Pathophysiology 6th Edition Banasik Test Bank
Chapter 26: Renal Function
Banasik: Pathophysiology, 6th Edition
MULTIPLE CHOICE
1. The primary selectivity barrier for glomerular filtration is the
a. glomerular basement membrane.
b. endothelial tight junctions.
c. epithelial fenestra.
d. mesangial cells.
ANS: A
The basement membrane is an important selectivity barrier of the glomerulus, preventing
plasma proteins, RBCs, WBCs, and platelets from passing through the glomerulus.
Endothelial tight junctions, epithelial fenestra, and mesangial cells are not the primary
selectivity barriers for glomerular filtration.
2. The glucose transporter in the proximal tubule
a. has no transport maximum.
b. does not depend on sodium reabsorption.
c. is ATP-dependent.
d. may be saturated at high filtered glucose loads.
ANS: D
The glucose transporter in the proximal tubule may be saturated at high filtered glucose loads;
glycosuria then results. A transport maximum does exist beyond which glycosuria occurs. A
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sodium-dependent protein co-transporter OMThe transporter is not ATP-dependent.
needed.
3. The primary function of the vasa recta is to
a. secrete renin.
b. reabsorb NaCl.
c. reabsorb interstitial fluid.
d. secrete urea.
ANS: C
The vasa recta are capillaries that surround the loops of Henle and collecting ducts and absorb
interstitial fluid. The vasa recta do not secrete rennin or urea, nor do they reabsorb NaCl.
4. Approximately two thirds of the water and electrolytes filtered by the kidney are reabsorbed
by the
a. loop of Henle.
b. collecting tubule.
c. distal tubule.
d. proximal tubule.
ANS: D
Approximately two thirds of the water and electrolytes filtered by the kidney are reabsorbed
by the proximal tubule. Two thirds of the water and electrolytes filtered by the kidney are not
reabsorbed by the loop of Henle, collecting tubule, or distal tubule.
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, Pathophysiology 6th Edition Banasik Test Bank
5. Which finding on urinalysis should prompt further evaluation?
a. pH 4.5
b. Red blood cells 2 per high-power field
c. Specific gravity of 1.015
d. White blood cells 20 per high-power field
ANS: D
This many WBCs in the urine indicate urinary tract infection; 5 or more is not expected. 4.5 is
a normal pH. Fewer than 5 RBCs is insignificant. 1.015 is a normal specific gravity.
6. Renin is released from
a. the posterior pituitary gland.
b. the liver.
c. juxtaglomerular cells.
d. macula densa cells.
ANS: C
Renin is released from the juxtaglomerular cells. Renin is not released from the posterior
pituitary gland, liver, or macula densa cells.
7. It is true that glucose reabsorption in the tubules
a. occurs passively.
b. occurs in the proximal convoluted tubule.
c. is unlimited.
d. simply does not occur.
ANS: B
Glucose reabsorption occurs N in the proximal convoluted tubule. Glucose reabsorption is not
URSIco-transporter
passive; a sodium-dependent protein NGTB.COMis required. Glucose reabsorption in the
tubules is limited by the number of co-transporters; a threshold exists beyond which
glycosuria will result. Glucose reabsorption occurs in the proximal convoluted tubule with the
assistance of a sodium-dependent protein co-transporter.
8. Serious renal impairment generally does not occur until ____ of the total nephrons have been
damaged.
a. 20%
b. 40%
c. 60%
d. 80%
ANS: D
Serious renal impairment generally does not occur until 75% to 90% of the total nephrons
have been damaged. The other answer options are incorrect.
9. An important sign of glomerular basement membrane dysfunction is
a. proteinuria.
b. hematuria.
c. glycosuria.
d. urinary casts.
ANS: A
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, Pathophysiology 6th Edition Banasik Test Bank
Proteinuria is an important sign of basement membrane dysfunction. Hematuria can be found
in glomerular disorders but it is not specific to this; it can be caused by many disorders.
Glycosuria is found primarily in diabetes mellitus. Urinary casts do not necessarily mean
basement membrane dysfunction.
10. The main driving force for glomerular filtration is
a. oncotic pressure in the Bowman’s capsule.
b. hydrostatic pressure in glomerular capillaries.
c. permeability of the glomerular membrane.
d. solute content of the blood in the glomerular capillaries.
ANS: B
Hydrostatic pressure within the glomerular capillaries is the main driving force for filtration.
A significant drop in blood pressure such as in shock severely reduces glomerular filtration.
Oncotic pressure in the Bowman’s capsule, permeability of the glomerular membrane, and
solute content of the blood in the glomerular capillaries are not the main driving forces for
filtration.
11. Factors that increase the glomerular filtration rate include
a. fluid volume excess.
b. increased hydrostatic pressure in the Bowman’s capsule.
c. high oncotic pressure in glomerular capillary blood.
d. obstruction in the renal tubules.
ANS: A
Fluid volume excess increases blood volume which increases glomerular filtration. Increased
hydrostatic pressure in the Bowman’s capsule, high oncotic pressure in the glomerular
capillary, and obstruction of N URS
renal INGToppose
tubules B.COfiltration.
M
12. The underlying mechanism which directly results in glycosuria is
a. filtration of glucose from the glomerulus.
b. exceeding the threshold for glucose reabsorption.
c. secretion of glucose into the distal tubule.
d. the mechanism is unknown.
ANS: B
Glucose is normally freely filtered but then reabsorbed from the tubules into the peritubular
capillaries. If the threshold for reabsorption is exceeded as in uncontrolled diabetes mellitus,
glycosuria results. Glucose is freely filtered from the glomerulus; this is not the direct cause of
glycosuria. Glucose is not secreted into the distal tubule. The underlying mechanism that
directly results in glycosuria is exceeding the threshold for glucose reabsorption.
13. Excess potassium is excreted from the body by the renal system primarily via
a. glomerular filtration based on blood level of potassium.
b. reabsorption based on blood level of potassium.
c. secretion based on aldosterone level.
d. an unknown mechanism.
ANS: C
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, Pathophysiology 6th Edition Banasik Test Bank
Potassium is secreted from the distal tubule and collecting ducts into the tubule lumen under
the influence of aldosterone. Excess potassium is not excreted from the body by the renal
system via glomerular filtration or the renal system based on the blood level of potassium, nor
is it excreted from the body by the renal system based on the aldosterone level.
14. The glomerular filtration rate is most accurately reflected in the
a. blood urea nitrogen level.
b. urinary output.
c. serum osmolality.
d. serum creatinine level.
ANS: D
Serum creatinine is a fairly reliable indicator of glomerular filtration as it is stable. The blood
urea nitrogen level, urinary output, and serum osmolality are affected by factors that make
them less reliable as indicators of glomerular filtration.
15. Serum creatinine may be increased by
a. carbohydrate intake.
b. fat intake.
c. muscle breakdown.
d. fluid intake.
ANS: C
Creatinine is an end product of muscle metabolism; muscle breakdown will increase the
serum creatinine level. Serum creatinine is not affected by carbohydrate, fat, or fluid intake.
Fluid volume deficit can increase the serum creatinine if it leads to acute renal failure.
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MULTIPLE RESPONSE
1. Hormones that increase sodium reabsorption from the tubular fluid include (Select all that
apply.)
a. aldosterone.
b. atrial natriuretic peptide.
c. antidiuretic hormone.
d. urodilatin.
e. angiotensin II.
ANS: A, E
Aldosterone and angiotensin II result in sodium reabsorption. Atrial natriuretic peptide and
urodilatin decrease sodium reabsorption. Antidiuretic hormone does not affect sodium
reabsorption.
2. The blood urea nitrogen (BUN) level is affected by (Select all that apply.)
a. protein intake.
b. fat intake.
c. fluid intake.
d. catabolism.
e. renal function.
ANS: A, C, D, E
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Chapter 26: Renal Function
Banasik: Pathophysiology, 6th Edition
MULTIPLE CHOICE
1. The primary selectivity barrier for glomerular filtration is the
a. glomerular basement membrane.
b. endothelial tight junctions.
c. epithelial fenestra.
d. mesangial cells.
ANS: A
The basement membrane is an important selectivity barrier of the glomerulus, preventing
plasma proteins, RBCs, WBCs, and platelets from passing through the glomerulus.
Endothelial tight junctions, epithelial fenestra, and mesangial cells are not the primary
selectivity barriers for glomerular filtration.
2. The glucose transporter in the proximal tubule
a. has no transport maximum.
b. does not depend on sodium reabsorption.
c. is ATP-dependent.
d. may be saturated at high filtered glucose loads.
ANS: D
The glucose transporter in the proximal tubule may be saturated at high filtered glucose loads;
glycosuria then results. A transport maximum does exist beyond which glycosuria occurs. A
NURSINGisTB.C
sodium-dependent protein co-transporter OMThe transporter is not ATP-dependent.
needed.
3. The primary function of the vasa recta is to
a. secrete renin.
b. reabsorb NaCl.
c. reabsorb interstitial fluid.
d. secrete urea.
ANS: C
The vasa recta are capillaries that surround the loops of Henle and collecting ducts and absorb
interstitial fluid. The vasa recta do not secrete rennin or urea, nor do they reabsorb NaCl.
4. Approximately two thirds of the water and electrolytes filtered by the kidney are reabsorbed
by the
a. loop of Henle.
b. collecting tubule.
c. distal tubule.
d. proximal tubule.
ANS: D
Approximately two thirds of the water and electrolytes filtered by the kidney are reabsorbed
by the proximal tubule. Two thirds of the water and electrolytes filtered by the kidney are not
reabsorbed by the loop of Henle, collecting tubule, or distal tubule.
NURSINGTB.COM
, Pathophysiology 6th Edition Banasik Test Bank
5. Which finding on urinalysis should prompt further evaluation?
a. pH 4.5
b. Red blood cells 2 per high-power field
c. Specific gravity of 1.015
d. White blood cells 20 per high-power field
ANS: D
This many WBCs in the urine indicate urinary tract infection; 5 or more is not expected. 4.5 is
a normal pH. Fewer than 5 RBCs is insignificant. 1.015 is a normal specific gravity.
6. Renin is released from
a. the posterior pituitary gland.
b. the liver.
c. juxtaglomerular cells.
d. macula densa cells.
ANS: C
Renin is released from the juxtaglomerular cells. Renin is not released from the posterior
pituitary gland, liver, or macula densa cells.
7. It is true that glucose reabsorption in the tubules
a. occurs passively.
b. occurs in the proximal convoluted tubule.
c. is unlimited.
d. simply does not occur.
ANS: B
Glucose reabsorption occurs N in the proximal convoluted tubule. Glucose reabsorption is not
URSIco-transporter
passive; a sodium-dependent protein NGTB.COMis required. Glucose reabsorption in the
tubules is limited by the number of co-transporters; a threshold exists beyond which
glycosuria will result. Glucose reabsorption occurs in the proximal convoluted tubule with the
assistance of a sodium-dependent protein co-transporter.
8. Serious renal impairment generally does not occur until ____ of the total nephrons have been
damaged.
a. 20%
b. 40%
c. 60%
d. 80%
ANS: D
Serious renal impairment generally does not occur until 75% to 90% of the total nephrons
have been damaged. The other answer options are incorrect.
9. An important sign of glomerular basement membrane dysfunction is
a. proteinuria.
b. hematuria.
c. glycosuria.
d. urinary casts.
ANS: A
NURSINGTB.COM
, Pathophysiology 6th Edition Banasik Test Bank
Proteinuria is an important sign of basement membrane dysfunction. Hematuria can be found
in glomerular disorders but it is not specific to this; it can be caused by many disorders.
Glycosuria is found primarily in diabetes mellitus. Urinary casts do not necessarily mean
basement membrane dysfunction.
10. The main driving force for glomerular filtration is
a. oncotic pressure in the Bowman’s capsule.
b. hydrostatic pressure in glomerular capillaries.
c. permeability of the glomerular membrane.
d. solute content of the blood in the glomerular capillaries.
ANS: B
Hydrostatic pressure within the glomerular capillaries is the main driving force for filtration.
A significant drop in blood pressure such as in shock severely reduces glomerular filtration.
Oncotic pressure in the Bowman’s capsule, permeability of the glomerular membrane, and
solute content of the blood in the glomerular capillaries are not the main driving forces for
filtration.
11. Factors that increase the glomerular filtration rate include
a. fluid volume excess.
b. increased hydrostatic pressure in the Bowman’s capsule.
c. high oncotic pressure in glomerular capillary blood.
d. obstruction in the renal tubules.
ANS: A
Fluid volume excess increases blood volume which increases glomerular filtration. Increased
hydrostatic pressure in the Bowman’s capsule, high oncotic pressure in the glomerular
capillary, and obstruction of N URS
renal INGToppose
tubules B.COfiltration.
M
12. The underlying mechanism which directly results in glycosuria is
a. filtration of glucose from the glomerulus.
b. exceeding the threshold for glucose reabsorption.
c. secretion of glucose into the distal tubule.
d. the mechanism is unknown.
ANS: B
Glucose is normally freely filtered but then reabsorbed from the tubules into the peritubular
capillaries. If the threshold for reabsorption is exceeded as in uncontrolled diabetes mellitus,
glycosuria results. Glucose is freely filtered from the glomerulus; this is not the direct cause of
glycosuria. Glucose is not secreted into the distal tubule. The underlying mechanism that
directly results in glycosuria is exceeding the threshold for glucose reabsorption.
13. Excess potassium is excreted from the body by the renal system primarily via
a. glomerular filtration based on blood level of potassium.
b. reabsorption based on blood level of potassium.
c. secretion based on aldosterone level.
d. an unknown mechanism.
ANS: C
NURSINGTB.COM
, Pathophysiology 6th Edition Banasik Test Bank
Potassium is secreted from the distal tubule and collecting ducts into the tubule lumen under
the influence of aldosterone. Excess potassium is not excreted from the body by the renal
system via glomerular filtration or the renal system based on the blood level of potassium, nor
is it excreted from the body by the renal system based on the aldosterone level.
14. The glomerular filtration rate is most accurately reflected in the
a. blood urea nitrogen level.
b. urinary output.
c. serum osmolality.
d. serum creatinine level.
ANS: D
Serum creatinine is a fairly reliable indicator of glomerular filtration as it is stable. The blood
urea nitrogen level, urinary output, and serum osmolality are affected by factors that make
them less reliable as indicators of glomerular filtration.
15. Serum creatinine may be increased by
a. carbohydrate intake.
b. fat intake.
c. muscle breakdown.
d. fluid intake.
ANS: C
Creatinine is an end product of muscle metabolism; muscle breakdown will increase the
serum creatinine level. Serum creatinine is not affected by carbohydrate, fat, or fluid intake.
Fluid volume deficit can increase the serum creatinine if it leads to acute renal failure.
NURSINGTB.COM
MULTIPLE RESPONSE
1. Hormones that increase sodium reabsorption from the tubular fluid include (Select all that
apply.)
a. aldosterone.
b. atrial natriuretic peptide.
c. antidiuretic hormone.
d. urodilatin.
e. angiotensin II.
ANS: A, E
Aldosterone and angiotensin II result in sodium reabsorption. Atrial natriuretic peptide and
urodilatin decrease sodium reabsorption. Antidiuretic hormone does not affect sodium
reabsorption.
2. The blood urea nitrogen (BUN) level is affected by (Select all that apply.)
a. protein intake.
b. fat intake.
c. fluid intake.
d. catabolism.
e. renal function.
ANS: A, C, D, E
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