The nursing instructor is discussing metabolic acidosis with her senior nursing students. What would she tell her students about the role of the kidneys in metabolic acidosis?
A) The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance.
B) The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.
C) The kidneys react rapidly to compensate for imbalances in the body.
D) The kidneys regulate the bicarbonate level in the ICF.
Ans: B
Feedback: The kidneys regulate the bicarbonate level in the ECF; they can regenerate bicarbonate ions as well as reabsorb them from the renal tubular cells. In respiratory acidosis and most cases of metabolic acidosis, the kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. In respiratory and metabolic alkalosis, the kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance. The kidneys obviously cannot compensate for the metabolic acidosis created by renal failure. Renal compensation for imbalances is relatively slow (a matter of hours or days). Therefore, options A, C, and D are incorrect.
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