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Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids and Bases

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Pathophysiology: The Biologic Basis of Disease in Adults and Children 8th Edition
Emily Doyle
Quiz by Emily Doyle, updated more than 1 year ago
Emily Doyle
Created by Emily Doyle over 4 years ago
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Resource summary

Question 1

Question
Why are infants most susceptible to significant losses in total body water?
Answer
  • High body surface-to-body size ratio
  • Slow metabolic rate
  • Kidneys are not mature enough to counter fluid losses
  • Inability to communicate adequately when he or she is thirsty

Question 2

Question
Why does obesity create a greater risk for dehydration in people?
Answer
  • Adipose cells contain little water because fat is water repelling.
  • The metabolic rate of obese adults is slower than the rate of lean adults.
  • The rate of urine output of obese adults is higher than in lean adults.
  • The thirst receptors of the hypothalamus do not function effectively.

Question 3

Question
A patient’s blood gases reveal the following findings: pH 7.3; bicarbonate (HCO3) 27 mEq/L; carbon dioxide (CO2) 58 mm Hg. What is the interpretation of these gases?
Answer
  • Respiratory alkalosis
  • Metabolic acidosis
  • Respiratory acidosis
  • Metabolic alkalosis

Question 4

Question
Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of what?
Answer
  • Osmotic forces
  • Plasma oncotic pressure
  • Antidiuretic hormone
  • Hydrostatic forces

Question 5

Question
In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
Answer
  • Oncotic pressure
  • Buffering
  • Net filtration
  • Hydrostatic pressure

Question 6

Question
Venous obstruction is a cause of edema because of an increase in which pressure?
Answer
  • Capillary hydrostatic
  • Interstitial hydrostatic
  • Capillary oncotic
  • Interstitial oncotic

Question 7

Question
At the arterial end of capillaries, why does fluid move from the intravascular space into the interstitial space?
Answer
  • Interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.
  • Capillary hydrostatic pressure is higher than the capillary oncotic pressure.
  • Interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
  • Capillary oncotic pressure is lower than the interstitial hydrostatic pressure.

Question 8

Question
Low plasma albumin causes edema as a result of a reduction in which pressure?
Answer
  • Capillary hydrostatic
  • Interstitial hydrostatic
  • Plasma oncotic
  • Interstitial oncotic

Question 9

Question
How are secretion of antidiuretic hormone (ADH) and the perception of thirst stimulated?
Answer
  • Decrease in serum sodium
  • Increase in plasma osmolality
  • Increase in glomerular filtration rate
  • Decrease in osmoreceptor stimulation

Question 10

Question
Thirst activates osmoreceptors following an increase in which blood plasma component?
Answer
  • Antidiuretic hormone
  • Aldosterone
  • Hydrostatic pressure
  • Osmotic pressure

Question 11

Question
A student asks about natriuretic peptides. Which statement by the professor is most accurate?
Answer
  • Decrease blood pressure and increase sodium and water excretion.
  • Increase blood pressure and decrease sodium and water excretion.
  • Increase heart rate and decrease potassium excretion.
  • Decrease heart rate and increase potassium excretion.

Question 12

Question
When changes in total body water are accompanied by proportional changes in electrolytes, what type of alteration occurs?
Answer
  • Isotonic
  • Hypertonic
  • Hypotonic
  • Normotonic

Question 13

Question
Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?
Answer
  • Angiotensin I
  • Angiotensin II
  • Aldosterone
  • Renin

Question 14

Question
A patient in the hospital has hypernatremia. What condition should the healthcare professional assess for?
Answer
  • Syndrome of inappropriate antidiuretic hormone
  • Hypersecretion of aldosterone
  • Brief bouts of vomiting or diarrhea
  • Excessive diuretic therapy

Question 15

Question
A patient has a serum sodium level of 165 mEq/L. The healthcare professional explains that the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma are caused by what mechanism?
Answer
  • High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink.
  • High sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell.
  • Low sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain.
  • Low sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell.

Question 16

Question
What does vomiting-induced metabolic alkalosis cause?
Answer
  • Retained sodium to bind with the chloride
  • Hydrogen to move into the cell and exchange with potassium
  • Retention of bicarbonate to maintain the anion balance
  • Hypoventilation to compensate for the metabolic alkalosis

Question 17

Question
The pathophysiologic process of edema is related to which mechanism?
Answer
  • Sodium depletion
  • Decreased capillary hydrostatic pressure
  • Increased plasma oncotic pressure
  • Lymphatic obstruction

Question 18

Question
Why is insulin used to treat hyperkalemia?
Answer
  • Stimulates sodium to be removed from the cell in exchange for potassium
  • Binds to potassium to remove it through the kidneys
  • Transports potassium from the blood into the cell along with glucose
  • Breaks down the chemical components of potassium, inactivating it

Question 19

Question
A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between what?
Answer
  • Intracellular and extracellular Na+
  • Intracellular and extracellular K+
  • Intracellular Na+ and extracellular K+
  • Intracellular K+ and extracellular Na+

Question 20

Question
During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?
Answer
  • Oxygen
  • Sodium
  • Potassium
  • Magnesium

Question 21

Question
A healthcare professional is caring for four patients. Which patient should the professional assess for hyperkalemia?
Answer
  • Hyperparathyroidism
  • Vomiting
  • Renal failure
  • Hyperaldosteronism

Question 22

Question
In hyperkalemia, what change occurs to the cells’ resting membrane potential?
Answer
  • Hypopolarization
  • Hyperexcitability
  • Depolarization
  • Repolarization

Question 23

Question
A patient’s chart indicates Kussmaul respirations. The student asks the healthcare professional what this is caused by. What response by the professional is most accurate?
Answer
  • Anxiety leads to Kussmaul respirations and is a cause of respiratory acidosis.
  • A compensatory measure is needed to correct metabolic acidosis.
  • Diabetic ketoacidosis is leading to metabolic acidosis
  • More oxygen is necessary to compensate for respiratory acidosis.

Question 24

Question
A healthcare provider notes that tapping the patient’s facial nerve leads to lip twitching. What electrolyte value is correlated with this finding?
Answer
  • K+: 2.8 mEq/L
  • K+: 5.4 mEq/L
  • Ca++: 8.2 mg/dL
  • Ca++: 12.9 mg/dL

Question 25

Question
A patient has a history of excessive use of magnesium-containing antacids and aluminum-containing antacids. What lab value does the healthcare professional correlate to this behavior?
Answer
  • Magnesium 1.8 mg/dL
  • Phosphate 1.9 mg/dL
  • Sodium 149 mEq/L
  • Potassium 2.5 mEq/L

Question 26

Question
A healthcare professional is caring for four patients. Which patient should the professional assess for hypermagnesemia as a priority?
Answer
  • Hepatitis
  • Renal failure
  • Trauma to the hypothalamus
  • Pancreatitis

Question 27

Question
Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in what ratio?
Answer
  • 20:1
  • 1:20
  • 10:2
  • 10:5

Question 28

Question
Where is two thirds of the body’s water found?
Answer
  • Interstitial fluid spaces
  • Vascular system
  • Intracellular fluid compartments
  • Intraocular fluids

Question 29

Question
A healthcare professional just administered a large dose of insulin to a patient. Which electrolyte value should the professional monitor as a priority?
Answer
  • Sodium
  • Potassium
  • Calcium
  • Magnesium

Question 30

Question
Why does increased capillary hydrostatic pressure result in edema?
Answer
  • Losses or diminished production of plasma albumin
  • Inflammation resulting from an immune response
  • Blockage within the lymphatic channel system
  • Sodium and water retention

Question 31

Question
A patient’s electrocardiogram (ECG) shows tall, peaked T waves. What lab value or assessment would the healthcare professional correlate with this finding?
Answer
  • Positive Chvostek sign
  • Serum potassium 6.7 mEq/L
  • Nausea and vomiting
  • Serum sodium 138 mEq/L
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