[Ex3] - C31 - AP

Question 1

31-1. The region of the kidneys that contains the glomeruli is called the:
a. medulla.
b. cortex.
c. pyramids.
d. columns.

Answer 1

ANS: B
The outer layer of the kidney is called the cortex and it contains all of the glomeruli, most of
the proximal tubules, and some segments of the distal tubule. The glomeruli are not located in
the kidney’s medulla, the pyramids, or the columns.

Question 2

31-2. When discussing the functional unit of the kidney, what term should the nurse use?
a. Calyx
b. Nephron
c. Collecting duct
d. Pyramid

Answer 2

ANS: B
The functional unit of the kidney is the nephron. The nephron does not serve the same
function as the calyx, the collecting duct, or the pyramid.

Question 3

31-3. Which type of nephron determines the concentration of the urine?
a. Juxtamedullary
b. Midcortical
c. Cortical
d. Medullary

Answer 3

ANS: A
The juxtamedullary nephrons lie close to and extend deep into the medulla and are important
for the concentration of urine. Concentration of urine is not associated with midcortical,
cortical, or medullary nephrons.

Question 4

31-4. What type of phagocytic cell lies between the layers of the renal capillaries?
a. Podocytes
b. Macula densa cells
c. Mesangial cells
d. Filtration slits

Answer 4

ANS: C

Mesangial cells lie between and support the capillaries. Mesangial cells have phagocytic
ability similar to monocytes, release inflammatory cytokines, and can contract to regulate
glomerular capillary blood flow. The epithelium has specialized cells called podocytes from
which pedicles (foot projections) radiate and adhere to the basement membrane. The macula
densa are sodium-sensing cells. The pedicles interlock with the pedicles of adjacent
podocytes, forming an elaborate network of intercellular clefts called filtration slits, or slit
membranes.

Question 5

31-5. When the nurse discusses the glomerulus and Bowman’s capsule together, it is referred to as
the renal:
a. corpuscle.
b. capsule.
c. medulla.
d. pyramid.

Answer 5

ANS: A
Together, the glomerulus and Bowman’s capsule are called the renal corpuscle. The
combination of these structures is not identified as the capsule, the medulla, or the pyramid.

Question 6

31-6. When a nurse is checking the urinalysis, plasma proteins should be absent from the urine
because:
a. all filtered proteins are subsequently reabsorbed.
b. the texture of the covering surrounding plasma proteins interferes with
reabsorption.
c. filtered proteins are subsequently degraded before elimination.
d. the negative charge of the glomerular filtration membrane repels the plasma
proteins.

Answer 6

ANS: D
Like other capillary membranes, the glomerulus is freely permeable to water and relatively
impermeable to large colloids, such as plasma proteins. The molecule’s size and electrical
charge affect the permeability of substances crossing the glomerulus. Protein filtration is not
as dependent on size, texture, or on degradation.

Question 7

31-7. When the nurse is discussing the sodium-sensing cells of the glomerulus, what term should
the nurse use?
a. Podocytes
b. Macula densa
c. Mesangial cells
d. Loop of Henle

Answer 7

ANS: B
The macula densa are sodium-sensing cells. The epithelium has specialized cells called
podocytes from which pedicles (foot projections) radiate and adhere to the basement
membrane. Mesangial cells lie between and support the capillaries. Mesangial cells have
phagocytic ability similar to that monocytes, release inflammatory cytokines, and can contract
to regulate glomerular capillary blood flow. The loop of Henle is where fluid reabsorption
occurs.

Question 8

31-8. What structure does urine pass through prior to entering the ureters?
a. Collecting duct
b. Renal pelvis
c. Urethra
d. Major calyx

Answer 8

ANS: B
Urine is collected in the renal pelvis, not the collecting duct or the major calyx, and then is
funneled into the ureters. The urethra receives urine from the bladder.

Question 9

31-9. The trigone is defined as:
a. the orifice of the ureter.
b. the inner area of the kidney.
c. a triangular area between the openings of the two ureters and the urethra.
d. the three divisions of the loop of Henle.

Answer 9

ANS: C
The trigone is a smooth triangular area between the openings of the two ureters and the
urethra. This description is not associated with the orifice of a ureter, the inner area of the
kidney, or a part of the loop of Henle.

Question 10

31-10. When describing the male urinary anatomy, which information should the nurse include? The
portion of the male urethra that is closest to the bladder is the _____ portion.
a. membranous
b. prostatic
c. cavernous
d. vas deferens

Answer 10

ANS: B
In the male, the prostatic urethra is closest to the bladder; the membranous follows after the
prostatic; the cavernous follows after the membranous. The vas deferens is not a portion of the
male urethra.

Question 11

31-11. On average, the kidneys receive approximately _____ of the cardiac output.
a. 10%–14%
b. 15%–19%
c. 20%–25%
d. 26%–35%

Answer 11

ANS: C
The kidney receives 20%–25% of the cardiac output.

Question 12

31-12. The glomerular filtration rate (GFR) is directly related to the:
a. perfusion pressure in the glomerular capillaries.
b. oncotic pressure in the glomerular capillaries.
c. vascular resistance in the glomerular arterioles.
d. hydrostatic pressure in the Bowman’s capsule.

Answer 12

ANS: A
The filtration of the plasma per unit of time is known as the GFR, which is directly related to
the perfusion pressure of the glomerular capillaries. The filtration of the plasma per unit of
time is not associated with the oncotic pressure of the glomerular capillaries, the vascular
resistance in the glomerular arterioles, or the hydrostatic pressure in the Bowman’s capsule.

Question 13

31-13. The blood vessels of the kidneys are innervated by the:
a. vagus nerve.
b. sympathetic nervous system.
c. somatic nervous system.
d. parasympathetic nervous system.

Answer 13

ANS: B
The blood vessels of the kidney are innervated by the sympathetic nervous system’s fibers.
The blood vessels of the kidney are not innervated by the vagus nerve or the parasympathetic
system. The somatic system regulates the musculoskeletal system.

Question 14

31-14. The renin-angiotensin system will be activated by:
a. increased blood volume.
b. elevated sodium concentrations.
c. decreased blood pressure in the afferent arterioles.
d. renal hypertension.

Answer 14

ANS: C
The renin-angiotensin system is activated by decreased blood pressure. Activation of the
renin-angiotensin system is not associated with the increased blood volume, elevated sodium
levels, or renal hypertension.

Question 15

31-15. A nurse realizes glucose will be excreted in the urine when:
a. the maximum rate of glucose filtration is achieved.
b. the carrier molecules have reached their maximum.
c. glucose is consumed.
d. the ability of the kidneys to regulate blood glucose is lost.

Answer 15

ANS: B
When the carrier molecules for glucose become saturated (i.e., with the development of
hyperglycemia), the excess will be excreted in the urine. There is no maximum rate of glucose
filtration. Glucose should not be found in the urine even when glucose is consumed. The
kidneys do not regulate blood glucose.

Question 16

31-16. Where does the majority of sodium reabsorption take place?
a. Proximal tubule
b. Loop of Henle
c. Distal tubule
d. Collecting duct

Answer 16

ANS: A
The majority of sodium reabsorption takes place in the proximal tubule. The majority of
sodium reabsorption is not associated with the loop of Henle, the distal tubule, or the
collecting duct.

Question 17

31-17. What structure supplies blood to the medulla?
a. Renal artery
b. Arcuate artery
c. Peritubular capillary
d. Vasa recta

Answer 17

ANS: D

The vasa recta is a network of capillaries that forms loops and closely follows the loops of
Henle and is the only blood supply to the medulla. This need is not met by the renal arteries,
the arcuate arteries, or the peritubular capillaries.

Question 18

31-18. The descending segment of the loop of Henle primarily allows for:
a. sodium secretion.
b. potassium secretion.
c. hydrogen ion reabsorption.
d. water reabsorption.

Answer 18

ANS: D
The descending segment of the loop of Henle is highly permeable to water and so is involved
in the reabsorption of water. The descending segment of the loop of Henle is not associated
with the reabsorption of hydrogen ions or the secretion of either sodium or potassium.

Question 19

31-19. When a staff member asks which of the following substances is actively secreted by the renal
tubules, what is the nurse’s best response?
a. Sodium and chlorine
b. Phosphate and calcium
c. Hydrogen and potassium
d. Bicarbonate and carbonic acid

Answer 19

ANS: C
Principal cells reabsorb sodium and secrete potassium, and intercalated cells reabsorb
potassium and bicarbonate and secrete hydrogen. This process is not associated with the
secretion of sodium and chlorine, phosphate and calcium, or bicarbonate and carbonic acid.

Question 20

31-20. Reabsorption of water in the collecting ducts requires which hormone?
a. Antidiuretic hormone (ADH)
b. Atrial natriuretic factor (ANP)
c. Renin
d. Aldosterone

Answer 20

ANS: A
ADH increases water permeability and reabsorption in the last segment of the distal tubule
and along the entire length of the collecting ducts. ANP inhibits secretion of renin, inhibits
angiotensin-induced secretion of aldosterone, relaxes vascular smooth muscle, and inhibits
sodium and water absorption by kidney tubules. Renin is secreted to raise blood pressure.
Aldosterone regulates water and sodium balance.

Question 21

31-21. A 35-year-old hypertensive male begins taking a diuretic. Which of the following common
side effects of this medication should the nurse monitor?
a. Hypokalemia
b. Hyponatremia
c. Increased uric acid secretion
d. Hypermagnesemia

Answer 21

ANS: A
Hypokalemia is a side effect of diuretics. Hypokalemia, not hyponatremia, is a side effect of
diuretic therapy. Diuretics promote uric acid retention, not excretion. Hypokalemia is a side
effect of diuretics. Hypermagnesemia is not.

Question 22

31-22. Which hormone is synthesized and secreted by the kidneys to stimulate bone marrow
production of red blood cells?
a. Creatinine
b. Aldosterone
c. Erythropoietin
d. Renin

Answer 22

ANS: C
Erythropoietin stimulates the bone marrow to produce red blood cells in response to tissue
hypoxia. This is not the function of creatinine, aldosterone, or renin.

Question 23

31-23. If a nurse wants to obtain the best estimate of renal function, which test should the nurse
monitor?
a. Glomerular filtration rate (GFR)
b. Circulating antidiuretic hormone (ADH) levels
c. Volume of urine output
d. Urine-specific gravity

Answer 23

ANS: A
The GFR provides the best estimate of functioning renal tissue. The best estimate of renal
function is not associated with the measurement of circulating ADH levels, urine output, or
specific gravity.

Question 24

31-24. A nurse recalls that the glomerular filtration rate (GFR) and plasma creatinine (Pcr)
concentration are _____ related.
a. directly
b. indirectly
c. inversely
d. not

Answer 24

ANS: C
The GFR and Pcr are inversely related.