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Fluid and Electrolyte balance & Disorders Basic Nursing & Human

Total questions: 126

Worksheet time: 1hrs 3mins

Name
Class
Date
1.

Which diagram shows the correct sequence for homeostasis?

a)

Receptor (sensing component) → control center (brain) → appropriate response (effectors muscles, organs, hormones) → change (positive or negative feedback) = homeostasis.

b)

Receptor (sensing component) → appropriate response (effectors-muscles, organs, hormones) → control center (brain) → change (positive or negative feedback) = homeostasis.

c)

Appropriate response (effectors—muscles, organs, hormones) → control center (brain) → change (positive or negative feedback) → receptor (sensing component) = homeostasis.

d)

Appropriate response (effectors-muscles, organs, hormones) → change (positive or negative feedback) → control center (brain) → receptor (sensing component) = homeostasis.

2.

What information should be included in discussion concerning intracellular fluid? Select all that apply.

a)

It is the fluid found inside the cell

b)

It constitutes about one half to two thirds of the total body fluid in an adult

c)

The major ions in intracellular fluid are potassium, magnesium, and phosphate. It appears mostly as interstitial fluid and intravascular fluid

d)

  1. It appears mostly as interstitial fluid and intravascular fluid

e)

The volume of intracellular fluid is the most important regulated aspect of body fluid balance.

3.

The body monitors extracellular fluid volume closely and sends messages to the brain, kidneys, and pituitary gland to maintain control. What information accurately describes the associated regulatory process?

a)

The thirst center in the thalamus stimulates or inhibits the desire for a person to drink.

b)

Antidiuretic hormone is released from storage in the anterior pituitary gland as part of the positive feedback mechanism in response to conditions within the cardiovascular system.

c)

When antidiuretic hormone is released, urine production is increased and water reabsorption is decreased.

d)

The renin-angiotensin-aldosterone system controls fluid volume with aldosterone causing increased reabsorption of sodium and water by the kidneys in an attempt to increase blood volume.

4.

A client asks the nurse how the fluid in the ankles keeps coming back. What principal causes of edema should the nurse review with the client? Select all that apply.

a)

Obstruction of arterial blood

b)

Increased capillary permeability

c)

Inflammatory reactions

d)

External pressure

e)

Obstruction of lymphatic return

5.

What are the functions of water related to fluid and electrolyte imbalances? Select all that apply.

a)

It requires only a small temperature change to alter its form

b)

It is a participant in all chemical reactions occurring in the body

c)

It is a poor solvent

d)

It functions as a suspension agent

e)

It is the source of hydrostatic pressure

6.

What major ion found in intracellular fluid is responsible for the normal functioning of neurons and muscles cells?

a)

Sodium

b)

Potassium

c)

Calcium

d)

Magnesium

7.

What food sources should the nurse encourage the client to eat to help raise the potassium level?

a)

Table salt, meat, dairy foods

b)

Dry fruits, nuts, and many vegetables

c)

Milk and other dairy products, broccoli, green leafy vegetables

d)

Green leafy vegetables, legumes, chocolate

8.

What factors affect the passage of molecules to pass through a permeable membrane? Select all that apply.

a)

Osmotic pressure

b)

Hydrostatic pressure

c)

Size of the molecule

d)

Composition of the body fluid

e)

Compatibility of the electrical charges of the molecule, the membrane and the body fluid

9.

How should the nurse describe the process of osmosis?

a)

Movement of molecules from an area of higher concentration to an area of lower concentration

b)

Most important mechanism by which nutrients and waste pass across the cell membrane

c)

Water moves from a hypotonic solution to a hypertonic solution

d)

Pressure exerted to start the flow of water across a membrane

10.

Which statement describes the process of filtration?

a)

Movement of molecules from an area of higher concentration to an area of lower concentration

b)

Most important mechanism by which nutrients and waste pass across the cell membrane

c)

Water moves from a hypotonic solution to a hypertonic solution

d)

Transport of water and dissolved materials through a membrane from an area of higher pressure to lower pressure

11.

Which item is alkaline in nature?

a)

Lemon juice

b)

Baking soda

c)

Black coffee

d)

Tomato juice

12.

Which sign or symptom is most representative of an early significant loss of extracellular fluid volume?

a)

High urine output

b)

Irregular heartbeat

c)

Hypotension

d)

Unresponsiveness

13.

The nurse should be aware of which effects of aging on fluid and electrolyte? Select all that apply.

a)

Intracellular fluid levels increase

b)

Thirst sensation declines

c)

Weight gain occurs

d)

Laxative abuse occurs

e)

Metabolism increases

14.

What nursing interventions should be implemented for older adults who are at high risk of fluid and electrolyte imbalance? Select all that apply.

a)

Encourage the client to increase intake of food and fluids

b)

Encourage the client to exercise

c)

Monitor the client's potassium intake

d)

Monitor the client's blood pressure

e)

Monitor the client's sodium level

15.

Which assist in the regulation of the body's pH? Select all that apply.

a)

Lungs

b)

Kidneys

c)

Cellular activities

d)

Buffer systems

e)

Liver

16.

Which arterial blood gas results indicate respiratory acidosis?

a)

Decreased pH; decreased bicarbonate

b)

Decreased pH; increased carbon dioxide

c)

Increased pH; increased bicarbonate

d)

Increased pH; decreased carbon dioxide

17.

Which arterial blood gas results indicate metabolic alkalosis?

a)

Decreased pH; decreased bicarbonate

b)

Decreased pH; increased carbon dioxide

c)

Increased pH; increased bicarbonate

d)

Increased pH; decreased carbon dioxide

18.

A client has experienced a significant loss of extracellular fluid (ECF) volume. What condition is this client at risk for developing?

a)

Hypovolemic shock

b)

Hypertension

c)

Heart failure

d)

Pulmonary embolus

19.

Which enzyme is released by the kidneys when there is a decrease in blood volume?

a)

Erythropoietin

b)

Renin

c)

Glucagon

d)

Protease

20.

What physiological process commonly occurs during dehydration?

a)

Increase in sodium and electrolyte disturbance

b)

Increased capillary permeability

c)

Loss of proteins in the plasma of the blood

d)

Obstruction of venous blood or lymphatic return

21.

The client has an order for IV fluids. Normal saline, an isotonic solution, is ordered. What is the best description the nurse can provide to a student nurse about isotonic solutions?

a)

Its osmotic pressure is similar to that of blood

b)

Causes blood cells to swell

c)

Causes blood cells to shrink

d)

Its concentration of solutes is greater than that of blood.

22.

An 82-year-old client is admitted for dehydration. The daughter asks the nurse why this may have happened. What explanation should the nurse provide for the risk of dehydration for this client?

a)

Increased frequency of urination

b)

Increased body temperature

c)

Decreased thirst sensations

d)

Loss of water through increased sweating

23.

CHAPTER 76

The nurse is preparing a client for testing to determine acidosis or alkalosis. Which laboratory test would be ordered?

a)

Complete blood count (CBC)

b)

Clotting factors

c)

Arterial blood gas (ABG)

d)

Liver function tests (LFT)

24.

Which assessments should the nurse conduct to identify possible indicators of fluid and electrolyte imbalances? Select all that apply.

a)

Respiratory for breathing pattern

b)

Gastrointestinal for presence of anorexia

c)

Skin for poor skin turgor

d)

Vital signs for hyperthermia

e)

Urinary for comparison between intake and output

25.

The nurse is caring for a client diagnosed with fluid volume excess that has resulted in edematous legs. Which intervention should the nurse implement to help resolve the edema?

a)

Keep the legs in the same position to avoid irritating the skin.

b)

Elevate the legs to a position higher than the heart's level.

c)

Limit walking to prevent the formation of ulcers.

d)

Perform skin care on the legs at least every 4 hours.

26.

What is a common cause of fluid volume excess?

a)

Too-slow administration of IV fluids containing sodium

b)

Increased urine output as occurs with kidney disorders

c)

Excess ingestion of sodium from table salt or medications containing sodium

d)

Inability of the body to conserve and reuse water by concentrating urine

27.

Which client should this nurse monitor closely for an increased risk for developing edema?

a)

A 30-year-old client with a prolonged fever

b)

A 16-year-old client diagnosed with anorexia nervosa

c)

A 20-year-old client who is vomiting excessively

d)

A 78-year-old client diagnosed with liver cirrhosis

28.

What is the preferred route of electrolyte administration when the oral route is contraindicated?

a)

Intramuscular

b)

Intravenous

c)

Subcutaneous

d)

Intradermal

29.

What causes fluid retention in the body?

a)

Elevated protein levels

b)

Increased venous pressure

c)

Elevated osmotic pressure

d)

Increased excretion of sodium

30.

Which discharge instruction should the nurse provide a client diagnosed with chronic renal failure?

a)

Monitor for differences between fluid intake and output.

b)

Allow feet to dangle at least 3 hours per day.

c)

Check the weight on a weekly basis.

d)

Keep walking to a minimum.

31.

A 25-year-old client is admitted to a healthcare facility with complaints of fever, vomiting, and watery diarrhea for 2 days. On examination, the client has dry skin, delayed skin turgor, and hypotension. What is the most likely nursing diagnosis?

a)

Impaired urinary elimination

b)

Acute gastroenteritis

c)

Infective diarrhea

d)

Deficient fluid volume

32.

An assessment indicates that the client's skin rebound from slight pressure in slightly less than 2 seconds. How should the nurse document this finding?

a)

No edema present

b)

+1 pitting edema

c)

+2 pitting edema

d)

Nonpitting edema present

33.

A nurse assessing a client documents +4 pitting edema in several different locations. What condition is commonly associated with +4 pitting edema?

a)

Sacral edema

b)

Dependent edema

c)

Anasarca

d)

Pulmonary edema

34.

The nurse caring for a postoperative client documents the following data: flushed dry skin, dry mucous membranes, hypotension, and lethargy. The client states that he is thirsty and requests water. Which medical condition is supported by this data?

a)

Hypernatremia

b)

Hyperkalemia

c)

Hypercalcemia

d)

Hypermagnesemia

35.

Which major electrolyte in the extracellular fluid (ECF) influences the distribution of water and maintains acid-base balance and nerve function?

a)

Potassium

b)

Sodium

c)

Calcium

d)

Phosphorus

36.

A client diagnosed with diabetes insipidus is prescribed a restricted diet. What dietary restriction should the nurse incorporate in the diet plan for this client?

a)

Potassium

b)

Calcium

c)

Chloride

d)

Sodium

37.

Which serum sodium level confirms a diagnosis of hyponatremia?

a)

150 mEq/L

b)

145 mEq/L

c)

135 mEq/L

d)

130 mEq/L

38.

For which electrolyte disturbance should the nurse monitor when caring for a client diagnosed with Hodgkin disease?

a)

Hyponatremia

b)

Hypercalcemia

c)

Hypochloremia

d)

Hyperphosphatemia

39.

A nurse is documenting the electrolyte report of a client on diuretic therapy for heart failure. The report is as follows: sodium, 142 mEq/L; potassium, 2.5 mEq/L; calcium, 5 mEq/L; and chloride, 98 mEq/L. Which electrolyte disturbance should the nurse report to the physician?

a)

Hyponatremia

b)

Hypochloremia

c)

Hypokalemia

d)

Hypocalcemia

40.

Which characteristics of aging predispose the older adult client to the risk of fluid and electrolyte imbalances? Select all that apply.

a)

Atypical or subtle confusion

b)

Depressed thirst mechanism

c)

Increased renal functioning

d)

Incontinence

e)

Decreased elasticity of skin

41.

Which condition is most commonly associated with hypocalcemia?

a)

Cancer

b)

Parathyroid hormone deficit

c)

Primary hyperparathyroidism

d)

Immobilization

42.

The nurse is caring for an alcoholic client. Which electrolyte imbalance typically occurs as the result of diuretic therapy?

a)

Hyperphosphatemia

b)

Hyperkalemia

c)

Hypernatremia

d)

Hypomagnesemia

43.

A 16-year-old presents at the emergency room with altered mental status, bradycardia, and cardiac dysrhythmia caused by uncontrolled diabetes mellitus. What acid-base imbalance is most likely occurring in this client?

a)

Metabolic acidosis

b)

Respiratory acidosis

c)

Metabolic alkalosis

d)

Respiratory alkalosis

44.

Which client condition poses the highest risk for the development of respiratory acidosis?

a)

Renal disease

b)

Hyperventilating

c)

Excessive gastric suctioning

d)

Chronic emphysema

45.

Which description accurately identifies metabolic alkalosis?

a)

HCO3- > 26 mEq/L

b)

CO₂ < 35

c)

HCO3- < 22 mEq/L

d)

CO₂ > 45

46.

A diabetic client is admitted to a healthcare facility for diarrhea, nausea, vomiting, and altered mental status. The arterial blood gas (ABG) report of the client shows decreased pH and decreased HCO3-. What immediate action should the nurse take?

a)

Give a bicarbonate infusion.

b)

Give Ringer solution.

c)

Notify the physician.

d)

Apply a rebreathing mask.

47.

A nurse is caring for a client admitted to the healthcare facility with narcotic overdose. The client has shallow respirations, tremors, headache, weakness, altered sensorium, and fruity-smelling breath. According to the arterial blood gas evaluation, the client's pH is decreased and PCO2 is increased. Which acid-base imbalance has occurred?

a)

Respiratory acidosis

b)

Respiratory alkalosis

c)

Metabolic acidosis

d)

Metabolic alkalosis

48.

Which nursing intervention should the nurse implement for a client diagnosed with respiratory acidosis?

a)

Notify the healthcare provider of skin changes.

b)

Lower the head of the client's bed.

c)

Administer prescribed antibiotics.

d)

Administer ordered oxygen.

49.

Which nursing intervention is recommended for the management of respiratory alkalosis?

a)

Administering oxygen

b)

Breathing into a paper bag

c)

Administering bicarbonate

d)

IV infusion of lactated Ringer solution

50.

Which acid-base imbalance, if not corrected, could lead to the need for mechanical ventilation?

a)

Respiratory acidosis

b)

Respiratory alkalosis

c)

Metabolic acidosis

d)

Metabolic alkalosis

51.

  1. CHAPTER 25

  2. Which of the following is true about interstitial fluid, plasma, lymph, and transcellular fluid?

a)

  1. Contain no electrolytes

b)

  1. Protein-free fluids

c)

  1. Classified as extracellular

d)

  1. pH less than 6 (highly acidic)

52.

  1. Which of the following forms the greatest extracellular fluid compartment?

a)

  1. Lymph

b)

  1. Interstitial

c)

  1. Plasma

d)

  1. Transcellular

53.

  1. Which fluid compartment is located between the cells and is also called tissue fluid?

a)

  1. a. Lymph

b)

  1. b. Plasma

c)

  1. c. Interstitial

d)

  1. d. Transcellular

54.

  1. Which of the following is descriptive of normal saline?

a)

  1. Distilled water

b)

  1. 0.9% sodium chloride

c)

  1. Highly acidic

d)

  1. Contains albumin

55.

  1. Which of the following is most likely to occur when output exceeds intake?

a)

a. Diuresis

b)

  1. b. Polyuria

c)

  1. c. Hematuria

d)

  1. d. Dehydration

56.

  1. Water and chloride usually follow the movement of which cation?

a)

  1. a. Bicarbonate

b)

  1. b. Sodium

c)

  1. c. Potassium

d)

  1. d. Albumin

57.

  1. Poor skin turgor is most indicative of

a)

  1. a. cystitis.

b)

  1. b. acidosis.

c)

  1. c. edema.

d)

  1. d. dehydration.

58.

  1. Kaliuresis refers to the urinary loss of

a)

  1. a. water.

b)

  1. b. albumin.

c)

  1. c. potassium.

d)

  1. d. sodium.

59.

  1. K+

a)

  1. is a cation.

b)

  1. is an acid.

c)

  1. neutralizes H+.

d)

  1. is the chief extracellular cation.

60.

  1. Bicarbonate (HCO3–) is considered an anion because it

a)

  1. contains hydrogen.

b)

  1. contains carbon.

c)

  1. contains oxygen.

d)

  1. carries a negative charge.

61.

  1. Which of the following can be defined as an H+ donor?

a)

  1. a. Ion

b)

  1. b. Tincture

c)

  1. c. Acid

d)

  1. d. Bicarbonate

62.

  1. Which of the following acts as a base?

a)

  1. H+

b)

  1. OH–

c)

  1. Calcium ion

d)

  1. Gastric juice

63.

  1. Excess diuresis is most likely to cause

a)

  1. edema.

b)

  1. overhydration.

c)

  1. blood volume depletion.

d)

  1. acidosis.

64.

  1. Which of the following is most likely to occur when output is less than intake?

a)

  1. a. Dehydration

b)

  1. b. Edema

c)

  1. c. Hypovolemia

d)

  1. d. Polyuria

65.

  1. Hypoventilation is most likely to cause

a)

  1. acidosis.

b)

  1. edema.

c)

  1. renal excretion of bicarbonate.

d)

  1. hypokalemia.

66.

  1. Which of the following is not a function of the lungs?

a)

  1. Oxygenation of blood

b)

  1. Excretion of carbon dioxide

c)

  1. Secretion of aldosterone and the regulation of Na+

d)

  1. Regulation of blood pH

67.

  1. Hyperventilation is most likely to cause

a)

  1. a blood pH higher than 7.45.

b)

  1. diuresis.

c)

  1. edema.

d)

  1. acidosis.

68.

  1. Metabolic acidosis, such as diabetic ketoacidosis, is most likely to cause

a)

  1. hypoventilation.

b)

  1. Kussmaul respirations.

c)

  1. the renal excretion of bicarbonate.

d)

  1. the renal retention of H+.

69.

  1. Most body water is located within which space?

a)

  1. a. Interstitial

b)

  1. b. Intravascular

c)

  1. c. Intracellular

d)

  1. d. Transcellular

70.

  1. Which of the following is not true of extracellular fluid?

a)

  1. Most body water is extracellular.

b)

  1. Plasma is extracellular fluid.

c)

  1. Transcellular fluid is extracellular.

d)

  1. There is more interstitial fluid than intravascular fluid.

71.

  1. Which ion determines pH?

a)

  1. a. Sodium

b)

  1. b. Hydrogen

c)

  1. c. Bicarbonate

d)

  1. d. Potassium

72.

  1. Hyperkalemia refers to an increase in the blood levels of which ion?

a)

  1. a. Hydrogen

b)

  1. b. Bicarbonate

c)

  1. c. Calcium

d)

  1. d. Potassium

73.

  1. Retention of which ion causes water retention and edema formation?

a)

  1. a. Potassium

b)

  1. b. Hydrogen

c)

  1. c. Sodium

d)

  1. d. Bicarbonate

74.

  1. More than 99% of which cation is stored in the bones and teeth?

a)

  1. a. Potassium

b)

  1. b. Hydrogen

c)

  1. c. Chloride

d)

  1. d. Calcium

75.

  1. Which of the following is the chief extracellular cation?

a)

  1. a. Chloride

b)

  1. b. Calcium

c)

  1. c. Sodium

d)

  1. d. Potassium

76.

  1. Which ion determines the resting membrane potential of nerve and muscle?

a)

  1. a. Sodium

b)

  1. b. Calcium

c)

  1. c. Hydrogen

d)

d. Potassium

77.

  1. Most diuretics increase urine production by blocking the effects of which cation?

a)

  1. a. Calcium

b)

  1. b. Bicarbonate

c)

  1. c. Chloride

d)

  1. d. Sodium

78.

  1. Which hormone causes the kidneys to retain sodium and to excrete potassium?

a)

  1. a. ADH

b)

  1. b. Erythropoietin

c)

  1. c. Aldosterone

d)

  1. d. PTH

79.

  1. Which hormone stimulates the kidneys to reabsorb calcium and to excrete phosphate?

a)

  1. ADH

b)

  1. Aldosterone

c)

  1. Parathyroid hormone

d)

  1. Erythropoietin

80.

  1. Respiratory rate is most sensitive to the effects of which ion?

a)

  1. a. Na+

b)

  1. b. K+

c)

  1. c. H+

d)

  1. d. Cl–

81.

  1. Which of the following anions buffers H+?

a)

  1. a. Ca2+

b)

  1. b. HCO3–

c)

  1. c. Na+

d)

  1. d. K+

82.

  1. Which of the following is characteristic of acidosis?

a)

  1. pH of 7.55

b)

  1. A decrease in the concentration of hydrogen ion in the blood

c)

  1. Urinary excretion of bicarbonate

d)

  1. pH less than 7.35

83.

  1. Which of the following is most likely to develop in a patient who hypoventilates because of a chronic respiratory disease, such as emphysema?

a)

  1. Kussmaul respirations

b)

  1. A decrease in the plasma concentration of hydrogen ion

c)

  1. An increase in plasma pH

d)

  1. Acidosis

84.

  1. Which of the following is most likely to develop in an anxious hyperventilating patient?

a)

  1. Respiratory acidosis

b)

  1. Alkalosis

c)

  1. A decrease in plasma pH

d)

  1. Ketoacidosis

85.

  1. Which condition is caused by vomiting stomach contents?

a)

  1. Hyperkalemia

b)

  1. Hypernatremia and blood volume expansion

c)

  1. Hypocalcemic tetany

d)

  1. Alkalosis

86.

  1. Which condition stimulates Kussmaul respirations?

a)

  1. Respiratory acidosis

b)

  1. Respiratory alkalosis

c)

  1. Ketoacidosis

d)

  1. Hypocalcemic tetany

87.

  1. Which of the following is a buffer pair?

a)

  1. PTH, aldosterone

b)

  1. ADH, ANF

c)

  1. HCO3–, H2CO3

d)

  1. Sodium, potassium

88.

  1. What does urinary specific gravity measure?

a)

  1. Plasma H+ concentration

b)

  1. Hydration status of the body

c)

  1. Plasma potassium

d)

  1. The buffering capacity of the blood

89.

  1. A patient is admitted with severe emphysema and a PO2 of 85. He also has a blood pH of 7.25 and a serum bicarbonate of 40 mEq/liter. Which of the following is the accurate description?

a)

Metabolic acidosis and respiratory compensation

b)

  1. Metabolic alkalosis with a respiratory compensation

c)

  1. Respiratory alkalosis with a renal compensation

d)

  1. Respiratory acidosis with a renal compensation

90.

  1. Which group is incorrect?

a)

  1. Cations: sodium, potassium, calcium

b)

  1. Acid–base imbalances: acidosis, alkalosis

c)

  1. Lines of defense against acid–base imbalance: buffers, lungs, kidneys

d)

  1. Transcellular fluids: aqueous humor, cerebrospinal fluid, plasma

91.

  1. Which group is incorrect?

a)

  1. Anions: bicarbonate, chloride, phosphate

b)

  1. Lines of defense against acid–base imbalance: buffers, lungs, kidneys

c)

  1. Transcellular fluids: aqueous humor, cerebrospinal fluid, synovial fluid

d)

  1. Hormones: aldosterone, ADH, ANP, urea

92.

  1. Which group is incorrect?

a)

  1. Ions: sodium, potassium, calcium, bicarbonate, chloride

b)

  1. Lines of defense against acid–base imbalance: buffers, lungs, kidneys

c)

  1. Extracellular fluid: intravascular, interstitial, transcellular

d)

  1. Substances that are normally found in a sample of urine: urea, creatinine, glucose

93.

  1. Hyperkalemia

a)

  1. refers to an elevated serum calcium level.

b)

  1. generally develops in response to declining renal function.

c)

  1. is often caused by a kaliuretic diuretic.

d)

  1. is caused by excess aldosterone.

94.

  1. Which of the following best indicates the role of albumin in water balance?

a)

  1. Blocks the renal reabsorption of Na+

b)

  1. Enhances the renal excretion of K+

c)

  1. Maintains plasma oncotic pressure

d)

  1. “Plugs up” capillary pores, keeping water in the plasma

95.

  1. Plasma oncotic pressure

a)

  1. is caused primarily by salt (sodium chloride).

b)

  1. “pulls” water into the capillaries from the interstitium.

c)

  1. pushes water out of the capillaries into the interstitium.

d)

  1. increases the flow of lymph.

96.

  1. Which of the following is (are) true of Na+?

a)

  1. Is the chief extracellular anion

b)

  1. Helps regulate extracellular volume

c)

  1. Is regulated by ADH

d)

  1. All of the above

97.

  1. Which of the following is most likely to happen when fatty acids are broken down rapidly and incompletely?

a)

  1. The plasma pH decreases, causing metabolic alkalosis.

b)

  1. The patient hypoventilates in an attempt to correct the pH disturbance.

c)

  1. Ketoacids are produced, causing metabolic acidosis.

d)

  1. The plasma [H+] decreases.

98.

  1. Hypocalcemia is most likely to

a)

  1. cause blood volume expansion (hypervolemia).

b)

  1. be treated with IV potassium.

c)

  1. cause tetany.

d)

  1. be caused by excess parathyroid hormone activity.

99.

  1. A patient with pulmonary edema is receiving furosemide (Lasix), a kaliuretic diuretic. He has lost 6.6 lb over a 48-hr period. Which of the following statements is true?

a)

  1. He is probably hyperkalemic secondary to the diuretic therapy.

b)

  1. He has lost 12 L of water.

c)

  1. His skin is “tenting.”

d)

  1. He has lost 3 L of water.

100.

  1. A patient with pulmonary edema is receiving furosemide (Lasix), a kaliuretic diuretic. He has lost 6.6 lb over a 48-hr period. Which statement is true?

a)

  1. His urinary output has decreased.

b)

  1. He has lost water weight.

c)

  1. He will become hyperkalemic if the furosemide is continued.

d)

  1. The loss of 6.6 lb causes “tenting.”

101.

  1. Aldosterone

a)

  1. is released in response to hypovolemia.

b)

  1. causes Na+ excretion.

c)

  1. causes K+ reabsorption.

d)

  1. determines the permeability of the collecting duct to water.

102.

  1. A drug that decreases the synthesis of aldosterone

a)

  1. decreases blood pressure.

b)

  1. causes hypernatremia.

c)

  1. causes hypokalemia.

d)

  1. does all of the above.

103.

  1. Which of the following is the trigger for the release of ADH?

a)

  1. Decreased blood volume

b)

  1. Renin

c)

  1. Dehydration

d)

  1. More than one of the above are true.

104.

  1. The determination of daily weights is used to monitor

a)

  1. serum K+.

b)

  1. diuretic therapy.

c)

  1. concentration of plasma protein.

d)

  1. pH.

105.

  1. Which of the following is least descriptive of dehydration?

a)

  1. Tenting

b)

  1. Anasarca

c)

  1. Hypovolemia

d)

  1. Concentrated plasma

106.

  1. Third spacing

a)

  1. is caused by aggressive diuretic therapy.

b)

  1. describes a severe state of hypovolemia and dehydration.

c)

  1. involves only the interstitial space.

d)

  1. can result in an abnormal accumulation of large amounts of water.

107.

  1. Which of the following is an example of metabolic acidosis with a respiratory compensation?

a)

  1. Morphine overdose and diuresis

b)

  1. Persistent vomiting and hypoventilation

c)

  1. Ketoacidosis and Kussmaul respirations

d)

  1. Hypocalcemic tetany and hyperventilation

108.

  1. Which of the following is most likely to cause acidosis?

a)

  1. Persistent vomiting

b)

  1. Accumulation of plasma H+

c)

  1. Renal loss of albumin

d)

  1. Diuresis

109.

  1. A change of pH from 7.40 to 7.25

a)

  1. is indicative of expanded blood volume.

b)

  1. is indicative of alkalosis.

c)

  1. reflects an increase in the amount of H+ in the blood.

d)

  1. is within normal limits.

110.

  1. An unconscious diabetic patient with a blood sugar of 450 mg/dL has an elevated temperature and is experiencing Kussmaul respirations. You suspect that

a)

  1. he is excreting large amounts of bicarbonate in his urine.

b)

  1. his PO2 is normal or high-normal.

c)

  1. his blood pH is 7.25.

d)

  1. Two of the above are true.

111.

  1. A patient is ventilating at a rate of 8 to 10 respirations/min, having been heavily medicated for pain. Which of the following is true? The patient is (may)

a)

  1. develop a respiratory acidosis.

b)

  1. experiencing Kussmaul respirations.

c)

  1. experiencing diuresis.

d)

  1. likely to develop a metabolic alkalosis.

112.

  1. Which of the following is true of dehydration?

a)

  1. Is characterized by poor skin turgor and “tenting”

b)

  1. Is accompanied by an decrease in urine specific gravity

c)

  1. Causes a shift of water from the vasculature into the interstitium

d)

  1. Is generally treated with a diuretic

113.

  1. Which of the following is true of hyperkalemia?

a)

  1. Also causes blood volume expansion and hypertension

b)

  1. Refers to an elevation in serum potassium

c)

  1. Is most often due to impaired respiratory function

d)

  1. Is due to an accumulation of urea in the blood

114.

  1. Excessive secretion of ADH, as occurs with head injury, is most likely to cause

a)

  1. tenting.

b)

  1. blood volume expansion.

c)

  1. diuresis.

d)

  1. hypernatremia.

115.

  1. A deficiency of ADH, called diabetes insipidus, is characterized by

a)

  1. glucosuria and an osmotic diuresis.

b)

  1. polyuria and polydipsia.

c)

  1. Kussmaul respirations and hyperventilation.

d)

  1. edema formation and sodium retention.

116.

  1. Which of the following is a pH descriptive of ketoacidosis?

a)

  1. 7.50

b)

  1. pH > 7.45

c)

  1. 14.0

d)

  1. 7.25

117.

  1. A drug that blocks the renal reabsorption of sodium

a)

  1. decreases the renal excretion of Na+.

b)

  1. increases the amount of urine.

c)

  1. decreases the excretion of bicarbonate.

d)

  1. always increases the reabsorption of K+.

118.

  1. Under which condition will the renal reabsorption of bicarbonate increase?

a)

  1. As a compensatory mechanism for respiratory acidosis

b)

  1. Whenever blood pH exceeds 7.45

c)

  1. As a compensatory mechanism for metabolic alkalosis

d)

  1. Whenever a person hyperventilates

119.

  1. Which of the following is true about these percentages: 60% and 28%? They represent the amount of

a)

  1. water eliminated as urine and through the skin and lungs.

b)

  1. Na+ and K+ reabsorbed by the kidneys in response to aldosterone.

c)

  1. water ingested through moist food and metabolism.

d)

  1. Na+ and K+ reabsorbed in response to ADH secretion.

120.

  1. Which of the following conditions is most apt to decrease glomerular filtration rate (GFR)?

a)

  1. Overhydration

b)

  1. Hypotension

c)

  1. Administration of a diuretic for the treatment of edema

d)

  1. Water intoxication

121.

  1. This anion is an important part of a major buffer pair and therefore plays an important role in acid–base regulation.

a)

  1. Na+

b)

  1. Bicarbonate

c)

  1. HCO3–

d)

  1. Both B and C are true

122.

  1. Generally speaking the movement of Na+ determines the

a)

  1. blood pH.

b)

  1. blood glucose.

c)

  1. secretion of PTH.

d)

  1. movement of water.

123.

  1. Which of the following conditions is most apt to cause a dilutional hyponatremia?

a)

  1. Excess ingestion of water

b)

  1. Dehydration

c)

  1. Hypotension

d)

  1. Diaphoresis

124.

  1. Where does most of the body’s acid come from?

a)

  1. It is reabsorbed from the urine by the kidneys.

b)

  1. Metabolic reactions within the body

c)

  1. Ingestion of fruit juices

d)

  1. Ingestion of a variety of sources of bicarbonate

125.

  1. Which of the following is most apt to cause a hypocalcemic tetany?

a)

  1. Hyperventilation

b)

  1. Rapid and excess fat catabolism

c)

  1. Metabolic acidosis

d)

  1. pH < 7.35

126.

  1. With carbon dioxide retention, CO2 + H2O

a)

  1. H2O2.

b)

  1. H+ + HCO3–.

c)

  1. bicarbonate.

d)

  1. H2O + H2O.

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