Review Chapter 23

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In life-threatening starvation, the kidneys synthesize glucose by

A. secreting erythropoietin
B. secreting renin.
C. deaminating amino acids.
D. contributing to calcium homeostasis.
E. producing uric acid.

deaminating amino acids.

This byproduct of protein catabolism constitutes approximately one-half of all nitrogenous waste.

A. urea
B. creatinine
C. uric acid
D. azotemia
E. ammonia


Which organ system does not excrete waste?

A. the urinary system
B. the cardiovascular system
C. the integumentary system
D. the digestive system
E. the respiratory system

the cardiovascular system

Which is not a function of the kidneys?

A. They regulate osmolarity of the body fluids.
B. They fight osteoporosis by synthesizing vitamin D.
C. They help control blood pressure
D. They release waste into the bloodstream.
E. They indirectly increase oxyhemoglobin.

They release waste into the bloodstream.

Which of the following is not an organ of the urinary system?

A. urethra
B. collecting duct
C. ureter
D. urinary bladder
E. kidney

collecting duct

A patient enters a hospital after a motorcycle accident. He complains of mid-back pain. X-rays reveal both rib and pelvic fractures. His emergency room examination includes urinalysis. Which of the following findings from the urinalysis would most likely suggest trauma to the kidneys from the accident, but not to the urinary bladder?

A. pyuria
B. hematuria
C. albuminuria
D. uremia
E. phenylketonuria


The innermost connective tissue layer protecting the kidney and assisting in staving off infection is known as

A. the perirenal fat capsule.
B. the renal fascia.
C. the hilum.
D. the fibrous capsule.
E. the renal medulla.

the fibrous capsule.

A single lobe of a kidney is comprised of

A. two calyces and a renal pelvis.
B. one pyramid and the overlying cortex.
C. one major calyx and all of its minor calyces.
D. a renal medulla and two renal columns
E. one collecting duct and all nephrons that drain into it.

one pyramid and the overlying cortex

A renal pyramid voids urine into

A. the minor calyx.
B. the major calyx.
C. the renal medulla.
D. the renal papilla.
E. the ureter.

the minor calyx.

Which of these correctly traces blood flow from the renal artery into the renal cortex?

A. arcuate a. → interlobar a. → afferent arteriole → interlobular a.
B. interlobar a. → interlobular a. → segmental a. → arcuate a.
C. segmental a. → interlobar a. → arcuate a. → interlobular a.
D. afferent arteriole → interlobular a. → arcuate a. → interlobar a.
E. segmental a. → arcuate a. → interlobar a. → interlobular a.

segmental a. → interlobar a. → arcuate a. → interlobular a.

The transition from an afferent arteriole to an efferent arteriole occurs in the

A. glomerulus.
B. medulla.
C. cortical radiate veins.
D. peritubular capillaries.
E. vasa recta.


The average person has approximately _______ nephrons per kidney.

A. 1.2 million
B. 2.4 million
C. 3.6 million
D. 4.8 million
E. 5.6 million

1.2 million

Which of these correctly traces blood flow from the renal cortex to the renal vein?

A. interlobular v. → interlobar v. → segmental v. → renal v.
B. arcuate v. → interlobar v. → segmental v. → renal v
C. interlobar v. → interlobular v. → arcuate v. → renal v.
D. segmental v. → arcuate v. → interlobar v. → renal v.
E. interlobular v. → arcuate v. → interlobar v. → renal v.

interlobular v. → arcuate v. → interlobar v. → renal v.

Blood plasma is filtered in

A. the renal tubule.
B. the renal corpuscle.
C. the renal capsule.
D. the renal column.
E. the renal calyx.

the renal tubule.

Which of these form the inner layer of the glomerular capsule and wrap around the capillaries of the glomerulus?

A. macula densa cell
B. mesangial cell
C. nephrocytes
D. podocytes
E. monocytes


All of the following are composed of cuboidal epithelium with the exception of

A. the thin segment of the nephron loop.
B. the thick segment of the nephron loop.
C. the collecting duct.
D. the proximal convoluted tubule.
E. the distal convoluted tubule.

the thin segment of the nephron loop.

Which are primarily responsible for maintaining the salinity gradient of the renal medulla?

A. cortical nephrons
B. juxtamedullary nephrons
C. collecting ducts
D. proximal convoluted tubules
E. distal convoluted tubules

juxtamedullary nephrons

In the nephron, the fluid that immediately precedes urine is known as

A. plasma
B. glomerular filtrate.
C. tubular fluid.
D. renal filtrate.
E. medullary filtrate.

tubular fluid.

Glucose and amino acids are reabsorbed from the glomerular filtrate by

A. the renal corpuscle.
B. the proximal convoluted tubule.
C. the distal convoluted tubule.
D. the glomerular capillaries.
E. the collecting duct.

the proximal convoluted tubule.

In a healthy kidney, very little ___ is filtered by the glomerulus.

A. amino acids
B. electrolytes
C. glucose
D. vitamins
E. protein


Which of the following would reduce the glomerular filtration rate?

A. vasoconstriction of the efferent arteriole
B. a drop in oncotic pressure
C. vasodilation of the afferent arteriole
D. vasoconstriction of the afferent arteriole
E. an increase in osmotic pressure in the glomerular capsule

vasoconstriction of the afferent arteriole

The mechanism of stabilizing the GFR based on the tendency of smooth muscle to contract when stretched is known as what?

A. renal autoregulation
B. the myogenic mechanism
C. tubuloglomerular feedback
D. sympathetic control
E. the renin-angiotensin-aldosterone mechanism

the myogenic mechanism

In response to a drop in overall blood pressure, ___ stimulates constriction of the glomerular inlet and even greater constriction of the outlet.

A. azotemia
B. sodium chloride
C. parathyroid hormone
D. aldosterone
E. angiotensin II

angiotensin II

Assuming all other values are normal, calculate the net filtration pressure in a patient with a drop in capsular hydrostatic pressure to 8 mmHg.

A. 10 mm Hg out
B. 20 mm Hg out
C. 30 mm Hg out
D. 40 mm Hg out
E. 50 mm Hg out

20 mm Hg out

Renin hydrolyzes angiotensinogen released from the ________ to form angiotensin I.

A. lungs
B. kidney
C. liver
D. heart
E. spleen


Because of the great deal of active transport that occurs here, the _________ of all the nephrons collectively account for about 6% of one’s daily resting ATP and caloric consumption.

A. proximal convoluted tubules
B. distal convoluted tubules
C. loops of Henle
D. collecting ducts
E. glomeruli

proximal convoluted tubules

Proximal convoluted tubules are responsible for reabsorbing all of the following except

A. potassium.
B. sodium chloride.
C. hydrogen ions.
D. urea.
E. water.

hydrogen ions.

Total saturation of protein transporters for a given solute in the renal tubules would result in

A. reabsorption of all the solute.
B. a renal clearance of zero.
C. a net filtration pressure of 1.0.
D. appearance of that solute in the urine.
E. absence of that solute from the urine.

appearance of that solute in the urine

Which of the following is a direct result of antidiuretic hormone?

A. decreased urine volume
B. decreased urine molarity
C. increased urine volume
D. increased urine salinity
E. increased urine acidity

decreased urine volume

Aldosterone acts on

A. the proximal convoluted tubule.
B. the medullary portion of the collecting duct.
C. the descending limb of the nephron loop.
D. the distal convoluted tubule.
E. the glomerulus.

the distal convoluted tubule.

Atrial natriuretic peptide reduces blood volume and pressure by all of the following means except

A. increasing glomerular filtration rate.
B. inhibiting renin and aldosterone secretion.
C. inhibiting the action of ADH on the kidney.
D. inhibiting NaCl reabsorption by the collecting duct.
E. preventing sodium loss in the urine.

preventing sodium loss in the urine.

Hypocalcemia stimulates

A. a decrease in aldosterone production.
B. secretion of parathyroid hormone.
C. secretion of renin.
D. an increase in blood urea nitrogen.
E. vasoconstriction of the afferent arterioles.

secretion of parathyroid hormone.

Which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass through?

A. glomerulus
B. proximal convoluted tubule
C. distal convoluted tubule
D. collecting duct
E. nephron loop

collecting duct

The urine is most likely to be hypotonic when

A. the body’s water volume is high.
B. the body’s pH is low.
C. the output of antidiuretic hormone is high.
D. the output of natriuretic peptides is high.
E. a person is lost and deprived of drinking water.

the body’s water volume is high.

Which of the following does not contribute to water conservation?

A. the collecting duct
B. the countercurrent multiplier
C. the countercurrent exchange system
D. diuretics
E. the length of the nephrons


The countercurrent multiplier recaptures ______ and is based on fluid flowing in ______ direction in two adjacent tubules.

A. potassium; the same
B. calcium; the opposite
C. calcium; the same
D. sodium; the opposite
E. sodium; the same

sodium; the opposite

The overall purpose of the countercurrent exchange system is

A. to supply salt and urea to the renal medulla.
B. to supply nutrients and oxygen to the renal cortex.
C. to supply nutrients and oxygen to the renal medulla.
D. to remove metabolic wastes from the renal cortex.
E. to remove metabolic wastes from the renal medulla.

to supply salt and urea to the renal medulla.

Which of these induces renin secretion, constricts afferent arterioles, and reduces GFR, and urine volume?

A. aldosterone
B. antidiuretic hormone
C. parathyroid hormone
D. norepinephrine
E. angiotensin II


Normal urine from a healthy person can be expected to contain all of the following except

A. creatinine
B. urobilin
C. glucose
D. ammonia
E. magnesium


What is the term for the pigment responsible for the color of urine?

A. monochrome
B. urochrome
C. cyanochrome
D. multichrome
E. pyuria


The minimum daily output of urine to meet the definition of polyuria is

A. 0.5 L.
B. 1.0 L.
C. 1.5 L.
D. 2.0 L.
E. 3.0 L.

2.0 L.

Prior to chemical tests for glycosuria, clinicians checked for sweetness of the urine as a sign of

A. diabetes insipidus.
B. acute glomerulonephritis.
C. diabetes mellitus.
D. renal calculus.
E. pyelitis.

diabetes mellitus.

Loop diuretics reduce body water content by acting on

A. the feedback loop between the kidney and posterior pituitary gland.
B. the countercurrent multiplier system.
C. the countercurrent exchanger system.
D. aquaporins of the collecting duct.
E. the thirst mechanism and water intake.

the countercurrent multiplier system.

A hospital patient produces 4 mL/min of urine with a urea concentration of 8 mg/mL. Venous blood draw reveals urea concentration of 0.4 mg/mL. What is the percentage of cleared urea from glomerular filtrate?

A. 40%
B. 56%
C. 64%
D. 72%
E. 80%


Which two substances are most useful for determining a patient’s glomerular filtration rate?

A. insulin and glucose
B. inulin and creatinine
C. sodium and water
D. albumin and inulin
E. insulin and urea

inulin and creatinine

46. Creatinine has a renal clearance of 140 mL/min due to the fact that

A. it is absorbed by the loop of Henle.
B. it is secreted by the glomerulus.
C. it is absorbed by the renal tubules.
D. it is secreted by the renal tubules.
E. it is produced in the pulmonary tissue.

it is absorbed by the renal tubules.

Which of the following is not found in the ureter?

A. adventitia
B. two layers of smooth muscle
C. three layers of smooth muscle
D. transitional epithelium
E. skeletal muscle

skeletal muscle

Which muscle is located in the bladder?

A. detrusor
B. distractor
C. pubococcygeus
D. corpus spongiosum
E. corpus cavernosum


Which is not a portion of the urethra?

A. external urethral orifice
B. internal urethral sphincter
C. prostatic urethra
D. membranous urethra
E. spongy urethra

internal urethral sphincter

Micturition is another term for

A. the production of nitrogenous wastes.
B. glomerular filtration.
C. the countercurrent multiplier process.
D. inflammation of the urinary bladder.
E. the elimination of urine.

the elimination of urine.

The ureters pass anterior to the bladder and enter it from below.

True False


Albuminuria is a common sign of diabetes mellitus.

True False


Diseases that affect the descending corticospinal tracts may limit inhibition of the sacral somatic motor neurons and thus could result in urinary incontinence.

True False


Ethyl (drinking) alcohol stimulates the secretion of ADH, thereby reducing reabsorption by the collecting duct.

True False


Parathyroid hormone increases phosphate excretion by the proximal convoluted tubule as well as promotes synthesis of calcitriol.

True False


The countercurrent multiplier mechanism for water conservation was discovered by limiting studies to humans and thus hypothesizing how form determines function.

True False


The thick segment of the nephron loop is impermeable to water.

True False


Glomerular filtration occurs because glomerular oncotic pressure overrides glomerular blood pressure.

True False


Angiotensin-converting enzyme is found only in the kidneys and converts angiotensinogen to angiotensin I.

True False


Cells in the cleft between the afferent and efferent arterioles and among capillaries of the glomerulus are known as mesangial cells.

True False


Glomerular capillaries suffer little damage from hypertension because of the protective influence of the afferent arterioles.

True False


The fenestrated endothelium of the capillary has pores small enough to exclude blood cells from the filtrate.

True False


The most toxic of our metabolic wastes are nitrogenous wastes.

True False


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