Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 38- Structure and Function of the Kidney
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | A dialysis technician is providing care for a client with chronic renal failure. The technician would recognize which of the following characteristics of healthy kidneys?
Select all that apply. |
|
| A) | The kidneys are contained within the peritoneal cavity. | |
| B) | Blood vessels, nerves, and ureters all connect with the kidney at the hilus. | |
| C) | The medulla of the kidney contains the glomeruli. | |
| D) | Each kidney consists of lobes, with each lobe comprised of nephrons. | |
| E) | Each nephron contains several hundred glomeruli that perform filtration. | |
| Ans: | B, D | |
| Feedback: | ||
| The hilus is the point of nerve and blood input and urine output for each kidney, and each kidney is composed of up to 18 lobes. The kidneys are outside the peritoneal cavity, and glomeruli exist in the outer cortex. Each nephron contains just one glomerulus. | ||
| 2. | A patient in the ICU has been diagnosed with hypovolemic shock. His BP is 88/53, heart rate 122, and respiratory rate 26. Given these vital signs, the nurse should expect the urine output to be | |
| A) | maintained between 30 and 50 mL/hour with no sediment in the bag. | |
| B) | increased to 60+ mL/hour with dilute urine. | |
| C) | decreased below 30 mL/hour with decreased GFR. | |
| D) | the patient’s normal amount with dark, concentrated urine. | |
| Ans: | C | |
| Feedback: | ||
| Under conditions of decreased perfusion or increased sympathetic nervous system stimulation, blood flow is redistributed away from the cortex toward the medulla. This redistribution of blood flow decreased glomerular filtration while maintaining the urine-concentrating ability of the kidneys, a factor that is important during conditions such as shock. The urine output would not increase, nor be normal. | ||
| 3. | At which of the following locations in the nephron would a health care professional first expect blood to be largely free of plasma proteins? | |
| A) | Proximal convoluted tubule | |
| B) | Bowman space | |
| C) | Loop of Henle | |
| D) | Afferent arteriole | |
| Ans: | B | |
| Feedback: | ||
| Active filtration occurs when the whole blood enters via the afferent arteriole in to the glomerular capillaries, and the blood is then filtered into the Bowman space, removing plasma proteins. The filtrate that enters the proximal convoluted tubule and the loop of Henle is already free of plasma proteins. | ||
| 4. | Which of the following statements about mesangial cells within the glomerulus is accurate? Select all that apply. Mesangial cells | |
| A) | cover the entire amount of endothelial cells contained within the capillaries. | |
| B) | have phagocytic properties that remove macromolecular materials. | |
| C) | exhibit vasodilator properties to assist with increase in blood flow in times of stress. | |
| D) | enlarge (hyperplasia) in response to glomerular diseases. | |
| E) | are coiled and drain Bowman capsule. | |
| Ans: | B, D | |
| Feedback: | ||
| Mesangial cells possess phagocytic properties and remove macromolecular materials that enter the intercapillary spaces. Mesangial cells also exhibit contractile properties in response to neurohumoral substances and are thought to contribute to the regulation of blood flow through the glomerulus. Mesangial hyperplasia and increased mesangial matrix occur in a number of glomerular diseases. The nephron tubule, called the proximal convoluted tubule, is coiled and drains the Bowman capsule | ||
| 5. | A nurse educator is orientating new nurses to a renal unit of the hospital. Which of the following teaching points should the nurse include as part of a review of normal glomerular function? | |
| A) | “Nephrons are delicate structures that cannot endure the high pressure that exists in capillary beds elsewhere in the body.” | |
| B) | “Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation.” | |
| C) | “Dilation of the afferent arteriole allows more blood into the nephron and increases the glomerular filtration rate.” | |
| D) | “The glomerulus is located between an arteriole and a venule that work together to regulate blood flow.” | |
| Ans: | B | |
| Feedback: | ||
| Because filtration achieves the removal of nearly all blood proteins, the glomerular filtrate is nearly identical to plasma. Nephrons require high pressure to function, and dilation decreases the glomerular filtration rate. The glomerulus is located between two arterioles. | ||
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