Section: Coach Water — Living with Water
This section covers Chapter 2, Lessons 2.1 through 2.4. This section includes content on hyponatremia, presented protectively and based on research consensus.
Part A — Vocabulary (20 points, 2 points each)
Select the best answer for each question.
1. Hyponatremia is:
A) High blood sodium B) Sodium concentration in the blood below the normal range (generally below 135 mmol/L) C) Low potassium D) A form of dehydration
2. Dilutional hyponatremia refers to:
A) Hyponatremia from sweating B) Hyponatremia caused by excess water intake diluting the body's sodium C) A form of low blood pressure D) Loss of sodium through urine
3. Exercise-Associated Hyponatremia (EAH) is:
A) A common form of dehydration B) A specific dilutional hyponatremia developing during or shortly after prolonged endurance exercise C) A type of heat stroke D) A normal training response
4. Water intoxication is:
A) A nontechnical name for severe dilutional hyponatremia B) A urinary tract infection C) A type of food poisoning D) Excess thirst
5. Overnight water loss refers to:
A) Water spilled during sleep B) Water lost during sleep through breath, sweat, and insensible skin loss, typically 200-400 mL C) Bathroom visits during the night D) Saliva loss only
6. Insensible water loss describes:
A) Water consumed without realizing it B) Water lost through routes other than urine and sweat — primarily exhaled breath and slow skin evaporation C) Sweat that does not evaporate D) Tears
7. Urochrome is:
A) A skin pigment B) The yellow pigment in urine, a breakdown product of old red blood cells, whose concentration depends mostly on dilution C) A vitamin D) A medical condition
8. Sweat rate is:
A) Body temperature B) Fluid lost through sweat per unit of time, usually expressed in liters per hour C) The temperature of sweat D) An emotional response
9. Heat acclimatization is:
A) Moving to a warm climate B) The set of physiological adaptations to repeated heat exposure over 7-14 days, including more dilute sweat C) Wearing extra layers D) A type of cooking
10. Voluntary dehydration refers to:
A) Deliberately not drinking water B) The documented tendency for people exercising in heat to under-replace sweat losses even when fluid is available C) A clinical disorder D) A drinking game
Part B — Concept Comprehension (20 points, 2 points each)
Select the best answer for each question.
11. Approximately how much water does the average adolescent lose during a typical night of sleep?
A) 50-100 mL B) 200-400 mL C) 1-2 L D) 3-5 L
12. "Eight glasses of water a day" most likely originated from:
A) A 2008 American Heart Association guideline B) The WHO's 1980 hydration report C) A 1945 U.S. National Research Council recommendation, with the "most from food" qualifier later dropped D) A 1962 athletic training manual
13. Hyponatremia is defined as:
A) Blood sodium above the normal range B) Blood sodium below the normal range (generally <135 mmol/L) C) Excess potassium in the blood D) Low blood pressure during exercise
14. The combination most associated with exercise-associated hyponatremia is:
A) Plain water + sodium replacement + short exercise B) Long-duration sweat exposure + plain water intake well beyond thirst + no sodium replacement C) Brief intense exercise in cold conditions D) Drinking sports drinks during a 20-minute workout
15. The healthy kidney can excrete water at a maximum rate of approximately:
A) 100-200 mL per hour B) 0.7-1.0 L per hour C) 5-10 L per hour D) 20 L per hour
16. Heat acclimatization typically develops over:
A) 1-2 days B) 7-14 days C) 4-6 weeks D) 6-12 months
17. A typical sweat rate for hard exercise in heat is:
A) 50-100 mL/hr B) 0.2-0.4 L/hr C) 1.5-2.5 L/hr D) 8-10 L/hr
18. During exercise lasting more than an hour in heat, the most appropriate hydration strategy is generally:
A) Plain water in very large volumes B) Fluids containing some sodium (such as sports drinks) plus thirst-guided intake C) No fluid intake during exercise D) Caffeinated energy drinks only
19. Voluntary dehydration refers to:
A) Deliberate water restriction for weight class B) The tendency to under-replace sweat losses even when fluid is freely available C) A medical condition involving impaired thirst D) The drying of urine overnight
20. Which of the following is the protective behavior the chapter recommends regarding hyponatremia?
A) Drink as much water as possible B) Drink to thirst; include sodium-containing fluids during prolonged sweating; never deliberately water-load C) Avoid fluid entirely during exercise D) Track exact ounces per hour
Part C — Application (30 points, 6 points each)
Write 2-4 complete sentences for each question. Show your reasoning.
21. Describe the typical 24-hour pattern of water gain and loss for an adolescent. Identify one segment where mild dehydration is most common and explain why.
22. Explain the mechanism by which dilutional hyponatremia develops during long endurance exercise in heat. Why does drinking only plain water make this worse, and what is the protective behavior?
23. A friend on the cross-country team has been told by an older athlete to "drink as much water as possible before and during long summer practice — you can never drink too much." Based on this chapter, write a respectful response that corrects the advice and explains the research-supported protective behavior.
24. Explain heat acclimatization. What changes occur in the body over the first two weeks of repeated heat exposure, and what practical implication does this have for an athlete starting summer training?
25. The Elephant's posture is "notice, do not measure" for everyday hydration. Explain what this means and identify two specific situations where more deliberate attention is warranted.
Continue to the next section.