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UT Arlington NURS 5315 - Chapter 38 Exam

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Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 38: Structure and Function of the Renal and Urologic SystemsMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. What is the area of the kidneys that contains the glomeruli and portions of the tubules called?a. Medullab. Cortexc. Pyramidsd. ColumnsANS: BThe cortex contains all the glomeruli and portions of the tubules of the kidneys. The medulla forms the inner part of the kidney and consists of regions called pyramids. The apices of the pyramids project into minor calyces (cup-shaped cavities) that unite to form major calyces. Renal columns are an extension of the cortex and lie between the pyramids and extend to the renal pelvis.PTS: 1 DIF: Cognitive Level: Remembering 2. What is the functional unit of the kidney called?a. Glomerulusb. Nephronc. Collecting ductd. PyramidANS: BThe nephron is the functional unit of the kidney. The glomerulus is a tuft of capillaries that loop into the circular Bowman glomerular capsule (Bowman space), like fingers pushed into bread dough and is the site of filtration. Final adjustments in urine composition are made by the distal tubule and collecting duct according to body needs. The apices of the pyramids project into minor calyces (cup-shaped cavities) that unite to form major calyces.PTS: 1 DIF: Cognitive Level: Remembering 3. What is the only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area called?a. Proximal convoluted tubulesb. Distal tubulesc. Ascending loop of Henled. Descending loop of HenleANS: AThe only surface inside the nephron where the cells are covered with microvilli (a brush border) is called the proximal convoluted tubules. This proximal convoluted tubular lumen consists of one layer of cuboidal cells with a surface layer of microvilli that increases the reabsorptive surface area.PTS: 1 DIF: Cognitive Level: Remembering 4. What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?a. Macula densab. Visceral epitheliumc. Juxtaglomerular apparatus (JGA)d. Filtration slitsANS: CControl of renal blood flow, glomerular filtration, and renin secretion occurs at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The macula densa prevent large fluctuations in body water and salt. The visceral epithelium becomes the parietal epithelium. The filtration slits are intercellular clefts that modulate filtration.PTS: 1 DIF: Cognitive Level: Remembering 5. Innervation of the bladder and internal urethral sphincter is supplied by which nerves?a. Peripheral nervesb. Parasympathetic fibersc. Sympathetic nervous systemd. Tenth thoracic nerve rootsANS: BThe innervation of the bladder and internal urethral sphincter is supplied by parasympathetic fibers of the autonomic nervous system. The process is not dependent on peripheral nerves, the sympathetic nervous system, or the tenth thoracic nerve roots.PTS: 1 DIF: Cognitive Level: Remembering 6. How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?a. 75 to 100 mLb. 100 to 150 mLc. 250 to 300 mLd. 350 to 400 mLANS: CWhen the bladder accumulates 250 to 300 mL of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the micturition reflex).PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 7. What is the trigone?a. A smooth muscle that comprises the orifice of the ureterb. The inner mucosal lining of the kidneysc. A smooth triangular area between the openings of the two ureters and the urethrad. One of the three divisions of the loop of HenleANS: CThe trigone is a smooth triangular area lying between the openings of the two ureters and the urethra.PTS: 1 DIF: Cognitive Level: Remembering 8. The glomerular filtration rate is directly related to which factor?a. Perfusion pressure in the glomerular capillariesb. Diffusion rate in the renal cortexc. Diffusion rate in the renal medullad. Glomerular active transportANS: AThe filtration of the plasma per unit of time is known as the glomerular filtration rate (GFR), which is directly related to the perfusion pressure in the glomerular capillaries. It is not related to diffusion rates in the renal cortex or medulla or on glomerular active transport.PTS: 1 DIF: Cognitive Level: Remembering 9. On average, what percent of cardiac output do the kidneys receive?a. 10% to 20%b. 15% to 20%c. 20% to 25%d. 30% to 35%ANS: CThe kidneys are highly vascular organs and usually receive 1000 to 1200 mL of blood per minute, or approximately 20% to 25% of the cardiac output.PTS: 1 DIF: Cognitive Level: Remembering 10. What are blood vessels of the kidneys innervated by?a. Vagus nerveb. Sympathetic nervous systemc. Somatic nervous systemd. Parasympathetic nervous systemANS: BThe blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. These vessels are not innervated by the vagus nerve, somatic nervous system, or parasympathetic nervous system.PTS: 1 DIF: Cognitive Level: Remembering 11. When renin is released, it is capable of which action?a. Inactivation of autoregulationb. Direct activation of angiotensin IIc. Direct release of antidiuretic hormone (ADH)d. Formation of angiotensin IANS: DWhen renin is released, it cleaves an α-globulin (angiotensinogen produced by liver hepatocytes) in the plasma to form angiotensin I.PTS: 1 DIF: Cognitive Level: Remembering 12. A student asks the professor to explain what effect natriuretic peptides have during heart failure when the heart dilates. Which response by the professor is best?a. Stimulates antidiuretic hormonesb. Inhibits antidiuretic hormonesc. Stimulates renin and aldosteroned. Inhibits renin and aldosteroneANS: DNatriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone,


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