Fluids & Electrolytes, Acids & Bases

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Module 3 Exam

Increased aldosterone, as in the case of hyperaldosteronism, results in:

A) decreased serum osmolarity.
B) renal retention of sodium and water.
C) increased sodium excretion coupled with retention of potassium.
D) increased water reabsorption without affecting sodium balance.

B) renal retention of sodium and water.

Aldosterone stimulates the renal tubules to increase the rate of sodium reabsorption. Since water passively follows sodium movement, the net result is an isotonic gain in sodium and water.

Symptoms of dehydration include:

A) decreased urine output.
B) increased skin turgor.
C) increased blood pressure.
D) edema.

A) decreased urine output.

One symptom of dehydration is decreased urine output as the body attempts to conserve fluid. Other symptoms include poor skin turgor and decreased blood pressure. Edema is a sign of volume excess.

Signs and symptoms of hypervolemia (fluid overload) include all of the following except:

A) elevated blood pressure.
B) weight gain.
C) edema.
D) increased hematocrit.

D) increased hematocrit.

Osmosis describes the movement of:

A) electrolytes.
B) glucose.
C) water.
D) blood.

C) water.

Osmosis specifically describes the movement of water from an area of high concentration of water to an area of low concentration of water.

Starling's hypothesis describes the forces that determine:

A) the intercellular concentration of electrolytes.
B) the net filtration of water at the capillary membrane.
C) the exchange of gases at the capillary membrane.
D) the concentration of albumin in the interstitial fluid.

B) the net filtration of water at the capillary membrane.

Starling's hypothesis describes the forces favoring and opposing filtration of water at the capillary membrane.

Which of the following electrolyte imbalances often occurs as a result of acute acidosis?

A) Hypernatremia
B) Hyponatremia
C) Hyperkalemia
D) Hypokalemia

C) Hyperkalemia

With acute acidosis, hydrogen ion shifts into the cells and isexchanged for potassium, which shifts out into the extracellular fluid. Acute acidosis is therefore often accompanied by hyperkalemia.

Which of the following electrolyte disturbances is manifested by muscle spasms?

A) Hypercalcemia
B) Hypocalcemia
C) Hyperphosphatemia
D) Hypophosphatemia

B) Hypocalcemia

Muscle spasms occur with hypocalcemia because low calcium levels increase membrane permeability to sodium in excitable cells. Increased sodium influx causes neuromuscular excitability.

Edema that occurs in the feet and legs when standing or around the sacrum and buttocks while lying down is called:

A) pitting edema.
B) generalized edema.
C) an effusion.
D) dependent edema.

D) dependent edema.

Edema that accumulates in the gravity-dependent areas of the body is called dependent edema.

Which of the following spaces does not belong to the water compartment of the body?

A) Vascular
B) Flesh
C) Intracellular
D) Interstitial

B) Flesh

The water compartment is composed of the intercellular and intracellular spaces. The extracellular space is composed of the vascular and interstitial spaces. The flesh compartment contains non-water elements such as fat and bone

Moderate to severe hypokalemia manifests with:

A) muscle spasms and rapid respirations.
B) muscle weakness and cardiac dysrhythmias.
C) confusion and irritability.
D) vomiting and diarrhea.

B) muscle weakness and cardiac dysrhythmias.

Low potassium causes decreased neuromuscular excitability, which results in skeletal muscle weakness (or paralysis) and cardiac dysrhythmias such as bradycardia and atrioventricular blocks.

An increase in antidiuretic hormone (ADH) secretion will result in which of the following changes?

A) Increased serum sodium concentrations
B) Decreased serum sodium concentrations
C) Increased serum potassium concentrations
D) Decreased serum potassium concentrations

B) Decreased serum sodium concentrations

ADH stimulates water reabsorption by the kidneys, which dilutes serum sodium, thus lowering its concentration.

Edema can result from all of the following alterations except:

A) decreased capillary hydrostatic pressure.
B) decreased capillary oncotic pressure.
C) lymphatic obstruction.
D) increased capillary membrane permeability.

A) decreased capillary hydrostatic pressure.

Which of the following groups of symptoms are caused by hyponatremia?

A) Weak pulses, low blood pressure, and increased heart rate
B) Thirst, dry mucous membranes, and diarrhea
C) Nausea, muscle cramps, and confusion
D) Cardiac arrhythmias, paresthesias, and acid-base imbalances

C) Nausea, muscle cramps, and confusion

Symptoms of hyponatremia include nausea, muscle cramps, and confusion.

The inward-pulling force of particles in the vascular fluid is called the:

A) capillary hydrostatic pressure.
B) interstitial osmotic pressure.
C) capillary oncotic pressure.
D) interstitial hydrostatic pressure.

C) capillary oncotic pressure.

The capillary oncotic pressure draws fluid from the interstitial space into the capillaries.

Hypernatremia can result from:

A) decreased aldosterone secretion.
B) decreased antidiuretic hormone secretion.
C) compulsive water drinking.
D) excessive dietary potassium.

B) decreased antidiuretic hormone secretion.

Decreased antidiuretic hormone secretion (called diabetes insipidus) prevents water reabsorption in the kidneys, which results in increased serum osmolarity and hypernatremia from water loss.

Which of the following electrolytes is found in the highest concentrations in the intracellular fluid (ICF)?

A) Sodium
B) Calcium
C) Magnesium
D) Potassium

D) Potassium

Over 90% of total body potassium is located in the ICF.

Which of the following conditions are known causes of hypokalemia?

A) Diuresis
B) Diarrhea
C) Insulin administration
D) All of the above

D) All of the above

In addition to water excretion, many diuretic drugs also stimulate electrolyte loss. Because electrolytes such as potassium are primarily absorbed in the colon, diarrhea and reduced absorption rates result in hypokalemia. Insulin causes potassium to shift into cells, resulting in hypokalemia.

Total body water (TBW) in elderly persons is:

A) increased because of decreased adipose tissue and decreased bone mass.
B) increased because of decreased renal function and hormonal fluctuations.
C) decreased because of increased adipose tissue and decreased muscle mass.
D) decreased because of diuresis and sodium loss.

C) decreased because of increased adipose tissue and decreased muscle mass.

Aging results in decreased skeletal muscle tissue and a corresponding increased adipose deposition. Because a large amount of TBW is contained in muscle tissue and because adipose tissue repels water, elderly persons often have decreased TBW.

Which of the following hormones stimulates sodium excretion by the kidneys?

A) Cortisol
B) Aldosterone
C) Natriuretic hormones
D) Antidiuretic hormone

C) Natriuretic hormones

Natriuretic hormones, such as atrial natriuretic peptide, stimulate sodium excretion by the kidneys in response to volume overload.

Which state describes the ideal proportion of electrolyte-to-water content in the body?

A) Homeostatic
B) Osmotic
C) Cationic
D) Isotonic

D) Isotonic

The ideal proportion of electrolyte-to-water content in the body is called an isotonic or iso-osmolar state.

Capillary oncotic pressure is primarily determined by which of the following molecules?

A) Glucose
B) Sodium
C) Albumin
D) Water

C) Albumin

Capillary oncotic pressure is primarily determined by the number of plasma proteins, with the predominant one being albumin.

Which of the following problems results in increased capillary hydrostatic pressure and the formation of edema?

A) Renal failure
B) Hemorrhaging
C) Liver failure
D) All of the above

A) Renal failure

Renal failure results in the retention of water and sodium, which increases blood volume and capillary hydrostatic pressure.

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