Question 1

Stefan was diagnosed with secondary vesicoureteral reflux; such condition usually results from which of the following?

Accepted Answer

Answer reason: Recurrent urinary tract infection and the associated cystitis can impair the ureterovesical junction’s flap-valve mechanism, allowing retrograde flow during voiding. This makes infection a typical precipitating factor for secondary VUR rather than a urine chemistry issue. In contrast, congenital defects are classically associated with primary VUR, and hydronephrosis is more commonly a consequence of reflux/obstruction than the initiating cause.

Question 2

Glomerulus is a network of?

Accepted Answer

Answer reason: This specialized structure sits between an afferent and an efferent arteriole, making the feeding and draining vessels arterioles, but the network itself is capillary loops. That capillary arrangement creates a large surface area and hydrostatic pressure necessary for glomerular filtration. Veins and nerves do not form the filtration tuft and therefore do not describe the glomerulus.

Question 3

Which hormone increases water reabsorption in kidneys?

Accepted Answer

Answer reason: This raises urine osmolality and decreases urine volume, helping maintain plasma osmolality and circulating volume. Aldosterone mainly increases sodium reabsorption (with potassium and hydrogen secretion), and water follows sodium only indirectly, so it is less directly correct for “water reabsorption.” Insulin and cortisol do not have a primary physiologic role in directly increasing collecting-duct water permeability.

Question 4

Which part of nephron is mainly responsible for glucose reabsorption?

Accepted Answer

Answer reason: The proximal segment has the highest capacity for reabsorption of filtered solutes and water, making it the primary site for glucose recovery back into the bloodstream. When filtered load exceeds transporter capacity (as in marked hyperglycemia), glucose appears in urine, highlighting this segment’s central role. Other segments like the loop of Henle and distal nephron primarily fine-tune electrolytes, water handling, and acid–base balance rather than bulk glucose reuptake.

Question 5

Gross hematuria means?

Accepted Answer

Answer reason: This contrasts with microscopic hematuria, where red blood cells are present but detected only on urinalysis/microscopy. Protein in urine indicates proteinuria and points to glomerular pathology rather than visible blood. Cloudy urine more commonly reflects pyuria, crystalluria, or contamination and is not the defining feature of hematuria.

Question 6

In kidney stones, hematuria occurs due to?

Accepted Answer

Answer reason: Hematuria with renal calculi is primarily caused by mechanical irritation and mucosal abrasion as the stone moves within the renal pelvis/ureter. This shearing of the urothelium leads to bleeding into the urinary tract, producing microscopic or gross blood in urine. Dehydration is a major risk factor for stone formation but does not directly cause bleeding unless a stone is present and traumatizes tissue. Hormonal imbalance and liver damage are not mechanisms that explain hematuria in the typical kidney stone presentation.

Question 7

The kidney is primarily responsible for...?

Accepted Answer

Answer reason: The kidneys accomplish this via glomerular filtration followed by tubular reabsorption and secretion, producing urine and controlling volume status and blood pressure. Digestion is primarily a gastrointestinal function, and oxygen is not “pumped” by any organ (the heart pumps blood). Insulin is produced by pancreatic beta cells, not by the kidneys.

Question 8

Proteinuria means protein in —?

Accepted Answer

Answer reason: In healthy kidneys, most plasma proteins are retained in the bloodstream and only trace amounts appear in the urine. Detecting protein on dipstick testing or quantifying it (e.g., albumin-to-creatinine ratio) is a key marker of kidney disease and can also occur transiently with fever, exercise, or dehydration. A common distractor is blood, but protein in blood is not termed proteinuria; it would be described by serum protein levels instead.

Question 9

Which organ stores urine?

Accepted Answer

Answer reason: The kidneys produce urine by filtration and tubular processing but do not serve as the primary storage organ. The ureters are transport tubes moving urine from kidneys to bladder, and the urethra conducts urine out of the body during voiding. Therefore the best single answer is the organ designed for storage and controlled release.

Question 10

A nurse is caring for a patient with acute kidney injury. The patient has a urine output of 150mL during a 12 hr shift. Which stage of AKI would this indicate?

Accepted Answer

Answer reason: 5 mL/kg/hr). A total of 150 mL over 12 hours is profoundly decreased output and aligns with the oliguric (maintenance) phase rather than a high-output phase. The diuretic phase is characterized by increased urine output as renal function begins to recover, which is the opposite pattern. The onset/initiation phase describes the period of injury development and may have variable urine output, but this degree of sustained low output best fits oliguric AKI.

Question 11

Inflammation of kidney is called –?

Accepted Answer

Answer reason: “Nephr-” refers to the kidney, so inflammation of the kidney is termed nephritis. By contrast, hepatitis is liver inflammation, colitis is colon inflammation, and dermatitis is skin inflammation. Therefore the kidney-specific inflammatory condition is best matched by the term nephritis.

Question 12

Which test checks kidney function?

Accepted Answer

Answer reason: When GFR declines, creatinine rises, making it a practical, widely used screening and monitoring lab for renal impairment (often incorporated into eGFR calculations). SGPT is a liver enzyme marker, not a renal function marker. CBC evaluates blood cell lines and can suggest anemia or infection but does not directly measure renal filtration.

Question 13

Which organ filters blood?

Accepted Answer

Answer reason: g., urea, creatinine) and regulating fluid, electrolytes, and acid–base balance. They continuously process plasma and form urine via filtration, reabsorption, and secretion in the nephron. The lungs mainly perform gas exchange and help regulate pH via CO2 removal rather than filtering blood solutes. The brain and uterus do not have a physiologic role in systemic blood filtration.

Question 14

Which of the following factors can cause blood pressure to drop to normal levels?

Accepted Answer

Answer reason: Blood pressure is strongly influenced by circulating volume, which the kidneys regulate by controlling sodium and water balance. When the kidneys excrete sodium, water follows osmotically, reducing extracellular fluid volume, venous return, and cardiac output, which lowers blood pressure. Retaining sodium and water would expand intravascular volume and tend to increase blood pressure rather than normalize it. Excreting sodium alone is not physiologically typical as sodium handling usually drives parallel water loss, making combined sodium-and-water excretion the best answer.

Question 15

Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis?

Accepted Answer

Answer reason: Costovertebral angle tenderness reflects irritation/inflammation of the kidney, and chills (often with fever) indicate bacteremia-level systemic response more consistent with pyelonephritis than a lower UTI. Dysuria is more characteristic of cystitis and may occur but is less discriminating for kidney involvement. Polyuria/nocturia point more toward chronic urinary conditions (e.g., diabetes, diuretics, or chronic renal concentrating defects) rather than an acute renal infection presentation.

Question 16

What is the primary disadvantage of using peritoneal dialysis for long-term management of chronic renal failure?

Accepted Answer

Answer reason: Peritoneal dialysis provides slower solute and fluid clearance than hemodialysis, so it is less effective for rapidly correcting life-threatening electrolyte/acid–base derangements (e.g., severe hyperkalemia, severe metabolic acidosis, pulmonary edema). This limitation is especially important when a patient needs urgent, high-efficiency removal of toxins or fluid. Hemorrhage is more strongly associated with systemic anticoagulation used during hemodialysis rather than peritoneal dialysis. Hepatitis risk is also higher with in-center hemodialysis exposure and blood handling, not a primary disadvantage of peritoneal dialysis.

Question 17

A patient presents with symptoms of frequent urination, burning sensation during urination, and lower abdominal pain. The healthcare provider suspects a urinary tract infection (UTI) and orders diagnostic tests. Which organs are primarily involved in the urinary system?

Accepted Answer

Answer reason: This option correctly accounts for two kidneys and two ureters while recognizing there is only one bladder and typically one urethra. Options listing one ureter are anatomically incorrect in normal anatomy. Options listing two urethrae are also incorrect because the urinary tract has a single urethra in both sexes.

Question 18

A male client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region, which radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnosed renal calculi and ordered flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

Accepted Answer

Answer reason: g., calcium oxalate/phosphate, uric acid), promoting nucleation and crystal growth in the renal calyces/pelvis. After forming there, stones may migrate into the ureter, which is why colicky flank pain can radiate toward the groin/bladder as the stone travels. The ureter is a common site of obstruction and pain, but it is less commonly the primary site of stone formation. Bladder and urethral stones are comparatively uncommon and often related to urinary stasis or foreign bodies rather than being the typical origin.

Question 19

Total amount of the filtrate formed by the kidney per day is ?

Accepted Answer

Answer reason: This represents the volume of plasma water filtered into Bowman’s space before tubular reabsorption. Although only ~1–2 L of urine is excreted daily, most of the filtrate is reabsorbed along the nephron, so urine output is not a proxy for filtrate volume. Values like 150 L/day are sometimes cited but are less consistent with the standard GFR-based estimate used in exams.

Question 20

A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury?

Accepted Answer

Answer reason: Acute kidney injury is commonly classified by where the primary problem occurs: before the kidney (perfusion), within the kidney (parenchymal injury), or after the kidney (obstruction). A massive GI bleed causes acute intravascular volume loss leading to hypotension and reduced renal perfusion pressure, which most directly produces prerenal azotemia/AKI. If hypoperfusion is prolonged it can progress to ischemic acute tubular necrosis (intrinsic), but the initial and most likely category from hemorrhage is prerenal. Post-renal causes would require urinary outflow obstruction, which is not suggested by the presentation.

Question 21

In a peritoneal dialysis the *dwell time* exceed more the prescribed,what complications may delevlop?

Accepted Answer

Answer reason: If dwell time is prolonged beyond what is prescribed, more glucose can be absorbed across the peritoneal membrane into the bloodstream. This increases the risk of elevated serum glucose, particularly in patients with diabetes or insulin resistance. In contrast, longer dwell generally improves solute clearance and tends to lower potassium rather than raise it, making hyperkalemia less consistent with an excessively long dwell.

Question 22

A normal human has how many kidneys?

Accepted Answer

Answer reason: Typical anatomy includes a right kidney slightly lower than the left due to the liver. While some individuals may be born with a single kidney or have one removed, that is a variation and does not define normal standard anatomy. Options suggesting 1, 3, or 4 do not match normal human renal anatomy.

Question 23

What type of equipment is used to remove excess fluid during hemodialysis?

Accepted Answer

Answer reason: The component that provides this membrane surface area and enables diffusion and ultrafiltration is the dialyzer (the “artificial kidney”). A catheter is only an access device to move blood to and from the circuit and does not perform fluid removal. An IV pump delivers fluids/medications and a Doppler is an ultrasound device for assessing blood flow, neither of which removes fluid during dialysis.

Question 24

Which organ purifies blood in the human body?

Accepted Answer

Answer reason: g., urea, creatinine), toxins, and excess water/electrolytes, producing urine and maintaining homeostasis. This “purification” function is a core role of the renal system and is continuous as blood passes through renal circulation. The heart mainly pumps blood, and the lungs primarily oxygenate blood and remove carbon dioxide rather than filtering solutes. While the liver detoxifies many substances and processes metabolites, the primary organ responsible for direct blood filtration and waste excretion is the kidneys.

Question 25

Urine is continuously formed by the ______?

Accepted Answer

Answer reason: The kidneys receive high renal blood flow, enabling ongoing filtration and formation of filtrate that becomes urine. The spleen is primarily involved in immune function and blood cell turnover, not urine production. The liver contributes to metabolism and urea formation but does not directly form urine.

Question 26

The first organ usually affected in shock is?

Accepted Answer

Answer reason: The kidneys are especially vulnerable because renal perfusion falls early, leading to decreased urine output (oliguria) as one of the earliest and most sensitive clinical indicators. Sustained hypoperfusion quickly causes acute kidney injury due to ischemic tubular damage. While cerebral and myocardial perfusion are prioritized initially, renal blood flow is sacrificed sooner, making renal dysfunction an early organ effect.

Question 27

What is the primary function of the ureters?

Accepted Answer

Answer reason: Urine is produced by the kidneys (nephrons), not by the ureters, so “Produce urine” is incorrect. Urine storage is primarily the bladder’s function, making “Store urine” a distractor. Blood filtration occurs at the glomeruli in the kidneys, not in the ureters.

Question 28

Which organ is responsible for regulating electrolyte balance and blood pressure?

Accepted Answer

Answer reason: The kidneys are the primary regulators of fluid and electrolyte homeostasis by adjusting tubular reabsorption and excretion of sodium, potassium, bicarbonate, and water. They also directly control blood pressure through the renin-angiotensin-aldosterone system, which alters systemic vascular resistance and sodium/water retention. By modulating extracellular fluid volume, renal function has a dominant effect on long-term arterial pressure. The heart influences blood pressure via cardiac output but does not provide the primary day-to-day regulation of electrolyte balance.

Question 29

Which test is used to measure kidney function?

Accepted Answer

Answer reason: When renal filtration declines, creatinine clearance falls and the serum creatinine level typically rises, making it a practical screening test for impaired kidney function. This value is also used to calculate eGFR, which helps stage chronic kidney disease and guide medication dosing. In contrast, SGPT primarily reflects hepatocellular injury, while lipid profile and ESR do not directly measure renal filtration.

Question 30

Which of the following is a symptom of a urinary tract infection (UTI)?

Accepted Answer

Answer reason: This directly fits common UTI presentations, which also often include urinary frequency, urgency, and suprapubic discomfort. Diarrhea is more consistent with gastrointestinal infection or medication side effects rather than an uncomplicated UTI. Chest pain and headache are nonspecific and do not localize to urinary tract pathology unless a different systemic condition is present.

Question 31

What is the name of the condition in which the kidneys form hard mineral deposits?

Accepted Answer

Answer reason: This process produces renal calculi that can reside in the kidney or migrate into the ureter, classically causing colicky flank pain and hematuria. Renal failure refers to loss of kidney function rather than stone formation, and UTI is infection without a primary mineral concretion. Glomerulonephritis is inflammation of the glomeruli and does not describe hard mineral deposits.

Question 32

A client has a serum creatinine level of 2 mg/dL and a urine output of 1000 mL/day. How does the nurse categorize the client’s kidney injury?

Accepted Answer

Answer reason: A daily urine output of 1000 mL indicates preserved urine production despite impaired filtration suggested by the elevated creatinine. This pattern fits a nonoliguric kidney injury presentation, which can occur in various AKI etiologies but is defined by urine volume rather than location of injury. The other options (pre-, intra-, postrenal) describe the anatomic/physiologic cause of AKI, which cannot be determined from creatinine and urine volume alone without additional data (e.g., history, imaging, urinary indices).

Question 33

Potassium sparing diuretics have the primary effect upon the _____ found in the kidney?

Accepted Answer

Answer reason: By blocking epithelial sodium channels (amiloride, triamterene) or antagonizing aldosterone receptors (spironolactone, eplerenone), they reduce sodium reabsorption and decrease the lumen-negative potential that drives potassium excretion. This site of action is primarily the cortical collecting tubule/collecting duct, so potassium is “spared” while mild natriuresis occurs. In contrast, loop diuretics act in the thick ascending limb and thiazides in the distal convoluted tubule, and neither is the primary mechanism for potassium-sparing effects.

Question 34

Which organ is responsible for filtering waste from the blood?

Accepted Answer

Answer reason: g., urea, creatinine) are primary functions of the renal system. Nephrons in the kidneys filter plasma at the glomerulus and then adjust solute and water handling through tubular reabsorption and secretion, producing urine to remove wastes. This directly matches the question’s focus on filtering waste from blood. The liver participates in detoxification and metabolism, but it does not perform the main filtration/excretory role for blood-borne wastes like the kidneys do.

Question 35

The tube that carries urine from kidney to bladder is called?

Accepted Answer

Answer reason: Peristaltic contractions in these tubes propel urine toward the bladder independent of gravity. The urethra instead carries urine from the bladder to the outside of the body, while a nephron is the kidney’s functional filtration unit and an axon is part of a neuron.

Question 36

The nurse knows which of the following body systems is responsible for the production of erythropoietin?

Accepted Answer

Answer reason: Its key physiologic role is to stimulate erythropoiesis in the bone marrow to increase red blood cell mass and improve oxygen delivery. Because the kidney is the main site of production, chronic kidney disease commonly leads to low erythropoietin levels and normocytic anemia. The endocrine system is involved in hormone signaling broadly, but this question asks which body system is responsible for production, and the kidneys belong to the urinary system.

Question 37

What is the name of the structure that connects the kidney to the bladder?

Accepted Answer

Answer reason: That connecting tube is the ureter, which runs from the renal pelvis to the urinary bladder. The urethra is a different structure that carries urine from the bladder to the outside of the body. The prostate gland and seminal vesicle are male reproductive organs and do not connect the kidney to the bladder.

Question 38

What is the function of the kidneys?

Accepted Answer

Answer reason: g., urea, creatinine) and excess water/solutes, producing urine to maintain internal homeostasis. This filtration occurs in nephrons via glomerular filtration with subsequent tubular reabsorption and secretion to fine-tune fluid, electrolyte, and acid–base balance. Producing bile is a liver function, not a renal function. Regulating body temperature and storing fat are primarily roles of the skin/vascular system and adipose tissue, respectively.

Question 39

Urine is stored in which part of the body before excretion?

Accepted Answer

Answer reason: The bladder’s detrusor muscle and internal/external sphincters allow controlled retention and timed release through the urethra. Kidneys primarily filter blood and form urine rather than store it, and the ureters are transport tubes that move urine from kidneys to the reservoir. The liver is not part of urine storage or excretion in the urinary tract.

Question 40

The part of nephron where maximum reabsorption occurs is?

Accepted Answer

Answer reason: The proximal tubule reclaims the majority of filtered sodium and water, along with nearly all filtered glucose and amino acids under normal conditions. In contrast, the glomerulus primarily performs filtration rather than reabsorption. The distal convoluted tubule and collecting duct mainly provide fine-tuning under hormonal control (e.g., aldosterone, ADH) rather than bulk reabsorption.

Question 41

What is the role of the renal vein in circulation?

Accepted Answer

Answer reason: The renal vein specifically drains blood that has passed through the kidney’s capillary beds and carries it into the inferior vena cava, en route to the heart. Supplying blood to the kidney is the role of the renal artery, not the vein. Urine transport is performed by the ureters, and filtration occurs in the renal glomeruli/nephrons rather than in veins.

Question 42

Your patient has been diagnosed with chronic kidney failure. Which of the following aspects of the patient’s history was likely to contribute to this?

Accepted Answer

Answer reason: Poorly controlled hyperglycemia drives diabetic nephropathy through glomerular hyperfiltration, thickening of the basement membrane, and mesangial expansion, which are major causes of CKD worldwide. This history item most directly aligns with the classic etiologic pathway to chronic renal failure. Hypertension is also a key contributor, but diabetes is typically the single most common primary cause in many populations and is the best single answer here. The other options are not primary drivers of chronic kidney failure in the same direct, high-prevalence way.

Question 43

Based on the client’s condition, the charge nurse decided to have a teaching session for a group of patients on Acute Renal Failure. She ask a student to classify Acute Renal failure. _____ would be an appropriate response?

Accepted Answer

Answer reason: “Before the capsule” corresponds to prerenal processes occurring upstream of the kidney, “inside the capsule” corresponds to intrinsic renal pathology, and “outside the capsule” corresponds to postrenal obstruction downstream of the kidney. This sequence matches the standard prerenal–intrarenal–postrenal framework used for evaluation and management. The other options mix nonstandard spatial descriptors (e.g., “left/right/beside the capsule”) that do not map to the accepted clinical classification.

Question 44

Which of the following organs is responsible for filtering blood and removing waste products?

Accepted Answer

Answer reason: This process removes metabolic wastes such as urea and creatinine by excreting them in urine. The spleen filters aged red blood cells and participates in immune function rather than eliminating nitrogenous wastes. The liver metabolizes toxins and produces bile, and the gallbladder stores bile, but neither serves as the body’s main blood filtration-and-waste excretion organ.

Question 45

What is the main function of the urinary bladder?

Accepted Answer

Answer reason: Its detrusor muscle relaxes to allow filling and contracts during micturition under coordinated autonomic and somatic control. Urine production and blood filtration are kidney functions (nephrons/glomeruli), not bladder functions. Water reabsorption occurs mainly in the renal tubules and collecting ducts rather than in the bladder.

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