Question 1

Which condition would result in an increased release of renin?&#10;A) Increased release of angiotensin I&#10;B) Increased release of angiotensin II&#10;C) Increased amount of sodium in the distal convoluted tubule&#10;D) Reduced pressure in the glomerulus

Accepted Answer

Renin is released in response to reduced pressure in the glomerulus,sympathetic stimulation of the kidneys,and a decrease in the amount of sodium in the distal convoluted tubule.Renin is converted to angiotensin I,which is converted to the powerful vasoconstrictor angiotensin II.Angiotensin II stimulates the adrenal glands to secrete aldosterone,which acts on the distal tubules to resorb sodium from the tubular lumen into the circulation.When sodium is retained,so is water.Angiotensin II also constricts the renal vasculature,reducing kidney blood flow and available glomerular filtrate,sending a signal to the posterior pituitary to release antidiuretic hormone.The two systems intertwine to maintain fluid and electrolyte balance.

Question 2

Ammonia,hydrogen,and ammonium are secreted in what part of the kidney?&#10;A) Loop of Henle&#10;B) Collecting duct&#10;C) Glomerulus&#10;D) Proximal tubule

Accepted Answer

In addition to its major role in resorbing water and solutes from the filtrate,the proximal tubule secretes organic anions and cations into the tubular lumen.Ammonia is produced from the metabolism of glutamine in the mitochondria of the proximal tubule cells,where ammonia (NH₃)combines with hydrogen (H⁺)to form ammonium (NH⁺₄),which is secreted into the proximal tubule lumen.

Question 3

A patient has been admitted with acute kidney injury.Which serum laboratory values would the nurse expect to be ordered to confirm this diagnosis?&#10;A) Sodium and potassium&#10;B) Creatinine and calcium&#10;C) Blood urea nitrogen (BUN) and creatine&#10;D) Potassium and magnesium

Accepted Answer

Urea and creatinine are the primary waste products that are measured in determining kidney function.Urea is measured as blood urea nitrogen and is the end product of protein metabolism and results from the breakdown of ammonia in the liver.Like urea,creatinine accumulates when the glomerulus is unable to filter it from the blood.

Question 4

What substance is the most responsible for maintaining the colloid osmotic pressure?&#10;A) Intravascular plasma proteins&#10;B) Intracellular potassium&#10;C) Extracellular sodium&#10;D) Interstitial potassium

Accepted Answer

Osmotic pressure is created by solutes and other substances (eg,albumin,globulin,fibrinogen)suspended in fluid.Colloid osmotic pressure is created primarily by the presence of plasma proteins in the intravascular space.Plasma proteins exert a pull on water molecules and therefore produce osmotic pressure,which retains fluid within the intravascular compartment.

Question 5

When a patient's blood pressure drops,which physiologic mechanism helps maintain adequate glomerular blood flow?&#10;A) Constriction of the afferent arteriole&#10;B) Dilation of the efferent arteriole&#10;C) Dilation of the collecting tubule&#10;D) Constriction of the efferent arteriole

Accepted Answer

When the mean arterial blood pressure is decreased,the afferent arteriole dilates and the efferent arteriole constricts to maintain a higher pressure in the glomerular capillary bed and maintain the glomerular filtration rate at 125 mL/min.The ability of the kidneys to autoregulate blood flow begins to fail when the mean arterial blood pressure is less than 80 mm Hg or greater than 180 mm Hg.

Question 6

The following substances,among others,are found in a patient's urine sample: urea,creatinine,sodium,chlorine,potassium,glucose,and bicarbonate ions.Which patient situation could account for this abnormal finding?

A) Blood pressure of 76/30 mm Hg
B) Blood glucose of 456 mg/dL
C) Blood glucose of 40 mg/dL
D) Blood potassium level of 4.1 mEq/L

Accepted Answer

This glucose reading is above the threshold concentration.Glucose is normally completely reabsorbed from the tubules.Above the threshold level,the tubules are unable to reabsorb all of the glucose,and some spills into the urine.All of the other findings in this urine sample are normal findings.

Question 7

Which type of intravenous fluid will not create a shift of fluids within the vascular space?&#10;A) Hypertonic&#10;B) Hypotonic&#10;C) Isotonic&#10;D) Osmotic pressure

Accepted Answer

An isotonic solution has roughly the same concentration of particles as the blood plasma; cells within an isotonic solution maintain consistency and do not lose or gain fluid to their surroundings.A hypertonic solution contains a greater concentration of particles than that inside the cell and causes fluid to be drawn out of the cells.Used inappropriately,too much fluid may be withdrawn,causing a withering of the cell (crenation).A hypotonic solution contains a lesser concentration of particles than that inside the cell and causes fluid to be drawn into the cells.If used incorrectly,a hypotonic solution can cause too much fluid to enter the cell,causing the cells to swell and burst (hemolysis).Osmotic pressure is created by solutes and other substances (eg,albumin,globulin,fibrinogen)suspended in fluid.

Question 8

What is the primary function of aldosterone?&#10;A) Excretion of potassium through the renal tubules&#10;B) Control of sodium and water&#10;C) Regulation of bicarbonate&#10;D) Reabsorption of sodium and potassium

Accepted Answer

Aldosterone acts on the distal tubule to facilitate sodium and water resorption,resulting in an expanded circulating blood volume and increased blood pressure.When the arterial blood pressure increases,the juxtaglomerular apparatus reduces the release of renin,and the renin-angiotensin-aldosterone system is less active.

Question 9

Stimulation from what receptors will cause contraction of the detrusor muscle of the bladder?&#10;A) Bladder wall and ureters&#10;B) Bladder wall and urethra&#10;C) Ureters and urethra&#10;D) Urethra and bladder neck

Accepted Answer

Nervous system control in the urinary tract is reflected in the process of micturition,or the release of urine.Bladder fullness stimulates stretch receptors in the bladder wall and a portion of the urethra.Signals are carried through nerves in the sacral area and return as parasympathetic messages to contract the detrusor muscle of the bladder.

Question 10

Which electrolytes are cations?&#10;A) Sodium, potassium, and chloride&#10;B) Sodium, chloride, and bicarbonate&#10;C) Bicarbonate, chloride, and calcium&#10;D) Sodium, potassium, and magnesium

Accepted Answer

A balance exists between cations (positively charged ions),anions (negatively charged ions),and other substances in the fluid compartments.Cations are sodium,potassium,magnesium,and calcium.Anions are chloride and bicarbonate.

Question 11

To prevent acid-base disturbances,what is the ratio between carbonic acid and bicarbonate?&#10;A) 10 mEq of carbonic acid to 20 mEq of bicarbonate&#10;B) 20 mEq of carbonic acid to 10 mEq of bicarbonate&#10;C) 1 mEq of carbonic acid to 20 mEq of bicarbonate&#10;D) 20 mEq of carbonic acid to 1 mEq of bicarbonate

Accepted Answer

The answer of To prevent acid-base disturbances,what is the ratio...

Question 12

Where does the concentration and dilution of urine occur?&#10;A) In the juxtamedullary nephrons&#10;B) In the cortical nephrons&#10;C) In the peritubular capillaries&#10;D) In the internal nephron

Accepted Answer

The answer of Where does the concentration and dilution of...

Question 13

A patient has been admitted with a severe kidney infection.The nurse suspects the patient has damage to the glomerular membrane.Which substance in the urine would confirm the nurse's suspicion?&#10;A) Creatinine&#10;B) Bicarbonate ions&#10;C) Sodium&#10;D) Albumin

Accepted Answer

The answer of A patient has been admitted with a...

Question 14

Chloride plays a major role in maintaining what physiologic process?&#10;A) Cellular immunity&#10;B) Serum osmolality&#10;C) Bone strength&#10;D) Adenosine triphosphate (ATP)

Accepted Answer

The answer of Chloride plays a major role in maintaining...

Question 15

The initial filtering of the blood occurs in which structure?&#10;A) The distal tubule&#10;B) The proximal tubule&#10;C) The glomerulus&#10;D) The collecting tubule

Accepted Answer

The answer of The initial filtering of the blood occurs...

Question 16

What is the functional unit of the kidney called?&#10;A) Bowman capsule&#10;B) Glomerulus&#10;C) Nephron&#10;D) Distal tubule

Accepted Answer

The answer of What is the functional unit of the...

Question 17

The mobilization of calcium from bone stores is accomplished through the influence of which hormone?&#10;A) Antidiuretic hormone (ADH)&#10;B) Parathyroid hormone (PTH)&#10;C) Thyroid-stimulating hormone (TSH)&#10;D) Erythropoietin

Accepted Answer

The answer of The mobilization of calcium from bone stores...

Question 18

A patient has been admitted with acute kidney injury.Which parameter would the nurse expect to find to confirm this diagnosis?&#10;A) Decreased blood urea nitrogen&#10;B) Bibasilar lung crackles&#10;C) Peripheral edema&#10;D) Decreased creatinine clearance

Accepted Answer

The answer of A patient has been admitted with acute...

Question 19

A patient is admitted with severe hypokalemia.On admission the patient's laboratory values are serum K⁺,2.2 mEq/L; blood urea nitrogen (BUN),15 mg/dL; and creatinine,1.2 mg/dL.Urine output is averaging 45 mL/h.The patient is given a total of 80 mEq of potassium over 4 hours.The potassium level is repeated and the result is K⁺,2.4 mEq/L.What other information would be beneficial at this time?

A) Magnesium level
B) Repeat creatinine level
C) Calcium level
D) Hemoglobin level

Accepted Answer

The answer of A patient is admitted with severe hypokalemia.On...

Question 20

Maintaining a normal range of serum potassium is important for what physiologic process?&#10;A) Fluid regulation&#10;B) Acid-base buffering&#10;C) Nervous impulse conduction&#10;D) Triggering antidiuretic hormone (ADH) release

Accepted Answer

The answer of Maintaining a normal range of serum potassium...

Question 21

What are the functions of the kidneys?&#10;A) Formation of urine&#10;B) Blood pressure regulation&#10;C) Erythrocyte destruction&#10;D) Breakdown of prostaglandins&#10;E) Regulation of acid-base balance

Accepted Answer

The answer of What are the functions of the kidneys?&#10;A)...

Question 22

Which factors stimulate the release of antidiuretic hormone (ADH)?&#10;A) Hypovolemia&#10;B) Hypernatremia&#10;C) Hypothermia&#10;D) Opioids&#10;E) Emotional stress

Accepted Answer

The answer of Which factors stimulate the release of antidiuretic...

Question 23

Which electrolyte abnormality is evident early in the course of kidney failure?&#10;A) Sodium&#10;B) Potassium&#10;C) Chloride&#10;D) Phosphorus

Accepted Answer

The answer of Which electrolyte abnormality is evident early in...

Question 24

Which statement regarding kidney function and aging is accurate?&#10;A) Kidney function declines with age but this usually does not affect homeostasis.&#10;B) Serum creatinine rises with age due to increased catabolism of red muscle.&#10;C) Glomerular filtration rate falls at a rate of 2 mL/min/year.&#10;D) Older adults are less susceptible to acute kidney dysfunction but more susceptible to chronic kidney dysfunction.

Accepted Answer

The answer of Which statement regarding kidney function and aging...

Question 25

When renin eventually stimulates angiotensin II,the adrenal glands then secrete what hormone?&#10;A) Aldosterone&#10;B) Adrenal stimulating hormone&#10;C) Antidiuretic hormone&#10;D) Vasopressin

Accepted Answer

The answer of When renin eventually stimulates angiotensin II,the adrenal...

Deck 24: Kidney Anatomy and Physiology