when the pH falls.
46)
Parathyroid hormone (PTH) activates osteoclasts that break down the bone matrix, resulting in the release of Ca2+ and
PO43– to the blood. PTH enhances intestinal absorption of Ca2+ indirectly by stimulating the kidneys to transform
vitamin D to its active form, which is necessary for calcium absorption by the small intestine. PTH increases the
reabsorption of calcium by the renal tubules, which simultaneously decreases phosphate ion reabsorption.
47)
If the infant is uncomfortable and cries forcefully for long periods of time, this would be similar to hyperventilation.
Hyperventilation would cause respiratory alkalosis because the infant is losing carbon dioxide rapidly.
48)
phosphoric
49)
The release of ADH causes the kidney tubules to reabsorb excess water, resulting in the excretion of concentrated
urine.
50)
Virtually all of the H+ that leaves the body in urine is secreted into the filtrate. The tubule cells, including collecting
ducts, appear to respond directly to the pH of the ECF and to alter their rate of H+ secretion accordingly. The secreted
H+ ions are obtained from the dissociation of carbonic acid within the tubule cells. For each H+ ion actively secreted
into the tubule lumen, one sodium ion is reabsorbed into the tubule cell from the filtrate, thus maintaining the
electrochemical balance.
51)
Chemical buffers act within a fraction of a second to resist a pH change. The longest–term mechanism is the kidney
system, which ordinarily requires from several hours to a day or more to effect changes in blood pH.
52)
TRUE
53)
TRUE
54)
FALSE
55)
FALSE
56)
FALSE
57)
TRUE
58)
TRUE
59)
TRUE
60)
TRUE
61)
FALSE
62)
FALSE
63)
TRUE
64)
TRUE
65)
TRUE
66)
TRUE
67)
TRUE
68)
FALSE
69)
TRUE
70)
FALSE
71)
TRUE
72)
TRUE
73)
TRUE
74)
FALSE
75)
TRUE
18
Answer Key
Testname: C26
Answer Key
Testname: C26
20