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Test Bank McCance Huether Pathophysiology 7th edition

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Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids and Bases

MULTIPLE CHOICE

1. Infants are most susceptible to significant losses in total body water because of an infant’s:
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

ANS: C
Renal mechanisms that regulate fluid and electrolyte conservation are often not mature enough to counter the losses; consequently, dehydration may rapidly develop. Infants can be susceptible to changes in total body water because of their high metabolic rate and the turnover of body fluids caused by their greater body surface area in proportion to their total body size. The inability to communicate their thirst is a problem only when they are poorly cared for.

PTS: 1 REF: Page 104

2. Obesity creates a greater risk for dehydration in people because:
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 the rate of output of lean adults.
d. The thirst receptors of the hypothalamus do not function effectively.

ANS: A
The percentage of total body water (TBW) varies with the amount of body fat and age. Because fat is water repelling (hydrophobic), very little water is contained in adipose cells. Individuals with more body fat have proportionately less TBW and tend to be more susceptible to fluid imbalances that cause dehydration.

PTS: 1 REF: Page 104

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 c. Respiratory acidosis
b. Metabolic acidosis d. Metabolic alkalosis

ANS: C
The values provided in this question characterize only acute uncompensated respiratory acidosis.

PTS: 1 REF: Pages 129-130

4. Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of:
a. Osmotic forces c. Antidiuretic hormone
b. Plasma oncotic pressure d. Hydrostatic forces

ANS: A
The movement of water between the ICF and ECF compartments is primarily a function of osmotic forces. (Osmosis and other mechanisms of passive transport are discussed in Chapter 1.)

PTS: 1 REF: Page 105

5. In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
a. Oncotic pressure c. Net filtration
b. Buffering d. Hydrostatic pressure

ANS: D
Water moves between the plasma and interstitial fluid through the forces of only osmosis and hydrostatic pressure, which occur across the capillary membrane. Buffers are substances that can absorb excessive acid or base to minimize pH fluctuations. Net filtration is a term used to identify fluid movement in relationship to the Starling hypothesis. Oncotic pressure encourages water to cross the barrier of capillaries to enter the circulatory system.

PTS: 1 REF: Page 105

6. Venous obstruction is a cause of edema because of an increase in which pressure?
a. Capillary hydrostatic c. Capillary oncotic
b. Interstitial hydrostatic d. Interstitial oncotic

ANS: A
Venous obstruction can increase the hydrostatic pressure of fluid in the capillaries enough to cause fluid to escape into the interstitial spaces. The remaining options are not causes of edema resulting from venous obstruction.

PTS: 1 REF: Page 106

7. At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the:
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.

ANS: B
At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial because capillary hydrostatic pressure is higher than the capillary oncotic pressure.

PTS: 1 REF: Page 105

8. Low plasma albumin causes edema as a result of a reduction in which pressure?
a. Capillary hydrostatic c. Plasma oncotic
b. Interstitial hydrostatic d. Interstitial oncotic

ANS: C
Losses or diminished production of plasma albumin is the only option that contributes to a decrease in plasma oncotic pressure.

PTS: 1 REF: Pages 106-107

9. Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by a(n):
a. Decrease in serum sodium c. Increase in glomerular filtration rate
b. Increase in plasma osmolality d. Decrease in osmoreceptor stimulation

ANS: B
Secretion of ADH and the perception of thirst are primary factors in the regulation of water balance. Thirst is a sensation that stimulates water-drinking behavior. Thirst is experienced when water loss equals 2% of an individual’s body weight or when osmotic pressure increases. The other options do not accurately describe how ADH and the perception of thirst are related.

PTS: 1 REF: Page 109

10. Thirst activates osmoreceptors by an increase in which blood plasma?
a. Antidiuretic hormone c. Hydrostatic pressure
b. Aldosterone d. Osmotic pressure

ANS: D
Thirst is experienced when water loss equals 2% of an individual’s body weight or when osmotic pressure increases. Dry mouth, hyperosmolality, and plasma volume depletion activate osmoreceptors (neurons located in the hypothalamus that are stimulated by increased osmotic pressure). The other options do not accurately identify what increases to activate osmoreceptors.

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