Final Test Session

2nd Professional BSN,4 year Programme

Subject: Adult Health Nursing I

Topic: Unit II (Fluid electrolytes acid base balance and imbalances)

Name:_______________ Roll No._____________ Date:_____________ Total Marks:65

(Objective Section)

Encircle the correct answer:

1. Osmoreceptors detect a decreased blood volume and increased blood concentration

of salt and stimulate:
a. Increased kidney activity
b. Increased salivary secretions
c. Thirst
d. Increased secretion of progesterone
2. The hormones aldosterone and ADH both have an important function in:
a. Fluid balance in the body
b. The regulation of acid concentrationin the body
c. Stimulation of a conscious desire for water
d. The activity of buffer systems
3. Which of the following may be a possible cause of edema in the tissues?
a. Decreased blood pressure
b. Decreased level of proteins in the plasma
c. The ingestion of a large amount of carbohydrates in the diet
d. Reduced temperature at the skin surface
4. The concentration of potassium in the blood is regulated by:
a. The enzyme potassium
b. The hormone aldosterone
c. The level of plasma proteins
d. The acidic content of the blood
5. An example of a strong acid found in the body is
a. Carbonic acid
b. Propionic acid
c. Acetic acid
d. Hydrochloric acid
6. The rate and depth of breathing has a regulatory influence on the:
 a. Acid/base balance of the body
b. Protein metabolism of the body
c. Amount of water taken into the body
d. Rate at which fats are broken down in the body
7. The loss of bicarbonate ions from the body through urine excretion:
a. Relieves the alkaline condition of the blood
b. Increases the excretion of protein from the blood
c. Has an effect on the nerve conduction system
d. Changes the temperature at the body surface
8. The normal pH of the venous blood and interstitial fluid is slightly:
a. More basic than arterial blood
b. Neutral as compared to arterial blood
c. More acidic than arterial blood
d. The same as arterial blood
9. All are true about metabolic alkalosis except ?
a. Associated with hyperkalemia
b. Associated with decreased ionic calcium concentration
c. Can be caused due to hyperaldosteronium
d. Can be caused due to renin secreting tumor
10. In metabolic alkalosis, the blood pH level is ?
a. Increases
b. Decreases
c. Stay the same
d. May increase or decrease
11. Which of the following is not a cause of metabolic acidosis ?
a. Aspirin toxicity
b. Ileostomy
c. Hyperaldosteronism
d. Carbonic anhydrase inhibitor
12. The following are the primary system that regulates the acid-base homeostasis. Which
of the following is the first acting regulatory mechanism?
a. Chemical buffer system
b. Protein buffer system
c. Respiratory mechanism
d. Renal mechanism
13. Which of the following statement is true regarding the respiratory control of acid-base
maintenance?
a. Increase in hydrogen ion concentration stimulates the respiratory system
b. The respiratory system can effectively correct the hydrogen ion concentration by
50% to 70%
 c. The impairment of lung function in a condition such as emphysema increases the
pCO2 concentrations
d. All of the above
14. The Kidney contributes to acid-base balance by:
a. Secretion of ammonia
b. Reclamation of bicarbonate
c. Increased ketogenesis
d. Decreased CO2 uptake
15. Excess Carbon dioxide (CO2) found in the following non-compensated conditions
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
16. Patient X is diagnosed with constipation. As a knowledgeable nurse, which nursing
intervention is appropriate for maintaining normal bowel function?
a. Assessing dietary intake
b. Decreasing fluid intake
c. Providing limited physical activity
d. Turning, coughing, and deep breathing
17. In the extracellular fluid, chloride is a major:
a. Compound
b. Ion
c. Anion
d. Cation
18. Which of the following findings would the nurse expect to assess in hypercalcemia?
a. Prolonged QRS complex
b. Tetany
c. Petechiae
d. Urinary calculi
19. Which of the following is not an appropriate nursing intervention for a patient with
hypercalcemia
a. Administering calcitonin
b. Administering calcium gluconate
c. Administering loop diuretics
d. Encouraging ambulation
20. Nursing intervention for the patient with hyperphosphatemia includes encouraging
intake of:
a. Vitamin D
b. Fleets phospho-soda
c. Milk
d. Amphojel
21. Etiologies associated with hypocalcemia may include all of the following except:
a. Renal failure
b. Inadequate intake calcium
c. Metastatic bone lesions
d. Vitamin D deficiency
22. The net diffusion of water from one solution of water from one solution through a
semipermeable membrane to another solution containing a lower concentration of
water is termed:
a. Filtration
b. Diffusion
c. Osmosis
d. Brownian motion
23. When assessing a patient’s total body water percentage, the nurse is aware that all of
the following factors influence this except:
a. Age
b. Fat tissue
c. Muscle mass
d. Gender
24. Orly Khan is suffering from fluid volume deficit (FVD), which of the following
symptoms would the nurse expect to assess in the patient?
a. Rales
b. Bounding pulse
c. Tachycardia
d. Bulging neck veins
25. Mr. Wenceslao is scheduled to receive an isotonic solution; which one of the following
is an example of such a solution?
a. D10% W
b. 0.45% saline
c. 0.9% saline
d. 3% normal saline W
26. The body’s compensation of metabolic alkalosis involves:
a. Increasing the respiratory rate
b. Decreasing the respiratory rate
c. Increasing urine output
d. Decreasing urine output
27. Which of the following blood products should be infused rapidly?
a. Packed red blood cells (PRBC)
b. Fresh frozen plasma (FFP)
c. Platelets
d. Dextran
28. Redd is receiving a blood transfusion. When monitoring the patient, the nurse would
analyze an elevated body temperature as indicating:
a. A normal physiologic process.
b. Evidence of sepsis.
c. A possible transfusion reaction.
d. An expected response to the transfusion.
29. The process of endocrine regulation of electrolytes involves:
a. Sodium reabsorption and chloride excretion
b. Chloride reabsorption and sodium excretion
c. Potassium reabsorption and sodium excretion
d. Sodium reabsorption and potassium excretion
30. The major cation in the ICF is:
a. Potassium
b. Sodium
c. Phosphorus
d. Magnesium
31. Calcium is absorbed in the GI tract under the influence of:
a. Vitamin D
b. Glucose
c. HCl
d. Vitamin C
32. When serum calcium levels rise, which of the following hormones is secreted?
a. Aldosterone
b. Renin
c. Parathyroid hormone
d. Calcitonin
33. Maria, an 85-year-old patient with a feeding tube, has been experiencing severe
watery stool. The patient is lethargic and has poor skin turgor, a pulse of 120, and
hyperactive reflexes. Nursing interventions would include:
a. Measuring and recording intake and output and daily weights.
b. Administering salt tablets and monitoring hypertonic parenteral solutions.
c. Administering sedatives.
d. Applying wrist restraints to avoid displacement of the feeding tube.
34. Disease of which of the following structures is most likely to affect electrolyte
reabsorption?
a. Glomerulus
b. Renal tubules
c. Bladder
d. Renal pelvis
35. The majority of the body’s water is contained in which of the following fluid
compartments?
 a. Intracellular
b. Interstitial
c. Intravascular
d. Extracellular
36. The danger of fluid sequestered in the third space is that the fluid:
a. Is hypertonic and can cause hypervolemia.
b. Is hypotonic and can cause water intoxication.
c. Is not available for circulation.
d. Contains large amounts of acids.
37. Which of the following clinical conditions exacerbates electrolyte excretion?
a. Nasogastric feedings
b. Use of surgical drains
c. Immobility from fractures
d. Chronic water drinking
38. A diet containing the minimum daily sodium requirement for an adult would be:
a. A no-salt diet
b. A diet including 2 gm sodium
c. A diet including 4 gm sodium
d. A 1500 calorie weight-loss diet
39. Which of the following electrolytes are lost as a result of vomiting?
a. Bicarbonate and calcium
b. Sodium and hydrogen
c. Sodium and potassium
d. Hydrogen and potassium
40. Body fluids perform which of the following functions?
a. Transport nutrients
b. Transport electrical charges
c. Cushion the organs
d. Facilitate fat metabolism
41. What two organs in the body serve as a compensatory function to maintain acid-base
balance?
a. Kidneys and Lungs
b. Lungs and Spleen
c. Heart and Liver
d. Gallbladder and Appendix
42. Arterial blood gas (ABG) measurement will give the information needed to determine
if the primary disturbance of acid-base balance is respiratory or metabolic in nature.
a. True
b. False
c. Both Carbonic Acid Excess and Deficit Only
d. Both Bicarbonate Excess and Deficit Only
43. The major effect of acidosis is overexcitement of the central nervous system.
a. True
b. False
c. Maybe
d. Both Acidosis and Alkalosis result in overexcitement of the central nervous system.
44. The human body functions optimally in a state of homeostasis.
a. True
b. False
c. Maybe
d. Homeostasis has nothing to do with metabolic balance.
45. Match the acid-base status of the following blood samples to the disorders in the
given choices. (PaCO2 values are in mm Hg and bicarbonate values in mmol/l).
pH 7.57, PaCO2 22, HCO3- 17
a. Respiratory Acidosis, Partially Compensated
b. Respiratory Alkalosis, Uncompensated
c. Metabolic Acidosis, Partially Compensated
d. Respiratory Alkalosis, Partially Compensated
46. Match the acid-base status of the following blood samples to the disorders in the
given choices. (PaCO2 values are in mm Hg and bicarbonate values in mmol/l).
pH 7.55, PaCO2 25, HCO3- 2
a. Respiratory Acidosis, Partially Compensated
b. Respiratory Alkalosis, Uncompensated
c. Metabolic Alkalosis, Partially Compensated
d. Metabolic Acidosis, Uncompensated
47. Match the acid-base status of the following blood samples to the disorders in the
given choices. (PaCO2 values are in mm Hg and bicarbonate values in mmol/l).
pH 7.17, PaCO2 48, HCO3- 3
a. Respiratory Acidosis, Uncompensated
b. Metabolic Acidosis, Partially Compensated
c. Respiratory Alkalosis, Partially Compensated
d. Respiratory Acidosis, Partially Compensated
48. Match the acid-base status of the following blood samples to the disorders in the
given choices. (PaCO2 values are in mm Hg and bicarbonate values in mmol/l).
pH 7.64, PaCO2 25, HCO3- 19
a. Respiratory Acidosis, Uncompensated
b. Respiratory Alkalosis, Partially Compensated
c. Respiratory Alkalosis, Uncompensated
d. Metabolic Alkalosis, Partially Compensated
49. The type of fluid used to manipulate fluid shifts among compartments states is:
a. Whole blood
b. TPN
 c. Albumin
d. Ensure
50. Daniel who is a marathon runner is at high risk for fluid volume deficit. Which one of
the following is a related factor?
a. Decreased diuresis
b. Disease-related process
c. Decreased breathing and perspiration
d. Increased breathing and perspiration

(Subjective Section)

1. Define metabolic alkalosis. Enlist the clinical manifestation of metabolic acidosis

2. A 60 year old patient is suffering from fluid volume deficit. If you are the nurse assigned
to this patient what will you observe and document as manifestation of fluid volume
deficit
3. Write down the management of metabolic acidosis