Deck 7: Urinary Function

Question 1

During times of increasing blood volume such as in heart failure, a compensatory renal response is:

A) afferent arteriole vasoconstriction and efferent arteriole vasodilation to promote reabsorption of fluid.
B) release of urodilatin, which inhibits water and sodium reabsorption thereby leading to diuresis.
C) inhibition of atrial and brain natriuretic peptides to prevent fluid retention.
D) increase in antidiuretic hormone release which promotes diuresis.

Answer 1

B

Question 2

A 70-year-old woman with severe rheumatoid arthritis has difficulty with activities of daily living such as eating and dressing herself. She also states that she sometimes is incontinent of urine because she has trouble walking to the bathroom because of pain and getting her underwear off quickly enough. The type of incontinence she is describing is:

A) gross.
B) mixed.
C) stress.
D) functional.

Answer 2

D

Question 3

A mother is concerned about her 5-year-old son wetting his bed at night. She says he has rarely had a "dry" night and during the day he does not have accidents. What is the most likely cause of this enuresis?

A) Urine infection
B) Reduced antidiuretic hormone response
C) Normal delay in voiding control maturation
D) Detrusor overstretching from holding his urine during the daytime

Answer 3

C

Question 4

Which of the following is an accurate description of a flaccid bladder?

A) The bladder is generally overactive with frequency and urgency.
B) It is often the result of central nervous system disorders such as a stroke.
C) Damage to the innervation from the bladder to the spinal cord causes detrusor areflexia.
D) There are mainly problems with the storage of urine.

Question 5

Escherichia coli is a common organism implicated in uncomplicated urinary tract infections because:

A) it is more virulent than other bacteria.
B) it is around the anus, and the proximity to the urethra allows easy access.
C) lactobacillus in the vagina promotes growth.
D) it easily spreads through the pelvic vascular system.

Question 6

Which of the following diagnostic findings is present in pyelonephritis but not in acute cystitis?

A) White blood cell casts
B) Nitrites
C) Leukocyte esterase
D) Hematuria

Question 7

A man has hematuria and colicky flank pain. A kidney stone is suspected. Which diagnostic test is best to order to evaluate the stone size, location, and hydronephrosis?

A) Kidney magnetic resonance image (MRI)
B) Ultrasound of the bladder and kidney
C) Computerized tomography (CT) scan of the abdomen and pelvis
D) X-ray of the kidneys, ureter, and bladder

Question 8

Stones form in the kidney as a result of:

A) excessive dietary calcium, which increases oxalate binding.
B) increased concentration of insoluble salts in the urine.
C) increased levels of citrate and magnesium.
D) a loss of integrity in the bladder lining causing a Hunner plaque.

Question 9

A mother brings in her 4-year-old daughter because she felt a "lump" on her abdomen and she feels her daughter's belly is swollen. The mother states her daughter is pretty healthy but has been stating that her stomach hurts on and off. Physical exam reveals a nontender abdominal mass that is firm and does not cross the midline. Based on this presentation, a possible diagnosis is:

A) polycystic kidney disease.
B) dysplastic kidney.
C) nephroblastoma.
D) renal cell carcinoma.

Question 10

Which of the following is the most common risk factor associated with the development of bladder cancer?

A) Chronic urinary infections
B) Excessive analgesic use
C) Obesity
D) Smoking

Question 11

Causes of painless, asymptomatic hematuria include:

A) urolithiasis
B) urothelial cell carcinoma
C) acute cystitis
D) renal cell carcinoma
E) urothelial cell carcinoma and renal cell carcinoma

Question 12

Discharge teaching is done for the patient after a nephrectomy for renal carcinoma. Which statement by the patient indicates that teaching has been effective?

A) Because renal carcinoma usually affects both kidneys, I'll need to be watched closely.
B) I'll need to decrease my fluid intake to prevent stress to my remaining kidney.
C) My remaining kidney should provide me with normal renal function.
D) I'll eventually require some type of renal replacement therapy.

Question 13

Finasteride, a 5α reductase inhibitor, is used for benign prostatic hypertrophy, because the medication:

A) increases the conversion of dihydrotestosterone.
B) prevents the conversion of testosterone to dihydrotestosterone.
C) increases testosterone levels.
D) prevents estrogen conversion.

Question 14

A man with benign prostatic hypertrophy is complaining that his urine stream is slower than in the past and sometimes his stream sprays. He also reports dribbling when he is almost done urinating. These symptoms are known as:

A) voiding symptoms.
B) storage symptoms.
C) irritative symptoms.
D) urge symptoms.

Question 15

The cause of a decreased glomerular filtration rate in rapidly progressive glomerulonephritis is due to the development of:

A) podocyte proliferation.
B) small vessel thrombosis.
C) albumin that gets trapped in the loop of Henle.
D) collagen and fibrin deposits that develop into crescents.

Question 16

A patient has stage V chronic kidney disease, and his family explains he is becoming progressively confused. Uremic encephalopathy is suspected. What other manifestations would support this complication?

A) Asterixis and hyperreflexia
B) Bone pain and fracture
C) Nausea and vomiting
D) Peripheral neuropathy and restless leg syndrome

Question 17

A patient with end-stage renal disease (ESRD) has tall, peaked T waves on his electrocardiogram (ECG). Which of the following is the best action?

A) Repeat the ECG.
B) Check the serum potassium level.
C) Prepare to give sodium bicarbonate to correct the acidosis.
D) Nothing. This is a normal finding for individuals with ESRD.

Question 18

Patients with chronic kidney disease may require:

A) higher levels of insulin to control their blood sugar.
B) lower levels of insulin to control their blood sugar.
C) glucagon to prevent hypoglycemia.
D) dialysis to clear insulin from the blood.