Chapter 26 Fluid, Electrolyte, And Acid Base Balance

24 July 2022
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question
The most abundant cation in intracellular fluid is sodium. True False
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False
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Salts are lost from the body in perspiration, and urine only. True False
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False
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Which of the following is not a disorder of water balance? a. edema or tissue swelling, which is usually due to an increased capillary hydrostatic pressure b. excessive hydration due to excess ANP secretion c. excess water in interstitial spaces due to a low level of plasma proteins d. hypotonic hydration, in which sodium content is normal but water content is high
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excessive hydration due to excess ANP secretion
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Aldosterone is secreted in response to low extracellular potassium. True False
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False
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A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates ________. a. respiratory alkalosis b. metabolic acidosis c. metabolic alkalosis d. respiratory acidosis
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respiratory acidosis
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Atrial natriuretic peptide reduces blood pressure and blood volume by inhibiting nearly all events that promote vasodilation and potassium and water retention. True False
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False
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Aldosterone stimulates the reabsorption of sodium while enhancing potassium secretion. True False
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True
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Respiratory acidosis results when lungs are obstructed and gas exchange is inefficient. True False
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True
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An atypical accumulation of fluid in the interstitial space
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Edema
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A condition of unusually low levels of plasma proteins resulting in tissue edema
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Hypoproteinemia
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A disorder entailing deficient mineralocorticoid hormone production by the adrenal cortex
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Addisons disease
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Regulates sodium ion concentration in the extracellular fluid
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Aldosterone
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A condition due to excessive water intake that results in net osmosis into tissue cells. This lead to severe metabolic disturbances
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Hyponatremia
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Carotid artery and aortic baroreceptors are involved in long term adjustment to total body sodium ion content. True False
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True
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Whereas sodium is found mainly in the extracellular fluid, most ________ is found in the intracellular fluid. a. potassium b. chloride c. bicarbonate d. iron
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potassium
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Adipose tissue is one of the most hydrated of all tissues in the human body. True False
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False
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Possibly cause by vomiting, use of diruetics, or use of antacids
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Metabolic alkalosis
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Possibly occuring with emphysema, extreme obesity, or narcotic overdose
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Respiratory alkalosis
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Possibly caused by asthma, pneumonia, or a severe panic attack
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Metabolic Acidosis
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Possibly caused by severe diarrhea or untreated diabetes mellitus
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Respiratory acidosis
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Blood analysis indicates a low pH, and the patient is breathing rapidly. Given your knowledge of acid-base balance, which of the following is most likely? a. respiratory alkalosis b. metabolic alkalosis c. metabolic acidosis d. respiratory acidosis
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metabolic acidosis
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Which of the following does not depend on the presence of electrolytes? a. neuromuscular excitability b. maintenance of osmotic relations between cells and ECF c. membrane polarity d. amount of body fat
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amount of body fat
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Hypoproteinemia is a condition of unusually low levels of plasma proteins. This problem is often characterized by ________. a. tissue edema b. nerve damage c. extreme weight loss d. confusion
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tissue edema
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Blood acidity results in depression of the CNS, whereas blood alkalosis results in overexcitement of the CNS. True False
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True
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A 13-year-old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64 inches. She admits to frequent self-induced vomiting and abuse of laxatives. She was treated on the medical unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as evidenced by mild puffiness and bloating. Why did she get these symptoms? a. The abuse of laxatives and self-induced vomiting caused her to be chronically fluid depleted. She developed a compensatory increased production of ADH. b. The abuse of laxatives and self-induced vomiting caused her to be chronically electrolyte depleted. She developed a compensatory increased production of aldosterone. c. The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH. d. The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed kidney failure, and the kidneys are no longer absorbing fluid correctly. e. The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed kidney failure, and the kidneys are no longer absorbing electrolytes correctly.
answer
The abuse of laxatives and self-induced vomiting caused her to be chronically fluid and electrolyte depleted. She developed a compensatory increased production of aldosterone and ADH.
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The regulation of sodium ________. is linked to blood pressure a. involves hypothalamic osmoreceptor detection of ion concentration b. involves aldosterone, a hormone that increases sodium excretion in the kidneys c. is due to specific sodium receptors in the hypothalamus
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is linked to blood pressure
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Which of the following describes the distribution of sodium and potassium between cells and body fluids? a. little of either in the cells, but large amounts of each in the body fluids b. Na+ mainly in the cells, K+ in the body fluids c. equal amounts of each ion in the cells and body fluids d. K+ mainly in the cells, Na+ in the body fluids
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K+ mainly in the cells, Na+ in the body fluids
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Total body water is not a function of which of the following? a. body mass b. amount of body fat c. age d. amount of water ingested
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amount of water ingested
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The movement of fluids between cellular compartments ________. a. is regulated by osmotic and hydrostatic forces b. requires ATP for the transport to take place c. involves filtration d. requires active transport
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is regulated by osmotic and hydrostatic forces
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Hypercalcemia causes muscle tetany. True False
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False
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The term alkaline reserve is used to describe the ________ buffer system. a. hemoglobin b. protein c. phosphate d. bicarbonate
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bicarbonate
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Thirst is always a reliable indicator of body water need. True False
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False
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The thirst center in the brain is located in the hypothalamus. True False
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True
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Most acidic substances (hydrogen ions) originate as by-products of cellular metabolism. True False
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True
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As ventilation increases and more carbon dioxide is removed from the blood, the hydrogen ion concentration of the blood decreases. True False
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True
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When aldosterone release is inhibited, sodium reabsorption cannot occur beyond the distal convoluted tubule. True False
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True
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A patient's anxiety caused her to develop respiratory alkalosis. What breathing technique did the nurse recommend, and why? a. The nurse instructed the patient to breathe more shallowly. This will decrease the patient's blood levels of carbon dioxide by eliminating more carbon dioxide from the lungs, resulting in a decrease in the blood pH. b. The nurse instructed the patient to breathe faster and deeper. This will decrease the patient's blood levels of carbon dioxide by eliminating more carbon dioxide from the lungs, resulting in a decrease in the blood pH. c. The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease. d. The nurse instructed the patient to breathe faster and deeper. This will increase the patient's blood levels of carbon dioxide by eliminating less carbon dioxide from the lungs, resulting in a decrease in the blood pH.
answer
The nurse instructed the patient to breathe slower and deeper, and to breathe into a paper bag. This will increase the patient's blood level of carbon dioxide by eliminating less carbon dioxide from the lungs, and by breathing in the expired air which has a higher concentration of carbon dioxide. As a result, the blood pH will decrease.
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Water imbalance, in which output exceeds intake, causing an imbalance in body fluids, is termed dehydration. True False
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True
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Problems with fluid, electrolyte, and acid-base balance are particularly common in infants because of their ________. a. inefficient kidneys b. low rate of insensible water loss c. low daily rate of fluid exchange d. comparatively low metabolic rates
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inefficient kidneys
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Atrial natriuretic peptide is a hormone that is made in the atria of the heart. The influence of this hormone is to ________. a. prevent pH changes caused by organic acids b. activate the renin-angiotensin mechanism c. enhance atrial contractions d. reduce blood pressure and blood volume by inhibiting sodium and water retention
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reduce blood pressure and blood volume by inhibiting sodium and water retention
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Which of the following statements is true regarding fluid shifts? a. Electrolytes are not as important as proteins in regulating fluid shifts in the body. b. Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts. c. Nonelectrolytes are the controlling factor in directing fluid shifts. d. There are always more positive electrolytes than negative in a solution; it is therefore impossible to follow fluid shifts.
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Electrolytes have greater osmotic power than nonelectrolytes and therefore have the greatest ability to cause fluid shifts.
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Which of the following is not a chemical buffer system? a. protein b. phosphate c. nucleic acid d. bicarbonate
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nucleic acid
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One of the most powerful and plentiful sources of buffers is the protein buffer system. True False
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True
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Weak acids are able to act as chemical buffering systems for the body because they partially dissociate. True False
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True
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The regulation of potassium balance ________. a. involves aldosterone-induced secretion of potassium b. includes renal secretion, but never absorption c. is accomplished mainly by hepatic mechanisms d. is not linked to sodium balance
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involves aldosterone-induced secretion of potassium
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Respiratory acidosis can occur when ________. a. a runner has completed a very long marathon b. a person's breathing is shallow due to obstruction c. a person consumes excessive amounts of antacids d. the kidneys secrete hydrogen ions
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a person's breathing is shallow due to obstruction
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Which of the following hormones is important in stimulating water conservation in the kidneys? a. aldosterone b. progesterone c. atrial natriuretic peptide d. antidiuretic hormone
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antidiuretic hormone
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The fluid link between the external and internal environment is ________. a. plasma b. interstitial fluid c. cerebrospinal fluid d. intracellular fluid
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plasma
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Heavy consumption of salt substitutes high in potassium can present a serious clinical problem when aldosterone release is not normal. True False
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True
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One of the major physiological factors that triggers thirst is ________. a. drinking caffeinated beverages b. a dry mouth from high temperatures c. a rise in plasma osmolality d. becoming overly agitated
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a rise in plasma osmolality
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Calcitonin targets the bones and causes the release of calcium from storage when serum levels are low. True False
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False
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Some potassium ions are reabsorbed from the kidney filtrate via type A intercalated cells. True False
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True
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Prolonged hyperventilation can cause alkalosis. True False
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True
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Sodium ions are highest in
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blood plasma
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Potassium ions are highest in
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Intracellular fluid
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Phosphate ions are highest in
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Intracellular fluid
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Bicarbonate ions are highest in
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interstitial fluid
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Proteins are highest in
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Intracellular fluid
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Solutes, regardless of size, are able to move freely between compartments because water carries them along the osmotic gradients. True False
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False
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A patient is 72 years old and was admitted to the hospital for severe shortness of breath and edema to her lower extremities. She was diagnosed with heart failure. Which side of the heart failed, and how did this cause edema? a. The left side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the systemic circulation caused pooling of blood in the pulmonary circulation, leading to edema. b. The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the pulmonary circulation, leading to edema. c. The left side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the systemic circulation caused pooling of blood in the systemic circulation, leading to edema. d. The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.
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The right side of the heart failed, causing edema in her lower extremities. The failure to pump blood around the pulmonary circulation caused pooling of blood in the systemic circulation, leading to edema.
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The single most important factor influencing potassium ion secretion is ________. a. the potassium ion content in the renal tubule cells b. intracellular sodium levels c. potassium ion concentration in blood plasma d. the pH of the ICF
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potassium ion concentration in blood plasma
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Which of the following is not a method for regulating the hydrogen ion concentration in blood? a. chemical buffer systems b. diet c. respiratory changes d. renal mechanism
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diet
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The two hormones responsible for the regulation of calcium are pituitary hormone and calcitonin. True False
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False
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The single most important blood buffer system is the bicarbonate buffer system. True False
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True
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It is impossible to overhydrate because people need as much water as they can drink to carry out ordinary body functions. True False
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False
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The phosphate buffer system is relatively unimportant for buffering blood plasma. True False
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True
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Although the sodium content of the body may be altered, its concentration in the ECF remains relatively stable because of immediate adjustments in water volume. True False
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True
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Which of the following is not a trigger for juxtaglomerular granular cells to release renin? a. sympathetic stimulation b. decreased filtrate NaCl concentration c. increased extracellular fluid water levels d. decreased stretch due to decreased blood pressure
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increased extracellular fluid water levels
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To remain properly hydrated, water intake must equal water output. True False
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True
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Dehydration can be caused by endocrine disturbances such as diabetes mellitus or diabetes insipidus. True False
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True
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Hypoproteinemia reflects a condition of unusually high levels of plasma proteins and causes tissue edema. True False
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False
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Sodium is pivotal to fluid and electrolyte balance and to the homeostasis of all body systems. True False
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True
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Which of the choices below exerts primary control over sodium levels in the body? a. water levels b. aldosterone c. ADH d. glucocorticoids
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aldosterone
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After traveling from Los Angeles to Denver, Claire finds she is not feeling well and checks into a clinic for help. What is the diagnosis, and what has caused this problem? a. Respiratory acidosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood. b. Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood. c. Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing slower and shallower to raise the oxygen levels in her blood. d. Respiratory acidosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing slower and shallower to raise the oxygen levels in her blood.
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Respiratory alkalosis caused by hyperventilation. Claire is experiencing the effect of the high altitude, breathing faster and deeper to raise her oxygen levels in her blood.
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A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3- is 20 mEq/L. A medical history reveals that this patient is a chronic alcoholic. What diagnosis would you give, and what prognosis? a. The pH and bicarbonate levels and the history of alcoholism indicate respiratory alkalosis. The patient will require dialysis to remove the bicarbonate ions. b. The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows. c. The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will require dialysis to remove the bicarbonate ions. d. The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will go into a coma and death soon follows. e. The pH and bicarbonate levels and the history of alcoholism indicate metabolic alkalosis. The patient will require dialysis to remove the bicarbonate ions.
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The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.
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A patient is breathing slowly and blood pH analysis indicates an abnormally high value. What is the likely diagnosis? a. respiratory acidosis b. metabolic acidosis c. respiratory alkalosis d. metabolic alkalosis
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metabolic alkalosis
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Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid? a. antidiuretic hormone b. aldosterone c. erythropoietin d. renin
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aldosterone
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The body's water volume is closely tied to the level of which of the following ions? a. calcium ions b. sodium ions c. potassium ions d. hydrogen ions
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sodium ions
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Magnesium excess
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Hypermagnesemia
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Calcium depletion
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Hypocalcemia
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Sodium excess
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Hypernatremia
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Potassium excess
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Hyperkalemia
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Sodium depletion
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Hyponatremia
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Premenstrual edema may be due to enhanced reabsorption of sodium chloride. True False
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True
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Electrolytes determine most of the chemical and physical reactions of body fluids. True False
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True
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The main way the kidney regulates potassium ions is to excrete them. True False
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True
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Dissociate in water
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Electrolytes
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Do not dissociate
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Nonelectrolytes
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The fluid compartments outside the cell
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Extracellular
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Fluid compartments located within the cell
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Intracellular
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Spaces between cells
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Interstitial
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The normal pH of blood is 7.35-7.45. True False
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True
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The maintenance of the proper pH of the body fluids may be the result of ________. a. the control of respiratory ventilation b. the active secretion of OH- into the filtrate by the kidney tubule cells c. the operation of the various buffer systems in the stomach d. control of the acids produced in the stomach
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the control of respiratory ventilation
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Annie has just eaten a large order of heavily salted french fries, some pickled eggs, and some cheese. How will consuming this much salt affect her physiology? a. There will be a temporary increase in blood volume. b. She will experience hypotension. c. It will cause a prolonged increase in the osmolality of the blood. d. There will be a shift in the pH of her body fluids to the higher side of the pH scale.
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There will be a temporary increase in blood volume.
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What hormone reduces blood pressure and blood volume by inhibiting nearly all events that promote vasoconstriction and sodium ion and water retention? a. aldosterone b. thyroxine c. ADH d. atrial natriuretic peptide
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atrial natriuretic peptide
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Which of the choices below is not an essential role of salts in the body? a. neuromuscular activity b. anabolism of lipids c. secretory activity d. membrane permeability
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anabolism of lipids
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The most important force causing net water flow across capillary walls is ________. a. hydrostatic pressure of capillary blood b. hydrostatic pressure of interstitial fluid c. intracellular hydrostatic pressure d. osmotic pressure of plasma proteins
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hydrostatic pressure of capillary blood
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Newborn infants have a relatively higher ________ content in their ECF than do adults. a. sodium b. bicarbonate c. magnesium d. iron
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sodium
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The term hypotonic hydration refers to ________. a. the feeling one might have after profuse sweating with exertion b. the unpleasant feeling people have after drinking too much liquor c. a condition that may result from renal insufficiency or drinking extraordinary amounts of water d. a condition that is caused by high levels of sodium in the extracellular fluid compartment
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a condition that may result from renal insufficiency or drinking extraordinary amounts of water