Deck 13: Renal Physiology and Urinalysis

Question 1

In testing for glucose in the urine,all of the following are true except:

A) if the blood glucose concentration becomes too high (usually greater than 180 to 200 mg/dL), the excess glucose will not be reabsorbed into the blood and will be eliminated from the body in the urine.
B) the renal threshold is the lowest blood glucose concentration that will result in glycosuria.
C) the most common condition in which the renal threshold for glucose is exceeded is diabetes mellitus.
D) the occurrence of glycosuria is diagnostic of diabetes mellitus.

Answer 1

the occurrence of glycosuria is diagnostic of diabetes mellitus.

Question 2

The most desirable type of routine urinalysis specimen is:

A) sterile.
B) first, early morning.
C) random, mid-day.
D) 24-hour.

Answer 2

first, early morning.

Question 3

The functional (working)unit of the kidney is the:

A) nephron.
B) glomerulus.
C) cortex.
D) medulla.

Answer 3

nephron.

Question 4

The normal pH of freshly voided urine is:

A) 4 or 5.
B) 5 or 6.
C) 6 or 7.
D) 7 or 8.

Question 5

Quality assessment of control specimens should include:

A) testing of all opened bottles of reagent strips or tablets each morning.
B) testing of each new bottle on opening.
C) recording data on the record sheet daily.
D) all of the above.

Question 6

The first part of the routine urinalysis is the ____ examination.

A) physical
B) chemical
C) microscopic
D) either b or c

Question 7

Reagent strips for glucose detection use):

A) an enzyme, glucose oxidase.
B) a chemical, hydrogen peroxide.
C) a chemical, copper sulfate.
D) both a and b.

Question 8

Urine should be examined ____ collection.

A) immediately after
B) within 30 minutes, if not refrigerated or suitably preserved at
C) within 2 hours if kept at room temperature after
D) within 24 hours if refrigerated after

Question 9

In the detection and diagnosis of renal disease,the most significant single finding probably is:

A) glucose.
B) protein.
C) pH
D) ketones.

Question 10

Important factors in the collection and handling of urine include all of the following except the:

A) container used.
B) collection procedure.
C) conditions of storage and preservation from the time of collection until the specimen is tested.
D) use of a sterile container.

Question 11

Specimens for bilirubin testing must be:

A) absolutely fresh.
B) less than 2 hours old.
C) less than 8 hours old.
D) less than 24 hours old.

Question 12

Ketone bodies can be detected in urine in:

A) lack of adequate insulin control.
B) starvation.
C) extreme dieting.
D) all of the above.

Question 13

A routine urinalysis can provide information regarding:

A) patient's general health.
B) a clinical picture of the patient.
C) a potential disease.
D) all of the above.

Question 14

Select the microscopic elements that could be found in normal or abnormal urinary sediment: 0-5/hpf (high-power field)RBCs.

A) Normal
B) Abnormal

Question 15

The presence of bilirubin in the urine is an early sign of:

A) liver disease.
B) pancreatic cancer.
C) intestinal inflammation.
D) various infectious diseases.

Question 16

A false-positive urinary glucose result can be observed if:

A) contamination by bleach or other strong oxidizing agents occurs.
B) reagent strips are exposed to air by improper storage.
C) large urinary concentrations of ascorbic acid are present.
D) both a and b occur.

Question 17

The major contributing factor to the decomposition of urine is:

A) the growth of bacteria.
B) the formation of crystals.
C) fading of color.
D) change in pH.

Question 18

The function of the distal convoluted tubule of the kidney is to:

A) reduce the volume of the urine.
B) maintain water and electrolyte balance.
C) remove acid from the body.
D) do both b and c.

Question 19

Functions of the kidney include all of the following except:

A) removal of waste products.
B) processing of nutrients.
C) retention of nutrients.
D) acid-base, water, and electrolyte balance.

Question 20

The minimum acceptable volume of urine for routine urinalysis is ____ mL.

A) 5
B) 12
C) 25
D) 50

Question 21

Select the microscopic elements that could be found in normal or abnormal urinary sediment: Moderate number of renal epithelial cells.

A) Normal
B) Abnormal

Question 22

Upon standing,RBCs either swell or become crenated.

Question 23

Casts disintegrate as urine becomes alkaline.

Question 24

Reagent strips (e.g.,Chemstrips)have a stable reaction color for up to 5 minutes.

Question 25

Urine specimens must be fresh and centrifuged for reagent strip testing.

Question 26

Select the microscopic elements that could be found in normal or abnormal urinary sediment: Hyaline cases (20 to 30/lpf).

A) Normal
B) Abnormal

Question 27

Select the microscopic elements that could be found in normal or abnormal urinary sediment: >10 WBCs/hpf.

A) Normal
B) Abnormal

Question 28

The growth of bacteria in urine produces a more acidic solution.

Question 29

Reagent strips will deteriorate if exposed to moisture or heat.

Question 30

WBCs rapidly deteriorate in hypotonic solutions.

Question 31

The longer a reagent strip is in contact with a urine specimen,the better the results that will be observed.

Question 32

Reagent strips will deteriorate if the cap is kept open for a prolonged period.

Question 33

MATCHING
Match the terms with the appropriate situations that result in abnormal urine volumes.
diuresis

A)any increase in urine volume, even if the increase is only temporary
B)complete absence of urine formation
C)abnormally small amount of urine, less than 500 mL/24 hours
D)excretion of more 400 mL urine at night
E)consistent elimination of an abnormally large volume of urine (more than 2000 mL/24 hours)

Question 34

The least pathological type of cast is:

A) hyaline.
B) finely granular.
C) waxy.
D) fatty.

Question 35

Select the microscopic elements that could be found in normal or abnormal urinary sediment: Few bacteria in a fresh,nonsterile specimen.

A) Normal
B) Abnormal

Question 36

MATCHING
Match the terms with the appropriate situations that result in abnormal urine volumes.
polyuria

A)any increase in urine volume, even if the increase is only temporary
B)complete absence of urine formation
C)abnormally small amount of urine, less than 500 mL/24 hours
D)excretion of more 400 mL urine at night
E)consistent elimination of an abnormally large volume of urine (more than 2000 mL/24 hours)

Question 37

Structures that can be confused microscopically with RBCs include:

A) leukocytes (WBCs).
B) yeast.
C) calcium oxalate crystals.
D) both b and c.

Question 38

MATCHING
Match the terms with the appropriate situations that result in abnormal urine volumes.
oliguria

A)any increase in urine volume, even if the increase is only temporary
B)complete absence of urine formation
C)abnormally small amount of urine, less than 500 mL/24 hours
D)excretion of more 400 mL urine at night
E)consistent elimination of an abnormally large volume of urine (more than 2000 mL/24 hours)

Question 39

Select the microscopic elements that could be found in normal or abnormal urinary sediment: Moderate number of squamous epithelial cells.

A) Normal
B) Abnormal

Question 40

Reagent strips must be used within 1 year of opening the container.

Question 41

Match the name of each type of crystal with the appropriate description.
acyclovir

A)found in acid urine
B)envelope-shaped, glistening and colorless
C)coffin lids
D)colorless slender needles that are strongly birefringent with polarized light
E)yellow or reddish-brown shapes (e.g., lemon- or barrel-shaped forms)

Question 42

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
in the reaction to detect blood in the urine,microbial peroxidase activity associated with urinary tract infection can produce

A)false positive
B)false negative

Question 43

Match the name of each type of crystal with the appropriate description.
uric acid

A)found in acid urine
B)envelope-shaped, glistening and colorless
C)coffin lids
D)colorless slender needles that are strongly birefringent with polarized light
E)yellow or reddish-brown shapes (e.g., lemon- or barrel-shaped forms)

Question 44

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
urinary preservatives in urine testing for leukocyte esterase

A)false positive
B)false negative

Question 45

Match the respective type of casts with an associated condition (use an answer only once).
RBC casts and RBCs

A)exposure to nephrotoxic substances
B)urinary tract infection
C)acute pyelonephritis
D)glomerular damage

Question 46

Match the respective type of casts with an associated condition (use an answer only once).
epithelial casts

A)exposure to nephrotoxic substances
B)urinary tract infection
C)acute pyelonephritis
D)glomerular damage

Question 47

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
proteins are present without the presence of albumin

A)false positive
B)false negative

Question 48

Match the respective type of casts with an associated condition (use an answer only once).
bacterial casts

A)exposure to nephrotoxic substances
B)urinary tract infection
C)acute pyelonephritis
D)glomerular damage

Question 49

Match the name of each type of crystal with the appropriate description.
amorphous urates

A)found in acid urine
B)envelope-shaped, glistening and colorless
C)coffin lids
D)colorless slender needles that are strongly birefringent with polarized light
E)yellow or reddish-brown shapes (e.g., lemon- or barrel-shaped forms)

Question 50

MATCHING
Match the terms with the appropriate situations that result in abnormal urine volumes.
anuria

A)any increase in urine volume, even if the increase is only temporary
B)complete absence of urine formation
C)abnormally small amount of urine, less than 500 mL/24 hours
D)excretion of more 400 mL urine at night
E)consistent elimination of an abnormally large volume of urine (more than 2000 mL/24 hours)

Question 51

Match the name of each type of crystal with the appropriate description.
triple phosphate

A)found in acid urine
B)envelope-shaped, glistening and colorless
C)coffin lids
D)colorless slender needles that are strongly birefringent with polarized light
E)yellow or reddish-brown shapes (e.g., lemon- or barrel-shaped forms)

Question 52

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
the reaction for protein may be produced,if a urine specimen is exceptionally alkaline or highly buffered

A)false positive
B)false negative

Question 53

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
in the detection of blood in the urine,ascorbic acid in urine specimens containing more than 25 mg/dL

A)false positive
B)false negative

Question 54

MATCHING
Match the terms with the appropriate situations that result in abnormal urine volumes.
nocturia

A)any increase in urine volume, even if the increase is only temporary
B)complete absence of urine formation
C)abnormally small amount of urine, less than 500 mL/24 hours
D)excretion of more 400 mL urine at night
E)consistent elimination of an abnormally large volume of urine (more than 2000 mL/24 hours)

Question 55

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
a blue color forms for the protein reaction,if the urine is exposed to the reagent strip for too long

A)false positive
B)false negative

Question 56

Match the respective type of casts with an associated condition (use an answer only once).
WBC casts

A)exposure to nephrotoxic substances
B)urinary tract infection
C)acute pyelonephritis
D)glomerular damage

Question 57

Match the following potential causes of false-positive or false-negative results with chemical reagent strips.
medications (e.g.,azo-containing compounds or dyes that color urine red or that turn red in an acidic medium when testing for nitrite for the detection of bacteria in urine)

A)false positive
B)false negative

Question 58

Match the name of each type of crystal with the appropriate description.
calcium oxalate

A)found in acid urine
B)envelope-shaped, glistening and colorless
C)coffin lids
D)colorless slender needles that are strongly birefringent with polarized light
E)yellow or reddish-brown shapes (e.g., lemon- or barrel-shaped forms)