Chapter 9: Water Balance Nursing School Test Banks

Chapter 9: Water Balance
Test Bank

MULTIPLE CHOICE

1. The hormone that conserves body water is
a. vitamin D hormone.
b. antidiuretic hormone.
c. aldosterone.
d. parathyroid hormone.
ANS: B
Antidiuretic hormone works on the kidneys nephrons to induce reabsorption and conservation of water.

DIF: Cognitive Level: Knowledge REF: 168 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The two minerals that occur in the extracellular fluid and regulate water balance are
a. calcium and potassium.
b. sodium and chloride.
c. phosphorus and magnesium.
d. potassium and magnesium.
ANS: B
Sodium and chloride are the two minerals that occur in the extracellular fluid and regulate water balance.

DIF: Cognitive Level: Knowledge REF: 163-164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. A person is most likely to have a high body water content if he/she is
a. overweight.
b. underweight.
c. a bodybuilder.
d. sedentary.
ANS: C
An athlete would have a high body water content related to the amount of muscle mass. Muscle mass contains a relatively large amount of water.

DIF: Cognitive Level: Application REF: 161
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

4. The term extracellular fluid includes
a. plasma and tissue secretions.
b. plasma and fluid inside cells.
c. fluid surrounding cells and in beverages.
d. fluid surrounding cells and fluid inside cells.
ANS: A
Extracellular fluid is the total body water outside the cells.

DIF: Cognitive Level: Knowledge REF: 161 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. A basic mechanism for maintaining body hydration is
a. thirst.
b. electrolyte balance.
c. acid-base balance.
d. activity level.
ANS: A
Thirst is the basic mechanism for maintaining hydration.

DIF: Cognitive Level: Knowledge REF: 161 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. The hormone responsible for promoting conservation of sodium in the kidney is
a. aldosterone.
b. antidiuretic hormone.
c. angiotensin.
d. renin.
ANS: A
Aldosterone is produced by the adrenal glands, which trigger the kidneys nephrons to reabsorb sodium.

DIF: Cognitive Level: Knowledge REF: 168 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. Mr. Jones consumes approximately 1500 mL/day from fluid contained in liquids and foods and from metabolism of foods. What percent of his fluid requirement does he meet if he requires 2400 mL/day?
a. 41%
b. 51%
c. 62%
d. 84%
ANS: C
The intake from liquids, liquids in foods, and metabolism is approximately 1500 mL/day so 1500 mL divided by 2400 mL = 62%.

DIF: Cognitive Level: Analysis REF: 163 TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

8. Water formed from metabolism comes from
a. what is contained in foods.
b. moving from compartment to compartment.
c. what is absorbed from gastrointestinal secretions.
d. oxidation of nutrients in the cells.
ANS: D
Metabolic water, or water of oxidation, is the product of cell oxidation when nutrients are burned in the body for energy.

DIF: Cognitive Level: Comprehension REF: 163 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The approximate volume of digestive secretions produced by the stomach each day is _____ mL.
a. 1000
b. 1500
c. 2000
d. 2500
ANS: D
The approximate total volume of digestive secretions produced by an average-sized adult is 8200 mL per 24 hours. Of this amount, 2500 mL is from gastric secretions.

DIF: Cognitive Level: Knowledge REF: 167 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. The kidneys must excrete water in the urine because
a. the body needs to get rid of the ingested water.
b. water provides the vehicle for excretion of waste products.
c. they physiologically cannot retain all the water.
d. hormones ensure that a maximal amount of water is retained by the body.
ANS: B
The largest amount of water exits through the kidneys. A certain amount of water must be excreted as urine to carry the various waste products of metabolism. This is called obligatory water loss because it is compulsory for survival and must occur daily for health.

DIF: Cognitive Level: Knowledge REF: 163 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. Plasma proteins and electrolytes are examples of solutes
a. filtered from the plasma by the kidneys.
b. found in body fluids that influence movement of water.
c. released into the plasma by the liver.
d. recycled by the mucosa during digestion.
ANS: B
Plasma proteins, mainly in the form of albumin and globulin, are organic compounds of large molecular size responsible for controlling water movement in the body and guarding blood volume by influencing the shift of water in and out of capillaries in balance with the surrounding water. Electrolytes are particles that are free to move throughout a solution to maintain chemical balance.

DIF: Cognitive Level: Application REF: 157|163-164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. An example of a substance that can pass through a capillary membrane is
a. glucose.
b. hemoglobin.
c. plasma proteins.
d. antibodies.
ANS: A
Glucose passes through a capillary membrane. The walls of the capillaries are thin and porous; therefore water molecules and small particles can move freely across them.

DIF: Cognitive Level: Application REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. An acid has a pH
a. greater than 7.0.
b. lower than 7.0.
c. greater than 5.0.
d. lower than 5.0.
ANS: B
A pH less than 7.0 is considered acidic, whereas anything above 7.0 is considered basic. A pH of 7.0 is neutral.

DIF: Cognitive Level: Knowledge REF: 169 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. An example of a cation is
a. sodium.
b. phosphate.
c. carbonate.
d. sulfate.
ANS: A
Cations are ions carrying positive charges, such as sodium, potassium, calcium, and magnesium.

DIF: Cognitive Level: Knowledge REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. The organic molecule responsible for creating colloidal osmotic pressure is
a. glucose.
b. an electrolyte.
c. protein.
d. sodium.
ANS: C
Protein is an organic molecule responsible for creating colloidal osmotic pressure.

DIF: Cognitive Level: Application REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. An example of an electrolyte is
a. glucose.
b. iron.
c. potassium.
d. carbon dioxide.
ANS: C
Electrolytes are small, inorganic substances that can dissociate or break apart in a solution and carry an electrical charge. Examples include potassium, sodium, chloride, calcium, magnesium, carbonate, phosphate, and sulfate.

DIF: Cognitive Level: Comprehension REF: 163-164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. Ways in which water and solutes move across membranes include
a. diffusion and filtration.
b. capillary action and circulation.
c. peristalsis and contraction.
d. conduction and pulsation.
ANS: A
Forces that move water and solutes across membranes include osmosis, diffusion, filtration, active transport, and pinocytosis.

DIF: Cognitive Level: Knowledge REF: 165-166 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. Functions of water in the body include
a. providing an energy source.
b. temperature control.
c. nerve impulse transmission.
d. transport of vitamins A, D, E, and K.
ANS: B
The body water supply acts as a solvent, serves as a means of transport, provides form and structure, regulates temperature control, and provides lubrication for the body.

DIF: Cognitive Level: Knowledge REF: 158 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness

19. The term used to denote concentration of electrolytes in a given volume is
a. valence.
b. colloidal osmotic pressure.
c. pH.
d. milliequivalent.
ANS: D
Milliequivalents are used to express the number of electrolytes per unit of fluid in a solution.

DIF: Cognitive Level: Knowledge REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. Cations primarily responsible for controlling body water distribution are
a. sodium and chloride.
b. calcium and phosphorus.
c. sodium and potassium.
d. sodium and bicarbonate.
ANS: C
Sodium and potassium are cations that function to control the distribution of water in the body. Sodium is the major extracellular electrolyte and potassium is the major intracellular electrolyte.

DIF: Cognitive Level: Knowledge REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. A patient who is experiencing severe diarrhea and vomiting would have
a. increased body water requirements.
b. decreased body water requirements.
c. no change in body water requirements.
d. an immediate need for intravenous fluid.
ANS: A
Diarrhea and vomiting increase the loss of fluid from the body and hence increase body water requirements to replace losses and maintain a state of homeostasis.

DIF: Cognitive Level: Application REF: 159
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

22. The kidneys launder the blood by
a. osmosis.
b. filtration.
c. active transport.
d. diffusion.
ANS: B
The kidneys filter the blood to maintain the appropriate levels of all constituents of blood and remove waste products.

DIF: Cognitive Level: Knowledge REF: 167 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. Oral rehydration therapy is preferred over intravenous therapy for fluid replacement caused by diarrhea because it
a. is quicker.
b. tastes better.
c. is more readily available.
d. provides electrolytes as well as fluid.
ANS: C
Oral hydration is preferred over intravenous therapy if it is able to be consumed by the patient because it is just as effective as intravenous therapy, is more readily available, and is less expensive.

DIF: Cognitive Level: Knowledge REF: 168 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies, Basic Care and Comfort

24. The predominant regulator(s) of circulating blood volume is(are)
a. electrolytes.
b. plasma proteins.
c. water intake.
d. hormones.
ANS: B
Plasma protein molecules are retained in blood vessels, controlling water movement in the body and guarding blood volume by influencing the shift of water in and out of capillaries in balance with the surrounding water.

DIF: Cognitive Level: Knowledge REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. Water retention would be the result of the hormone
a. ADH.
b. estrogen.
c. progesterone.
d. insulin.
ANS: A
Antidiuretic hormone promotes water conservation; it works on the kidneys nephrons to induce reabsorption of water. In any stressful situation with threatened or real loss of body water, this hormone is released to conserve vital body water.

DIF: Cognitive Level: Comprehension REF: 168 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

26. Thirst tends to be an unreliable index of fluid needs in
a. infants.
b. pregnant women.
c. breast-feeding women.
d. older adults.
ANS: D
Thirst is an unreliable index of fluid needs in the elderly because the thirst mechanism usually diminishes with age and dehydration can easily occur.

DIF: Cognitive Level: Knowledge REF: 159|161
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

27. Plasma proteins maintain colloidal osmotic pressure because
a. they are large molecules.
b. proteins are not found in the cells.
c. proteins are positively charged.
d. they contain water as part of their structure.
ANS: A
Plasma proteins maintain colloidal osmotic pressure because they are large molecules, mainly in the form of albumin and globulin. Plasma protein molecules are retained in the blood vessels, controlling water movement in the body and guarding blood volume by influencing the shift of water in and out of capillaries in balance with the surrounding water.

DIF: Cognitive Level: Knowledge REF: 164 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. Treatment for diarrhea in children is to
a. withhold oral intake and immediately begin intravenous fluids until diarrhea stops.
b. sponge with an electrolyte solution of sodium, potassium, and sugar.
c. give an age-appropriate diet along with oral fluids that contain sodium, potassium, sugar, and sodium bicarbonate.
d. administer the BRAT (bananas, rice, applesauce, and tea) diet.
ANS: C
Administering an age-appropriate diet along with fluids that contain sodium, potassium, glucose, and sodium bicarbonate is beneficial in treating diarrhea and replacing lost fluid and electrolytes to bring the body to a state of homeostasis.

DIF: Cognitive Level: Application REF: 168
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Basic Care and Comfort

29. The electrolyte present in the most abundance in gastric digestive fluids is
a. chloride.
b. potassium.
c. sodium.
d. bicarbonate.
ANS: A
The approximate concentration of certain electrolytes in gastric secretions of the digestive fluids is mostly composed of chloride followed by sodium and potassium.

DIF: Cognitive Level: Knowledge REF: 167 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. For osmosis to occur there must be
a. a semipermeable membrane.
b. cations and anions.
c. membrane channels.
d. hormonal control.
ANS: A
Osmosis is the process by which water moves from an area of low concentration to an area of high concentration; this can only happen if the two areas are separated by a semipermeable membrane.

DIF: Cognitive Level: Application REF: 165 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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