Chapter 27 Fluid, Electrolyte, and Acid-Base Balance

1) Which of the following fluid compartments contains the largest volume of water?

A) Plasma

B) Interstitial compartment

C) Intracellular compartment

D) Extracellular compartment

E) Lymph

Intracellular compartment

2) Which of the following fluid compartments contains the smallest volume of water?

A) Plasma

B) Interstitial compartment

C) Intracellular compartment

D) Extracellular compartment

E) Cytoplasm

Plasma

3) Synovial fluid is a part of which of the following fluid compartments?

A) Plasma

B) Interstitial

C) Intracellular

D) Extracellular

E) Cytoplasm

Extracellular

4) Which of the following individuals would have the largest percentage of their body weight as water?

A) A 7-month-old female

B) A lean 35-year-old male athlete

C) A chunky 52-year-old male athlete

D) A healthy 88-year-old male

E) An adult female marathon runner

A 7-month-old female

5) Which of the following people would be most severely affected by prolonged vomiting?

A) 3-year-old male

B) 15-year-old male

C) 35-year-old male

D) 35-year-old female

E) 50-year-old male

3-year-old male

6) Extracellular fluid has a ________.

A) higher protein content than intracellular fluid

B) higher K+ content than intracellular fluid

C) higher Na+ content than intracellular fluid

D) higher Mg2+ content than intracellular fluid

E) higher number of large organic molecules than intracellular fluid

higher Na+ content than intracellular fluid

7) The predominant intracellular cation is ________.

A) K+

B) Na+

C) Ca2+

D) Mg2+

E) Cl−

K+

8) The predominant extracellular cation is ________.

A) bicarbonate

B) Na+

C) Cl−

D) K+

E) H+

Na+

9) The distribution of Na+ and K+ between intracellular and extracellular compartments is ________.

A) K+ mainly intracellular; Na+ mainly in extracellular

B) Na+ mainly intracellular; K+ mainly in extracellular

C) little of either intracellular but large amounts of both extracellular

D) equal amounts of both ions, in both intracellular and extracellular fluids

E) None of the choices are correct.

K+ mainly intracellular; Na+ mainly in extracellular

10) One difference between the plasma and interstitial fluid is that the plasma has significantly more ________ than interstitial fluid.

A) protein

B) bicarbonate

C) Cl−

D) water volume

E) H+

protein

11) Serum electrolyte concentrations are most often expressed as ________.

A) mg %

B) mmHg

C) mg/dl

D) mEq/L

E) None of the choices are correct.

mEq/L

12) The predominant extracellular anion is ________.

A) protein

B) phosphate

C) bicarbonate

D) Cl−

E) Na+

Cl−

13) Where is the highest concentration of bicarbonate ion found?

A) Plasma

B) Intracellular fluid

C) Interstitial fluid

D) Lymph

Interstitial fluid

14) Water moves back and forth across the plasma membrane by the process of ________.

A) osmosis

B) filtration

C) facilitated diffusion

D) active transport

E) endocytosis

osmosis

15) The cation that plays a major role in determining the osmotic pressure of the plasma is ________.

A) Na+

B) K+

C) Cl−

D) phosphate

E) H+

Na+

16) The major route of excretion for Na+ (under normal conditions) is the ________.

A) skin

B) kidney

C) GI tract

D) adrenal cortex

E) sweat

kidney

17) When aldosterone is absent, Na+ reabsorption in the nephron is ________.

A) greatly increased

B) greatly decreased

C) unchanged

greatly decreased

18) As the rate of sweat production increases, the amount of Na+ lost in the urine ________.

A) increases

B) decreases

C) remains the same

decreases

19) Receptors sensitive to changes in the osmolality of extracellular fluid are the ________.

A) baroreceptors

B) chemoreceptors

C) osmoreceptors

D) pressoreceptors

E) proprioreceptors

osmoreceptors

20) Renin is released by the ________.

A) lungs

B) kidney

C) spleen

D) liver

E) pancreas

kidney

21) Which of the following events occurs last?

A) Release of renin by the kidney

B) Release of aldosterone by the adrenal cortex

C) Sodium ion reabsorption by the kidney tubules

D) Angiotensinogen → angiotensin I

E) Angiotensin I → angiotensin II

Sodium ion reabsorption by the kidney tubules

22) The primary regulator of plasma Na+ concentration is ________.

A) renin

B) aldosterone

C) antidiuretic hormone (ADH)

D) atrial natriuretic hormone

E) insulin

antidiuretic hormone (ADH)

23) Which of the following is most likely to happen to a group of students who relax by drinking a pitcher of their favorite beverage?

A) An increase in urine volume

B) An increase in urine osmolality

C) An increase in ADH production

D) Increased aldosterone secretion

E) A decrease in urine volume

An increase in urine volume

24) Antidiuretic hormone (ADH)

A) increases plasma osmolality.

B) is secreted by the anterior pituitary.

C) increases water reabsorption in the kidneys.

D) causes the production of a large volume of urine.

E) increases urine volume.

increases water reabsorption in the kidneys.

25) A decrease in plasma osmolality would increase ________.

A) ADH production

B) plasma Na+ levels

C) renin production

D) urine production

E) thirst

urine production

26) The stimulus for secretion of atrial natriuretic hormone is increased ________.

A) blood osmolality

B) aldosterone production

C) blood pressure in atria of heart

D) blood pressure in the kidneys' afferent arterioles

E) blood pressure in the ventricles of the heart.

blood pressure in atria of heart

27) Which of the following is NOT a principle sensor for thirst regulation?

A) Osmoreceptors in the hypothalamus

B) Arterial baroreceptors

C) Juxtaglomerular apparatus

D) Mouth mucosa

Mouth mucosa

28) Loss of water through diffusion and evaporation from the skin is called ________ and is important in ________ control.

A) insensible perspiration; blood volume

B) insensible perspiration; heat loss

C) sensible perspiration; blood volume

D) sensible perspiration; temperature

insensible perspiration; heat loss

29) Elevated blood pressure under resting conditions results in increased urinary output because

A) baroreceptors signal the hypothalamus to increase ADH secretion.

B) elevated blood pressure stimulates renin secretion.

C) the amount of angiotensin II formed is increased.

D) aldosterone levels increase.

E) baroreceptors signal the hypothalamus to decrease ADH secretion.

baroreceptors signal the hypothalamus to decrease ADH secretion.

30) You've been working outside in the hot sun and are dripping wet with sweat. Your fluid intake has been minimal as you have been too busy to stop and get a drink. You would expect

A) your blood osmolality to be low.

B) an increase in the production of urine.

C) aldosterone levels to decrease.

D) ADH levels to increase.

E) ADH levels to decrease.

ADH levels to increase.

31) Increased ADH secretion could be stimulated by which of the following situations?

A) Increased renal blood flow

B) Increased blood osmolality

C) Increased atrial natriuretic hormone production

D) Increased blood pressure

E) Decreased blood osmolality

Increased blood osmolality

32) Atrial natriuretic hormone increases ________.

A) urine volume.

B) ADH secretion.

C) aldosterone secretion.

D) the reabsorption of Na+.

E) blood volume.

urine volume.

33) Which characteristic of the plasma membrane is responsible for maintaining the difference between intracellular and extracellular fluid?

A) Presence of channels in the membrane

B) Presence of lipids in the membrane

C) Being selectively permeable

D) High Na+ concentration inside the cell

Being selectively permeable

34) True or False?

The composition of extracellular fluid has little affect on intracellular fluid

amounts.

False

35) Which of the following would be expected to cause hyponatremia?

A) High intake of Na+

B) Increased aldosterone production

C) Increased urine output

D) Decreased aldosterone production

E) Decreased ADH production

Decreased aldosterone production

36) Oversecretion of aldosterone causes ________.

A) hyperkalemia

B) hypercalcemia

C) hypernatremia

D) increased urine volume

E) hyponatremia

hypernatremia

37) Chloride ions

A) are cations.

B) are found only inside cells.

C) are part of the DNA molecule.

D) are regulated with Na+.

E) are not found in extracellular fluid.

are regulated with Na+.

38) Decreased extracellular K+ levels cause

A) cells to become more excitable.

B) hyperpolarization of plasma membranes.

C) more action potentials to be generated.

D) increased permeability of plasma membranes.

E) hypopolarization of plasma membranes.

hyperpolarization of plasma membranes.

39) Which of the following statements concerning K+ is false?

A) An increase in the extracellular K+ concentration leads to depolarization.

B) Potassium ions are secreted into the nephron by the distal convoluted tubule.

C) When aldosterone levels are high, K+ secretion is low.

D) Aldosterone secretion is stimulated by high blood levels of K+.

E) None of the choices are false.

When aldosterone levels are high, K+ secretion is low.

40) Potassium levels in the body are regulated by ________.

A) ADH

B) PTH

C) calcitonin

D) aldosterone

E) insulin

aldosterone

41) Oversecretion of aldosterone causes

A) decreased secretion of Ca2+ by the kidney.

B) increased secretion of K+ by the kidney.

C) decreased reabsorption of Na+ by the kidney.

D) increased reabsorption of phosphate ions by the kidney.

E) decreased secretion of K+ by the kidney.

increased secretion of K+ by the kidney.

42) Aldosterone secretion may be stimulated by ________.

A) ADH

B) elevated K+ levels

C) excess water intake

D) elevated Na+ levels

E) low K+ levels

elevated K+ levels

43) The most common cause of hyperkalemia is ________.

A) vomiting

B) increased dietary intake

C) increased urinary output

D) cellular injury or death

E) diarrhea

cellular injury or death

44) Which of the following will the body begin to do in order to compensate for hyperkalemia?

A) Vasoconstriction of blood vessels

B) Increase ADH secretion

C) Decrease aldosterone secretion

D) Increase the release of atrial natriuretic hormone

E) Increase aldosterone secretion

Increase aldosterone secretion

45) Hyperkalemia is defined as

A) excess excitability of kalems.

B) reduction of plasma Ca2+ level.

C) increase in plasma K+ level.

D) increase in plasma Na+ level.

E) decrease in plasma K+ level.

increase in plasma K+ level.

46) Which of the following is correctly matched?

A) Alkalosis - hypokalemia

B) Cell destruction - hypokalemia

C) Increased secretion of aldosterone - hyperkalemia

D) Overuse of diuretics - hyperkalemia

E) Acidosis - hypokalemia

Alkalosis - hypokalemia

47) Most of the Ca2+ in the body is in the ________.

A) bones

B) plasma

C) kidneys

D) GI tract

E) extracellular fluid

bones

48) In hypocalcemia,

A) depolarization is prevented.

B) PTH production is reduced.

C) blood Ca2+ levels are increased.

D) neuromuscular excitability increases.

E) neuromuscular excitability decreases.

neuromuscular excitability increases.

49) Calcium balance is influenced by

A) ADH and parathyroid hormone levels.

B) ADH and aldosterone levels.

C) parathyroid hormone and vitamin D levels.

D) aldosterone and parathyroid hormone levels.

E) insulin and glucagon.

parathyroid hormone and vitamin D levels.

50) Calcium's roles in the body include

A) bone health.

B) muscle contraction.

C) blood clotting.

D) action potentials in heart muscle.

E) All of the choices are correct.

All of the choices are correct.

51) An increase in parathyroid hormone levels results in

A) increased rate of bone resorption.

B) increased rate of vitamin D degradation.

C) increased concentration of K+ in the urine.

D) increased rate of Ca2+ excretion by the kidneys.

E) decreased levels of blood Ca2+.

increased rate of bone resorption.

52) Adequate Ca2+ absorption from the GI tract depends on

A) serum K+ levels.

B) serum calcitonin levels.

C) adequate amounts of vitamin D.

D) the osmolality of the extracellular fluid.

E) adequate amounts of vitamin C.

adequate amounts of vitamin D.

53) Stimulus for the secretion of parathyroid hormone is a decrease in serum ________ levels.

A) K+

B) Ca2+

C) calcitonin

D) phosphate

E) Na+

Ca2+

54) Parathyroid hormone affects the ________.

A) bones, heart, and blood

B) kidney, liver, and spleen

C) intestine, kidneys, and bone

D) liver, stomach, and small intestine

E) stomach, pancreas, and bone

intestine, kidneys, and bone

55) What is the main role of Mg2+ in the body?

A) Muscle contraction

B) Nerve impulse

C) Blood clotting

D) Cofactors for intracellular enzymes

Cofactors for intracellular enzymes

56) The main regulator of serum phosphate levels is a transport process in the ________.

A) liver

B) kidneys

C) pancreas

D) small intestine

E) large intestine

kidneys

57) A major complication of thyroid surgery is the accidental damaging or removal of the parathyroid glands. This damage or removal of the parathyroid glands can result in

A) increased Na2+ retention.

B) increased plasma volume.

C) decreased plasma Ca2+.

D) delayed healing.

E) increased plasma Ca2+.

decreased plasma Ca2+.

58) Calcitonin

A) promotes the absorption of Ca2+ from the gastrointestinal tract.

B) promotes osteoclast activity in the bones.

C) reduces Ca2+ excretion by the kidneys.

D) reduces extracellular Ca2+ ion levels.

E) increases blood Ca2+ levels.

reduces extracellular Ca2+ ion levels.

59) Increased osmolality of the extracellular fluid

A) increases thirst.

B) inhibits ADH.

C) increases renin secretion.

D) increases aldosterone secretion.

E) decreases thirst.

increases thirst.

60) The sensation of thirst results from

A) an increase in the plasma volume.

B) hypertension (increased blood pressure).

C) stimulation of osmoreceptor cells in the hypothalamus.

D) a decrease in the osmolality of the extracellular fluid.

E) stimulation of baroreceptors.

stimulation of osmoreceptor cells in the hypothalamus.

61) Angiotensin II increases blood volume by stimulating

A) thirst.

B) vasodilatation.

C) water movement into the cells.

D) renal excretion of Na+.

E) ADH production.

thirst.

62) Under normal conditions, most water loss from the body is through the ________.

A) skin

B) kidneys

C) lungs

D) GI tract

E) sweat

kidneys

63) Which of the following is an example of water conservation by the body?

A) Diarrhea

B) Perspiration

C) Decreased water intake

D) Decreased urine volume

E) Increased urine volume

Decreased urine volume

64) Sensible perspiration

A) contains only water.

B) is water lost through simple evaporation.

C) is secreted by the sweat glands.

D) is invisible on the skin.

E) is secreted by salivary glands.

is secreted by the sweat glands.

65) Loss of a large volume of sweat will

A) decrease the hematocrit.

B) decrease ADH production.

C) increase the blood pressure.

D) increase the osmolality of body fluids.

E) decrease the osmolality of body fluids.

increase the osmolality of body fluids.

66) In which of the following situations does one see large volumes of dilute urine produced?

A) ADH levels decrease.

B) Renin levels increase.

C) Aldosterone levels increase.

D) Parathyroid hormone levels decrease.

E) ADH levels increase.

ADH levels decrease.

67) A person working in the hot sun loses the greatest amount of water from the ________.

A) lungs

B) urine

C) mouth

D) skin

E) GI tract

skin

68) pH

A) increases with acidity.

B) is measured on a scale of 0 to 10.

C) is a measure of the H+ concentration.

D) reflects Na+ content of body fluids.

E) is not related to amounts of CO2 in the body.

is a measure of the H+ concentration.

69) Which of the following substances releases H+ into a solution?

A) Acids

B) Bases

C) Salts

D) Glucose

E) Water

Acids

70) Chemicals that function to minimize changes in the pH of body fluids are called ________.

A) buffers

B) inhibitors

C) accelerators

D) activators

E) stabilizers

buffers

71) If the H+ concentration in the blood increases, bicarbonate ions act as buffers by

A) removing excess H+ from the plasma.

B) releasing H+ into the plasma.

C) dissociating into H+ and CO3−.

D) combining with Cl−.

E) combining with hemoglobin.

removing excess H+ from the plasma.

72) Which of the following is NOT a buffer system of the body?

A) Bicarbonate buffer system

B) Phosphate buffer system

C) Protein buffer system

D) NaCl buffer system

E) Hemoglobin buffer

NaCl buffer system

73) Body fluid pH will rise dramatically when

A) Na+ is excreted by the kidney.

B) large amounts of bicarbonate are ingested.

C) carbonic acid is formed.

D) the respiratory rate decreases.

E) CO2 levels increase.

large amounts of bicarbonate are ingested.

74) As a result of hyperventilation,

A) the body pH decreases.

B) the plasma PCO2 level decreases.

C) the kidney will increase the rate of H+ excretion.

D) more bicarbonate ions are added to the plasma.

E) the plasma PCO2 level increases.

the plasma PCO2 level decreases.

75) An increase in blood CO2 levels is followed by a/an ________ in H+ ions and a/an ________ in blood pH.

A) decrease; decrease

B) decrease; increase

C) increase; increase

D) increase; decrease

E) increase; no change

increase; decrease

76) Which of the following terms does not belong with the other three?

A) Acidosis

B) pH increases

C) H+ concentration increases

D) Carbonic acid levels increase

E) pH decreases

pH increases

77) Wilma's plasma pH is 7.2. Which of the following indicates that the body is attempting to compensate and return the body pH to normal?

A) An increase in respiration rate

B) A decrease in respiration rate

C) No change in respiration rate

An increase in respiration rate

78) In renal compensation of acidosis,

A) H+ secretion decreases; bicarbonate excretion increases.

B) H+ secretion decreases; bicarbonate reabsorption increases.

C) H+ secretion increases; bicarbonate reabsorption increases.

D) H+ secretion increases; bicarbonate excretion increases.

E) H+ secretion decreases; bicarbonate excretion decreases.

H+ secretion increases; bicarbonate reabsorption increases.

79) Which of the following can play a role in buffering the pH of urine?

A) Ammonia

B) Bicarbonate ions

C) Phosphate ions

D) All of the choices are correct.

All of the choices are correct.

80) The normal pH for blood plasma is ________.

A) 7.00

B) 7.25 - 7.35

C) 7.35 - 7.45

D) 7.45 - 7.55

E) 6.80 - 7.20

7.35 - 7.45

81) Once alkalosis has occurred, which of the following would you expect to happen?

A) Increased respiratory rate

B) A plasma pH less than 7.40

C) Retention of H+ by the kidney

D) Increased renal reabsorption of bicarbonate ions

E) Secretion of H+ by the kidney

Retention of H+ by the kidney

82) Hyposecretion of aldosterone would lead to

A) increased secretion of H+.

B) decreased secretion of H+.

C) no change in secretion of H+.

decreased secretion of H+.

83) When normal buffer mechanisms are overwhelmed by excessive numbers of H+, which of

the following will result?

A) Acidosis

B) Alkalosis

C) Neither of these

Acidosis

84) A falling blood pH and a rising concentration of CO2 due to emphysema, indicate ________.

A) metabolic acidosis

B) metabolic alkalosis

C) respiratory acidosis

D) respiratory alkalosis

E) None of the choices are correct.

respiratory acidosis

85) Ingesting large amounts of sodium bicarbonate can lead to ________.

A) metabolic acidosis

B) metabolic alkalosis

C) respiratory acidosis

D) respiratory alkalosis

E) None of the choices are correct.

metabolic alkalosis

86) Respiratory alkalosis can occur as a result of ________.

A) asphyxia

B) asthma

C) severe emphysema

D) hyperventilation

E) hypoventilation

hyperventilation

87) Prolonged vomiting of stomach contents will result in ________.

A) metabolic acidosis

B) metabolic alkalosis

C) respiratory acidosis

D) respiratory alkalosis

E) None of the choices are correct.

metabolic alkalosis

88) Which of the following regulatory mechanisms would be stimulated as a result of the increased osmolality that results from a Na+ level of 152 mEq/L?

A) Increased urine output

B) An increased release of ADH

C) An increase in renin production

D) An increase in the secretion of aldosterone

E) A decreased release of ADH

An increased release of ADH

89) The increase in extracellular osmolality would cause

A) water to move out of the cells.

B) water to move into the cells.

C) no change in the net movement of water into or out of the cells.

water to move out of the cells.

90) The K+ level of 2.8 mEq/L indicates hypokalemia. Low plasma K+ levels will cause ________.

A) thirst

B) muscle weakness

C) increased body temperature

D) tremors, tetany, and convulsions

E) paralysis

muscle weakness

91) Robert has an enteropathogenic E. coli infection resulting in severe diarrhea for 2 days. This could produce which of the following:

(1) Acidosis

(2) Alkalosis

(3) Increased respiration

(4) Decreased respiration

(5) Increased ADH secretion

(6) Increased renin secretion

(7) Increased urine concentration

A) 1, 3, 5, 6, 7

B) 2, 4, 5, 6, 7

C) 1, 3, 6

D) 2, 4, 5, 7

E) 1, 4, 5, 7

1, 3, 5, 6, 7

92) Acetazolamide (Diamox) is a diuretic that functions by blocking the activity of carbonic anhydrase inside kidney tubule cells. This slows the formation of carbonic acid, which slows H+ the formation in the cells and Na+ reabsorption at the tubule. This results in the diuretic effect.

Select from the following list the possible side-effects of Azetazolamide.

(1) Acidosis

(2) Reduced movement of bicarbonate ion into the plasma

(3) An alkaline urine is produced

(4) Respiration increases

A) 1, 4

B) 2, 3

C) 1, 2, 3

D) 2, 3, 4

E) 1, 2, 3, 4

1, 2, 3, 4

93) Edema results when the amount of ________ fluid increases.

A) interstitial

B) intracellular

C) plasma

D) cerebrospinal

E) synovial

interstitial

94) Which of the following are sources of water intake? (Check all that apply.)

A) Cellular metabolism

B) Ingestion

C) Perspiration

D) Respiratory intake

E) Osmosis

Cellular metabolism & Ingestion

95) Wetting the oral mucosa and stretching the digestive tract will cause ________ in thirst sensations.

A) a temporary interruption

B) a tremendous increase

C) an increase in blood osmolarity and an increase

D) an increase in blood osmolarity and a decrease

a temporary interruption

96) An increase in the osmolarity of the extracellular fluid will trigger a/an ________ in the secretion of ADH and a/an ________ in thirst.

A) increase; increase

B) increase; decrease

C) decrease; decrease

D) decrease; increase

increase; increase

97) Which cell structure regulates the composition of the intracellular fluid?

A) Plasma membrane

B) Cell wall

C) Endoplasmic reticulum

D) Ribosomes

E) Nucleus

Plasma membrane

98) Which organ(s) play(s) a role in the excretion of Na+? (Check all that apply.)

A) Skin

B) Kidneys

C) Lungs

D) Liver

Skin & Kidneys

99) Sodium homeostasis leads to the homeostasis of ________.

A) chloride

B) hydrogen

C) calcium

D) potassium

E) magnesium

chloride

100) Which hormone regulates K+ levels, and how does it work?

A) Aldosterone; increases secretion of K+

B) Aldosterone; increases reabsorption of K+

C) ADH; increases secretion of K+

D) ADH; increases reabsorption of K+

E) ANH; increases reabsorption of K+

Aldosterone; increases secretion of K+