chapter 5: acids and bases

A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?

a. Intracellular fluid (ICF)

b.     Extracellular fluid (ECF)

c.     Interstitial fluid

d.     Intravascular fluid

intravascular fluid

 

A 35-year-old male weighs 70 kg. Approximately how much of this weight is considered the total volume of body water?

a.    5 L

b.     10 L

c.     28 L

d.     42 L

42L

While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have:

a.    a higher total body water volume.

b.     decreased muscle mass.

c.     increased thirst.

d.     an increased tendency toward developing edema.

decreased muscle mass

Which of the following patients should the nurse assess for decreased oncotic pressure in the capillaries? A patient with:

a.   a high-protein diet.

b.     liver failure.

c.     low blood pressure.

d.     low blood glucose.

liver failure

Water movement between the ICF and ECF compartments is determined by:

a.   osmotic forces.

b.     plasma oncotic pressure.

c.     antidiuretic hormone.

d.     buffer systems.

osmotic forces

An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid moving into the interstitial space?

a.   Increased capillary oncotic pressure.

b.     Increased interstitial hydrostatic pressure.

c.     Decreased capillary hydrostatic pressure.

d.     Increased interstitial oncotic pressure.

increased interstitial oncotic pressure

When planning care for a dehydrated patient, the nurse remembers that the principle of water balance is closely related to the balance of:

a.    potassium.

b.     chloride.

c.     bicarbonate.

d.     sodium.

sodium

A 70-year-old male with chronic renal failure presents with edema. Which of the following is the most likely cause of this condition?

a.     Increased capillary oncotic pressure.

b.     Decreased interstitial oncotic pressure.

c.     Increased capillary hydrostatic pressure.

d.     Increased interstitial hydrostatic pressure.

increased capillary hydrostatic pressure

A 10-year-old male is brought to the emergency room (ER) incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as:

a.    localized edema.

b.     generalized edema.

c.     pitting edema.

d.     lymphedema.

localized edema

A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include? Secretion of ADH is stimulated by:

a.   increased serum potassium.

b.     increased plasma osmolality.

c.     decreased renal blood flow.

d.     generalized edema.

increased plasma osmolality

Which statement by the staff indicates teaching was successful concerning aldosterone?

Secretion of aldosterone results in:

a.   decreased plasma osmolality.

b.     increased serum potassium levels.

c.     increased blood volume.

d.     localized edema.

increased blood volume

A 25-year-old male is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which finding would the nurse expect to see in the lab results?

a.   Decreased blood volume

b.     Decreased blood K⁺ levels

c.     Increased urine Na⁺ levels

d.     Increased white blood cells

decreased blood K levels

A patient has been searching on the Internet about natriuretic hormones. When the patient asks the nurse what these hormones do, how should the nurse respond? Natriuretic hormones affect the balance of:

a.   calcium.

b.     sodium.

c.     magnesium.  

d.     potassium.

sodium

A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected? a.   Symptoms subside quickly

b.     Increased ICF volume

c.     Decreased ECF volume

d.     Intracellular dehydration

intracellular dehydration

Which of the following patients is the most at risk for developing hypernatremia? A patient with:

a.     vomiting.

b.     diuretic use.

c.     dehydration.

d.     hypoaldosteronism.

dehydration

Which of the following conditions would cause the nurse to monitor for hyperkalemia?

a.    Excess aldosterone

b.     Acute acidosis

c.     Insulin usage

d.     Metabolic alkalosis

acute acidosis

Which organ system should the nurse monitor when the patient has long-term potassium deficits?

a.     Central nervous system (CNS)

b.     Lungs

c.     Kidneys

d.     Gastrointestinal tract

kidneys

A 19-year-old male presents to his primary care provider reporting restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemic. Which of the following could have caused his condition?

a.    Primary hyperaldosteronism

b.     Acidosis

c.     Insulin secretion

d.     Diuretic use

acidosis

A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe?

a.   Weak pulse

b.     Excessive thirst

c.     Oliguria        

d.     Constipation

oliguria

Which of the following buffer pairs is considered the major plasma buffering system?

a.    Protein/fat

b.     Carbonic acid/bicarbonate

c.     Sodium/potassium

d.     Amylase/albumin

carbonic acid/bicarbonate

A nurse recalls that regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:

a.   buffer systems.

b.     skin.

c.     lungs.

d.     liver.

lungs

Which patient is most prone to metabolic alkalosis? A patient with:

a.     retention of metabolic acids.

b.     hypoaldosteronism.

c.     excessive loss of chloride (Cl).

d.     hyperventilation.

excessive loss of chloride

Which patient should the nurse assess for both hyperkalemia and metabolic acidosis? A patient diagnosed with:

a.   diabetes insipidus.

b.     pulmonary disorders.

c.     Cushing syndrome.

d.     renal failure

renal failure

For a patient experiencing metabolic acidosis, the body will compensate by:

a.     excreting H⁺ through the kidneys.

b.     hyperventilating.

c.     retaining CO₂ in the lungs.

d.     secreting aldosterone.

hyperventilating

Which finding would support the diagnosis of respiratory acidosis?

a.      Vomiting

b.     Hyperventilation

c.      Pneumonia

d.     An increase in noncarbonic acids

pneumonia

A 54-year-old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feelings. Lab results reveal decreased pH, increased CO₂, and normal bicarbonate ion. These findings help to confirm the diagnosis of:

a.    respiratory alkalosis.

b.     metabolic acidosis.

c.     respiratory acidosis.

d.     metabolic alkalosis.

respiratory acidosis

For a patient with respiratory acidosis, chronic compensation by the body will include:

a.   kidney excretion of H⁺.

b.     kidney excretion of HCO₃.

c.     prolonged exhalations to blow off CO₂.

d.     protein buffering.

kidney excretion of H+

A 55-year-old female presents to her primary care provider and reports dizziness, confusion, and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO₂, and slightly decreased HCO₃. Which of the following is the most likely diagnosis?

a.   Respiratory alkalosis with renal compensation

b.     Respiratory acidosis with renal compensation

c.     Metabolic alkalosis with respiratory compensation

d.     Metabolic acidosis with respiratory compensation

respiratory alkalosis with renal compensation

A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor. Further testing indicates that the tumor secretes ADH. Which of the following assessment findings should the nurse expect? (select all that apply)

a. Confusion

b.     Weakness

c.      Nausea

d.     Muscle twitching

e.      Increased reflexes

A, B, C, D