Chapter 24 Structure and Function of the Kidney

Chapter 24  Structure and Function of the Kidney

Complete Chapter Questions And Answers
 

Sample Questions

1.
Protein and blood cell leakage into the filtrate that occurs in many forms of glomerular disease is a result of changes in the structure and function of the glomerular:
A)
Renal corpuscle
B)
Bowman capsule
C)
Peritubular network
D)
Basement membrane
Ans:
D

Feedback:

The basement membrane is a meshwork of collagen fibers, with slit pores between the fibers creating size-dependent permeability that (normally) does not allow large molecules, such as protein and blood cells through. The renal corpuscle contains the Bowman capsule and capillaries surrounding it. Peritubular capillary network is a low-pressure reabsorptive system that permits rapid fluid/solute transfer to/from the tubules.

2.
While studying for renal test in pathophysiology class, a student helps a peer by reviewing facts about the cells of the proximal tubule. Which of the following functions should they include in this discussion? Select all that apply.
A)
Aids in reabsorption
B)
Location for high-pressure capillary filtration
C)
Rich in mitochondria
D)
Plays a role in the medullary collecting tubule
E)
Supports active transport processes
Ans:
A, C, E

Feedback:

The cells of the proximal tubule have a fine, villous structure that increases the surface area for reabsorption; they also are rich in mitochondria, which support active transport processes. The epithelial layer thins in segments of the loop of Henle and has few mitochondria, indicating minimal metabolic activity and reabsorptive function.

3.
In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries is beginning to have a decrease in BP and increased pulse rate and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find:
A)
Excess output of blood-tinged urine
B)
Complaints of flank pain rotating around the abdominal muscles
C)
Significant decrease in urine output due to decrease in renal blood flow
D)
An increase in GFR due to relaxation of the afferent arterioles
Ans:
C

Feedback:

During periods of strong sympathetic stimulation, such as shock, constriction of the afferent arteriole causes a marked decrease in renal blood flow and thus glomerular filtration pressure. Consequently, urine output can fall almost to 0. Unless the injury is specific to the kidney, the client will not have blood in urine and urine production will not be excessive. Flank pain is associated with obstruction due to stone formation. The GFR will decrease rather than increase.

4.
When explaining to a CKD client how urea is absorbed, which of the following transport mechanisms will be mentioned?
A)
Primary active transport
B)
Secondary active transport
C)
Passive transport
D)
Active sodium transport
Ans:
C

Feedback:

The mechanisms of transport across the tubular cell membrane are similar to those of other cell membranes in the body and include active and passive transport mechanisms. Water and urea (a by-product of protein metabolism) are passively absorbed along concentration gradients. Sodium (Na+), other electrolytes, as well as urate, glucose, and amino acids, are reabsorbed using primary or secondary active transport mechanisms to move across the tubular membrane. The bulk of energy used by the kidney is for active sodium transport mechanisms that facilitate sodium reabsorption and cotransport of other electrolytes and substances such as glucose and amino acids.