Question 1

Which of the following statements is true as it relates to acid-base balance?

Accepted Answer

A)   Renal mechanisms for correcting an acid-base imbalance are less rapid than respiratory mechanisms, but they continue to function until pH has been returned to a normal or near-normal range.
B)   pH provides an accurate measure of serum bicarbonate and carbonic acid levels.
C)   The acid-base buffer systems of the body consist of a weak acid and strong base.
D)   The body uses respiratory compensatory mechanisms to prevent large changes in pH resulting from respiratory disease.E) A) and D)
F) C) and D)

Question 2

In which scenario is hypercalcemia likely?

Accepted Answer

A)   A 55-year-old who is an alcoholic
B)   A woman diagnosed with hyperparathyroidism
C)   A 40-year-old man with pancreatitis
D)   A 60-year-old woman with heart failure who is on diureticsE) A) and B)
F) A) and C)

Question 3

Which of the following is the highest priority for meeting the needs of a patient who presents with a 3-day history of vomiting and diarrhea, blood pressure of 85/60 mm Hg, heart rate of 105 beats/min, and temperature of 99°F?

Accepted Answer

A)   Finding the source of infection
B)   Preventing nutritional deficit
C)   Replacing fluid loss
D)   Relieving nauseaE) A) and C)
F) A) and D) C

Question 4

Which of the following signs would indicate a fluid deficit?

Accepted Answer

A)   Acute weight loss and increase in blood pressure
B)   Tachycardia, acute weight loss, weakness, and dry mucous membranes
C)   Physical weakness, weight gain, bradycardia, and decreased urine output
D)   Dry fissured tongue, rapid respirations, weight gain, and confusion or deliriumE) A) and D)
F) A) and C)

Question 5

A patient with decompensated heart failure with reduced ejection fraction has edema and shortness of breath. The patient has hyponatremia. Which of the following is the most likely cause of the hyponatremia?

Accepted Answer

A)   Coexisting high triglycerides
B)   Antidiuretic hormone imbalances
C)   Thirst mechanism is impaired, leading to reduction in sodium intake
D)   An excess of water is retained, causing a dilutional hyponatremiaE) A) and B)
F) B) and D)

Question 6

Classify the following arterial blood gas: pH = 7.35, PaCO2 = 50 mm Hg, HCO3- = 29 mEq/L.

Accepted Answer

A)   Compensated respiratory acidosis
B)   Partially compensated respiratory acidosis
C)   Compensated metabolic acidosis
D)   Partially compensated metabolic acidosisE) A) and B)
F) A) and C)

Question 7

In which of the following data would acidosis be more likely?

Accepted Answer

A)   Serum sodium level of 130 mEq/L
B)   Serum sodium level of 150 mEq/L
C)   Serum potassium level of 6.2 mEq/L
D)   Serum potassium level of 3.5 mEq/LE) C) and D)
F) B) and C)

Question 8

A patient with a history of angina and hypertension is getting a preoperative evaluation for a knee replacement. His preoperative history and physical examination revealed no abnormalities. The preoperative labs, however, reveal a serum potassium level of 5.9 mEq/L. The next intervention would be to:

Accepted Answer

A)   withhold potassium in all intravenous fluids during the surgery.
B)   draw another serum potassium level.
C)   administer insulin and D50.
D)   prescribe Kayexalate.E) A) and D)
F) A) and C)

Question 9

Which of the following would be appropriate treatment for a patient on a ventilator with respiratory alkalosis, a low CO2, and normal sodium bicarbonate?

Accepted Answer

A)   Increase the respiratory rate on the ventilator
B)   Administer sodium bicarbonate IV
C)   Decrease the respiratory rate on the ventilator
D)   Administer dialysisE) B) and C)
F) C) and D)

Question 10

Respiratory acidosis occurs most commonly in:

Accepted Answer

A)   uncontrolled diabetes mellitus.
B)   renal insufficiency.
C)   emphysema.
D)   potassium depletion.E) A) and D)
F) C) and D)

Question 11

Which of the following compensatory mechanisms occur when osmolality increases?

Accepted Answer

A)   Inhibition of thirst mechanism
B)   Stimulation of thirst mechanism
C)   Suppression of antidiuretic hormone
D)   Inhibition of aldosteroneE) A) and B)
F) A) and C)

Question 12

Which of the following would be used to treat severe hyperkalemia?

Accepted Answer

A)   Angiotensin-converting enzyme
B)   Lactated Ringer's
C)   Arginine HCL
D)   Insulin and Dextrose 50%E) B) and D)
F) A) and B)

Question 13

Reduced capillary osmotic pressure can be caused by:

Accepted Answer

A)   dehydration.
B)   low concentration of plasma proteins.
C)   increased hydrostatic pressure in the veins draining the capillaries.
D)   edema.E) A) and D)
F) All of the above

Question 14

Which serum value can cause an abnormal total calcium levels and, if known, should be used to calculate a corrected serum calcium level?

Accepted Answer

A)   Phosphorus
B)   Bicarbonate
C)   Sodium
D)   AlbuminE) B) and D)
F) C) and D)

Question 15

Which of the following patients should be evaluated first?

Accepted Answer

A)   76-year-old female admitted 3 days ago with pneumonia; most recent blood gases are pH 7.35, PaO2 of 90, HCO3 of 35, and PaCO2 of 29
B)   48-year-old male admitted yesterday with kidney stones complaining of pain of a 5 on a 0-10 scale
C)   52-year-old female admitted yesterday with acute renal failure; most recent lab results are pH of 7.3, PaO2 of 94, HCO3 of 15, PaCO2 of 44, K of 6.1, Na of 148, and osmolality of 369
D)   59-year-old male admitted 2 days ago with stage III bronchogenic carcinoma complaining of nausea and pain of a 6 on a 0-10 scaleE) A) and D)
F) A) and C)

Question 16

What fluid and electrolyte changes will occur in a patient with diabetes and a very high blood glucose?

Accepted Answer

A)   Hyperkalemia develops.
B)   Water shifts by osmosis from the cells into the extracellular fluid (ECF) .
C)   Water shifts by osmosis from the extracellular fluid into the cells.
D)   Equal amounts of water move from the cells into the ECF and from the ECF into the cells, and thus, there is no net change in the water content of either the cells or the ECF.
E)   Hyperkalemia develops, and water shifts by osmosis from the cells into the extracellular fluid (ECF) .F) B) and E)
G) C) and E) E

Question 17

Aldosterone's main effect is the regulation of:

Accepted Answer

A)   sodium.
B)   water.
C)   chloride.
D)   potassium.E) B) and C)
F) C) and D)

Question 18

Classify the following arterial blood gas: pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L.

Accepted Answer

A)   Metabolic acidosis
B)   Metabolic alkalosis
C)   Respiratory acidosis
D)   Respiratory alkalosisE) A) and C)
F) B) and C)

Question 19

Insensible water losses are those that occur as the result of water that is lost in:

Accepted Answer

A)   urine.
B)   breathing and sweating.
C)   urine and bowel movements.
D)   vomitus and bowel movements.E) C) and D)
F) B) and C)

Question 20

A patient just ran a marathon in extreme heat and is diagnosed with dehydration. What is an expected finding in the urine-specific gravity?

Accepted Answer

A)   It will be normal.
B)   It will be low.
C)   It will be high.
D)   It will be indeterminate.E) A) and B)
F) A) and C) C

Exam 6: Fluid, Electrolyte, and Acid-Base Homeostasis

Which of the following statements is true as it relates to acid-base balance?

Correct Answer
verified

In which scenario is hypercalcemia likely?

Correct Answer
verified

Which of the following is the highest priority for meeting the needs of a patient who presents with a 3-day history of vomiting and diarrhea, blood pressure of 85/60 mm Hg, heart rate of 105 beats/min, and temperature of 99°F?

Correct Answer
verified
C

Which of the following signs would indicate a fluid deficit?

Correct Answer
verified

A patient with decompensated heart failure with reduced ejection fraction has edema and shortness of breath. The patient has hyponatremia. Which of the following is the most likely cause of the hyponatremia?

Correct Answer
verified

Classify the following arterial blood gas: pH = 7.35, PaCO₂ = 50 mm Hg, HCO₃^- = 29 mEq/L.

Correct Answer
verified

In which of the following data would acidosis be more likely?

Correct Answer
verified

Correct Answer
verified

Which of the following would be appropriate treatment for a patient on a ventilator with respiratory alkalosis, a low CO₂, and normal sodium bicarbonate?

Correct Answer
verified

Respiratory acidosis occurs most commonly in:

Correct Answer
verified

Which of the following compensatory mechanisms occur when osmolality increases?

Correct Answer
verified

Which of the following would be used to treat severe hyperkalemia?

Correct Answer
verified

Reduced capillary osmotic pressure can be caused by:

Correct Answer
verified

Which serum value can cause an abnormal total calcium levels and, if known, should be used to calculate a corrected serum calcium level?

Correct Answer
verified

Which of the following patients should be evaluated first?

Correct Answer
verified

What fluid and electrolyte changes will occur in a patient with diabetes and a very high blood glucose?

Correct Answer
verified
E

Aldosterone's main effect is the regulation of:

Correct Answer
verified

Classify the following arterial blood gas: pH = 7.52, PaCO₂ = 30 mm Hg, HCO₃^- = 24 mEq/L.

Correct Answer
verified

Insensible water losses are those that occur as the result of water that is lost in:

Correct Answer
verified

A patient just ran a marathon in extreme heat and is diagnosed with dehydration. What is an expected finding in the urine-specific gravity?

Correct Answer
verified
C

Exam 6: Fluid, Electrolyte, and Acid-Base Homeostasis

Which of the following statements is true as it relates to acid-base balance?

Correct AnswerverifiedShow Answer

In which scenario is hypercalcemia likely?

Correct AnswerverifiedShow Answer

Which of the following is the highest priority for meeting the needs of a patient who presents with a 3-day history of vomiting and diarrhea, blood pressure of 85/60 mm Hg, heart rate of 105 beats/min, and temperature of 99°F?

Correct AnswerverifiedC

Which of the following signs would indicate a fluid deficit?

Correct AnswerverifiedShow Answer

A patient with decompensated heart failure with reduced ejection fraction has edema and shortness of breath. The patient has hyponatremia. Which of the following is the most likely cause of the hyponatremia?

Correct AnswerverifiedShow Answer

Classify the following arterial blood gas: pH = 7.35, PaCO2 = 50 mm Hg, HCO3- = 29 mEq/L.

Correct AnswerverifiedShow Answer

In which of the following data would acidosis be more likely?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Which of the following would be appropriate treatment for a patient on a ventilator with respiratory alkalosis, a low CO2, and normal sodium bicarbonate?

Correct AnswerverifiedShow Answer

Respiratory acidosis occurs most commonly in:

Correct AnswerverifiedShow Answer

Which of the following compensatory mechanisms occur when osmolality increases?

Correct AnswerverifiedShow Answer

Which of the following would be used to treat severe hyperkalemia?

Correct AnswerverifiedShow Answer

Reduced capillary osmotic pressure can be caused by:

Correct AnswerverifiedShow Answer

Which serum value can cause an abnormal total calcium levels and, if known, should be used to calculate a corrected serum calcium level?

Correct AnswerverifiedShow Answer

Which of the following patients should be evaluated first?

Correct AnswerverifiedShow Answer

What fluid and electrolyte changes will occur in a patient with diabetes and a very high blood glucose?

Correct AnswerverifiedE

Aldosterone's main effect is the regulation of:

Correct AnswerverifiedShow Answer

Classify the following arterial blood gas: pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L.

Correct AnswerverifiedShow Answer

Insensible water losses are those that occur as the result of water that is lost in:

Correct AnswerverifiedShow Answer

A patient just ran a marathon in extreme heat and is diagnosed with dehydration. What is an expected finding in the urine-specific gravity?

Correct AnswerverifiedC

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified
C

Correct Answer
verified

Correct Answer
verified

Classify the following arterial blood gas: pH = 7.35, PaCO₂ = 50 mm Hg, HCO₃^- = 29 mEq/L.

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Which of the following would be appropriate treatment for a patient on a ventilator with respiratory alkalosis, a low CO₂, and normal sodium bicarbonate?

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified
E

Correct Answer
verified

Classify the following arterial blood gas: pH = 7.52, PaCO₂ = 30 mm Hg, HCO₃^- = 24 mEq/L.

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified
C