URINARYTEST - Matching Questions Figure 25.1 Using Figure...

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: Matching Questions Figure 25.1 Using Figure 25.1, match the following: 1) Glomerulus. Answer: C Diff: 1 Page Ref: 1004; Fig. 25.5a 2) Afferent arteriole. Answer: A Diff: 1 Page Ref: 1004; Fig. 25.5a 3) Collecting duct. Answer: B Diff: 1 Page Ref: 1004; Fig. 25.5a 4) Loop of Henle. Answer: E Diff: 1 Page Ref: 1004; Fig. 25.5a 5) Peritubular capillaries. Answer: D Diff: 1 Page Ref: 1004; Fig. 25.5a 6) Site where granular cells are found. Answer: A Diff: 1 Page Ref: 1004 7) Medulla of the kidney. Answer: E Diff: 1 Page Ref: 1004; Fig. 25.5a Figure 25.2 Using Figure 25.2, match the following: 8) Podocyte. Answer: B Diff: 1 Page Ref: 1006; Fig. 25.7 9) Is composed of simple squamous epithelium. Answer: A Diff: 1 Page Ref: 1006; Fig. 25.7 10) Collecting duct cells. Answer: C Diff: 1 Page Ref: 1002; Fig. 25.4 11) Proximal convoluted tubule cells. Answer: E Diff: 1 Page Ref: 1002; Fig. 25.4 12) Filtrate at the site of these cells is about the same osmolarity as blood plasma. Answer: E Diff: 2 Page Ref: 1001; Fig. 25.4 13) Cells that are the most active in reabsorbing the filtrate. Answer: E Diff: 2 Page Ref: 1003; Fig. 25.4 14) Cells that reabsorb virtually all the nutrients. Answer: E Diff: 2 Page Ref: 1003; Fig. 25.4 15) Cells that are most affected by ADH. Answer: C Diff: 3 Page Ref: 1003; Fig. 25.4 16) Almost no water is absorbed in these cells. Answer: D Diff: 3 Page Ref: 1003; Fig. 25.4 Match the following: 17) Proximal convoluted tubule. Answer: C Diff: 1 Page Ref: 1013 18) Glomerulus. Answer: E Diff: 1 Page Ref: 1007 19) Peritubular capillaries. Answer: B Diff: 2 Page Ref: 1003 20) Collecting duct. Answer: D Diff: 2 Page Ref: 1001 A) Receives venous blood from the cortical radiate vein. B) Blood supply that directly receives substances from the tubular cells. C) Site at which most of the tubular reabsorption occurs. D) Site that drains the distal convoluted tubule. E) Site of filtrate formation. 21) Arcuate vein. Answer: A Diff: 2 Page Ref: 1001 True/False Questions 1) The glomerular filtration rate is approximately 350 ml/min. Answer: FALSE Diff: 1 Page Ref: 1007 2) The functional unit of the kidney is the renal column. Answer: FALSE Diff: 1 Page Ref: 1000 3) The ureter transports urine from the kidney to the urinary bladder. Answer: TRUE Diff: 1 Page Ref: 1024 4) The terminal portion of the urinary system is the urethra. Answer: TRUE Diff: 1 Page Ref: 1026 5) The position of the kidneys behind the peritoneal lining of the abdominal cavity is described by the term retroperitoneal. Answer: TRUE Diff: 1 Page Ref: 998 6) The entire responsibility for urine formation lies with the nephron. Answer: TRUE Diff: 1 Page Ref: 1001 7) Urine is 95% water by volume. Answer: TRUE Diff: 1 Page Ref: 1022 8) The act of emptying the bladder is called voiding. Answer: TRUE Diff: 1 Page Ref: 1027 9) Glomerular filtration is an ATP-driven process. Answer: FALSE Diff: 1 Page Ref: 1007 10) In the absence of hormones, the distal tubule and collecting ducts are relatively impermeable to water. Answer: TRUE Diff: 1 Page Ref: 1015 11) The collecting duct is impermeable to water in the presence of ADH. Answer: FALSE Diff: 1 Page Ref: 1015 12) The urethra contains an internal sphincter of smooth muscle. Answer: TRUE Diff: 1 Page Ref: 1026 13) Angiotensin II is a substance made by the body to lower blood pressure during stress. Answer: FALSE Diff: 1 Page Ref: 1010 14) Aldosterone is a hormone that causes the renal tubules to reclaim sodium ions from the filtrate. Answer: TRUE Diff: 1 Page Ref: 1015 15) Blood pressure in the renal glomerulus is lower than in most parts of the body in order to conserve body water. Answer: FALSE Diff: 1 Page Ref: 1007-1008 16) The proximal convoluted tubule is the portion of the nephron that attaches to the collecting duct. Answer: FALSE Diff: 1 Page Ref: 1013 17) Major calyces are large branches of the renal column. Answer: FALSE Diff: 1 Page Ref: 1000 18) Urea is reabsorbed in the loop of Henle. Answer: FALSE Diff: 1 Page Ref: 1013 19) Ureters, like the urethra, are lined only with transitional epithelium. Answer: FALSE Diff: 1 Page Ref: 1023-1024 20) Incontinence is the inability to control voluntary micturition. Answer: TRUE Diff: 1 Page Ref: 1027 21) The myogenic mechanism reflects the tendency of vascular smooth muscle to stretch. Answer: FALSE Diff: 2 Page Ref: 1008 22) An excessive urine output is called anuria. Answer: FALSE Diff: 2 Page Ref: 1011 23) Tubular secretion is effective in controlling blood pH. Answer: TRUE Diff: 2 Page Ref: 1015 24) The trigone is so named because of the shape of the urinary bladder. Answer: FALSE Diff: 2 Page Ref: 1025 25) Atrial naturetic factor inhibits sodium reabsorption. Answer: TRUE Diff: 2 Page Ref: 1011-1012 26) Particles smaller than 3 nanometers are passed into the filtrate. Answer: TRUE Diff: 2 Page Ref: 1007 27) The macula densa cells are chemoreceptors that respond to changes in the urea content of the filtrate. Answer: FALSE Diff: 1 Page Ref: 1005 28) Blood in the urine may be a symptom of bladder cancer. Answer: TRUE Diff: 2 Page Ref: 1030-1031 29) Obligatory water reabsorption involves the movement of water along an osmotic gradient. Answer: TRUE Diff: 3 Page Ref: 1013 30) Having a kinked ureter is called renal ptosis. Answer: FALSE Diff: 3 Page Ref: 999 31) The kidney consumes about 15% of all oxygen used by the body at rest. Answer: FALSE Diff: 1 Page Ref: 1007 Multiple-Choice Questions 1) The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________. A) loop of Henle B) glomerular filtration membrane C) collecting duct D) distal convoluted tubule. Answer: A Diff: 1 Page Ref: 1017; Fig. 25.14 2) Urine passes through the ________. A) renal hilum to the bladder to the ureter B) pelvis of the kidney to ureter to bladder to urethra C) glomerulus to ureter to renal tubule D) hilus to urethra to bladder Answer: B Diff: 1 Page Ref: 1000 3) A Bowmanʹs capsule does not contain ________. A) a podocyte B) a vasa recta C) a fenestrated capillary D) an efferent arteriole Answer: B Diff: 1 Page Ref: 1001 4) An increase in the permeability of the cells of the collecting tubule to water is due to ________. A) a decrease in the production of ADH B) an increase in the production of ADH C) an increase in the production of aldosterone D) a decrease in the concentration of the blood plasma Answer: B Diff: 1 Page Ref: 1019 5) The urinary bladder is composed of ________ epithelium. A) transitional B) simple squamous C) stratified squamous D) pseudostratified columnar Answer: A Diff: 1 Page Ref: 1025 6) The kidneys are stimulated to produce renin ________. A) when the peritubular capillaries are dilated B) when the pH of the urine decreases C) by a decrease in the blood pressure D) when the specific gravity of urine rises above 1.10 Answer: C Diff: 1 Page Ref: 1008, 1010 7) Blood vessels of the renal columns are called ________. A) lobar B) segmental C) interlobar D) cortical radiate Answer: C Diff: 1 Page Ref: 1001 8) Which gland sits atop each kidney? A) adrenal B) thymus C) pituitary D) pancreas Answer: A Diff: 1 Page Ref: 998 9) The ________ artery lies on the boundary between the cortex and medulla of the kidney. A) lobar B) arcuate C) interlobar D) cortical radiate Answer: B Diff: 1 Page Ref: 1001 10) The glomerulus differs from other capillaries in the body in that it ________. A) has a basement membrane B) is impermeable to most substances C) is drained by an efferent arteriole D) has a blood pressure much lower than other organ systems Answer: C Diff: 1 Page Ref: 1003 11) The descending limb of the loop of Henle ________. A) is not permeable to water B) is freely permeable to sodium and urea C) pulls water by osmosis into the lumen of the tubule D) contains fluid that becomes more concentrated as it moves down into the medulla Answer: D Diff: 1 Page Ref: 1003 12) Select the correct statement about the ureters. A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine. B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch. C) The ureters are capable of peristalsis like that of the gastrointestinal tract. D) The ureter is innervated by parasympathetic nerve endings only. Answer: C Diff: 1 Page Ref: 1024 13) The fatty tissue surrounding the kidneys is important because ________. A) it ensures adequate energy for the adrenal glands to operate efficiently B) it stabilizes the position of the kidneys by holding them in their normal position C) it is necessary as a barrier between the adrenal glands and kidneys D) it produces vitamin D Answer: B Diff: 1 Page Ref: 999 14) The renal corpuscle is made up of ________. A) Bowmanʹs capsule and glomerulus B) the descending loop of Henle C) the renal pyramid D) the renal papilla Answer: A Diff: 1 Page Ref: 1001 15) The functional and structural unit of the kidneys is ________. A) the nephron B) the loop of Henle C) Bowmanʹs capsule D) the basement membrane of the capillaries Answer: A Diff: 1 Page Ref: 1001 16) The juxtaglomerular apparatus is responsible for ________. A) the secretion of drugs B) the secretion of acids and ammonia C) reabsorption of organic molecules, vitamins, and water D) regulating the rate of filtrate formation and controlling systemic blood pressure Answer: D Diff: 1 Page Ref: 1003, 1005 17) The chief force pushing water and solutes out of the blood across the filtration membrane is ________. A) the design and size of the podocytes B) the thickness of the capillary endothelium C) glomerular hydrostatic pressure (glomerular blood pressure) D) the size of the pores in the basement membrane of the capillaries Answer: C Diff: 1 Page Ref: 1007 18) Which of the following statements describes the histology of the ureters? A) They are trilayered (mucosa, muscularis, and adventitia). B) They are actually an extension of the visceral peritoneum. C) They are made up of several layers of endothelium. D) They are made up entirely of muscle tissue because they need to contract in order to transport urine efficiently. Answer: A Diff: 1 Page Ref: 1023 19) The first major branch of the renal artery is ________. A) arcuate B) interlobular C) segmental D) cortical radiate Answer: C Diff: 1 Page Ref: 1001 20) Which of the following acts as the trigger for the initiation of micturition (voiding)? A) The stretching of the bladder wall serves as the trigger. B) Motor neurons control micturition. C) The pressure of the fluid in the bladder opens a sphincter and allows the urine to flow by gravity down the urethra. D) The sympathetic efferents are the predominant system controlling micturition. Answer: A Diff: 1 Page Ref: 1027 21) The filtration membrane includes all except ________. A) glomerular endothelium B) podocytes C) renal fascia D) basement membrane Answer: C Diff: 2 Page Ref: 1005 22) The mechanism of water reabsorption by the renal tubules is ________. A) active transport B) osmosis C) solvent drag D) cotransport with sodium ions Answer: B Diff: 2 Page Ref: 1012-1013 23) Most electrolyte reabsorption by the renal tubules ________. A) is not Tm limited B) is in the distal convoluted tubule C) is hormonally controlled in distal tubule segments D) is completed by the time the loop of Henle is reached Answer: C Diff: 2 Page Ref: 1015 24) The macula densa cells respond to ________. A) aldosterone B) antidiuretic hormone C) changes in pressure in the tubule D) changes in solute content of the filtrate Answer: D Diff: 2 Page Ref: 1005 25) Which of the following is not reabsorbed by the proximal convoluted tubule? A) Na+ B) K+ C) glucose D) creatinine Answer: D Diff: 2 Page Ref: 1013 26) The fluid in the glomerular (Bowmanʹs) capsule is similar to plasma except that it does not contain a significant amount of ________. A) glucose B) hormones C) electrolytes D) plasma protein Answer: D Diff: 2 Page Ref: 1007 27) Alcohol acts as a diuretic because it ________. A) is not reabsorbed by the tubule cells B) increases the rate of glomerular filtration C) increases secretion of ADH D) inhibits the release of ADH Answer: D Diff: 2 Page Ref: 1019, 1021 28) The function of angiotensin II is to ________. A) constrict arterioles and increase blood pressure B) decrease the production of aldosterone C) decrease arterial blood pressure D) decrease water absorption Answer: A Diff: 2 Page Ref: 1010 29) A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________. A) diabetes mellitus B) diabetes insipidus C) diabetic acidosis D) coma Answer: B Diff: 2 Page Ref: 1031 30) An important characteristic of urine is its specific gravity or density, which is ________. A) 1.041-1.073 B) 1.001-1.035 C) 1.030-1.040 D) 1.000-1.015 Answer: B Diff: 2 Page Ref: 1021 31) Place the following in correct sequence from the formation of a drop of urine to its elimination from the body. 1. major calyx 2. minor calyx 3. nephron 4. urethra 5. ureter 6. collecting duct A) 3, 1, 2, 6, 5, 4 B) 6, 3, 2, 1, 5, 4 C) 2, 1, 3, 6, 5, 4 D) 3, 6, 2, 1, 5, 4 Answer: D Diff: 2 Page Ref: 998-1001 32) Select the correct statement about the nephrons. A) The parietal layer of the glomerular capsule is simple squamous epithelium. B) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule. C) Podocytes are the branching epithelial cells that line the tubules of the nephron. D) Filtration slits are the pores that give fenestrated capillaries their name. Answer: A Diff: 2 Page Ref: 1001 33) What would happen if the capsular hydrostatic pressure were increased above normal? A) Net filtration would increase above normal. B) Net filtration would decrease. C) Filtration would increase in proportion to the increase in capsular pressure. D) Capsular osmotic pressure would compensate so that their filtration would not change. Answer: B Diff: 2 Page Ref: 1008 34) Which of the following is not a part of the juxtaglomerular apparatus? A) granular cells B) macula densa C) podocyte cells D) mesanglial cells Answer: C Diff: 2 Page Ref: 1003, 1005 35) Tubular reabsorption ________. A) includes substances such as creatinine B) by active mechanisms usually involves movement against an electrical and/or chemical gradient C) by passive processes requires ATP to move solutes from the interior of the tubule to the blood D) is a way for the body to get rid of unwanted waste Answer: B Diff: 2 Page Ref: 1011 36) Which statement is true about urine? A) Urine is usually slightly alkaline. B) Urine has an ammonialike odor when fresh. C) Urine has nitrogenous waste such as urea and uric acid. D) Urine has a yellow color due to the presence of hemoglobin. Answer: C Diff: 2 Page Ref: 1022-1023 37) Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________. A) facilitated diffusion B) passive transport C) countertransport D) secondary active transport Answer: D Diff: 2 Page Ref: 1013 38) While the kidneys process about 180 L of blood-derived fluids daily, the amount that actually leaves the body is ________. A) 50%, or 90 L B) all of the 180 L C) 1%, or 1.8 L D) 100 L Answer: C Diff: 2 Page Ref: 1007 39) Fetal kidneys do not have to work very hard because ________. A) fetuses do not have any waste to excrete B) there are no functional nephrons until after birth C) the placenta allows the motherʹs urinary system to clear the waste from fetal blood D) there is no way a fetus could excrete urine until the seventh month of development Answer: C Diff: 2 Page Ref: 1028 40) Which of the following best describes kidney function in older adults (70 years or older)? A) Kidney function remains the same throughout life, regardless of age. B) Only about 3% of older adults have any loss of kidney function. C) Only obese and diabetic older adults have any kidney dysfunction. D) Kidney function decreases due to kidney atrophy. Answer: D Diff: 2 Page Ref: 1030 41) The factor favoring filtrate formation at the glomerulus is ________. A) the colloid osmotic pressure of the blood B) the glomerular hydrostatic pressure C) the capsular hydrostatic pressure D) the myogenic mechanism Answer: B Diff: 3 Page Ref: 1007 42) If the Tm for a particular amino acid is 120 mg/100 ml and the concentration of that amino acid in the blood is 230 mg/100 ml, the amino acid ________. A) will be actively secreted into the filtrate B) will be completely reabsorbed by the tubule cells C) will appear in the urine D) will be reabsorbed by secondary active transport Answer: C Diff: 3 Page Ref: 1013 43) If one says that the clearance value of glucose is zero, what does this mean? A) The glucose molecule is too large to be filtered out of the blood. B) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules. C) Normally all the glucose is reabsorbed. D) The clearance value of glucose is relatively high in a healthy adult. Answer: C Diff: 3 Page Ref: 1021 44) Excretion of dilute urine requires ________. A) relative permeability of the distal tubule to water B) impermeability of the collecting tubule to water C) transport of sodium and chloride ions out of the descending loop of Henle D) the presence of ADH Answer: B Diff: 3 Page Ref: 1019, 1021 45) As the renal artery approaches the kidney, it branches to supply the renal tissue. Place the following in correct sequence starting from the renal artery. 1. segmental 2. cortical radiate 3. arcuate 4. interlobar A) 1, 4, 3, 2 B) 3, 1, 4, 2 C) 1, 2, 3, 4 D) 1, 4, 2, 3 Answer: A Diff: 3 Page Ref: 1001 46) In the ascending limb of the loop of Henle ________. A) the thin segment is freely permeable to water B) the thick segment is permeable to water C) the thin segment is not permeable to sodium and chloride D) the thick segment moves ions out into interstitial spaces for reabsorption Answer: D Diff: 3 Page Ref: 1003 47) Select the correct statement about urinary system development. A) Kidneys develop from urogenital ridges. B) The metanephric ducts will become the urethras. C) The pronephros (first tubule system) develops during the tenth week of gestation. D) The mesonephros will develop into the kidneys. Answer: A Diff: 3 Page Ref: 1027 48) The disruption in homeostasis known as pyelitis is ________. A) a virus that appears only in children because of poor hygiene B) the aftermath of a severe upper respiratory infection C) an infection of the renal pelvis and calyces D) more prevalent in the elderly Answer: C Diff: 3 Page Ref: 1026 49) Which statement is correct? A) Reabsorption of water is hormonally controlled. B) Normal filtrate contains a large amount of protein. C) Most of the water passing through the kidney is eliminated as urine. D) The excretion of sodium ions is one of the mechanisms that maintains the pH balance of the blood. Answer: A Diff: 3 Page Ref: 1011 Fill-in-the-Blank/Short Answer Questions 1) The capillary bed that surrounds the descending and ascending loop of Henle is called the ________. Answer: vasa recta Diff: 1 Page Ref: 1003 2) Abnormally low output of urine is called ________. Answer: anuria Diff: 1 Page Ref: 1011 3) Urine crystals in the renal pelvis are called ________. Answer: renal calculi Diff: 1 Page Ref: 1024 4) The need to get up in the middle of the night to urinate is called ________. Answer: nocturia Diff: 1 Page Ref: 1030 5) The areas on either side of the renal pyramids are called the renal ________. Answer: columns Diff: 1 Page Ref: 1000 6) The area between the ureters and urethra is called the ________ in a bladder. Answer: trigone Diff: 1 Page Ref: 1025 7) The ________ mechanism is the general tendency of vascular smooth muscle to contract when stretched. Answer: myogenic Diff: 2 Page Ref: 1008 8) The renal clearance rate equation is RC = ________. Answer: UV/P Diff: 2 Page Ref: 1021 9) The presence of pus in the urine is a condition called ________. Answer: pyuria Diff: 2 Page Ref: 1022-1023 10) Sodium-linked water flow across a membrane is called ________ water reabsorption. Answer: obligatory Diff: 2 Page Ref: 1013 11) Explain the path of the blood vessels in the kidney. Answer: renal artery divides into smaller segmental arteries, which in turn branch into lobar arteries. Lobar The arteries branch and enter the columns as interlobar, then turn and follow the cortex-medulla boundary as arcuate arteries. Cortical radiate arteries travel up into the cortex and branch into afferent arterioles, which enter the Bowmanʹs capsule as glomerular capillaries and exit as efferent arterioles branching further into peritubular capillaries and the vasa recta. These capillaries return via the cortical radiate, arcuate, interlobar, lobar, segmental, and renal veins. Diff: 2 Page Ref: 1001 12) Explain how filtration works in the glomerular capillaries. Answer: glomerular capillaries are fenestrated, allowing fairly large molecules to pass through. The The substances must pass through the basement membrane, where they are further selected for size by the filtration slits of the podocytes. Diff: 2 Page Ref: 1007 13) List three substances that are abnormal urinary constituents and provide the proper clinical term for such abnormalities. Answer: Abnormal urinary constituents include the following (the clinical term for each is listed in parentheses): glucose (glycosuria), proteins (proteinuria or albuminuria), ketone bodies (ketonuria), hemoglobin (hemoglobinuria), bile pigments (bilirubinuria), erythrocytes (hematuria), and leukocytes (pyuria). Diff: 3 Page Ref: 1022-1023 14) Explain the role of aldosterone in sodium and water balance. Answer: Aldosterone targets the distal tubule and collecting duct and enhances sodium-ion reabsorption so that very little leaves the body in urine. Aldosterone also causes increased water reabsorption because, as sodium is reabsorbed, water follows it back into the blood. Diff: 2 Page Ref: 1015 15) Explain what is meant by the terms cotransport process and transport maximum. Answer: Cotransport process refers to the active transport of one solute coupled to the active movement of another during tubular reabsorption. Transport maximum reflects the number of carriers in the renal tubules available to ʺferryʺ a particular substance. Diff: 2 Page Ref: 1013 16) Humans can survive for a period of time without water thanks to the ability of the kidneys to produce concentrated urine. Briefly explain what factors allow this to happen. Answer: Facultative water reabsorption depends on the presence of antidiuretic hormone. In the presence of ADH, the pores of the collecting tubule enlarge and the filtrate loses water by osmosis as it passes through the medullary regions of increasing osmolarity. Consequently, water is conserved and urine becomes concentrated. The water that passes through these regions is reabsorbed by the body in order to prevent dehydration. Diff: 3 Page Ref: 1018-1019 17) List and describe three pressures operating at the filtration membrane, and explain how each influences net filtration pressure. Answer: Glomerular hydrostatic pressure is the chief force pushing water and solutes across the filtration membrane. The higher the glomerular hydrostatic pressure, the more filtrate is pushed across the membrane. Colloid osmotic pressure of plasma proteins in the glomerular blood, and capsular hydrostatic pressure exerted by fluids in the glomerular capsule, drive fluids back into the glomerular capillaries. The net filtration pressure equals glomerular hydrostatic pressure minus colloid osmotic pressure of glomerular blood plus capsular hydrostatic pressure. Diff: 3 Page Ref: 1007-1008 18) In addition to the renin-angiotensin mechanism, the renal cells produce other chemicals. Name five, and briefly give the main function of each. Answer: Renal cells also produce chemicals, some of which act locally as signaling molecules. These chemicals include prostaglandins (vasodilators and vasoconstrictors), which probably regulate GFR; nitric oxide, a potent vasodilator produced by the vascular endothelium; adenosine, which constricts renal vasculature; and endothelin, a vasoconstrictor that inhibits renin release. Diff: 3 Page Ref: 1010-1011 19) What are aquaporins? Answer: Water-filled pores in water-permeable portions of the convoluted tubules such as the PCT. Diff: 2 Page Ref: 1013 20) Freshly voided urine has very little smell, but shortly after voiding it can take a very strong smell. Why? Answer: Freshly voided urine is relatively sterile but if it is allowed to stand, bacteria begin to metabolize the urea solutes to release ammonia and other smells depending on the personʹs diet. A fruity smell generally means there is a diabetes problem. Diff: 2 Page Ref: 1021 Clinical Questions 1) An older man sees his doctor for severe pain in his lower abdominal or flank area, elevated temperature, and nausea. Exhaustive tests rule out abdominal obstructions and infections. X rays indicate a shadow on his right ureter. Diagnose his problem. Give suggested treatment and prognosis. Answer: symptoms indicate a kidney stone that has been passed into the ureter. Treatment would be IV The therapy to flush the stone out, surgery, or ultrasound waves to shatter the calculi. The prognosis is for complete recovery. There is a possibility of kidney stones forming again. Diff: 2 Page Ref: 1024 2) What clinical effects would high blood pressure have on the kidneys of a bedridden client? Answer: client would have a much higher glomerular hydrostatic pressure and would therefore lose more This fluids than normal. Because of the threat of dehydration, the staff should make sure the client drinks plenty of water. Diff: 3 Page Ref: 1007-1008 3) Eleven-year-old Harry is complaining of a severe sore throat and gets to stay home from school. His pediatrician prescribes a course of broad-spectrum antibiotics, and Harry feels much better within a few days. However, some two weeks later, Harry has a dull, bilateral pain in his lower back and his urine is a smoky brown color. On the basis of Harryʹs signs and symptoms, diagnose his condition and indicate the relationship (if any) between his present condition and his earlier sore throat. Answer: Harry is showing the symptoms of kidney inflammation. The smoky brown color of the urine indicates the presence of blood or bile. Kidney inflammations usually result from infections either of the lower urinary tract or, in Harryʹs case, from his earlier infection of a sore throat. The kidney inflammation is called either pyelitis (involves only the renal pelvis and calyces) or pyelonephritis (affects the whole kidney). Diff: 3 Page Ref: 1026 4) Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs? Answer: Proteinuria is a condition in which the permeability of the glomerular capillaries is increased to such an extent that large amounts of plasma proteins (mostly albumin) pass into the glomerular filtrate and are excreted in the urine. If the condition is severe, the loss of plasma proteins may decrease osmotic pressure substantially. When this happens there is a tendency for fluid to leave the systemic blood vessels and enter the tissue space. This is the reason for Ellenʹs swollen limbs. Diff: 3 Page Ref: 1024; Tbl. 25.2 5) Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis, and how can it cause these symptoms? Answer: is possible that Rachael has cystitis, a condition in which the mucous membrane lining the bladder It becomes swollen and bleeding occurs. This condition is caused by bacterial invasion of the bladder or by chemical or mechanical irritation. Diff: 2 Page Ref: 1026 6) A client is 18 years old and has a complaint of painful urination, fever, chills, and back pain. This is her second urinary tract infection (UTI) within 5 months. How can the RN instruct the client on prevention of another UTI? Answer: Escherichia coli are normal residents of the digestive tract and generally cause no problems there, but these bacteria account for 80% of all urinary tract infections. The nurse can instruct the client on proper hygiene measures. The nurse should also explain that sexually transmitted diseases can also inflame the urinary tract, clogging some of its ducts. Diff: 2 Page Ref: 1026 7) A 58-year-old woman complains of loss of urine when coughing, sneezing, and exercise. She has had three children. Describe the possible causes of urinary incontinence in this client. Answer: Stress incontinence is found most commonly in women with relaxed pelvic musculature deprived of estrogen. Stress incontinence may occur with a sudden increase in intra-abdominal pressure such as coughing or sneezing, which forces urine through the external sphincter. Diff: 2 Page Ref: 1027 8) Explain how an angiotensin-converting enzyme inhibitor (ACE inhibitor) such as captopril would be effective as an antihypertensive. Answer: Angiotension II is a potent vasoconstrictor activating smooth muscle of arterioles throughout the body, causing mean arterial blood pressure to rise. ACE inhibitors reduce blood pressure by interrupting the renin-angiotension-aldosterone system. Diff: 2 Page Ref: 1010 ...
View Full Document

Ask a homework question - tutors are online