Chapter 28- Anatomy and Physiology of the Renal System My Nursing Test Banks

 

1.

A patient has been admitted to the ICU following a car wreck in which she suffered blunt, penetrating trauma. She has lost quite a bit of blood and is in shock. Which of the following conditions should the nurse expect in this patient? Select all that apply.

A)

Hypotension

B)

Vasodilation of afferent arterioles

C)

Increased glomerular filtration rate

D)

Anuria

E)

Homeostasis

F)

Effective autoregulation

2.

A child in the ICU has been diagnosed with Bartter syndrome, a rare genetic defect in the thick ascending limb of the loop of Henle that impairs the function of this structure. Which characteristic should the nurse expect in this patient, based on the function of the thick ascending limb of the loop of Henle?

A)

Excessive loss of sodium in urine

B)

Overly diluted urine

C)

Impaired reabsorption of water

D)

Decreased concentration of chloride ions in urine

3.

The nurse is working with a patient with a juxtaglomerular cell tumor, which accelerates the function of these cells. What effects should the nurse expect to see with this condition? Select all that apply.

A)

Increased renin production

B)

Decreased angiotensin I levels

C)

Constriction of smooth muscle surrounding arterioles

D)

Hypertension

E)

Decreased glomerular filtration rate

F)

Decreased urine production

4.

A patient has a severe deficit of sodium and potassium. The nurse should expect impaired reabsorption of which substance in this patient?

A)

Glucose

B)

Water

C)

Urea

D)

Chloride

5.

A patient is currently taking an aldosterone blocker, which reduces reabsorption of sodium. What other condition should the nurse expect to see as a result of the patient taking this medication?

A)

Hyperkalemia

B)

Increased hydrogen level

C)

Hypernatremia

D)

Edema

6.

An athlete has been admitted to the ICU for heat stroke and severe dehydration after participating in a marathon on a hot day. Which of the following would the nurse expect to find in this patient?

A)

Decreased serum osmolality

B)

Increased renin secretion

C)

Increased glomerular filtration rate

D)

Hypertension

7.

The nurse observes that an elderly patients urine samples have become increasingly dark yellow. Which of the following would best explain this phenomenon?

A)

The patient is drinking too much water.

B)

The patient is diabetic.

C)

The patient is hypertensive.

D)

The patient is dehydrated.

8.

A patient with severe anorexia is admitted to the ICU. Which of the following would the nurse expect to find in this patient? Select all that apply.

A)

Hypoproteinemia

B)

Decreased glomerular filtration rate

C)

Lower filtrate osmotic pressure

D)

Hyperglycemia

9.

A patient with acute renal failure is in the ICU. Which of the following would best help the nurse assess the health of the patients renal tubules?

A)

Sodium concentration of urine

B)

pH

C)

Clearance of inulin

D)

Urine output

10.

A patient in the ICU is experiencing a flare-up of arthritis. A lack of fluid in which subcompartment of the body would contribute most directly to this condition?

A)

Transcellular

B)

Interstitial

C)

Plasma

D)

Intracellular

11.

A patient is found to have low blood levels of magnesium. What effect should the nurse expect this to have in the patient?

A)

Impaired active transport via the sodiumpotassium pump

B)

Alkalosis

C)

Stimulation of parathyroid hormone release

D)

Osmotic regulation

12.

A patient is experiencing a sudden drop in blood pressure with a mean arterial pressure ranging between 78 and 82 mm Hg. What effect on the functioning of the renal system does the nurse expect?

A)

Dilation of afferent renal arterioles

B)

Increase in glomerular filtration rate

C)

Dilation of efferent renal arterioles

D)

Reduction of glomerular filtration rate

13.

A patient has a condition resulting in malfunction of the proximal tubules of nephrons. What would the nurse expect to find?

A)

All urine values within normal limits

B)

Low levels of electrolytes in urine

C)

Reduction of drug clearance rates

D)

Decrease in urine urea levels

14.

A patient has a reduced urine output. What situation will reduce glomerular filtration rate and hence urine output?

A)

Increase in mean arterial pressure to 100 mm Hg

B)

Decrease in hydrostatic pressure in Bowmans capsule

C)

Decrease in plasma protein concentrations

D)

Condition resulting in afferent arteriole constriction

15.

The patient has a reduced clearance rate for a drug usually secreted by the nephrons. The nurse should assess for malfunction in which of the following?

A)

Osmosis in Bowmans capsule

B)

Active transport in distal tubules

C)

Filtration rate in glomerulus

D)

Rate of flow in collecting duct

16.

The patient has a low serum sodium level and a high serum potassium level. In normal compensation, what body function would increase?

A)

Proximal tubule reabsorption of sodium

B)

Conversion of angiotensin II to renin

C)

Secretion of aldosterone

D)

Response to diuretic therapy

17.

The patient is experiencing a fluid volume overload from excess intravenous fluids. Assuming that normal kidney function exists, what hormone actions would the nurse expect?

A)

Hypothalamic secretion of antidiuretic hormone

B)

Adrenal secretion of renin

C)

Reduction of renin and aldosterone functions

D)

Increased conversion of angiotensin I to angiotensin II

18.

The patient has a low serum sodium level. Based on the major role of sodium in the body, the nurse would look for alterations in which of the following?

A)

Fluid balance

B)

Calcium balance

C)

Energy levels

D)

Pulmonary function

19.

The patient has an abnormally high level of serum potassium. What associated life-threatening alteration should the nurse look for?

A)

Gastrointestinal distress

B)

Cardiac dysrhythmias

C)

Muscle spasm

D)

Increased aldosterone

20.

The patient is experiencing metabolic acidosis. What kidney function is impaired?

A)

Hydrogen ion filtration by the glomerulus

B)

Electrochemical bicarbonate reabsorption

C)

Hydrogen ion secretion by the distal tubules

D)

Sodium reabsorption by bicarbonate

Answer Key

1.

A, B, D

2.

A

3.

A, C, D

4.

A

5.

A

6.

B

7.

D

8.

A, C

9.

A

10.

A

11.

A

12.

D

13.

C

14.

D

15.

B

16.

C

17.

C

18.

A

19.

B

20.

C

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