Urinalysis and Body Fluids 6th Edition By by Susan King Strasinger

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Urinalysis and Body Fluids 6th Edition By by Susan King Strasinger

Chapter 3: Renal Function

 

 

 

Multiple Choice

 

 

 

  1. Normal functions of the kidney include all of the following except:
  2. Regulating body hydration
  3. Elimination of nitrogenous wastes
  4. Regulating electrolyte balance
  5. Elimination of serum proteins

 

ANS: D

DIF: Level 1

OBJ: 3

TOP: Renal physiology

 

 

 

  1. The approximate number of nephrons contained in each kidney is:
  2. 100,000
  3. 500,000
  4. 1,000,000
  5. 5,000,000

 

ANS: C

DIF: Level 1

OBJ: 1

TOP: Renal physiology

 

 

 

  1. The order of blood flow through the nephron is:
  2. Afferent arteriole, peritubular capillaries, vasa recta, efferent arteriole
  3. Efferent arteriole, peritubular capillaries, vasa recta, afferent arteriole
  4. Peritubular capillaries, vasa recta, afferent arteriole, efferent arteriole
  5. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta

 

ANS: D

DIF: Level 2

OBJ: 2

TOP: Renal physiology

 

 

 

  1. The total renal blood flow is approximately:
  2. 40 mL/min
  3. 120 mL/min
  4. 600 mL/min
  5. 1200 mL/min

 

ANS: D

DIF: Level 1

OBJ: 2

TOP: Renal physiology

 

 

 

  1. The total renal plasma flow is approximately:
  2. 60 mL/min
  3. 120 mL/min
  4. 600 mL/min
  5. 1200 mL/min

 

ANS: C

DIF: Level 2

OBJ: 2

TOP: Renal physiology

 

 

 

  1. The glomerular filtrate is described as a:
  2. Plasma filtrate containing glucose and protein
  3. Protein-free ultrafiltrate of plasma
  4. Selective filtrate of plasma containing urea
  5. Plasma filtrate without glucose and protein

 

ANS: B

DIF: Level 1

OBJ: 3

TOP: Renal physiology

 

 

 

  1. Increased production of aldosterone causes:
  2. Decreased plasma sodium levels
  3. Decreased glomerular blood pressure
  4. Increased plasma sodium levels
  5. Increased urine volume

 

ANS: C

DIF: Level 2

OBJ: 4

TOP: Renal physiology

 

 

 

  1. The primary chemical affected by the renin-angiotensin-aldosterone system is:
  2. Glucose
  3. Potassium
  4. Chloride
  5. Sodium

 

ANS: D

DIF: Level 1

OBJ: 4

TOP: Renal physiology

 

 

 

  1. The specific gravity of the glomerular ultrafiltrate is:
  2. 1.002
  3. 1.010
  4. 1.020
  5. 1.030

 

ANS: B

DIF: Level 1

OBJ: 3

TOP: Renal physiology

 

 

 

  1. All of the following substances are reabsorbed from the glomerular filtrate by active transport except:
  2. Glucose
  3. Water
  4. Sodium
  5. Amino acids

 

ANS: B

DIF: Level 1

OBJ: 3

TOP: Renal physiology

 

 

 

  1. For active transport to occur a substance:
  2. Must combine with a carrier protein to create electrochemical energy
  3. Must be filtered through the proximal convoluted tubule
  4. Must be in higher concentration in the filtrate than in the blood
  5. Must be in higher concentration in the blood than in the filtrate

 

ANS: A

DIF: Level 2

OBJ: 5

TOP: Reabsorption mechanisms

 

 

 

  1. Water is passively reabsorbed in all parts of the nephron except the:
  2. Proximal convoluted tubule
  3. Descending loop of Henle
  4. Ascending loop of Henle
  5. Collecting duct

 

ANS: C

DIF: Level 1

OBJ: 5

TOP: Reabsorption mechanisms

 

 

 

  1. Most of the sodium filtered by the glomerulus is reabsorbed in the:
  2. Proximal convoluted tubule
  3. Descending loop of Henle
  4. Distal convoluted tubule
  5. Collecting duct

 

ANS: A

DIF: Level 1

OBJ: 5

TOP: Reabsorption mechanisms

 

 

 

  1. The enzyme renin is produced by the kidney:
  2. To activate antidiuretic hormone
  3. In response to low plasma sodium levels
  4. When too much sodium is being reabsorbed
  5. To regulate secretion of hydrogen ions

 

ANS: B

DIF: Level 2

OBJ: 7

TOP: Renin-angiotensin-aldosterone system

 

 

 

  1. Concentration of the tubular filtrate by the countercurrent mechanism is dependent on all of the following except:
  2. High salt concentration in the medulla
  3. Water-impermeable walls of the ascending loop of Henle
  4. Reabsorption of sodium and chloride from the ascending loop of Henle
  5. Active transport reabsorption of sodium and glucose in the proximal convoluted tubule

 

ANS: D

DIF: Level 2

OBJ: 7

TOP: Tubular concentration

 

 

 

  1. The osmotic gradient of the medulla:
  2. Controls the permeability of the walls of the collecting duct
  3. Affects passive reabsorption of water in the descending loop of Henle
  4. Stimulates sodium reabsorption in the proximal convoluted tubule
  5. Controls ammonia production by the distal convoluted tubule

 

ANS: C

DIF: Level 2

OBJ: 7

TOP: Tubular concentration

 

 

 

  1. Aldosterone regulates sodium reabsorption in the:
  2. Proximal convoluted tubule
  3. Descending loop of Henle
  4. Ascending loop of Henle
  5. Distal convoluted tubule

 

ANS: D

DIF: Level 1

OBJ: 4

TOP: Renin-angiotensin-aldosterone system

 

 

 

  1. Decreased production of aldosterone:
  2. Produces a low urine volume
  3. Produces a high urine volume
  4. Increases ammonia excretion
  5. Affects active transport of sodium

 

ANS: B

DIF: Level 2

OBJ: 4

TOP: Collecting duct concentration

 

 

 

  1. Production of antidiuretic hormone is controlled by the:
  2. Osmotic gradient of the medulla
  3. Renin-angiotensin-aldosterone system
  4. State of body hydration
  5. Cells of the renal cortex

 

ANS: C

DIF: Level 1

OBJ: 6

TOP: Collecting duct concentration

 

 

 

  1. Substances removed from the blood by tubular secretion include primarily:
  2. Protein, hydrogen, and ammonia
  3. Protein, hydrogen, and potassium
  4. Amino acids, urea, and glucose
  5. Protein-bound substances, hydrogen, and potassium

 

ANS: D

DIF: Level 1

OBJ: 8

TOP: Renal physiology

 

 

 

  1. Kidneys with impaired production of ammonia will consistently produce urine with a:
  2. High pH
  3. High volume
  4. Low pH
  5. Low volume

 

ANS: A

DIF: Level 2

OBJ: 2

TOP: Acid-base balance

 

 

 

  1. To enhance the excretion of hydrogen ions, ammonia is produced by the cells of the:
  2. Proximal convoluted tubule
  3. Loop of Henle
  4. Distal convoluted tubule
  5. Collecting duct

 

ANS: C

DIF: Level 1

OBJ: 7

TOP: Acid-base balance

 

 

 

  1. To maintain the buffering capacity of the blood, hydrogen ions combine with:
  2. Filtered phosphate ions
  3. Filtered bicarbonate ions
  4. Secreted ammonia
  5. Secreted ammonium ions

 

ANS: B

DIF: Level 1

OBJ: 7

TOP: Acid-base balance

 

 

 

  1. Clearance tests used to determine the glomerular filtration rate must measure substances that are:
  2. Not filtered by the glomerulus
  3. Completely reabsorbed by the proximal convoluted tubule
  4. Secreted in the distal convoluted tubule
  5. Neither reabsorbed or secreted by the tubules

 

ANS: D

DIF: Level 1

OBJ: 9

TOP: Glomerular filtration tests

 

 

 

  1. Results for glomerular filtration tests are reported in:
  2. Milliliters per minute
  3. Milliliters per 24 hours
  4. Milligrams per deciliter
  5. Milliequivalents per liter

 

ANS: A

DIF: Level 1

OBJ: 11

TOP: Glomerular filtration tests

 

 

 

  1. All of the following are endogenous clearance test substances except:
  2. Urea
  3. Creatinine
  4. Inulin
  5. Beta2 microglobulin

 

ANS: C

DIF: Level 1

OBJ: 11

TOP: Glomerular filtration tests

 

 

 

  1. Performing a clearance test using radionucleotides:
  2. Requires the patient to abstain from all food
  3. Roes not require an infusion
  4. Provides visualization of the filtration
  5. Requires patient hospitalization

 

ANS: C

DIF: Level 1

OBJ: 11

TOP: Clearance tests

 

 

 

  1. If a substance is completely filtered by the glomerulus and then completely reabsorbed by the tubules, the clearance of that substance will be:
  2. Falsely decreased
  3. Falsely increased
  4. Normal
  5. Zero

 

ANS: D

DIF: Level 2

OBJ 11

TOP: Clearance tests

 

 

 

  1. The most routinely used laboratory method for measuring the glomerular filtration rate is the:
  2. Inulin clearance
  3. Estimated glomerular filtration rate
  4. Creatinine clearance
  5. Beta2 microglobulin clearance

 

ANS: B

DIF: Level 1

OBJ: 9

TOP: Glomerular filtration tests

 

 

 

  1. Calculate the creatinine clearance for a patient of average size from the following data:
    Urine volume: 720 mL for 12 hours
    Urine creatinine: 120 mg/dL
    Serum creatinine: 1.5 mg/dL
  2. 60 mL/min
  3. 80 mL/min
  4. 100 mL/min
  5. 120 mL/min

 

ANS: B

DIF: Level 2

OBJ: 10

TOP: Creatinine clearance

 

 

 

  1. Performing an estimated glomerular filtration rate is helpful for determining:
  2. Renal concentrating ability
  3. The feasibility of administering medications
  4. Early renal disease
  5. Renal blood flow

 

ANS: B

DIF: Level 1

OBJ: 9

TOP: Glomerular filtration rate

 

 

 

  1. John White donates one of his two healthy kidneys to his twin brother. His glomerular filtration rate can be expected to:
  2. Decrease by 50%
  3. Increase by 50%
  4. Decrease gradually over 1 year
  5. Remain within a normal range

 

ANS: D

DIF: Level 1

OBJ: 11

TOP: Glomerular filtration tests

 

 

 

  1. The renal function that is most frequently the first affected by early renal disease is:
  2. Renal blood flow
  3. Glomerular filtration
  4. Tubular reabsorption
  5. Tubular secretion

 

ANS: C

DIF: Level 1

OBJ: 10

TOP: Tubular reabsorption tests

 

 

 

  1. For accurate evaluation of renal tubular concentrating ability, patient preparation should include:
  2. Fasting
  3. Fluid deprivation
  4. Increased hydration
  5. Abstaining from all medications

 

ANS: B

DIF: Level 1

OBJ: 11

TOP: Tubular reabsorption tests

 

 

 

 

  1. Measurement of urine osmolality is a more accurate measure of renal concentrating ability than specific gravity because:
  2. Osmolality is measured by instrumentation
  3. Specific gravity is not influenced by urea and glucose molecules
  4. Osmolality is influenced equally by small and large molecules
  5. Specific gravity measures only urea and glucose molecules

 

ANS: C

DIF: Level 1

OBJ: 13

TOP: Osmolality

 

 

 

  1. In the measurement of osmolality, a solute that is dissolved in solvent will:
  2. Decrease the boiling point
  3. Decrease the freezing point
  4. Raise the vapor pressure
  5. Raise the dew point

 

ANS: B

DIF: Level 1

OBJ: 14

TOP: Osmolality

 

 

 

  1. Clinical osmometers use NaCl as a reference solution because:
  2. 1 g molecular weight of NaCl will lower the freezing point 1.86oC
  3. NaCl is readily frozen and vaporized
  4. NaCl is partially ionized similar to the composition of urine
  5. 1 g equivalent weight of NaCl will lower the freezing point 1.86oC

 

ANS: C

DIF: Level 2

OBJ: 14

TOP: Freezing-point osmometers

 

 

 

  1. Substances that can interfere with serum osmolality readings include all of the following except:
  2. Lipids
  3. Lactic acid
  4. Ethanol
  5. Sodium

 

ANS: D

DIF: Level 1

OBJ: 13

TOP: Freezing-point osmometers

 

 

 

  1. The results of a serum osmolality performed by both freezing-point and vapor-pressure osmometry do not agree. A possible cause of this discrepancy would be:
  2. Increased ethanol
  3. Increased lipids
  4. Decreased lactic acid
  5. Decreased potassium

 

ANS: A

DIF: Level 2

OBJ: 14

TOP: Technical factors

 

 

 

  1. A technical error that could cause a discrepancy between freezing-point and vapor-pressure osmometry readings is:
  2. Failure to refrigerate the sample
  3. Evaporation of the sample
  4. Failure to separate cells and serum
  5. Fluid deprivation of the patient

 

ANS: C

DIF: Level 3

OBJ: 14

TOP: Technical factors

 

 

 

  1. The normal serum osmolality is:
  2. 50 to 100 mOsm
  3. 275 to 300 mOsm
  4. 400 to 500 mOsm
  5. Three times urine osmolality

 

ANS: B

DIF: Level 1

OBJ: 13

TOP: Osmolality clinical significance

 

 

 

  1. The extent to which the kidney concentrates the glomerular filtrate can be determined by measuring:
  2. Serum creatinine
  3. Urine creatinine
  4. Serum osmolality
  5. Urine and serum osmolality

 

ANS: D

DIF: Level 1

OBJ: 12

TOP: Osmolality clinical significance

 

 

 

  1. Following fluid deprivation, a patient has a serum osmolality of 276 mOsm and a urine osmolality of 1000 mOsm. This patient:
  2. Has normal concentration ability
  3. May have defective antidiuretic hormone (ADH) production
  4. May have insufficient tubular ADH response
  5. Has a high serum lipid concentration

 

ANS: A

DIF: Level 2

OBJ: 13

TOP: Free water clearance

 

 

 

  1. Which of the following tests provides information similar to specific gravity?
  2. Total colloid content
  3. Protein concentration
  4. Absorbance
  5. Osmolality

 

ANS: D

DIF: Level 1

OBJ: 13

TOP: Free water clearance

 

 

 

  1. The serum osmolality of a patient with hyponatremia:
  2. Will be similar to the urine osmolality
  3. Should be greater than 300 mOsm
  4. Should be lower than 275 mOsm
  5. Will be falsely increased

 

ANS: C

DIF: Level 2

OBJ: 13

TOP: Tubular secretion and renal blood flow

 

 

 

  1. Following injection of ADH, a patient has a serum osmolality of 290 mOsm and a urine osmolality of 450 mOsm. The patient:
  2. Continued to observe water deprivation
  3. Lacks tubular response to ADH
  4. May have ingested excess alcohol
  5. Should be evaluated with a creatinine clearance

 

ANS: B

DIF: Level 2

OBJ: 12

TOP: Tubular secretion and renal blood flow

 

 

 

  1. To determine the amount of water that must be cleared to produce urine with the same osmolality as the ultrafiltrate, one should perform:
  2. A free water clearance
  3. A Mosenthal test
  4. An osmolar clearance
  5. A urine-to-plasma ratio

 

ANS: C

DIF: Level 1

OBJ: 15

TOP: Tubular secretion and renal blood flow

 

 

 

  1. Which of the following tests should be used to determine the ability of the kidneys to respond to filtrate osmolality?
  2. Free water clearance
  3. Fishberg test
  4. Urine-to-plasma osmolality
  5. p-aminohippuric acid (PAH) test

 

ANS: A

DIF: Level 1

OBJ: 15

TOP: Free water clearance

 

 

 

  1. A free water clearance of -2.5 could be indicative of:
  2. Lack of renal concentration and dilution
  3. Decreased ADH production
  4. Hyponatremia
  5. Dehydration

 

ANS: D

DIF: Level 2

OBJ: 15

TOP: Free water clearance

 

 

 

  1. Given the following laboratory data, calculate the free water clearance: Volume = 2800 mL/24 hour; Urine Osmo = 1200 mOsm, Plasma Osmo = 400 mOsm
  2. +2 mL/min
  3. +4 mL/min
  4. -2 mL/min
  5. -4 mL/min

 

ANS: D

DIF: Level 3

OBJ: 15

TOP: Free water clearance

 

 

 

  1. A patient with insufficient production of ADH would have which of the following results?
  2. Urine volume—2 mL/min; osmolar clearance—2 mL/min
  3. Urine volume—5 mL/min; osmolar clearance—2 mL/min
  4. Urine volume—3 mL/min; osmolar clearance—4 mL/min
  5. Urine volume—1 mL/min; osmolar clearance—3 mL/min

 

ANS: B

DIF: Level 2

OBJ: 15

TOP: Free water clearance

 

 

 

  1. The PAH test is used to measure:
  2. Glomerular filtration
  3. Tubular reabsorption
  4. Albumin excretion
  5. Renal blood flow

 

ANS: D

DIF: Level 2

OBJ: 16

TOP: PAH test

 

 

 

  1. To provide an accurate measure of renal blood flow, a test substance should be:
  2. Filtered by the glomerulus
  3. Reabsorbed by the tubules
  4. Secreted by the distal convoluted tubule
  5. Cleared on each contact with functional renal tissues

 

ANS: D

DIF: Level 2

OBJ: 16

TOP: Renal blood flow tests

 

 

 

  1. PAH is secreted by the:
  2. Proximal convoluted tubule
  3. Descending loop of Henle
  4. Distal convoluted tubule
  5. Collecting duct

 

ANS: A

DIF: Level 1

OBJ: 16

TOP: PAH test

 

 

 

  1. A PAH test result showing a renal plasma flow of 400 mL/min:
  2. Is a normal result
  3. May be falsely decreased from impaired tubular secretion
  4. Should be corrected to correspond to the patient’s body size
  5. Indicates glomerular filtration of PAH

 

ANS: B

DIF: Level 3

OBJ: 16

TOP: PAH test

 

 

 

  1. Which of the following is not associated with the elimination of hydrogen ions?
  2. Protein
  3. Phosphate
  4. Ammonia
  5. Bicarbonate

 

ANS: A

DIF: Level 1

OBJ: 1

TOP: Renal physiology

 

 

 

  1. Renal tubular acidosis can be caused by the:
  2. Production of excessively acidic urine due to increased filtration of hydrogen ions
  3. Production of excessively acidic urine due to increased secretion of hydrogen ions
  4. Inability to produce an acid urine due to impaired production of ammonia
  5. Inability to produce an acid urine due to increased production of ammonia

 

ANS: C

DIF: Level 2

OBJ: 1

TOP: Acid–base balance

 

 

 

  1. Tests to measure the tubular secretion of hydrogen ions include all of the following except:
  2. pH
  3. Titratable acidity
  4. Urinary bicarbonate
  5. Urinary ammonia

 

ANS: C

DIF: Level 1

OBJ: 17

TOP: Acid–base balance

 

 

 

  1. Following administration of oral ammonium chloride, a patient with renal tubular acidosis will produce:
  2. Highly concentrated urine
  3. Urine with a low pH
  4. Urine with a high pH
  5. Very dilute urine

 

ANS: C

DIF: Level 2

OBJ: 17

TOP: Acid–base balance

 

 

 

  1. Total acidity of a urine specimen is a combination of:
  2. Titratable acidity and pH
  3. Titratable acidity and ammonium ion
  4. pH and total acidity
  5. Total acidity and ammonium ion

 

ANS: B

DIF: Level 2

OBJ: 17

TOP: Acid–base balance

 

 

 

  1. Which of the following clearance substances does not require urine collection?
  2. Creatinine
  3. Cystatin C
  4. Inulin
  5. 5-HIAA

 

ANS: B

DIF: Level 2

OBJ: 11

TOP: Cystatin C

 

 

 

  1. A 12-hour urine specimen with a volume of 360 mL is collected for a creatinine clearance. What is the volume (V) used to calculate the clearance?
  2. 0.5 mL/min
  3. 1.0 mL/min
  4. 1.5 mL/min
  5. 2.0 mL/min

 

ANS: A

DIF: Level 2

OBJ: 15

TOP: Creatinine clearance

 

 

  1. Using the following values, calculate the creatinine clearance: urine volume—1200 mL/12h, urine creatinine—60 mg/dL, and serum creatinine—0.8 mg/dL
  2. 60 mL/min
  3. 75mL/min
  4. 112 mL/min
  5. 128 mL/min

 

ANS: D

DIF: Level 2

OBJ: 15

TOP: Creatinine clearance

 

 

 

  1. Can a patient with the following results be given a nephrotoxic medication: urine volume—720 mL/24 h, urine creatinine—100 mg/dL, and serum creatinine—2.5 mg/dL?
  2. No, clearance is 20 mL/min
  3. No, clearance is 40 mL/min
  4. Yes, clearance is 80 mL/min
  5. Yes, clearance is 120 mL/min

 

ANS: A

DIF: Level 3

OBJ: 15

TOP: Creatinine clearance

 

 

 

  1. Given the following information, calculate the osmolar clearance: urine volume—720 mL in 24 hours, urine osmolality—700 mOsm, and plasma osmolality—300 mOsm
  2. 1.0 mL/min
  3. 1.2 mL/min
  4. 1.8 mL/min
  5. 2.0 mL/min

 

ANS: B

DIF: Level 2

OBJ: 15

TOP: Osmolality

 

 

 

  1. Given the following information, calculate the patient’s free water clearance: urine volume—360 mL in 12 hours, urine osmolality—1400 mOsm, and plasma osmolality—275 mOsm
  2. +0.5 mL/min
  3. -1.5 mL/min
  4. -1.0 mL/min
  5. -2.0 mL/min

 

ANS: D

DIF: Level 2

OBJ: 15

TOP: Osmolality

 

 

 

  1. Following a 2-hour infusion of p-aminohippuric acid (PAH), during which 200 mL of urine is collected, the urine PAH is 260 mg/dL, and the patient’s plasma PAH is 0.8 mg/dL. Calculate the renal plasma volume.
  2. 525 mL/min
  3. 553 mL/min
  4. 614 mL/min
  5. 765 mL/min

 

ANS: B

DIF: Level 2

OBJ: 16

TOP: PAH test

 

 

 

  1. What is the physical property measured by a vapor-pressure osmometer?
  2. Vapor temperature
  3. Dew point temperature
  4. Osmotic pressure
  5. Oncotic pressure

 

ANS: B

DIF: Level 1

OBJ: 14

TOP: Osmolality

 

 

 

NARRBEGIN: 03-nar-01

A patient showing symptoms of impaired renal function has a battery of tests performed. Results are:

Serum creatinine: 2.0 mg/dL

Urine creatinine: 150 mg/dL

Serum osmolality: 270 mOsm

Urine osmolality: 100 mOsm

24-hour urine volume: 2000 mL

NARREND

 

 

  1. Using the information provided, calculate the creatinine clearance.
  2. 50 mL/min
  3. 85 mL/min
  4. 105 mL/min
  5. 110 mL/min

 

ANS: C

NAR: 03-nar-01

DIF: Level 2

OBJ: 10

TOP: Renal function case study

 

 

 

  1. Using the information provided, calculate the osmolar clearance.
  2. 0.5
  3. 1.0
  4. 2.0
  5. 2.5

 

ANS: A

NAR: 03-nar-01

DIF: Level 2

OBJ: 15

TOP: Renal function case study

 

 

 

  1. Based on the information provided, calculate the free water clearance.
  2. -0.5
  3. -1.0
  4. +0.6
  5. +0.9

 

ANS: D

NAR: 03-nar-01

DIF: Level 2

OBJ: 15

TOP: Renal function case study

 

 

 

  1. Based on the information provided, which renal function is abnormal in this patient?
  2. Glomerular filtration
  3. Tubular reabsorption
  4. Tubular secretion
  5. Renal blood flow

 

ANS: B

NAR: 03-nar-01

DIF: Level 3

OBJ: 15

TOP: Renal function case study

 

 

 

  1. Based on the information provided, can this patient be safely given a nephrotoxic antibiotic?
  2. Yes
  3. No

 

ANS: A

NAR: 03-nar-01

DIF: Level 3

OBJ: 15

TOP: Renal function case study

 

 

 

  1. Based on the information provided, would increasing the patient’s intake of fluids alleviate this problem?
  2. Yes
  3. No

 

ANS: B

NAR: 03-nar-01

DIF: Level 3

OBJ: 15

TOP: Renal function case study

 

 

 

NARRBEGIN: 03-nar-02

A laboratory supervisor is authorized to purchase a new osmometer. The supervisor must decide between a freezing-point and a vapor-pressure model.

NARREND

 

 

 

  1. Based on the information provided, if this is a pediatric hospital, which model is better?
  2. Freezing-point
  3. Vapor-pressure

 

ANS: B

NAR: 03-nar-02

DIF: Level 3

OBJ: 14

TOP: Osmolality technical factors case study

 

 

 

  1. Using the information provided, which model is more likely to be affected by technical errors?
  2. Freezing-point
  3. Vapor-pressure

 

ANS: B

NAR: 03-nar-02

DIF: Level 3

OBJ: 14

TOP: Osmolality technical factors case study

 

 

 

  1. Using the information provided, which model is affected by lipemic serum but not elevated ethanol levels?
  2. Freezing-point
  3. Vapor-pressure

 

ANS: A

NAR: 03-nar-02

DIF: Level 3

OBJ: 14

TOP: Osmolality technical factors case study

 

 

 

  1. Using the information provided, what substance is used as a reference standard in both models?
  2. KCl
  3. Distilled water
  4. NaCl
  5. Deionized water

 

ANS: C

NAR: 03-nar-02

DIF: Level 2

OBJ: 14

TOP: Osmolality technical factors case study

 

 

 

NARRBEGIN: 03-nar-03

A physician is treating a patient exhibiting symptoms of impaired renal function following a massive hemorrhage. The physician orders a serum sodium and a PAH clearance test. The patient has a serum PAH of 1.0 mg/dL, urine PAH of 200 mg/dL, and a urine volume of 240 mL in 2 hours. The serum sodium is decreased.

NARREND

 

 

 

  1. Using the information provided, based on the tests ordered, what renal function is the physician’s primary concern?
  2. Glomerular filtration
  3. Tubular reabsorption
  4. Tubular secretion
  5. Renal blood flow

 

ANS: D

NAR: 03-nar-03

DIF: Level 3

OBJ: 16

TOP: Renal function case study

 

 

 

  1. Calculate the patient’s renal blood flow using the information provided.
  2. 100 mL/min
  3. 200 mL/min
  4. 300 mL/min
  5. 400 mL/min

 

ANS: D

NAR: 03-nar-03

DIF: Level 2

OBJ: 16

TOP: Renal function case study

 

 

 

  1. Based on the information provided, would it be better for this patient to have an increased or decreased serum renin level?
  2. Increased
  3. Decreased

 

ANS: A

NAR: 03-nar-03

DIF: Level 2

OBJ: 16

TOP: Renal function case study

 

 

 

True/False

 

 

 

  1. The afferent and efferent arterioles have the ability to vary in size.

 

ANS: True

DIF: Level 1

OBJ: 1

TOP: Renal physiology

 

 

 

  1. Blood pressure within the glomerulus varies directly with systemic blood pressure.

 

ANS: False

DIF: Level 2

OBJ: 2

TOP: Renal physiology

 

 

 

  1. A decrease in plasma sodium produces an increase in blood volume.

 

ANS: False

DIF: Level 2

OBJ: 2

TOP: Renal physiology

 

 

 

  1. The filtrate leaving the ascending loop of Henle is highly concentrated.

 

ANS: False

DIF: Level 2

OBJ: 2

TOP: Renal physiology

 

 

 

  1. A substance that is not filtered by the glomerulus will not be found in the urine.

 

ANS: False

DIF: Level 1

OBJ: 2

TOP: Renal physiology

 

 

 

  1. Hydrogen ions are filtered by the glomerulus and reabsorbed and secreted by the renal tubules.

 

ANS: True

DIF: Level 1

OBJ: 2

TOP: Renal physiology

 

 

 

  1. An increase in the plasma level of beta2 microglobulin correlates with decreased glomerular filtration.

 

ANS: True

DIF: Level 2

OBJ: 3

TOP: Glomerular filtration tests

 

 

 

  1. To calculate a creatinine clearance using the MDSD formula, the patient must collect at least a 2-hour urine specimen.

 

ANS: False

DIF: Level 2

OBJ: 9

TOP: Creatinine clearance

 

 

 

  1. The nephrons with the longest loops of Henle are the cortical nephrons.

 

ANS: False

DIF: Level 2

OBJ: 2

TOP: Renal anatomy

 

 

 

Chapter 15: Vaginal Secretions

 

 

 

Multiple Choice

 

 

 

  1. Which of the following is the most likely reason a physician would collect vaginal fluid for analysis?
  2. Preeclampsia
  3. Vaginitis
  4. Pregnancy testing
  5. As part of a police rape kit for sexual assault

 

ANS: B

DIF: Level 1

OBJ: 1

TOP: Physiology

 

 

 

  1. Which of the following vaginitis conditions is of a noninfectious origin?
  2. Chemical irritation
  3. Bacterial vaginitis
  4. Trichomoniasis
  5. Candidiasis

 

ANS: A

DIF: Level 1

OBJ: 1

TOP: Physiology

 

 

 

  1. A vaginal secretion collection can be performed to help for all of the following except:
  2. Determine causative agent
  3. Avoid reinfection
  4. Prevent pregnancy
  5. Provide a basis for treatment

 

ANS: C

DIF: Level 2

OBJ: 1

TOP: Physiology

 

 

 

  1. Vaginal secretion collection kits are specific for which of the following?
  2. Temperature in which they must be used
  3. Pricing for the medical practice
  4. For the organism sought
  5. For left- or right-handed medical personnel

 

ANS: C

DIF: Level 1

OBJ: 2

TOP: Specimen collection

 

 

 

  1. Which of the following specimen handling combinations is incorrect?
  2. Trichomonas: room temperature
  3. N. gonorrhoeae: room temperature
  4. Herpes simplex virus (HSV): room temperature
  5. C. trachomatis: refrigerated

 

ANS: C

DIF: Level 1

OBJ: 2

TOP: Specimen collection

 

 

 

  1. A vaginal fluid collection kit is dropped off in the laboratory for analysis and the technologist notices condensation inside the biohazard bag. Which of the following tests cannot be performed?
  2. Trichomonas motility testing
  3. HSV testing
  4. C. trachomatis testing
  5. Atropic vaginitis

 

ANS: A

DIF: Level 2

OBJ: 2

TOP: Specimen collection

 

 

 

  1. You receive a call from a physician’s practice asking about “extra swabs” for a vaginal secretions collection for Neisseria possible infection. Which of the following swabs cannot be used and why?
  2. Sterile polyester tipped swabs because they are toxic to Neisseria
  3. Sterile polyester tipped swabs because they inactivate Neisseria
  4. Sterile wood shaft swabs with cotton because they are toxic to Neisseria
  5. Sterile wood shaft swabs with cotton because they inactivate Neisseria

 

ANS: C

DIF: Level 2

OBJ: 3

TOP: Specimen collection

 

 

 

  1. Which of the following secretion combinations are considered to be normal?
  2. White, curd-like
  3. White, flocculent discharge
  4. Yellow-green, frothy
  5. Yellow, opaque

 

ANS: B

DIF: Level 1

OBJ: 3

TOP: Specimen collection

 

 

 

  1. A vaginal fluid was collected from a 25-year-old female that showed the following results: appearance is pink with flocculent discharge, pH is 3.9, whiff test is negative, many Gram-positive rods, clue cells are absent. What is your interpretation of these results?
  2. Patient has a possible bacterial infection
  3. Patient has a possible yeast infection
  4. Patient is normal and is menstruating
  5. Patient has a possible Trichomonas infection

 

ANS: C

DIF: Level 2

OBJ: 3

TOP: Specimen collection

 

 

 

  1. When testing for vaginal pH, the health-care provider collecting the sample should:
  2. Place the specimen on the pH paper before placing swab into the saline solution
  3. Place the specimen on the pH paper after mixing with potassium hydroxide (KOH)
  4. Place the pH paper on the swab before collecting from the patient
  5. Place the pH paper into the swab collection tube

 

ANS: A

DIF: Level 1

OBJ: 4

TOP: pH

 

 

 

  1. A vaginal pH value of 6.0 could indicate which of the following conditions?
  2. Normal condition
  3. Bacterial infection
  4. Yeast infection
  5. Increased estrogen production

 

ANS: B

DIF: Level 1

OBJ: 4

TOP: pH

 

 

  1. Which of the following conditions is not likely if a vaginal pH value is greater than 4.5?
  2. Vulvovaginal candidiasis
  3. Trichomoniasis
  4. Desquamative inflammatory vaginitis
  5. Bacterial vaginosis

 

ANS: A

DIF: Level 2

OBJ: 4

TOP: pH

 

 

 

  1. Based on the following description, identify the cell: a large irregular shaped cell that ranges from 25 to 70 microns in diameter with a prominent central nucleus that is 8–10 microns in size, a cytoplasm that contains no granules, with “shaggy” borders.
  2. Squamous epithelial cell
  3. Clue cell
  4. Transitional epithelial cell
  5. Renal tubule epithelial cell

 

ANS: B

DIF: Level 1

OBJ: 5

TOP: Diagnostic testing

 

 

 

  1. Which diagnostic test uses a 10% solution of potassium hydroxide to detect the volatilization of amines to produce a distinctive odor?
  2. Whiff test
  3. KOH test
  4. DNA test
  5. Western Blot test

 

ANS: A

DIF: Level 1

OBJ: 5

TOP: Diagnostic testing

 

 

 

  1. Which of the following bacterial characteristics best describes the “normal flora” found in a vaginal specimen?
  2. Gram-positive cocci
  3. Gram-variable curved rods
  4. Gram-positive large rods
  5. Gram-negative rods

 

ANS: C

DIF: Level 2

OBJ: 5

TOP: Diagnostic testing

 

 

 

  1. Normal flora is predominantly of which genus?
  2. Mobiluncus sp
  3. Gardnerella sp
  4. Bacteroides sp
  5. Lactobacillus sp

 

ANS: D

DIF: Level 1

OBJ: 5

TOP: Diagnostic testing

 

 

 

  1. Of the following organisms, which one requires DNA probe amplified by the polymerase chain reaction (PCR)?
  2. G. vaginalis
  3. Candida sp.
  4. Trichomonas vaginalis
  5. Bacteroides sp

 

ANS: C

DIF: Level 1

OBJ: 5

TOP: Diagnostic testing

 

 

 

  1. All of the following cellular elements are seen in patients with desquamative inflammatory vaginitis, except:
  2. Clue cells
  3. Basal cells
  4. Red blood cells
  5. White blood cells

 

ANS: A

DIF: Level 1

OBJ: 6

TOP: Microscopic testing

 

 

 

  1. All of the following cellular elements can be seen in patients with candidiasis, except:
  2. Clue cells
  3. White blood cells
  4. Epithelial cells
  5. Budding yeast

 

ANS: A

DIF: Level 1

OBJ: 6

TOP: Microscopic testing

 

 

 

  1. A female patient presents to her OB/GYN with the following complaints: genital itching, dysuria, and an abnormal looking white “chunky” substance on her undergarments. The immediate next step the physician should take is:
  2. Order DNA and PCR testing
  3. Perform a saline wet prep
  4. Perform a whiff test and KOH test
  5. Send the patient home

 

ANS: B

DIF: Level 2

OBJ: 7

TOP: Case study

 

 

 

  1. The fetal fibronectin test is used to determine which of the following conditions?
  2. Pregnancy
  3. Preterm delivery
  4. Postpartum status
  5. Gestational age

 

ANS: B

DIF: Level 1

OBJ: 8

TOP: Diagnostic testing

 

 

 

  1. The test for placental alpha-1 microglobulin protein is used to determine:
  2. Fetal membrane rupture
  3. Pregnancy
  4. Bacterial vaginosis
  5. Atropic vaginosis

 

ANS: A

DIF: Level 1

OBJ: 8

TOP: Diagnostic testing

 

 

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