Ch26-Acid-Base+Balance

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1. True or False Because infants have a higher breathing rate than adults, they are at greater risk of Respiratory Alkalosis.

2.Systemic arterial blood HCO3 less than 22meq/liter results in...

A. Respiratory Alkalosis

B. Metabolic Acidosis

C. Respiratory Acidosis

D.Metabolic Alkalosis

E. None of these

3.Which term is used to describe low blood potassium levels.

A. Hypernatremia

B.Hyponatremia

C.Hyperkalemia

D. Hypokalemia

E. Hypercalcemia

4. The state in which excessive body water causes cells to swell dangerously is called

A. Dehydration

B.Renal Compensation

C. Water Intoxication

D. Hypercalcemia

E. Both A and B

5.True or False Inadequate exhalation of Co2 causes blood pH to drop

6. When body has the requirred amount of water and solutes and correctly proportioned among various compartments is called.

a. plasma b. fluid balance c. body fluid d. intracellular fluid

7. When water loss is greater than water gain.

a. electrolytes b. thirst center c. dehydration d. metabolic water

8. When renal function is poor and a person consume more water than the kidneys can excrete it can cause.

a. water intoxication b. aldosterone c. thirst center d. vasopressin

9. Excessive urinary loss of Na+ causes excessive water loss and abnormally low blood volume.

a. edema b. protein buffer system c. hypovolemia d. volatile acid

10. Systemic arterial blood Pco2 falls below 35mmHg increasing PH is hyperventilation conditions that stimulate inspiratory area in the brain stem.

a. respiratory acidosis b. metabolic acidosis c. metabolic alkalosis d. respiratory alkalosis

21. When there is a high concentration of H+, pH is _ __…”___.” a. Low, base b. High,base c. Low, acidic d. High, acidic

22. The buffer systems ensure that small changes in H+ concentration in a fluid will not significantly alter pH (acts quickly). a. TRUE b. FALSE

23. What would occur to pH if a patient is hypoventilating? a. Hypoventilation decreases the amount of CO2 in the blood, increasing CO2 results in more H+ so pH will decrease. b. Hypoventilation increases the amount of CO2 in the blood, increasing CO2results in more H+ so pH will decrease. c. Hypoventilation increases the amount of CO2 in the blood, decreasing CO2results in less H+ so pH will decrease. d. Hypoventilation increases the amount of CO2 in the blood, increasing CO2results in more H+ so pH will increase.

24. A normal pH is: a. 7.10-7.35 b. 4.75-7.35 c. 7.35-7.45 d. 6.35-6.75

25. Respiratory system and renal system are two mechanism that also help control the regulation of pH. a.TRUE b. FALSE

26. Metabolic rate of infants is double that of adults. a. true b. false

27. Respiratory alkalosis is caused by all the following except: a. hyperventilation b. stroke c. diarrhea d. O2 deficiency

28. Sandy has been in some pain and took an over abundance of aspirin. Her H+ is elevated while her pH and HCO3 is low. What is she most likely suffering from? a. respiratory acidosis b. metabolic acidosis c. respiratory alkalosis d. metabolic alkalosis

29. Excessive intake of vitamin D can cause- a. hypercalcemia b. hyperkalemia c. hypernatremia d. hyperchloremia

30. The most prevalent anion in the extracellular fluid is- a. calcium b. chloride c. patassium d. sodium

31. Peter came into the ER and stated that he has been vomiting for two days. He is at risk for a. metabolic acidosis b. respiratory acidosis c. metabolic alkalosis d. respiratory alkalosis.

32. Hypoventilation causes a build up of HCO3 in the lungs. True or false 33. When a person in renal failure consume more water than the kidney's can excrete, this may result in water intoxication. True or false. 34. Which of the following is the most abundant extracellular fluid a. K+ b. Na+ c. Mg d. Phos

35. Increased kidney function with aging adversley affects fluid and electrolyte balance. True or False 36. Which of the following promotes insertion of water-channel proteins into the apical membrane of principal cells in the collecting ducts of the kidneys? a.ANP b.aldosterone c.ADH d.angiotensin II 37. All of the following reduces the loss of water in urine except? a.ANP b.ADH c.aldosterone d.angiotenon II 38. Which ion is the most abundant ion in extracelluar fluid? a.chloride b.calicum c.potassium d.sodium 39.Which of the buffer system is the most abundant buffer in intracelluar fluid and blood plasma? a.protien buffer system b.carbonic acid-bicarbonate buffer system c.phosphate buffer system 40. When the systemic arterial blood Pco2 falls below 35mmHg, what is happening to the person? a.Respiratory Acidosis b.Metabolic Acidosis c.Metabolic Alkalosis d.Respiratory Alkalosis

41. A person with which of the following conditions is at the greatest risk for metabolic alkalosis: a. diarrhea b. renal failure c. prolonged vomiting d. acid poisoning

42. Which electrolyte abnormalities are associated with acidosis? a. hypernatremia b. hyperkalemia c. hypocalcemia d. hypomagnesemia

43. Which of the following are true? a. excessive use of antacids may cause alkalosis b. diuretics decrease the risk of alkalosis c. dehydration is related to alkalosis d. laxative use may decrease the risk of alkalosis

44. <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt;">The maintenance of proper pH of the body fluids is a result of: <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: normal; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">a. buffers in the blood <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: normal; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">b. control of respiratory ventilation <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: normal; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">c. active secretion of H+ into kidney tubule cells <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: normal; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">d. all of the above

<span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 115%; margin: 0in 0in 0pt 0.5in; text-indent: -0.25in;">45. A buffer is a substance that <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 115%; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">a. returns an acid solution to neutral <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 115%; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">b. converts acid solutions to alkaline solutions <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 115%; margin: 0in 0in 0pt 0.75in; text-indent: -0.25in;">c. converts strong acids or bases to weak acids or bases <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 115%; margin: 0in 0in 10pt 0.75in; text-indent: -0.25in;">d. returns an alkaline solution to neutral

<span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 115%; margin: 0in 0in 10pt 0.75in; text-indent: -0.25in;">46. Which hormone is needed to maintain water balance through promoting insertion of aquaporin-2 into th e principal cells of collecting ducts of the kidneys? a. Atrial natriuretic peptide (ANP) b. Antidiuretic hormone (ADH) c. Aldosterone d.Angiotensin II

47. Which electrolyte is the prime mover of water in the body? a. Sodium NA+ b. Chloride Cl- c. Potassium K+ d. Calcium CA+

48. A _ when put into a solution will completely and irreversibly breakdown. Because all of the breaks down into H+, it is a very ___ acid. a. Weak Acid, Weak Acid, potent b. Weak Acid, Strong Acid, weak c. Strong Acid, Strong Acid, potent d. Strong Acid, Weak Acid, weak

49. When using the Carbonic Acid Buffer system; when there is too little H+ ions in which direction will reaction go? a. Right b. Left c. Both directions because it is reversible d. None of the above

50. Which Acid Base imbalance has to do with changes in bicarbonate ion concentrationin the blood? a. Respiratory Acidosis and Alkalosis b. Metabolic Acidosis and Alkalosis c. Respiratory Acidosis d. Metabolic Alkalosis

51. True or False Most abundant anion in ECF is Sodium. A. true B. false

52. An elderly woman was at the doctors office when she found out she had emphysema. What is her acid base status? A. metabolic acidosis B. respiratory alkalosis C. respiratory acidosis D. metabolic alkalosis

53. True or False Calcium plays important roles in blood clotting, neurotransmitter, muscle tone, and excitability of nervous and muscle tissue. A. true B. false

54. Which of the following does not cause metabolic acidosis? A. failure of kidneys to excrete H+ from dietary proteins B. loss of HCO3 C. accumulation of acids D. all of the above causes metabolic acidosis

55. A young boy went to the hospital with severe dehydration, vomiting, and the doctor found out he had increase PH. What is his acid base status? A. metabolic alkalosis B. metabolic acidosis C. respiratory alkalosis D. respiratory acidosi

<span style="font-family: 'Times New Roman',Times,serif;">56. Madison went to the Dr. complaining of lower back pain, a fever, some blood in her urine and not urinating frequently. After the Dr. tested Madison’s urine and did some imaging tests the Dr. diagnosed Madison with which of the following? <span style="font-family: 'Times New Roman',Times,serif;">A. Urinary tract infection <span style="font-family: 'Times New Roman',Times,serif;">B. Renal Calculi (kidney stones) <span style="font-family: 'Times New Roman',Times,serif;">C. Glomerulonephritis <span style="font-family: 'Times New Roman',Times,serif;">D. Polycystic kidney disease

<span style="font-family: 'Times New Roman',Times,serif;">57. True or False. The left kidney is lower because the liver sits on top of it.

<span style="font-family: 'Times New Roman',Times,serif;">58. Functions of the kidneys include all of the following except: <span style="font-family: 'Times New Roman',Times,serif;">A. regulates blood pressure <span style="font-family: 'Times New Roman',Times,serif;">B. regulates blood Ph <span style="font-family: 'Times New Roman',Times,serif;">C. maintains blood volume <span style="font-family: 'Times New Roman',Times,serif;">D. produce substances that break down fats

<span style="font-family: 'Times New Roman',Times,serif;">59. Which of the following pick up filtered plasma and then moves the plasma to the renal tubule? <span style="font-family: 'Times New Roman',Times,serif;">A. Bowmans capsule <span style="font-family: 'Times New Roman',Times,serif;">B. Nephron <span style="font-family: 'Times New Roman',Times,serif;">C. Glomerulus <span style="font-family: 'Times New Roman',Times,serif;">D. Loop of Henle

<span style="font-family: 'Times New Roman',Times,serif;">60. A 32 year old female came into the Dr. complaining of having a lack of control over micturation. She says when she sneezes, coughs, laughs or picks up her 3 year old son she is unable to control the urine coming out of her bladder. What is she describing? <span style="font-family: 'Times New Roman',Times,serif;">A. Urge incontinence <span style="font-family: 'Times New Roman',Times,serif;">B. Overflow incontinence <span style="font-family: 'Times New Roman',Times,serif;">C. Stress incontinence <span style="font-family: 'Times New Roman',Times,serif;">D. Functional incontinence

61. Which of the following hormone/s promotes Na/Cl reabsorption and also activates the thirst center in the hypothalamus? A. Aldosterone B. Angiotensin II C. Antidiuretic hormone D. Both A and B

62. ANP blood pressure by promoting excretion of -? A. Lowers, sodium B. Lowers, calcium C. Raises, calcium D. Raises, hydrogen

63. Which of the following is the most important cation in ICF? A. Potassium B. Chloride C. Sodium D. Hydrogen

64. Which hormone would be secreted if hypercalcemia within the blood occurs? A. Calcitonin B. Calcitriol C. Aldosterone D. ADH

65. NSAIDs are considered to be acids which means they will breakdown when put in to a solution. A. Strong, partially B. Strong, completely C. Weak, partially D. Weak, Completely

66)Which of the following is responsible for the majority of fluid intake in m L/day? a)Drink b)Food c)Metabolic Water d)Inspired Air

67)Veronica enters the ER and says that she has been uncontrollably vomiting for the past couple of days. She also has high levels of bicarbonate and a low [H+], causing an overall high pH. Which of the following pH imbalances is Veronica most likely suffering from? a)Metabolic Acidosis b)Respiratory Alkalosis c)Respiratory Acidosis d)Metabolic Alkalosis

68)Claude shows high levels of pCO2, high [H+] , and relatively low pH. Which of the following is least likely to be the cause of this patient’s pH imbalance? a)Emphysema b)Asthma c)Hyperventilation d)OD on an opiate drug

69)Which of the following would be an appropriate treatment for respiratory acidosis due to emphysema? a)Breath into a bag b)IV Bicarbonate c)Give Insulin d)Give Electrolytes

70)Which of the following is a mechanism that the body uses to compensate for Respiratory Acidosis? a)Decrease respiration rate b)Increase respiration rate c)The kidneys secrete more H+ and reabsorb more HCO3- d)The kidneys secrete less H+ and reabsorb less HCO3-

71. T or F: Metabolic Water Gain depends on the level of dehydration? a. True b. False

72. What hormone promotes the excretion of Na+ Cl-, decreasing blood volume? a. Angiotension II b. Parathyroid Hormone (PTH) c. Antidiuretic Hormone (ADH) d. Aldosterone e. Atrial Naturietic Peptide (ANP)

73. T or F: Urinary Salt (Na+Cl-) determines osmolarity & water gain. a. True b. False

74. What hormone is also known as a vasopressin? a. Angiotension II b. Aldosterone c. Aquaporin-2 d. Antidiuretic Hormone (ADH)

75. What is the cause for abnormally low Pco2 in systemic arterial blood (Respiratory Alkalosis)? a. Increased production of acids b. Hyperventilation c. Dehydration d. Certain Diuretics

76. Which is NOT a role of calcium in the body? a. helps maintain muscle tone b. plays an important role in blood clotting c. acts as storage for sodium d. crucial to neurotransmitter release 77. Which of the following is NOT a parameter of a normal blood gas test? a. blood viscosity b. pCO 2 c. HCO3 concentration d. hemoglobin saturation 78. A patient has a low pH and high pCO2. She likely suffers from a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis 79. The respiratory system reduces carbonic acid levels by exhaling CO2. What will this do to arterial blood pH? a. It will become more acidic. b. It will become less acidic. c. It will have no effect. d. It will become less base. 80. Which is a function of electrolytes? a. control osmosis of water between ICF and ECF b. control cardiovascular output c. cause cells to lyse (explode) d. insulate against electrical currents in nervous system

<span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">81. Water follows stuff. Which electrolyte, which is the most abundant, would directly increase or decrease blood pressure? <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">a. Calcium <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">b. Chloride <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">c. Potassium <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">d. Sodium <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">82. Which demographic is not affected by the thirst sensation? <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">a. Infants <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">b. Young adults <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">c. Elderly <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">d. Mentally confused <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">83. Jose’ was diagnosed with hyperkalemia. Which hormone was either not working or overworked? <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">a. Aldosterone <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">b. Erythropoietin <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">c. Phosphate <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">d. Antidiuretic <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">84. Shalanda made a dish and included too much vinegar. She started having diarrhea. She went to the doctor and diagnosed her with what illness? <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">a. Respiratory Acidosis <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">b. Metabolic Alkalosis <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">c. Respiratory Alkalosis <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">d. Metabolic Acidosis <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> True / False <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">85. Carrie does not have much carbon dioxide in her body, so she is trying to hypoventilate to gain more carbon dioxide. Did she do the right ventilation? <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">a. True <span style="font-family: 'Times New Roman','serif'; font-size: 12pt;">b. False

ANSWERS

1. True 2.B 3.D. 4.C 5.True 6. B 7. C 8. A 9. C 10.D

21. C 22. A 23. B 24. C 25. A 26. a. true 27. c. diarrhea 28. b. metabolic acidosis 29. a. hypercalcemia 30. b. chloride 31. c 32. false 33. true 34. b 35. False 36.C 37.A  38.D  39.A  40.D  41. C 42. B 43. A 44. D 45. C 46. B 47. A 48. C 49. B 50. B 51. B 52. C 53. A 54. D 55. A 56. B 57. False 58. D 59. A 60. C 61.B  62. A 63. A 64. A 65. C

56)a 57)d 58)c 59)b 70)d 71.a  72.e  73.b  74.d  75.b  76.c  77.a  78.c  79.b  80.a 81. D 82. B 83. A 84. D 85. A