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Urinary System and Urinary Disorders Basic Nursing & Human Body

Total questions: 151

Worksheet time: 1hrs 16mins

Name
Class
Date
1.

Chapter 27

The nurse is reviewing the organs and functions of the urinary system with a client who is to have bladder surgery. What information should the nurse give to the client about the function of the urinary bladder?

a)

Excretes wastes from the blood, balances body fluids, and forms urine

b)

Conducts urine from the bladder to the outside of the body for elimination

c)

Serves as a reservoir for urine

d)

Conducts urine from the kidneys to the urinary bladder

2.

What is the function of the loop of Henle?

a)

Filters water, wastes (urea), glucose, and salts out of the blood

b)

Glucose, amino acids, and salts are actively transported across membranes and returned to the blood

c)

Concentrates salts by reabsorbing water

d)

Reabsorbs sodium, water, and the remainder of glucose

3.

What is the function of ADH in the maintenance of the body's homeostasis?

a)

Assists in regulation of water balance

b)

Important in blood pressure regulation

c)

Promotes sodium and water retention

d)

Increases kidney filtration and blood flow

4.

What is the function of renin?

a)

Assists in regulation of water balance

b)

Important in blood pressure regulation

c)

Promotes sodium and water retention

d)

Increases kidney filtration and blood flow

5.

Which condition results in insufficient production of erythropoietin?

a)

Hypoxia

b)

Cardiac disorders

c)

End-stage renal disease

d)

Anemia

6.

What is the function of aldosterone?

a)

Assists in regulation of water balance

b)

Important in blood pressure regulation

c)

Promotes sodium and water retention

d)

Increases kidney filtration and blood flow

7.

The mineralocorticoid hormone aldosterone responds to which levels of electrolytes? Select all that apply.

a)

Low levels of calcium

b)

Low levels of sodium

c)

High levels of chloride

d)

High levels of potassium

e)

Low level of potassium

8.

What is the function of the afferent arterioles?

a)

Brings highly oxygenated blood to the kidneys

b)

Supplies blood to the glomeruli

c)

Carries blood away from the glomeruli

d)

Empties blood into the inferior vena cava

9.

What is the function of tubular secretion?

a)

Process of removing particles from a solution by allowing the liquid solvent to pass across a barrier

b)

Movement of wastes across glomeruli into Bowman's capsule

c)

Reabsorption of most small proteins and peptides

d)

Process by which substances move from blood into the urine

10.

The nurse is reviewing the chemical difference between plasma, glomerular filtrate, and urine with a group of nursing students. What components are involved in glomerular filtrate? Select all that apply.

a)

Blood cells

b)

Protein

c)

Glucose

d)

Urea

e)

Water

11.

The nurse is reviewing the difference between micturition and incontinence with a client. Which statement accurately explains the process of micturition?

a)

The maximum of urine in the bladder

b)

Waking up at night to void

c)

Involuntary voiding on actions such as sneezing and coughing

d)

Release of urine from the body

12.

Which specific gravity of a urine sample confirms the presence of dehydration?

a)

1.015

b)

1.020

c)

1.025

d)

1.030

13.

The client has been drinking 5,000 mL of fluid a day to attempt to flush a kidney stone. Based on this information, which specific gravity is most likely?

a)

1.005

b)

1.010

c)

1.015

d)

1.020

14.

The nurse needs to consider the effects of aging on the urinary system. What nursing interventions are related to the effect of aging on the urinary system? Select all that apply.

a)

Monitoring the fluid intake and urinary output.

b)

Assessing the client for dehydration.

c)

Allowing one hour between the last fluid intake and bedtime.

d)

Keeping a nightlight on to make nighttime bathroom visits safe.

e)

Assessing the client for edema.

15.

Which is the proper sequence for the pathway of urine in the kidney?

a)

1, 4, 2, 3, 5, 6, 7

b)

2, 4, 3, 5, 1, 7, 6

c)

3, 4, 5, 1, 2, 6, 7

d)

4, 1, 2, 5, 6, 3, 7

16.

Which are functions of the kidneys? Select all that apply.

a)

Waste removal

b)

Regulation of electrolytes by excretion

c)

Conversion of vitamin B12 to a useful form

d)

Maintenance of acid-base, and fluid and electrolyte balance

e)

Regulation of electrolytes and reabsorption

17.

A nurse is caring for a client with diabetic nephropathy. The nurse should monitor the client for which urinary complication?

a)

Increased incidence of urinary incontinence

b)

Concentrated urine

c)

Low blood pressure

d)

Urinary retention

18.

A nurse is caring for a client with history of nocturia who is confined to bed. What intervention should be implemented for this client?

a)

Ensure fluid restriction during the day.

b)

Have client refrain from drinking cranberry juice.

c)

Assist the client in using incontinence pads.

d)

Offer the bedpan frequently.

19.

Which factor could result in stress incontinence?

a)

Reduced bladder capacity

b)

Decreased urine formation

c)

Reduced renal blood flow

d)

Loss of muscle tone

20.

What is the function of the juxtaglomerular apparatus?

a)

Secretes aldosterone

b)

Promotes water retention

c)

Regulates blood pressure

d)

Produces erythropoietin

21.

Chapter 89

Which is a function of the lower urinary tract?

a)

Filter by-products of metabolism.

b)

Adjust fluid and electrolyte balance.

c)

Deliver urine to the bladder.

d)

Store urine until micturition occurs.

22.

The nurse is assessing the urinary functioning of a client. Which conditions are most likely to result in alterations in kidney function? Select all that apply.

a)

Diabetes mellitus

b)

Staphylococcus infection

c)

Hypothyroidism

d)

Collagen/vascular disease

e)

Uncontrolled hypertension

23.

The nurse is preparing a client for a cystoscope. What is the meaning of the prefix 'cysto'?

a)

Pertaining to the bladder

b)

Pertaining to the kidney

c)

Pertaining to the renal pelvis

d)

Pertaining to the ureter

24.

The nurse is reviewing the laboratory results of a client being evaluated for urinary functioning and notes that bilirubin is present in the urine. What condition would the nurse suspect?

a)

Gout

b)

Diabetes

c)

Hepatitis

d)

Calculi

25.

A routine urinalysis is performed on a 59-year-old female client diagnosed with kidney disease and electrolyte imbalances. Which abnormality would the nurse suspect to be documented?

a)

Abnormal pH

b)

Abnormal specific gravity

c)

Glycosuria

d)

Ketonuria

26.

The nurse is checking the laboratory results of a 76-year-old woman who had a urinalysis performed. The nurse notes that there is calcium in her urine. What condition does this abnormal substance in the urine signify?

a)

Infection

b)

Bone degeneration

c)

Kidney disease

d)

Hypertension

27.

A nurse is caring for a client who reports frequent urination. When assessing the urinalysis report, the nurse should look for what component to confirm a normal urinalysis?

a)

A specific gravity of 1.030 to 1.050

b)

A pH level ranging from 12 to 16

c)

Absence of glucose in the urine

d)

Presence of red blood cells (RBCs)

28.

A 48-year-old client is undergoing testing to confirm kidney disease. Which test uses a collected urine specimen to indicate glomerular filtration rate and renal insufficiency?

a)

Urinalysis

b)

Blood urea nitrogen (BUN)

c)

Uric acid studies

d)

Creatinine clearance test

29.

A 37-year-old male client presents at the emergency department reporting excruciating pain that comes in waves, along with nausea, vomiting, and chills. The nurse suspects the client has kidney stones. What test would be ordered to confirm or rule out this condition?

a)

KUB flat plate of the abdomen

b)

Uric acid studies

c)

Cystogram

d)

Renal arteriogram

30.

A nurse is preparing a client for an intravenous pyelogram (IVP). What intervention should the nurse be prepared to implement?

a)

Keep the client NPO (nothing by mouth) for at least 4 hours.

b)

Avoid the use of laxatives before the procedure.

c)

Provide the client with only a few sips of water if thirsty.

d)

Determine whether the client is allergic to shellfish.

31.

A client is scheduled for cystoscopy to determine which of her kidneys is diseased. Which should the nurse consider when caring for this client?

a)

Obtain a urine culture immediately after the test.

b)

Help the client with sitz baths to ease voiding.

c)

Report any blood-tinged urine following the procedure.

d)

Keep the client NPO for 24 hours following the procedure.

32.

A client is scheduled for a cystoscopy for removal of a kidney polyp. What nursing measure should the nurse undertake when caring for this client?

a)

Ask the client to reduce salt intake for 2 weeks after the cystoscopy.

b)

Make sure the client is not allergic to iodine dye before the cystoscopy.

c)

Report any darkening urine after the cystoscopy.

d)

Ask the client not to drink fluids immediately after the cystoscopy.

33.

Following identification of a mass by imaging studies, a client undergoes a needle biopsy of the kidney for a specific diagnosis. Which should the nurse consider for this procedure?

a)

Prepare the client for general anesthesia.

b)

Place the client in a side-lying position.

c)

Place a soft pillow under the client's abdomen.

d)

Apply pressure to the site to minimize bleeding.

34.

The nurse is preparing a client for urodynamic tests. Which component of this series is a noninvasive assessment of the status of micturition and generally the first test done in a urodynamic evaluation?

a)

Uroflowmetry

b)

Residual urine volume

c)

Cystometrogram

d)

Urethral pressure profile

35.

A postoperative client is prescribed morphine to control pain related to knee replacement. The medication causes the client to be confused and agitated with attempts to get out of bed on her own. Restraints are ordered, which cause the client to be incontinent. What type of incontinence is this client experiencing?

a)

True incontinence

b)

Iatrogenic incontinence

c)

Stress incontinence

d)

Urge incontinence

36.

A nurse is caring for a client experiencing urge incontinence. What should the nurse include in the client education?

a)

Tell the client to perform Kegel exercises daily.

b)

Ask the client to decrease fluid intake.

c)

Ask the client to void small amounts frequently.

d)

Tell the client to perform Credé maneuvers.

37.

A 60-year-old female client experiencing stress urinary incontinence is not considered a good candidate for surgical repair of the problem. Her healthcare provider recommends a pessary. Which describes this treatment?

a)

A small electrode connected to a generator is placed in the vagina or rectum.

b)

The healthcare provider applies firm, gentle pressure above the bladder.

c)

A device is inserted into the vagina to support the organs of the pelvis.

d)

A computer is used to monitor how well the client does Kegel exercises.

38.

A nurse is caring for a female client diagnosed with recurrent urinary tract infection (UTI). What intervention should the nurse implement with this client?

a)

Instruct the client to take a bath with mild soap.

b)

Tell the client to take vitamin D tablets daily.

c)

Instruct the client to wipe the perineal area from back to front.

d)

Instruct the client to void before and after intercourse.

39.

A 28-year-old female client presents at the emergency department with a rapid onset of fever and chills, as well as flank pain, pyuria, nausea, vomiting, and headache. Laboratory results indicate bacteriuria, WBCs, and casts. These symptoms and lab results support which medical diagnosis?

a)

Chronic cystitis

b)

Acute pyelonephritis

c)

Interstitial cystitis

d)

Glomerulonephritis

40.

A client is diagnosed with hydronephrosis. What occurs in this condition?

a)

Urine forms, but the flow of urine from the kidney is obstructed.

b)

Calculi and lithiasis form primarily in the kidneys.

c)

Fibrous bands form along the ureters or the urethra, thereby narrowing it.

d)

Multiple clusters of benign tumors form on the kidneys.

41.

A nurse is caring for a client with renal calculi. What measure should the nurse employ for this client?

a)

Encourage the client to drink at least 1 liter of fluids daily.

b)

Strain all urine through a piece of gauze, cheesecloth, or strainer.

c)

Ask the client to try to avoid ambulating, if possible.

d)

Encourage the client to consume plenty of dairy products.

42.

The nurse is teaching a student nurse about the incidence and etiology of nephromas. Which accurately describes this condition? Select all that apply.

a)

Kidney tumors are almost always benign.

b)

Kidney tumors occur more frequently in women.

c)

Kidney tumors are rare in people under 30 years of age.

d)

Some nephromas have a hereditary risk factor.

e)

Clients over age 65 should be screened for this condition

43.

The nurse discusses the risk factors of bladder cancer with a client who is being tested for the disease. Which is one of these risk factors? Select all that apply.

a)

High alcohol consumption

b)

Diagnosis of lung cancer

c)

Exposure to UV rays

d)

Frequent urinary tract infections

e)

History of smoking

44.

A nurse is caring for a client with an ileal conduit for urinary diversion following bladder removal. What intervention should the nurse be prepared to implement when caring for this client?

a)

Change the conduit appliance daily.

b)

Use a synthetic barrier cream that contains karaya.

c)

Use a solvent to loosen the appliance during removal.

d)

Wet the skin before applying the new appliance.

45.

The nurse is caring for a client who has a urinary diversion in which the ureters are brought to the abdominal wall as a stoma. This is known as what type of diversion?

a)

Ileal conduit urinary diversion

b)

Cutaneous ureterostomy

c)

Continent cutaneous diversion

d)

Neobladder to urethra diversion

46.

The nurse is caring for a client who diagnosed with renal failure. Which of the following is a characteristic of this disease?

a)

Waste products are removed from the blood into the kidneys.

b)

Azotemia occurs and potassium is retained in the blood.

c)

The phases of renal failure are always characterized by overproduction of urine.

d)

Abnormal levels of potassium, calcium, and phosphate are found in the blood.

47.

The nurse monitoring clients for symptoms of renal failure knows that oliguria is common in the early phases of renal failure. How would the nurse describe this condition?

a)

Urinary output is <400 mL in a 24-hour period.

b)

Urinary output is >400 mL in a 24-hour period.

c)

Urinary output has stopped altogether.

d)

Urinary output is <100 mL/day.

48.

A nurse is caring for a client during peritoneal dialysis as treatment for kidney failure. What measure should the nurse employ for this client?

a)

Encourage the client to breathe deeply.

b)

Cool the dialysate solution before use.

c)

Allow the client to drink water before dialysis.

d)

Leave the solution in the peritoneum for only 30 minutes.

49.

A nurse is caring for a client who is receiving hemodialysis. During dialysis, what measure should the nurse be prepared to implement when caring for this client?

a)

Check the shunt every 20 to 30 minutes for vibration.

b)

Measure blood pressure on the nondominant hand.

c)

Encourage the client to drink enough orange juice.

d)

Keep two clamps on the dressing over the cannula.

50.

A nurse is caring for a client who is receiving dialysis. An order on the client's chart reads 'Guaiac all stools.' What should the nurse be prepared to do?

a)

Monitor all stools for consistency and color.

b)

Measure all stools to monitor the output.

c)

Send all stools for occult blood test.

d)

Send all stools for a culture and sensitivity test.

51.
  1. CHAPTER 24

  2. What vascular structure is found between the afferent and efferent arterioles?

a)
  1. Peritubular capillaries

b)
  1. Renal artery

c)
  1. Glomerulus

d)
  1. Renal veins

52.
  1. What is the major artery that supplies the kidneys?

a)
  1. Carotid

b)
  1. Portal

c)
  1. Celiac axis

d)
  1. Renal

53.
  1. Which of the following is correct?

a)
  1. One kidney

b)
  1. One ureter

c)
  1. Two urinary bladders

d)
  1. One urethra

54.
  1. The urinary tract is lined with

a)
  1. serous membrane.

b)
  1. the renal capsule.

c)
  1. mucous membrane.

d)
  1. tubular epithelium.

55.
  1. The renal cortex descends between the pyramids as the

a)
  1. pelvis.

b)
  1. collecting ducts.

c)
  1. calyces.

d)
  1. renal columns.

56.
  1. The renal capsule

a)
  1. lines the tubules.

b)
  1. lines the urinary bladder.

c)
  1. surrounds the kidneys.

d)
  1. outlines the trigone.

57.
  1. Which blood vessel(s) is (are) primarily concerned with reabsorption?

a)
  1. Renal artery

b)
  1. Glomeruli

c)
  1. Renal vein

d)
  1. Peritubular capillaries

58.
  1. What is the urine-making structure of the kidney?

a)
  1. Trigone

b)
  1. Renal pyramid

c)
  1. Renal capsule

d)
  1. Nephron unit

59.
  1. Where does aldosterone exert its effects?

a)
  1. Glomeruli

b)
  1. Efferent arteriole

c)
  1. Distal convoluted tubule

d)
  1. Ascending limb (loop of Henle)

60.
  1. The efferent arterioles extend to become the

a)
  1. peritubular capillaries.

b)
  1. afferent arterioles.

c)
  1. glomeruli.

d)
  1. renal artery.

61.
  1. The proximal convoluted tubules extend to become the

a)
  1. peritubular capillaries.

b)
  1. collecting duct.

c)
  1. descending limb (loop of Henle).

d)
  1. glomeruli.

62.
  1. Urine flows from the ascending limb (loop of Henle) into the

a)
  1. glomeruli.

b)
  1. proximal convoluted tubule.

c)
  1. distal convoluted tubule.

d)
  1. ureter.

63.
  1. The calyces receive urine from the

a)
  1. proximal convoluted tubule.

b)
  1. collecting ducts.

c)
  1. glomeruli.

d)

peritubular capillaries.

64.
  1. ADH exerts its effects primarily on the

a)
  1. proximal convoluted tubule.

b)
  1. afferent arteriole.

c)
  1. collecting duct.

d)
  1. renal pelvis.

65.
  1. Which of the following is not “plumbing”?

a)
  1. Glomeruli

b)
  1. Ureters

c)
  1. Urinary bladder

d)
  1. Urethra

66.
  1. The detrusor muscle is located in the

a)
  1. urethra.

b)
  1. renal pelvis.

c)
  1. urinary bladder.

d)
  1. glomeruli.

67.
  1. The word voiding refers to

a)
  1. urine formation.

b)
  1. catheterization.

c)
  1. micturition.

d)
  1. cystitis.

68.
  1. Which of the following words best describes the function of the urinary bladder?

a)
  1. Filtration

b)
  1. Storage

c)
  1. Reabsorption

d)
  1. Buffering of H+

69.
  1. Which structure is located between the renal pelvis and the urinary bladder?

a)
  1. Urethra

b)
  1. Trigone

c)
  1. Urinary meatus

d)
  1. Ureter

70.
  1. The urinary meatus is a part of the

a)
  1. ureter.

b)
  1. urinary bladder.

c)
  1. urethra.

d)
  1. collecting duct.

71.
  1. The detrusor muscle is concerned with

a)
  1. urine formation.

b)
  1. micturition.

c)
  1. sodium reabsorption.

d)
  1. potassium excretion.

72.
  1. Kaliuresis refers to the renal excretion of

a)
  1. sodium.

b)
  1. bicarbonate.

c)
  1. water.

d)
  1. potassium.

73.
  1. Natriuresis refers to the renal excretion of

a)
  1. K+.

b)
  1. Na+.

c)
  1. water.

d)
  1. bicarbonate.

74.
  1. The renal excretion of Na+ is generally accompanied by the excretion of

a)
  1. bicarbonate

b)
  1. water

c)
  1. albumin

d)

renin

75.
  1. The juxtaglomerular apparatus (JGA) secretes

a)
  1. aldosterone.

b)
  1. ADH.

c)

angiotensin.

d)
  1. renin.

76.
  1. Renin activates

a)
  1. aldosterone.

b)
  1. converting enzyme.

c)
  1. angiotensinogen.

d)
  1. angiotensin II.

77.
  1. Activation of the renin-angiotensin-aldosterone system

a)
  1. reabsorbs K+ and eliminates Na+ in the urine.

b)
  1. causes albuminuria.

c)
  1. expands blood volume.

d)
  1. causes hematuria.

78.
  1. Aldosterone

a)
  1. depletes blood volume.

b)
  1. depletes blood volume.

c)
  1. causes sodium excretion.

d)
  1. causes Na+ and water reabsorption.

79.
  1. The juxtaglomerular apparatus (JGA) is located near the

a)
  1. collecting duct.

b)
  1. afferent arteriole.

c)
  1. ureter.

d)
  1. renal pelvis.

80.
  1. The internal and external sphincters are associated with (the)

a)
  1. renal pelvis.

b)
  1. Bowman’s capsule.

c)
  1. juxtaglomerular apparatus.

d)
  1. urinary bladder.

81.
  1. Which of the following is not located within the urinary bladder?

a)
  1. Trigone

b)
  1. Detrusor muscle

c)
  1. Internal sphincter

d)
  1. Calyces

82.
  1. Which of the following should not be found in the glomerular filtrate?

a)
  1. Albumin

b)
  1. Sodium

c)
  1. Potassium

d)
  1. Water

83.
  1. Which of the following is most likely to cause polyuria?

a)
  1. Oversecretion of aldosterone

b)
  1. Decreased glomerular filtration rate (GFR)

c)

Deficiency of ADH

d)

Activation of angiotensinogen

84.
  1. Which of the following is not true of ADH?

a)
  1. Secreted by the posterior pituitary gland

b)
  1. Secreted in response to low blood volume and concentrated plasma (as in

    dehydration)

c)
  1. Causes the renal excretion of sodium, potassium, and water

d)
  1. Deficiency causes diabetes insipidus

85.
  1. Which of the following is absorbed across the walls of the collecting duct under the influence of ADH?

a)
  1. Potassium

b)
  1. Urea

c)
  1. Water

d)
  1. Albumin

86.
  1. Pyuria is indicative of

a)
  1. infection.

b)
  1. glomerular damage.

c)
  1. deficiency of ADH.

d)
  1. excess secretion of aldosterone.

87.
  1. Which substance is filtered by the glomerulus and is excreted in the urine (there is minimal reabsorption)?

a)
  1. Albumin

b)
  1. Glucose

c)
  1. Sodium

d)
  1. Creatinine

88.
  1. Cystitis refers to inflammation of the

a)
  1. kidneys.

b)
  1. meatus.

c)
  1. urinary bladder.

d)
  1. renal pelvis.

89.
  1. Which of the following is found in the kidney?

a)
  1. Detrusor muscle

b)
  1. Trigone

c)
  1. Nephron units

d)
  1. Urethra

90.
  1. Bowman’s capsule is part of the

a)
  1. nephron unit.

b)
  1. renal pelvis.

c)
  1. collecting duct.

d)
  1. urinary bladder.

91.
  1. What part of the nephron unit filters 180 L of water per day?

a)
  1. Peritubular capillaries

b)
  1. Glomeruli

c)
  1. Calyces

d)
  1. Trigone

92.
  1. Creatinine is

a)
  1. completely reabsorbed by the peritubular capillaries.

b)
  1. a waste product that is filtered and not reabsorbed.

c)
  1. a renal enzyme that activates angiotensinogen.

d)
  1. a renal hormone that stimulates red blood cell production by the bone marrow.

93.
  1. A diuretic

a)
  1. causes the excretion of sodium and water in the urine.

b)
  1. causes hyperglycemia.

c)
  1. blocks the effects of PTH.

d)
  1. stimulates the reabsorption of sodium by the peritubular capillaries.

94.
  1. Which of the following occurs at the distal convoluted tubule?

a)
  1. 180 L of water is filtered into the tubules.

b)
  1. Renin is secreted.

c)
  1. Urine flows from the distal convoluted tubule into the ascending loop of Henle.

d)
  1. Sodium and water are reabsorbed.

95.
  1. Which of the following terms refers to the voluntary expulsion of urine?

a)
  1. Polyuria

b)
  1. Diuresis

c)
  1. Micturition

d)
  1. Dialysis

96.
  1. With regard to reabsorption, which structure plays the most important role?

a)
  1. Glomeruli

b)
  1. Renal pelvis

c)
  1. Urinary bladder

d)
  1. Peritubular capillaries

97.

ADH

a)
  1. is secreted by the anterior pituitary gland.

b)
  1. is a mineralocorticoid that is secreted by the adrenal cortex.

c)

stimulates the collecting duct to reabsorb water.

d)
  1. increases the GFR.

98.
  1. Low levels of oxygen stimulate the kidneys to secrete which hormone?

a)
  1. Renin

b)
  1. Aldosterone

c)
  1. Erythropoietin

d)
  1. Converting enzyme

99.
  1. In the process of secretion, a substance moves from the peritubular capillaries into what structure?

a)
  1. Glomeruli

b)
  1. Calyces

c)
  1. Renal pelvis

d)
  1. Renal tubules

100.
  1. Under normal conditions, which substance is present in the urine?

a)
  1. a. Creatinine

b)
  1. b. Fibrinogen

c)
  1. c. Myosin

d)
  1. d. Albumin

101.
  1. Which condition is associated with proteinuria?

a)
  1. Bladder infection

b)
  1. Urethritis

c)
  1. Glomerular damage

d)
  1. Deficiency of ADH

102.
  1. Which hormone affects blood volume?

a)
  1. a. PTH

b)
  1. b. Erythropoietin

c)
  1. c. Insulin

d)
  1. d. Aldosterone

103.
  1. Aldosterone

a)
  1. is secreted by the posterior pituitary gland.

b)
  1. acts on the collecting duct blocking the reabsorption of water.

c)
  1. stimulates the reabsorption of water but has no effect on potassium.

d)
  1. is a mineralocorticoid that stimulates the reabsorption of sodium

104.
  1. Which of the following is caused by a deficiency of erythropoietin?

a)
  1. a. Oliguria

b)
  1. b. Anemia

c)
  1. c. Albuminuria

d)
  1. d. Cystitis

105.
  1. Which of the following is caused by prolonged hypotension?

a)
  1. a. Oliguria

b)
  1. b. Albuminuria

c)
  1. c. Cystitis

d)
  1. d. Glomerulonephritis

106.
  1. What is the meaning of an elevated serum creatinine?

a)
  1. The kidneys are making too much creatinine.

b)
  1. Too much creatinine is being reabsorbed by the peritubular capillaries.

c)
  1. The kidneys are not filtering creatinine; this is a sign of kidney failure.

d)
  1. The kidneys are excreting too much urine.

107.
  1. A drug is classified as a diuretic. Most likely, the drug

a)
  1. decreases the GFR.

b)
  1. blocks the tubular reabsorption of Na+.

c)
  1. activates the renin-angiotensin-aldosterone system.

d)
  1. causes the release of ADH.

108.
  1. Which condition is characterized by hematuria and pyuria?

a)
  1. Renal failure

b)
  1. Diuresis

c)
  1. Urinary retention

d)
  1. Cystitis

109.
  1. Renal failure causes anemia because of

a)
  1. a lack of erythropoietin.

b)
  1. gross hematuria.

c)

uremia-induced hemolysis.

d)

uremia-induced hypokalemia.

110.
  1. The urinary bladder

a)
  1. contains only skeletal muscle.

b)
  1. receives urine from two urethras.

c)
  1. causes diuresis in response to ADH deficiency.

d)
  1. causes micturition when the detrusor muscle contracts and the internal sphincter

    relaxes.

111.
  1. When the arterial blood pressure declines to 70/40 mm Hg,

a)
  1. GFR decreases.

b)
  1. diuresis occurs.

c)
  1. aldosterone secretion decreases.

d)
  1. ADH secretion diminishes.

112.
  1. What happens at the glomerular membrane?

a)
  1. Water and dissolved solute are filtered into Bowman’s capsule.

b)
  1. The JGA cells release ADH.

c)
  1. The JGA cells release aldosterone.

d)
  1. Na+ is reabsorbed.

113.
  1. The distal convoluted tubule

a)
  1. receives urine from the collecting duct.

b)
  1. reabsorbs Na+ and water in response to aldosterone.

c)
  1. is the nephron structure that is primarily associated with filtration.

d)
  1. empties its urine into Bowman’s capsule.

114.
  1. A patient with stenosis (narrowing) of the renal artery is most likely to present with

a)
  1. uremia.

b)
  1. hypertension.

c)
  1. albuminuria, hypoalbuminemia, and edema.

d)
  1. glucosuria.

115.
  1. Micturition

a)
  1. is another term for urination.

b)
  1. occurs across the glomerular membrane.

c)
  1. is the opposite of voiding.

d)
  1. All of the above are true.

116.
  1. Which of the following is true of glomerular function?

a)
  1. It is unaffected by blood pressure.

b)
  1. It is concerned with the filtration of 1.5 L/24 hr (of water).

c)
  1. A decline in GFR (glomerular filtration rate) causes polyuria.

d)
  1. An increase in GFR increases urine formation.

117.
  1. A deficiency of aldosterone causes a decrease in the tubular reabsorption of sodium and water, causing a significant decrease in blood volume and

a)
  1. azotemia and uremia.

b)
  1. generalized edema.

c)
  1. hypotension.

d)
  1. anemia.

118.
  1. Which of the following is true of aldosterone?

a)
  1. It is an androgen.

b)
  1. It is the “salt-retaining” hormone.

c)
  1. It causes the tubular reabsorption of sodium, potassium, and water.

d)
  1. All of the above are true.

119.
  1. Which of the following urine-making processes occurs first?

a)
  1. Urine concentration by the collecting ducts

b)
  1. Glomerular filtration

c)
  1. Reabsorption of Na+

d)
  1. Secretion of K+

120.
  1. Which of the following is false with regard to normal urine?

a)
  1. Normal urine has E. coli as part of its normal flora.

b)
  1. Urinary tract infections are more common in alkaline urine than in acid urine.

c)
  1. Urine does not contain glucose.

d)
  1. Urine does not contain significant amounts of albumin.

121.
  1. Glucosuria is most likely to cause

a)
  1. hyperglycemia.

b)
  1. uremia and azotemia.

c)
  1. polyuria and dehydration.

d)
  1. hematuria and anemia.

122.
  1. Renin

a)
  1. is a hormone secreted by the posterior pituitary gland.

b)
  1. is called converting enzyme.

c)

activates angiotensinogen.

d)

Two of the above are true.

123.
  1. Angiotensin II

a)
  1. is secreted by the JGA cells in the kidney.

b)
  1. is converted to angiotensin I by renin.

c)
  1. is a potent vasoconstrictor.

d)
  1. inhibits the release of aldosterone from the adrenal cortex.

124.
  1. Most tubular reabsorption takes place

a)
  1. across the glomerular membrane.

b)
  1. in response to aldosterone.

c)
  1. in response to ADH.

d)
  1. across the proximal tubule.

125.
  1. A drug that blocks the effects of aldosterone

a)
  1. decreases the reabsorption of Na+ and water.

b)
  1. is kaliuretic.

c)
  1. causes oliguria.

d)
  1. Two of the above are true.

126.
  1. Glucose is not normally excreted in the urine because

a)
  1. glucose cannot be filtered.

b)
  1. all filtered glucose is reabsorbed.

c)
  1. glucose is used up by the metabolizing nephron units.

d)
  1. glucose is converted to ammonia in the distal tubule and excreted as urea.

127.
  1. Albuminuria is most indicative of

a)
  1. an enlarged pore size of the collecting duct membrane.

b)
  1. urinary incontinence.

c)
  1. increased pore size of the glomeruli

d)
  1. a deficiency of ADH and/or aldosterone.

128.
  1. Albuminuria and generalized edema (anasarca) are usually accompanied by

a)
  1. cystitis.

b)
  1. hypoalbuminemia.

c)
  1. glucosuria.

d)
  1. pyuria.

129.
  1. What is the earliest consequence of a decreased GFR, as in shock?

a)
  1. Urinary retention

b)
  1. Glucosuria

c)
  1. Albuminuria

d)
  1. Oliguria

130.
  1. An anticholinergic (muscarinic antagonist) drug, such as atropine, prevents both the relaxation of the urinary sphincter and the contraction of the detrusor muscle. You would therefore observe the patient for signs of

a)
  1. uremia.

b)
  1. urinary suppression.

c)
  1. urinary retention.

d)
  1. nephrotic syndrome.

131.
  1. Which of the following structures is considered “plumbing”?

a)
  1. Collecting duct

b)
  1. Ureter

c)
  1. Glomerulus

d)
  1. Two of the above are true.

132.
  1. Urea is

a)
  1. transported from the liver to the kidneys by the blood.

b)
  1. made in the liver.

c)
  1. excreted by the kidneys.

d)
  1. All of the above are true.

133.
  1. An elevated serum creatinine level is most indicative of

a)
  1. a. urinary retention.

b)
  1. b. declining renal function.

c)
  1. c. urinary bladder infection.

d)
  1. d. renal calculi.

134.
  1. The “urine-making” structure of the kidney is the

a)
  1. urinary bladder.

b)
  1. nephron unit.

c)
  1. trigone.

d)
  1. renal pelvis.

135.
  1. Glomerular filtration pressure is caused by

a)
  1. intrathoracic pressure.

b)
  1. pressure within the renal tubules.

c)

blood pressure.

d)

intraabdominal pressure.

136.
  1. A sudden decline in blood pressure to 80/45 mm Hg is most apt to

a)
  1. increase GFR.

b)
  1. increase glomerular filtration.

c)
  1. cause oliguria.

d)
  1. cause hematuria.

137.
  1. When does renal reabsorption occur?

a)
  1. When water and dissolved solute move from the tubules into the peritubular

    capillaries

b)
  1. When water and dissolved solute move from the tubules into the glomerular

    capillaries

c)
  1. When water moves from the collecting duct into the renal pelvis

d)
  1. When water and dissolved solute move from the peritubular capillaries into the

    renal tubules

138.
  1. The collecting duct

a)
  1. is primarily concerned with the concentration of urine.

b)
  1. collects urine from the renal pelvis and pumps it into the ureters.

c)
  1. collects urine from Bowman’s capsule and pumps it into the peritubular capillaries.

d)
  1. is primarily concerned with micturition.

139.
  1. Which of the following is handled by the kidneys as either urea or ammonia?

a)
  1. Carbon dioxide

b)
  1. Creatinine

c)
  1. Nitrogen

d)
  1. Glucose

140.
  1. Most diuretics work by

a)
  1. increasing blood flow to the kidneys.

b)
  1. increasing the urge to urinate.

c)
  1. stimulating the contraction of the detrusor muscle.

d)
  1. blocking the tubular reabsorption of Na+.

141.
  1. Severe hyperglycemia is most apt to induce

a)
  1. glucosuria.

b)
  1. osmotic diuresis.

c)
  1. increased tubular solute load.

d)
  1. All of the above are true.

142.
  1. The juxtaglomerular apparatus

a)
  1. secretes angiotensin in response to a decline in blood pressure.

b)
  1. is located within the walls of the collecting ducts.

c)
  1. secretes aldosterone.

d)
  1. is a blood pressure regulating structure.

143.
  1. Angiotensin II

a)
  1. causes vasodilation.

b)
  1. is secreted by the JGA.

c)
  1. elevates blood pressure.

d)
  1. activates angiotensinogen.

144.
  1. Most angiotensin I is converted to angiotensin II primarily in the

a)
  1. a. kidneys.

b)
  1. b. JGA.

c)
  1. c. lungs.

d)
  1. d. liver.

145.
  1. The trigone, detrusor, and rugae are all related to the

a)
  1. nephron unit.

b)
  1. renal pelvis.

c)
  1. Bowman’s capsule.

d)
  1. urinary bladder.

146.
  1. Which of the following is true of aldosterone?

a)
  1. Is secreted by the adrenal medulla

b)
  1. Stimulates the distal tubule to reabsorb Na+

c)
  1. Stimulates the proximal tubule to reabsorb K+

d)
  1. Works on the collecting duct membrane to determine membrane permeability to

    water

147.
  1. A severe decline in blood pressure is most apt to induce

a)
  1. respiratory acidosis.

b)
  1. osmotic diuresis.

c)
  1. oliguria.

d)
  1. hematuria.

148.
  1. This hormone increases systemic vascular resistance and causes the release of aldosterone.

a)
  1. Renin

b)
  1. Erythropoietin

c)
  1. Brain natriuretic hormone

d)
  1. Angiotensin II

149.
  1. Which of the following is true of dehydration?

a)
  1. Is characterized by an increase in urine specific gravity

b)
  1. Is accompanied by a decrease in sodium retention

c)
  1. Causes a shift of water from the vasculature into the interstitium

d)
  1. Is generally treated with a diuretic

150.
  1. Which of the following is true of urea?

a)
  1. Is an excretable form of nitrogen

b)
  1. Is synthesized by the kidneys

c)
  1. Is converted to ammonia by converting enzyme in the lungs

d)
  1. Is a pancreatic proteolytic enzyme

151.

Hyperkalemia

a)
  1. causes blood volume expansion and hypertension.

b)
  1. refers to an elevation in serum potassium.

c)
  1. is uncomfortable but never serious.

d)
  1. is due to an accumulation of urea in the blood.