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Sample Test
Chapter 3: Renal Function
Multiple Choice
ANS: D
DIF: Level 1
OBJ: 3
ANS: C
DIF: Level 1
OBJ: 1
ANS: D
DIF: Level 2
OBJ: 2
ANS: D
DIF: Level 1
OBJ: 2
ANS: C
DIF: Level 2
OBJ: 2
ANS: B
DIF: Level 1
OBJ: 3
ANS: C
DIF: Level 2
OBJ: 4
8. The primary chemical affected by the renin-angiotensin-aldosterone
system is:
9. Glucose
10. Potassium
11. Chloride
12. Sodium
ANS: D
DIF: Level 1
OBJ: 4
ANS: B
DIF: Level 1
OBJ: 3
10. All of the following substances are reabsorbed from the glomerular filtrate
by active transport except:
11. Glucose
12. Water
13. Sodium
14. Amino acids
ANS: B
DIF: Level 1
OBJ: 3
ANS: A
DIF: Level 2
OBJ: 5
ANS: C
DIF: Level 1
OBJ: 5
ANS: A
DIF: Level 1
OBJ: 5
ANS: B
DIF: Level 2
OBJ: 7
TOP: Renin-angiotensin-aldosterone system
ANS: D
DIF: Level 2
OBJ: 7
ANS: C
DIF: Level 2
OBJ: 7
ANS: D
DIF: Level 1
OBJ: 4
ANS: B
DIF: Level 2
OBJ: 4
ANS: C
DIF: Level 1
OBJ: 6
20. Substances removed from the blood by tubular secretion include primarily:
21. Protein, hydrogen, and ammonia
22. Protein, hydrogen, and potassium
23. Amino acids, urea, and glucose
24. Protein-bound substances, hydrogen, and potassium
ANS: D
DIF: Level 1
OBJ: 8
ANS: A
DIF: Level 2
OBJ: 2
ANS: C
DIF: Level 1
OBJ: 7
23. To maintain the buffering capacity of the blood, hydrogen ions combine
with:
24. Filtered phosphate ions
25. Filtered bicarbonate ions
26. Secreted ammonia
27. Secreted ammonium ions
ANS: B
DIF: Level 1
OBJ: 7
24. Clearance tests used to determine the glomerular filtration rate must
measure substances that are:
25. Not filtered by the glomerulus
26. Completely reabsorbed by the proximal convoluted tubule
27. Secreted in the distal convoluted tubule
28. Neither reabsorbed or secreted by the tubules
ANS: D
DIF: Level 1
OBJ: 9
ANS: A
DIF: Level 1
OBJ: 11
TOP: Glomerular filtration tests
ANS: C
DIF: Level 1
OBJ: 11
ANS: C
DIF: Level 1
OBJ: 11
ANS: D
DIF: Level 2
OBJ 11
29. The most routinely used laboratory method for measuring the glomerular
filtration rate is the:
30. Inulin clearance
31. Estimated glomerular filtration rate
32. Creatinine clearance
33. Beta2 microglobulin clearance
ANS: B
DIF: Level 1
OBJ: 9
30. 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
31. 60 mL/min
32. 80 mL/min
33. 100 mL/min
34. 120 mL/min
ANS: B
DIF: Level 2
OBJ: 10
ANS: B
DIF: Level 1
OBJ: 9
32. John White donates one of his two healthy kidneys to his twin brother. His
glomerular filtration rate can be expected to:
33. Decrease by 50%
34. Increase by 50%
35. Decrease gradually over 1 year
36. Remain within a normal range
ANS: D
DIF: Level 1
OBJ: 11
33. The renal function that is most frequently the first affected by early renal
disease is:
34. Renal blood flow
35. Glomerular filtration
36. Tubular reabsorption
37. Tubular secretion
ANS: C
DIF: Level 1
OBJ: 10
ANS: B
DIF: Level 1
OBJ: 11
ANS: C
DIF: Level 1
OBJ: 13
TOP: Osmolality
ANS: B
DIF: Level 1
OBJ: 14
TOP: Osmolality
ANS: C
DIF: Level 2
OBJ: 14
38. Substances that can interfere with serum osmolality readings include all
of the following except:
39. Lipids
40. Lactic acid
41. Ethanol
42. Sodium
ANS: D
DIF: Level 1
OBJ: 13
ANS: A
DIF: Level 2
OBJ: 14
ANS: C
DIF: Level 3
OBJ: 14
ANS: B
DIF: Level 1
OBJ: 13
42. The extent to which the kidney concentrates the glomerular filtrate can be
determined by measuring:
43. Serum creatinine
44. Urine creatinine
45. Serum osmolality
46. Urine and serum osmolality
ANS: D
DIF: Level 1
OBJ: 12
TOP: Osmolality clinical significance
43. Following fluid deprivation, a patient has a serum osmolality of 276 mOsm
and a urine osmolality of 1000 mOsm. This patient:
44. Has normal concentration ability
45. May have defective antidiuretic hormone (ADH) production
46. May have insufficient tubular ADH response
47. Has a high serum lipid concentration
ANS: A
DIF: Level 2
OBJ: 13
ANS: D
DIF: Level 1
OBJ: 13
ANS: C
DIF: Level 2
OBJ: 13
46. Following injection of ADH, a patient has a serum osmolality of 290 mOsm
and a urine osmolality of 450 mOsm. The patient:
47. Continued to observe water deprivation
48. Lacks tubular response to ADH
49. May have ingested excess alcohol
50. Should be evaluated with a creatinine clearance
ANS: B
DIF: Level 2
OBJ: 12
47. To determine the amount of water that must be cleared to produce urine
with the same osmolality as the ultrafiltrate, one should perform:
48. A free water clearance
49. A Mosenthal test
50. An osmolar clearance
51. A urine-to-plasma ratio
ANS: C
DIF: Level 1
OBJ: 15
48. Which of the following tests should be used to determine the ability of the
kidneys to respond to filtrate osmolality?
49. Free water clearance
50. Fishberg test
51. Urine-to-plasma osmolality
52. p-aminohippuric acid (PAH) test
ANS: A
DIF: Level 1
OBJ: 15
ANS: D
DIF: Level 2
OBJ: 15
50. Given the following laboratory data, calculate the free water clearance:
Volume = 2800 mL/24 hour; Urine Osmo = 1200 mOsm, Plasma Osmo = 400
mOsm
51. +2 mL/min
52. +4 mL/min
53. -2 mL/min
54. -4 mL/min
ANS: D
DIF: Level 3
OBJ: 15
51. A patient with insufficient production of ADH would have which of the
following results?
52. Urine volume—2 mL/min; osmolar clearance—2 mL/min
53. Urine volume—5 mL/min; osmolar clearance—2 mL/min
54. Urine volume—3 mL/min; osmolar clearance—4 mL/min
55. Urine volume—1 mL/min; osmolar clearance—3 mL/min
ANS: B
DIF: Level 2
OBJ: 15
ANS: D
DIF: Level 2
OBJ: 16
ANS: D
DIF: Level 2
OBJ: 16
ANS: A
DIF: Level 1
OBJ: 16
55. A PAH test result showing a renal plasma flow of 400 mL/min:
56. Is a normal result
57. May be falsely decreased from impaired tubular secretion
58. Should be corrected to correspond to the patient’s body size
59. Indicates glomerular filtration of PAH
ANS: B
DIF: Level 3
OBJ: 16
ANS: A
DIF: Level 1
OBJ: 1
ANS: C
DIF: Level 2
OBJ: 1
58. Tests to measure the tubular secretion of hydrogen ions include all of the
following except:
59. pH
60. Titratable acidity
61. Urinary bicarbonate
62. Urinary ammonia
ANS: C
DIF: Level 1
OBJ: 17
ANS: C
DIF: Level 2
OBJ: 17
60. Total acidity of a urine specimen is a combination of:
61. Titratable acidity and pH
62. Titratable acidity and ammonium ion
63. pH and total acidity
64. Total acidity and ammonium ion
ANS: B
DIF: Level 2
OBJ: 17
ANS: B
DIF: Level 2
OBJ: 11
TOP: Cystatin C
ANS: A
DIF: Level 2
OBJ: 15
63. 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
64. 60 mL/min
65. 75mL/min
66. 112 mL/min
67. 128 mL/min
ANS: D
DIF: Level 2
OBJ: 15
ANS: A
DIF: Level 3
OBJ: 15
65. Given the following information, calculate the osmolar clearance: urine
volume—720 mL in 24 hours, urine osmolality—700 mOsm, and plasma
osmolality—300 mOsm
66. 1.0 mL/min
67. 1.2 mL/min
68. 1.8 mL/min
69. 2.0 mL/min
ANS: B
DIF: Level 2
OBJ: 15
TOP: Osmolality
66. 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
67. +0.5 mL/min
68. -1.5 mL/min
69. -1.0 mL/min
70. -2.0 mL/min
ANS: D
DIF: Level 2
OBJ: 15
TOP: Osmolality
ANS: B
DIF: Level 2
OBJ: 16
ANS: B
DIF: Level 1
OBJ: 14
TOP: Osmolality
NARRBEGIN: 03-nar-01
NARREND
ANS: C
NAR: 03-nar-01
DIF: Level 2
OBJ: 10
ANS: A
NAR: 03-nar-01
DIF: Level 2
OBJ: 15
71. Based on the information provided, calculate the free water clearance.
72. -0.5
73. -1.0
74. +0.6
75. +0.9
ANS: D
NAR: 03-nar-01
DIF: Level 2
OBJ: 15
ANS: B
NAR: 03-nar-01
DIF: Level 3
OBJ: 15
73. Based on the information provided, can this patient be safely given a
nephrotoxic antibiotic?
74. Yes
75. No
ANS: A
NAR: 03-nar-01
DIF: Level 3
OBJ: 15
74. Based on the information provided, would increasing the patient’s intake
of fluids alleviate this problem?
75. Yes
76. No
ANS: B
NAR: 03-nar-01
DIF: Level 3
OBJ: 15
NARRBEGIN: 03-nar-02
NARREND
ANS: B
NAR: 03-nar-02
DIF: Level 3
OBJ: 14
76. Using the information provided, which model is more likely to be affected
by technical errors?
77. Freezing-point
78. Vapor-pressure
ANS: B
NAR: 03-nar-02
DIF: Level 3
OBJ: 14
77. Using the information provided, which model is affected by lipemic serum
but not elevated ethanol levels?
78. Freezing-point
79. Vapor-pressure
ANS: A
NAR: 03-nar-02
DIF: Level 3
OBJ: 14
TOP: Osmolality technical factors case study
ANS: C
NAR: 03-nar-02
DIF: Level 2
OBJ: 14
NARRBEGIN: 03-nar-03
NARREND
79. Using the information provided, based on the tests ordered, what renal
function is the physician’s primary concern?
80. Glomerular filtration
81. Tubular reabsorption
82. Tubular secretion
83. Renal blood flow
ANS: D
NAR: 03-nar-03
DIF: Level 3
OBJ: 16
80. Calculate the patient’s renal blood flow using the information provided.
81. 100 mL/min
82. 200 mL/min
83. 300 mL/min
84. 400 mL/min
ANS: D
NAR: 03-nar-03
DIF: Level 2
OBJ: 16
81. Based on the information provided, would it be better for this patient to
have an increased or decreased serum renin level?
82. Increased
83. Decreased
ANS: A
NAR: 03-nar-03
DIF: Level 2
OBJ: 16
True/False
82. The afferent and efferent arterioles have the ability to vary in size.
ANS: True
DIF: Level 1
OBJ: 1
83. Blood pressure within the glomerulus varies directly with systemic blood
pressure.
ANS: False
DIF: Level 2
OBJ: 2
ANS: False
DIF: Level 2
OBJ: 2
85. The filtrate leaving the ascending loop of Henle is highly concentrated.
ANS: False
DIF: Level 2
OBJ: 2
86. A substance that is not filtered by the glomerulus will not be found in the
urine.
ANS: False
DIF: Level 1
OBJ: 2
87. Hydrogen ions are filtered by the glomerulus and reabsorbed and secreted
by the renal tubules.
ANS: True
DIF: Level 1
OBJ: 2
ANS: True
DIF: Level 2
OBJ: 3
89. 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
90. The nephrons with the longest loops of Henle are the cortical nephrons.
ANS: False
DIF: Level 2
OBJ: 2
Chapter 4: Physical Examination of Urine
Multiple Choice
ANS: B
DIF: Level 1
OBJ: 1
ANS: D
DIF: Level 1
OBJ: 3