1. Why are infants most susceptible to significant losses in total body water?
a. High body surface-to-body size ratio
b. Slow metabolic rate
c. Kidneys are not mature enough to counter fluid losses
d. Inability to communicate adequately when he or she is thirsty
2. Why does obesity create a greater risk for dehydration in people?
a. Adipose cells contain little water because fat is water repelling.
b. The metabolic rate of obese adults is slower than the rate of lean adults.
c. The rate of urine output of obese adults is higher than in lean adults.
d. The thirst receptors of the hypothalamus do not function effectively.
3. A patient’s blood gases reveal the following findings: pH 7.3; bicarbonate (HCO3) 27 mEq/L; carbon dioxide (CO2) 58 mm Hg. What is the interpretation of these gases?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Metabolic alkalosis
4. Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of what?
a. Osmotic forces
b. Plasma oncotic pressure
c. Antidiuretic hormone
d. Hydrostatic forces
5. In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
a. Oncotic pressure
b. Buffering
c. Net filtration
d. Hydrostatic pressure
6. Venous obstruction is a cause of edema because of an increase in which pressure?
a. Capillary hydrostatic
b. Interstitial hydrostatic
c. Capillary oncotic
d. Interstitial oncotic
7. At the arterial end of capillaries, why does fluid move from the intravascular space into the interstitial space?
a. Interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.
b. Capillary hydrostatic pressure is higher than the capillary oncotic pressure.
c. Interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
d. Capillary oncotic pressure is lower than the interstitial hydrostatic pressure.
8. Low plasma albumin causes edema as a result of a reduction in which pressure?
c. Plasma oncotic
9. How are secretion of antidiuretic hormone (ADH) and the perception of thirst stimulated?
a. Decrease in serum sodium
b. Increase in plasma osmolality
c. Increase in glomerular filtration rate
d. Decrease in osmoreceptor stimulation
10. Thirst activates osmoreceptors following an increase in which blood plasma component?
a. Antidiuretic hormone
b. Aldosterone
c. Hydrostatic pressure
d. Osmotic pressure
11. A student asks about natriuretic peptides. Which statement by the professor is most accurate?
a. Decrease blood pressure and increase sodium and water excretion.
b. Increase blood pressure and decrease sodium and water excretion.
c. Increase heart rate and decrease potassium excretion.
d. Decrease heart rate and increase potassium excretion.
12. When changes in total body water are accompanied by proportional changes in electrolytes, what type of alteration occurs?
a. Isotonic
b. Hypertonic
c. Hypotonic
d. Normotonic
13. Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?
a. Angiotensin I
b. Angiotensin II
c. Aldosterone
d. Renin
14. A patient in the hospital has hypernatremia. What condition should the healthcare professional assess for?
a. Syndrome of inappropriate antidiuretic hormone
b. Hypersecretion of aldosterone
c. Brief bouts of vomiting or diarrhea
d. Excessive diuretic therapy
15. A patient has a serum sodium level of 165 mEq/L. The healthcare professional explains that the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma are caused by what mechanism?
a. High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink.
b. High sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell.
c. Low sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain.
d. Low sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell.
16. What does vomiting-induced metabolic alkalosis cause?
a. Retained sodium to bind with the chloride
b. Hydrogen to move into the cell and exchange with potassium
c. Retention of bicarbonate to maintain the anion balance
d. Hypoventilation to compensate for the metabolic alkalosis
17. The pathophysiologic process of edema is related to which mechanism?
a. Sodium depletion
b. Decreased capillary hydrostatic pressure
c. Increased plasma oncotic pressure
d. Lymphatic obstruction
18. Why is insulin used to treat hyperkalemia?
a. Stimulates sodium to be removed from the cell in exchange for potassium
b. Binds to potassium to remove it through the kidneys
c. Transports potassium from the blood into the cell along with glucose
d. Breaks down the chemical components of potassium, inactivating it
19. A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between what?
a. Intracellular and extracellular Na+
b. Intracellular and extracellular K+
c. Intracellular Na+ and extracellular K+
d. Intracellular K+ and extracellular Na+
20. During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?
a. Oxygen
b. Sodium
c. Potassium
d. Magnesium
21. A healthcare professional is caring for four patients. Which patient should the professional assess for hyperkalemia?
a. Hyperparathyroidism
b. Vomiting
c. Renal failure
d. Hyperaldosteronism
22. In hyperkalemia, what change occurs to the cells’ resting membrane potential?
a. Hypopolarization
b. Hyperexcitability
c. Depolarization
d. Repolarization
23. A patient’s chart indicates Kussmaul respirations. The student asks the healthcare professional what this is caused by. What response by the professional is most accurate?
a. Anxiety leads to Kussmaul respirations and is a cause of respiratory acidosis.
b. A compensatory measure is needed to correct metabolic acidosis.
c. Diabetic ketoacidosis is leading to metabolic acidosis.
d. More oxygen is necessary to compensate for respiratory acidosis.
24. A healthcare provider notes that tapping the patient’s facial nerve leads to lip twitching. What electrolyte value is correlated with this finding?
a. K+: 2.8 mEq/L
b. K+: 5.4 mEq/L
c. Ca++: 8.2 mg/dL
d. Ca++: 12.9 mg/dL
25. A patient has a history of excessive use of magnesium-containing antacids and aluminum- containing antacids. What lab value does the healthcare professional correlate to this behavior?
a. Magnesium 1.8 mg/dL
b. Phosphate 1.9 mg/dL
c. Sodium 149 mEq/L
d. Potassium 2.5 mEq/L
26. A healthcare professional is caring for four patients. Which patient should the professional assess for hypermagnesemia as a priority?
a. Hepatitis
b. Renal failure
c. Trauma to the hypothalamus
d. Pancreatitis
27. Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in what ratio?
a. 20:1
b. 1:20
c. 10:2
d. 10:5
28. Where is two thirds of the body’s water found?
a. Interstitial fluid spaces
b. Vascular system
c. Intracellular fluid compartments
d. Intraocular fluids
29. A healthcare professional just administered a large dose of insulin to a patient. Which electrolyte value should the professional monitor as a priority?
a. Sodium
b. Potassium
c. Calcium
30. Why does increased capillary hydrostatic pressure result in edema?
a. Losses or diminished production of plasma albumin
b. Inflammation resulting from an immune response
c. Blockage within the lymphatic channel system
d. Sodium and water retention
31. A patient’s electrocardiogram (ECG) shows tall, peaked T waves. What lab value or assessment would the healthcare professional correlate with this finding?
a. Positive Chvostek sign
b. Serum potassium 6.7 mEq/L
c. Nausea and vomiting
d. Serum sodium 138 mEq/L
1. Which groups are at risk for fluid imbalance? (Select all that apply.)
a. Women
b. Infants
c. Men
d. Obese persons
e. Older adults
2. A patient is admitted to the hospital with dehydration. For which signs or symptoms would the healthcare professional assess? (Select all that apply.)
a. Moist mucous membranes
b. Weak pulses
c. Tachycardia
d. Polyuria
e. Weight loss
3. What are the causes of hypocalcemia? (Select all that apply.)
a. Repeated blood administration
b. Pancreatitis
c. Decreased reabsorption of calcium
d. Hyperparathyroidism
e. Kidney stones
4. A patient is admitted with hyponatremia. For which clinical manifestations would the healthcare professional assess? (Select all that apply.)
a. Headache
b. Seizures
c. Paranoia
d. Confusion
e. Lethargy
5. A patient has been diagnosed with hypercalcemia. Which manifestations does the healthcare professional assess for? (Select all that apply.)
a. Diarrhea
b. Calcium-based kidney stones
c. ECG showing narrow T waves
d. Lethargy
e. Bradycardia
6. A patient’s serum potassium level is 2.7 mEq/L. Which clinical manifestations does the healthcare professional assess for? (Select all that apply.
a. Paralytic ileus
b. Sinus bradycardia
c. Atrioventricular block
d. Dry mucous membranes
e. Tetany
7. A third of the body’s fluid is contained in the extracellular interstitial fluid spaces that include what? (Select all that apply.)
a. Urine
b. Intraocular fluids
c. Lymph
d. Blood plasma
e. Sweat
8. An imbalance of potassium can produce which dysfunctions? (Select all that apply.)
a. Weakness of skeletal muscles
b. Cardiac dysrhythmias
c. Smooth muscle atony
d. Visual impairment
e. Hearing loss
9. Which statements regarding total body water (TBW) are true? (Select all that apply.)
a. During childhood, TBW slowly decreases in relationship to body weight.
b. Gender has no influence on TBW until old age.
c. Men tend to have greater TBW as a result of their muscle mass.
d. Estrogen plays a role in female TBW.
e. Older adults experience a decrease in TBW as a result of decreased muscle mass.
10. The calcium and phosphate balance is influenced by which three substances? (Select all that apply.)
a. Parathyroid hormone
b. Vasopressin
c. Thyroid hormone
d. Calcitonin
e. Vitamin D
