Urine 3.2

Question 1

Substances that require elimination from the body by renal excretion include
A) carbon dioxide and water.
B) urea, fat metabolites, and carbon dioxide.
C) metabolites of carbohydrates and triglycerides.
D) urea, creatinine, and uric acid.

Answer 1

D) urea, creatinine, and uric acid.

Question 2

A patient with diabetes mellitus may excrete an elevated number of osmoles of solute per day, resulting in
A) oliguria.
B) polydipsia.
C) decreased specific gravity.
D) iso-osmotic urine.

Answer 2

B) polydipsia

Question 3

The normal reference range for urine specific gravity is
A) 1.002 to 1.035.
B) 1.001 to 1.045.
C) 1.000 to 1.025.
D) 1.005 to 1.030.

Answer 3

A) 1.002 to 1.035

Question 4

All of the statements about specific gravity are true except
A) specific gravity expresses the solute concentration.
B) the specific gravity of the ultrafiltrate is the same as that of protein-free plasma.
C) specific gravity relates the volume of urine to the density of an equal volume of pure water.
D) specific gravity is always greater than 1.000.

Answer 4

C) specific gravity relates the volume of urine to the density of an equal volume of pure water.

Question 5

The technologist reads over the urinalysis test results that just printed off the Clinitek and notes that the specific gravity was 1.039. Which urinalysis test results should the technologist check for correlation?
A) Mannitol
B) Radiopaque contrast medium
C) Urea
D) Glucose

Answer 5

D) Glucose

Question 6

Urine concentration measuring the number of solutes present can be assessed by
A) A and B
B) urine osmolality.
C) specific gravity.
D) sodium/chloride ratio.

Answer 6

B) urine osmolality.

Question 7

Water homeostasis is achieved by which of the following?
A) Excreting small amounts of solute when the body is dehydrated
B) Urine volume relevant to hydration status and metabolic water production
C) Balancing solute excretion with urine production to achieve isotonicity
D) Increasing solute excretion during times of water depravation

Answer 7

B) Urine volume relevant to hydration status and metabolic water production

Question 8

Conditions of water diuresis or solute diuresis result in
A) polyuria.
B) oliguria.
C) dysuria.
D) anuria.

Answer 8

A) polyuria

Question 9

A 35-year-old male patient has complained of polyuria and polydipsia. A 24-hour urine collection yields a volume of 5200 mL. Urinalysis reveals negative test results across the board. The physician suspects that the patient may be suffering from
A) juvenile diabetes.
B) diabetes insipidus.
C) type 2 diabetes.
D) diabetes mellitus.

Answer 9

B) diabetes insipidus.

Question 10

Uncontrolled diabetes mellitus will result in
A) cold diuresis.
B) osmotic (solute) diuresis.
C) iatrogenic diuresis.
D) water diuresis.

Answer 10

B) osmotic (solute) diuresis.

Question 11

A patient showing signs of polydipsia, polyuria, polyphagia, and glycosuria most likely is not producing enough
A) insulin.
B) vasopressin.
C) ADH.
D) glycogen.

Answer 11

A) insulin

Question 12

An elderly trauma patient presents to the emergency department with sudden anuria. The most likely finding is
A) dramatically decreased renal perfusion.
B) urinary obstruction.
C) progressive renal disease.
D) renal tubular dysfunction.

Answer 12

A) dramatically decreased renal perfusion

Question 13

The daily total urine volume reflects all of the following except
A) fluid intake.
B) amount of solutes ingested.
C) activity of ADH.
D) patient’s surface area.

Answer 13

D) patient’s surface area.

Question 14

Measurement of which of the following is a means of monitoring the kidneys’ ability to process and concentrate urine ultrafiltrate?
A) Urea
B) Sodium or chloride
C) Potassium
D) Creatinine

Answer 14

B) Sodium or chloride

Question 15

Osmolality better reflects the kidneys’ ability to concentrate urine because specific gravity
A) is based on the number of milliosmoles versus density.
B) cannot detect the presence of high-molecular-weight solutes.
C) is influenced by the presence of glucose and protein.
D) Osmolality better reflects the kidneys’ ability to concentrate urine because specific

Answer 15

C) is influenced by the presence of glucose and protein.

Question 16

A urine specific gravity is ordered for a patient, and it is performed on the first morning specimen and the last evening specimen. The specific gravity for both urine samples is 1.010; this indicates
A) low specific gravity as a result of decreased fixed production of ADH.
B) increased production of ADH as a result of decreased fluid intake.
C) hypo-osmolality of both the AM and PM specimens.
D) fixation of the urine solute composition as a result of renal failure.

Answer 16

D) fixation of the urine solute composition as a result of renal failure

Question 17

Polyuria and nocturia are common features of chronic renal failure as a result of
A) active secretion of solutes, resulting in increased ADH.
B) fixation of the urine solute composition in the filtrate.
C) low specific gravity and osmolality of the urine filtrate.
D) decreased reabsorption of solutes in the tubules.

Answer 17

B) fixation of the urine solute composition in the filtrate.

Question 18

The osmolality of an 8 AM urine specimen in a fluid deprivation test was greater than 800 mOsm/kg, which indicates
A) limited production of ADH.
B) dysfunctional renal receptors for ADH.
C) inability to concentrate urine.
D) normal renal function.

Answer 18

D) normal renal function.

Question 19

The ultimate goal of the kidneys is to
1. maintain normal plasma osmolality.
2. eliminate unwanted solutes and water.
3. manipulate water excretion to achieve fluid homeostasis.
A) 2 and 3
B) 1 and 2
C) 1 and 3
D) 1, 2, and 3

Answer 19

D) 1, 2, and 3

Question 20

When a solute is filtered but not secreted or reabsorbed by the nephrons, its concentration in the urine is referred to as
A) osmolar clearance.
B) glomerular filtration rate.
C) renal plasma flow.
D) renal clearance.

Answer 20

D) renal clearance

Question 21

Which clearance test results can be normalized using the patient’s height, weight, and body surface area?
A) Creatinine clearance
B) Free-water clearance
C) Inulin clearance
D) Osmolar clearance

Answer 21

A) Creatinine clearance

Question 22

The correct formula for calculating creatinine clearance is C (mL/min) =
A) (P × U)/V × SA/1.73 m2.
B) 1.73 m2 x SA/P × U/V.
C) (U × V/P x SA/1.73 m2.
D) (U x V)/P × 1.73 m2/SA.

Answer 22

D) (U x V)/P × 1.73 m2/SA

Question 23

Urine creatinine clearance levels can be underestimated because of which of the following?
A) Plasma creatinine
B) Salicylate
C) Secretion of creatinine
D) Insulin

Answer 23

B) Salicylate

Question 24

Which factor is a consideration in the collection of urine for creatinine clearance measurement?
A) Temperature sensitivity
B) Water restriction
C) Added preservative
D) Light sensitivity

Answer 24

A) Temperature sensitivity

Question 25

B2-Microglobulin is a useful marker for
A) differentiating glomerular and tubular renal diseases.
B) all of the above.
C) identifying renal function (rather than the GFR) in all patients.
D) identifying allograft rejection in kidney transplant recipients.

Answer 25

B) all of the above.

Question 26

Detection of proteinuria in individuals with diabetes is important as a marker for all of the following except
A) cardiovascular morbidity and mortality.
B) glomerular changes.
C) renal plasma flow.
D) diabetic nephropathy.

Answer 26

C) renal plasma flow

Question 27

Diseased renal tubules can put a patient at risk for which of the following?
A) Cardiovascular, stroke
B) Kidney rejection
C) Acidosis
D) Ketoacidosis

Answer 27

C) Acidosis

Question 28

Which of the following processes of renal excretion is true?
A) Selective conserving organic acids and bases
B) Selective eliminating byproducts of carbohydrates and triglyceride metabolism
C) Selective conserving water and electrolytes
D) Selective conserving certain soluble drugs

Answer 28

C) Selective conserving water and electrolytes

Question 29

Which of the following substances provides a means of monitoring and evaluating renal function such as GFR?
1. Urea
2. ADH
3. Creatinine
4. Uric acid
A) 2 and 3
B) 1 and 3
C) 1,2, and 4
D) 1,3, and 4

Answer 29

B) 1 and 3

Question 30

Final osmolality of urine is determined in which of the following?
A) Distal tubules and collecting ducts
B) Proximal tubule
C) Loops of Henle
D) Collecting ducts

Answer 30

A) Distal tubules and collecting ducts

Question 31

Nocturia can occur due to which of the following?
A) Reduced bladder capacity
B) Fixed specific gravity of 1.025
C) Anuresis
D) Increased ADH

Answer 31

A) Reduced bladder capacity

Question 32

Which of the following test is used to assess renal concentrating ability?
A) Fluid deprivation
B) GFR
C) Inulin clearance
D) Creatinine clearance

Answer 32

A) Fluid deprivation

Question 33

All of the following tests and evaluation purpose are correctly matched except
A) p-aminohippurate-renal tubular reabsorption.
B) urine osmolality-tubular concentrating ability.
C) creatinine clearance-GFR.
D) urine protein electrophoresis- glomerular permeability for plasma proteins.

Answer 33

A) p-aminohippurate-renal tubular reabsorption.