Question 1

Waste products excreted by the kidneys are?

Accepted Answer

Answer reason: Urea is the major nitrogenous waste filtered and excreted, while water and dissolved salts (electrolytes such as sodium and chloride) are excreted in variable amounts to maintain osmolarity and volume homeostasis. Carbon dioxide is primarily removed by the lungs via ventilation rather than by renal excretion. Options missing either water or salts are incomplete because urine normally contains both in addition to urea.

Question 2

Glomerulus is a network of?

Accepted Answer

Answer reason: Filtration depends on hydrostatic pressure driving plasma water and small solutes across the capillary endothelium, basement membrane, and podocyte slit diaphragm. This structure is supplied by an afferent arteriole and drained by an efferent arteriole, but the filtering network itself is capillaries. Veins, arteries, and nerves are not the primary microscopic exchange vessels responsible for ultrafiltration in the nephron.

Question 3

Regulation of ph within the body is done by ...?

Accepted Answer

Answer reason: The kidneys excrete nonvolatile acids (e.g., as ammonium and titratable acids) and regenerate bicarbonate, directly adjusting plasma pH over hours to days. While the lungs provide rapid compensation by altering CO2, they are not listed among the options, making the renal mechanism the best match. The spleen, liver, and heart do not serve as primary regulators of systemic pH.

Question 4

Which organ is primarily responsible for the production of erythropoietin in adult?

Accepted Answer

Answer reason: In adults, the predominant source is peritubular interstitial cells in the renal cortex/outer medulla, making renal function central to maintaining red blood cell production. This is why chronic kidney disease commonly causes a normocytic, normochromic anemia from reduced hormone signaling. The liver is a major source in fetal life but contributes relatively less to baseline production in healthy adults.

Question 5

Which human body organ is involved in the purification of blood?

Accepted Answer

Answer reason: g., urea, creatinine) and excess electrolytes as urine. This filtration also helps regulate fluid volume, acid–base balance, and blood pressure via sodium/water handling and renin release. The heart primarily pumps blood and does not perform waste filtration. The spleen removes aged red blood cells and participates in immune surveillance, but it is not the main organ responsible for systemic waste clearance from the bloodstream.

Question 6

Glomerulus is a network of...?

Accepted Answer

Answer reason: The glomerulus is a tuft of fenestrated capillaries supplied by an afferent arteriole and drained by an efferent arteriole, enabling high-pressure filtration into Bowman’s space. Veins are low-pressure return vessels and are not the site of initial urine formation, making that distractor incompatible with the function. Nerves and generic “cells” do not describe the vascular network structure responsible for plasma ultrafiltration.

Question 7

Waste product excreted by kidney?

Accepted Answer

Answer reason: Urea is formed in the liver via the urea cycle and is filtered at the glomerulus, with a portion reabsorbed but a significant amount excreted in urine. Glucose and most proteins are normally reabsorbed/retained; their presence in urine typically indicates pathology (e.g., diabetes mellitus or glomerular damage). Fat is not a routine urinary excretion product under normal physiology.

Question 8

Increase nitrogenous substance in blood is?

Accepted Answer

Answer reason: This is the classic term used when nitrogen-containing metabolites accumulate in blood, often preceding or accompanying acute or chronic kidney dysfunction. In contrast, azotorrhea describes excess nitrogenous compounds in urine, not blood. Steatorrhea is fat in stool, and melena is black tarry stool from upper GI bleeding, neither related to nitrogenous blood levels.

Question 9

What electrolytes are manipulated in hemodialysis dialysate?

Accepted Answer

Answer reason: Sodium is adjusted to support osmolality and intradialytic hemodynamic stability, potassium is set lower than plasma to remove excess and prevent dysrhythmias, and calcium is tailored to manage calcium balance and bone-mineral physiology. Because these electrolytes are intentionally set in the dialysate to control net movement into or out of the blood, multiple listed electrolytes are manipulated. Choosing a single electrolyte would be incomplete because standard dialysate formulations routinely include and titrate all three.

Question 10

A patient diagnosed with rhabdomyolysis is at risk for which of the following complications?

Accepted Answer

Answer reason: Myoglobin can precipitate in renal tubules (especially with hypovolemia and acidic urine), producing pigment-induced acute tubular necrosis and decreased GFR. This makes acute kidney injury a classic and high-priority complication to anticipate and monitor (rising creatinine, oliguria, dark urine). Pulmonary embolism and deep vein thrombosis are not hallmark direct complications of rhabdomyolysis in the way pigment nephropathy is, although immobility from the precipitating event can independently increase clot risk.

Question 11

Water level is balanced by;?

Accepted Answer

Answer reason: The kidneys adjust urine volume and concentration via nephron function under hormonal control (especially ADH and aldosterone), directly determining total body water. While the brain (hypothalamus/pituitary) senses osmolality and triggers thirst/ADH release, the organ that executes day-to-day water balance is the kidney. The lungs contribute to insensible water loss but are not the primary regulator of fluid balance.

Question 12

Glucose and amino acid are reabsorbed in the body?

Accepted Answer

Answer reason: The proximal tubule has abundant sodium-coupled cotransporters that reabsorb nearly all filtered glucose and amino acids under normal plasma levels. In contrast, the loop of Henley primarily reabsorbs water and NaCl to build the medullary gradient, while the distal tubule and collecting duct mainly fine-tune electrolytes, acid–base balance, and water under hormonal control. When proximal transport maximum is exceeded (e.g., hyperglycemia), glucose appears in urine, underscoring that this reabsorption normally occurs in the proximal segment.

Question 13

Which part of the kidney forms the urine?

Accepted Answer

Answer reason: Urine is formed through the integrated processes of filtration, reabsorption, secretion, and concentration carried out by the kidney’s functional unit. The nephron includes the renal corpuscle and the tubular system, so it encompasses all steps needed to produce final urine. The glomerulus alone only performs the initial filtration step (creating filtrate), while the proximal tubule and loop of Henle modify that filtrate but do not represent the entire urine-forming apparatus. Therefore, the most complete and accurate structure responsible for forming urine is the nephron as a whole.

Question 14

The nurse is aware that perineal pain in the absence of any observable cause is suggestive of which condition?

Accepted Answer

Answer reason: Prostatic inflammation can produce deep aching or pressure in the perineum and rectal area, sometimes with urinary symptoms, even when external inspection of the perineum is normal. Internal hemorrhoids are typically painless unless thrombosed or prolapsed, and would usually have an anorectal source on exam. Renal calculi most often cause flank pain radiating to the groin/testicle rather than isolated perineal pain, while endometriosis is a gynecologic cause of pelvic pain and is less specifically characterized by isolated, unexplained perineal pain.

Question 15

When a client with nephrotic syndrome manifests anasarca, the nurse relates this assessment finding to which abnormally low laboratory value?

Accepted Answer

Answer reason: Hypoalbuminemia is the key lab abnormality that explains generalized, severe edema. Nephrotic syndrome more typically causes hyperlipidemia (so cholesterol is not low). While total calcium can be reduced due to decreased protein binding, it is not the main mechanism producing anasarca compared with low serum albumin.

Question 16

The nurse is assessing a client who reports painful urination during and after voiding. The nurse suspects the client may have a problem with which area of the client’s urinary system?

Accepted Answer

Answer reason: Urethritis causes burning with urination because the inflamed urethral lining is directly exposed to urine flow and friction. In contrast, kidney pathology more often presents with flank pain, fever, and systemic symptoms rather than pain specifically tied to the act of voiding. Bladder involvement can cause suprapubic discomfort and frequency/urgency, but the classic “burning with urination” symptom points more directly to the urethra.

Question 17

The nurse is caring for the client who was newly diagnosed with renal cell carcinoma. The nurse should assess for which specific symptoms?

Accepted Answer

Answer reason: Hematuria (often painless initially) is a common early clue, and flank pain can occur as the tumor enlarges, stretches the renal capsule, or causes local invasion. This pairing best matches the typical RCC symptom cluster (often taught with a palpable flank mass as the third feature). Dysuria, suprapubic pain, and foul-smelling urine are more consistent with lower urinary tract infection or cystitis rather than a primary renal malignancy.

Question 18

The pediatric client with CKD has elevations in serum creatinine and BUN. The nurse interprets this to mean that the child has a reduction in which component?

Accepted Answer

Answer reason: In chronic kidney disease, nephron loss and dysfunction reduce filtration across the glomerulus, which directly lowers the rate at which these solutes are excreted. A lower filtration rate therefore correlates with higher serum creatinine and BUN. Decreased erythropoietin and growth issues can occur in CKD, but they do not directly explain elevated BUN/creatinine as the primary mechanism. Reduced renal blood flow can lower filtration in some settings, but the lab pattern is most directly interpreted as decreased filtration capacity.

Question 19

When teaching a client about cystitis, a nurse explains that females are more prone to the disorder than males. Which factor explains a female’s increased susceptibility?

Accepted Answer

Answer reason: In females, the urethral meatus is closer to the anus, making transfer of organisms like E. coli to the periurethral area more likely during wiping, intercourse, or poor perineal hygiene. This anatomic relationship also acts alongside the relatively shorter female urethra to facilitate ascent into the bladder. Inadequate fluid intake can contribute to UTIs in any sex but does not explain the sex-based difference in susceptibility.

Question 20

A nurse suspects that a client with polyuria is experiencing water diuresis. The nurse assesses the laboratory values for which of the following?

Accepted Answer

Answer reason: Dilute urine contains fewer solutes per unit volume, so urine concentration measures fall rather than rise. Urine specific gravity tracks urine concentration; therefore it is expected to be low (or at most normal) in water diuresis. By contrast, solute diuresis would tend to increase urine osmolarity and specific gravity, making those options less consistent with pure water diuresis.

Question 21

The client is hospitalized with nephrotic syndrome and has 3+ pitting edema in all extremities. Which laboratory test result should the nurse associate with this condition?

Accepted Answer

Answer reason: This makes proteinuria the hallmark associated lab finding. Serum albumin would be decreased (hypoalbuminemia), not elevated. Nephrotic syndrome is also associated with hyperlipidemia (increased lipids), not low serum lipid levels, while multiple renal cysts suggests polycystic kidney disease rather than nephrotic syndrome.

Question 22

The physician tells a client who underwent an orchiectomy for testicular cancer that a persistent elevation in alpha-fetoprotein level remains. The nurse is aware that this finding is consistent with which statement?

Accepted Answer

Answer reason: Alpha-fetoprotein is a tumor marker associated with certain nonseminomatous testicular germ cell tumors, and it should fall after definitive treatment if all tumor burden has been removed. Persistent elevation after orchiectomy implies ongoing production from residual tumor tissue elsewhere in the body. This most strongly indicates metastatic or residual disease rather than normal postoperative physiology. Fertility status and testosterone levels are not determined by AFP, and “recurrence” is less precise here than persistent post-treatment elevation indicating remaining disease burden.

Question 23

The nurse is educating the parents of the pediatric client with recurrent UTIs about perineal hygiene. The nurse’s rationale for including this component is that 80% of cases of UTI are caused by which bacteria?

Accepted Answer

Answer reason: This organism is the dominant uropathogen because its adhesins (fimbriae) allow strong attachment to uroepithelium and facilitate ascent into the bladder. Teaching perineal hygiene reduces transfer of GI bacteria to the urethral opening, thereby lowering recurrence risk. Klebsiella can cause UTIs but is less common than the leading cause in community-acquired disease. Candida typically causes fungal urinary infection in specific high-risk settings rather than accounting for the majority of routine pediatric UTIs.

Question 24

The 75-year-old client is hospitalized with ESRD. Which finding in the client’s medical record should the nurse associate with the diagnosis of ESRD?

Accepted Answer

Answer reason: A glomcular filtration rate less than 15 ml|min/1.73 m2 ESRD (kidney failure) is defined by severely reduced kidney function, most specifically an eGFR below 15 mL/min/1.73 m2 (CKD stage 5). This threshold is the standard diagnostic criterion used to stage chronic kidney disease and identify kidney failure, often prompting evaluation for dialysis or transplant. The other choices (very low urine output, markedly elevated creatinine, and very high BUN) can occur in advanced renal failure but are less definitive because they vary with hydration status, muscle mass, catabolic state, and acute vs chronic processes. Therefore, the eGFR criterion best matches the diagnosis of ESRD.

Question 25

Early sign of renal carcinoma is?

Accepted Answer

Answer reason: This finding can be intermittent and may be microscopic, making it an important early clue even before other symptoms develop. Flank pain and a palpable mass are more suggestive of more advanced local growth or obstruction rather than an early presentation. Dysuria and pyuria more strongly indicate lower urinary tract infection/inflammation, not a typical early hallmark of renal carcinoma.

Question 26

Which of the following lab values would be most significant in determining renal function in a client with a history of polycystic kidney disease?

Accepted Answer

Answer reason: Creatinine 8.7 mg/dL Serum creatinine is the most reliable routine lab marker of glomerular filtration because it is produced at a relatively constant rate and is primarily cleared by the kidneys. In progressive polycystic kidney disease, declining GFR leads to a marked rise in creatinine, making it the most direct indicator of loss of renal function. BUN can be significantly influenced by hydration status, GI bleeding, catabolic states, and protein intake, so it is less specific for renal function than creatinine. Potassium reflects impaired renal excretion and is critical for immediate safety, but it is not the best overall measure of kidney filtration performance. Uric acid may rise in reduced excretion but is nonspecific and not used as a primary renal function marker.

Question 27

Which functional unit of the kidneys is responsible for filtering the blood?

Accepted Answer

Answer reason: The nephron is the kidney’s functional unit because it contains the glomerulus and the tubular segments that then reabsorb needed solutes/water and secrete wastes to form urine. By contrast, the renal pyramid is a gross anatomic region mainly involved in concentrating urine via collecting ducts, not the primary filtration step. The ureter and renal pelvis are urine-conducting/collecting structures and do not participate in filtering blood.

Question 28

Functional unit of kidney is –?

Accepted Answer

Answer reason: Each nephron contains a renal corpuscle (glomerulus and Bowman’s capsule) that filters plasma and a tubular system that modifies filtrate to maintain fluid, electrolyte, and acid–base balance. The other options are functional units of different organs: neuron (nervous system), alveoli (lungs), and villus (intestine). Therefore, the only option that matches kidney function at the microscopic working-unit level is the nephron.

Question 29

Renal pyramids are located in?

Accepted Answer

Answer reason: Their apices (renal papillae) project into minor calyces, channeling urine toward the renal pelvis. The renal cortex instead contains renal corpuscles and convoluted tubules, not pyramids. The capsule is an external fibrous covering, and the pelvis is a collecting space for urine rather than renal parenchyma.

Question 30

Hematuria with pus cells indicates?

Accepted Answer

Answer reason: When pyuria accompanies hematuria, it supports a diagnosis such as cystitis or pyelonephritis where mucosal irritation and capillary bleeding occur alongside leukocyte migration. Nephrolithiasis can cause hematuria but typically does not produce significant pus cells unless there is a concurrent infection. Cancer is more classically associated with painless hematuria, and hypertension does not explain pyuria.

Question 31

Which organ is most affected by hypertension?

Accepted Answer

Answer reason: Chronic hypertension causes progressive small-vessel and glomerular damage (nephrosclerosis), which steadily reduces renal perfusion and filtration capacity. The kidneys are especially vulnerable because their microvasculature is continuously exposed to high intraglomerular pressures and responds with arteriole thickening and sclerosis. Over time this leads to proteinuria, rising creatinine, and chronic kidney disease, creating a harmful cycle that can further worsen blood pressure control. While the heart and brain are major target organs (LV hypertrophy/heart failure and stroke), the renal microvascular injury is among the most direct and sustained consequences of long-standing systemic hypertension.

Question 32

Which organ primarily regulates fluid balance?

Accepted Answer

Answer reason: Fluid balance is primarily controlled by adjusting water and sodium excretion to match intake and physiologic needs. The kidneys regulate extracellular fluid volume via glomerular filtration and tubular reabsorption/secretion, and they respond to key hormonal signals such as ADH and aldosterone to concentrate or dilute urine. They also participate in blood pressure/volume regulation through the renin-angiotensin-aldosterone system, linking volume status to perfusion. The heart and lungs influence volume indirectly (e.g., natriuretic peptides, CO2/water loss), but they are not the main organs that set day-to-day fluid balance.

Question 33

Which is the outermost layer of the kidney?

Accepted Answer

Answer reason: This fibrous renal capsule lies superficial to the renal cortex, making it the true outermost layer of the kidney itself. The cortex is the outermost functional parenchymal region but is still deep to the capsule. The medulla is deeper than the cortex, and the hilum is a medial indentation where vessels and the ureter enter/exit rather than a covering layer.

Question 34

Which color indicates gross hematuria?

Accepted Answer

Answer reason: Gross hematuria means blood in the urine that is visible to the naked eye, so the urine’s appearance changes. Fresh bleeding often makes urine pink to red, while older blood or oxidized hemoglobin can turn it tea-colored to brown. Yellow is typical concentrated urine, and white/cloudy urine suggests pyuria, crystals, or chyluria rather than blood. Blue urine is uncommon and usually related to dyes/medications, not hematuria.

Question 35

The functional unit of the kidney is?

Accepted Answer

Answer reason: A nephron includes the renal corpuscle and the renal tubule, allowing it to generate filtrate and then modify it into final urine. The glomerulus and Bowman’s capsule are components of the renal corpuscle and mainly participate in filtration but cannot complete urine formation alone. The loop of Henle is only one segment of the tubule specialized for concentrating urine, making it a partial structure rather than the full functional unit.

Question 36

A 70-year-old man with chronic hypertension now has decreased urine output, high creatinine, and swollen legs. What is the most likely diagnosis?

Accepted Answer

Answer reason: Reduced kidney function commonly presents with oliguria and sodium/water retention, producing dependent edema such as swollen legs. This triad (oliguria, high creatinine, edema) is most consistent with chronic renal impairment rather than a primary pulmonary or gastrointestinal disorder. Acute liver failure would more typically feature jaundice, coagulopathy, and encephalopathy rather than isolated renal indices and leg edema as the main findings.

Question 37

Which is secreted by the kidneys to increase blood pressure?

Accepted Answer

Answer reason: Juxtaglomerular cells in the afferent arteriole secrete renin, which converts angiotensinogen to angiotensin I and ultimately leads to angiotensin II–mediated vasoconstriction and aldosterone release. This raises systemic vascular resistance and promotes sodium and water retention, increasing blood pressure. Sucrase is a brush-border intestinal enzyme, not a renal secretion involved in hemodynamic control. Urea is a metabolic waste product excreted by the kidneys and does not function as a primary hormonal mediator to elevate blood pressure.

Question 38

A nurse caring for a patient with glomerulonephritis understands that due to an increase in membrane permeability the patient will have?

Accepted Answer

Answer reason: The associated swelling and obstruction within the glomerulus reduces the effective filtration surface area and hydraulic conductivity, which lowers GFR. A reduced GFR leads to decreased urine output, commonly presenting as oliguria and fluid retention. Polyuria is more consistent with impaired concentrating ability or osmotic diuresis rather than the acute inflammatory reduction in filtration seen here.

Question 39

Normal number of nephrons in each kidney is about?

Accepted Answer

Answer reason: This approximate nephron count is the standard taught baseline for normal renal microanatomy. Counts like 100,000 or 500,000 are too low to represent typical nephron endowment per kidney, while 10 million is far above accepted human values. Knowing the approximate nephron number helps contextualize how significant nephron loss can still be clinically silent until remaining nephrons can no longer compensate.

Question 40

Common renal cause of hematuria is?

Accepted Answer

Answer reason: Glomerulonephritis classically presents with hematuria (often with proteinuria and RBC casts) and is a primary renal parenchymal cause. Diabetes more typically causes diabetic nephropathy with albuminuria/proteinuria rather than frank hematuria as a defining feature. Liver cirrhosis and asthma are not typical primary renal causes of hematuria.

Question 41

Hematuria due to renal trauma may lead to?

Accepted Answer

Answer reason: Ongoing blood loss reduces circulating volume, leading to hypovolemic shock with tachycardia, hypotension, and poor perfusion. The other options are nonspecific and not direct, expected consequences of bleeding from kidney injury. Clinically, the priority concern with traumatic hematuria is occult hemorrhage and hemodynamic instability.

Question 42

Hematuria after strenuous exercise is?

Accepted Answer

Answer reason: It is typically self-limited and resolves with rest and hydration within about 24–72 hours. In contrast, persistent hematuria, associated dysuria/fever, flank pain, or recurrent episodes would raise concern for infectious or other pathological causes and warrant evaluation. The question asks the usual classification of hematuria immediately after strenuous exercise, which fits a benign, functional process rather than chronic disease.

Question 43

Hematuria with fever and dysuria suggests?

Accepted Answer

Answer reason: This symptom cluster is classic for cystitis and, when fever is prominent, raises concern for upper-tract involvement (pyelonephritis). Hypertension and diabetes are not typical direct causes of acute dysuria with fever. While malignancy can cause hematuria, it more often presents with painless hematuria and does not usually cause fever unless complicated by infection.

Question 44

Hematuria with flank pain indicates?

Accepted Answer

Answer reason: Hematuria with acute flank pain most strongly suggests urinary tract obstruction with mucosal irritation, classically from nephrolithiasis. A stone moving in the ureter produces colicky flank pain and can abrade the urothelium, leading to visible or microscopic blood in urine. Peptic ulcer pain is epigastric and not associated with hematuria, and diabetes or hypertension do not typically present with sudden flank colic plus bleeding. This symptom pairing is a high-yield presentation for renal/ureteral calculi.

Question 45

The process of urine formation includes all EXCEPT?

Accepted Answer

Answer reason: These steps determine what solutes and water are removed from blood, reclaimed back to circulation, or actively added into tubular fluid to be excreted. Digestion is a gastrointestinal process involving breakdown of food and absorption of nutrients, not a renal mechanism of urine production. A common confusion is with “absorption,” but renal reabsorption specifically refers to moving filtered substances from the tubule back into the blood.

Question 46

Which structure carries urine from kidney to bladder?

Accepted Answer

Answer reason: The urethra is distal to the bladder and carries urine from the bladder to the outside of the body, so it is not the transport pathway from kidney to bladder. The renal vein returns filtered blood from the kidney to the systemic circulation and does not transport urine. The collecting duct is an intrarenal structure that drains nephrons into the renal pelvis, but it does not connect directly to the bladder.

Question 47

Which of the following can cause hematuria due to infection?

Accepted Answer

Answer reason: Hematuria can occur when infection and inflammation involve the urinary tract mucosa, making it friable and prone to bleeding. A lower UTI (cystitis) commonly causes dysuria, frequency, urgency, and may produce gross or microscopic blood in the urine. In contrast, infections primarily in the respiratory tract or gastrointestinal tract would not typically cause urinary bleeding unless there is separate urinary involvement. Therefore, a urinary tract infection is the most direct infectious cause of hematuria among the choices.

Question 48

A male client is scheduled for a renal clearance test. Nurse Sheldon should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in?

Accepted Answer

Answer reason: Renal clearance is defined as the volume of plasma that is completely cleared of a given substance by the kidneys per unit time, classically expressed in mL/min. The key concept is that the standard unit of time for reporting clearance (e.g., creatinine clearance, inulin clearance) is per minute, reflecting an instantaneous rate rather than the duration of urine collection. While urine for creatinine clearance may be collected over hours (often 24 hours) to obtain an accurate urine concentration, the calculated result is still normalized to a per-minute rate. Therefore the explanation of what clearance represents aligns with a 1-minute time basis.

Question 49

Which patient is at greatest risk for developing a urinary tract infection (UTI)?

Accepted Answer

Answer reason: Postmenopausal estrogen decline leads to urogenital atrophy and reduced vaginal lactobacilli, increasing vaginal pH and promoting colonization with uropathogens that can ascend into the bladder. This also decreases local mucosal defenses, making symptomatic bacteriuria and recurrent infections more likely. The other options do not inherently increase UTI risk in the absence of urinary retention, catheterization, diabetes, or immunosuppression. Age/menopausal status is therefore the strongest risk factor among the choices provided.

Question 50

A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client?

Accepted Answer

Answer reason: This concentrating defect can appear before advanced loss of filtration, so urine output may be normal-to-high rather than low early in the disease course. Oliguria and anuria are more consistent with advanced renal failure or acute severe reductions in renal perfusion/obstruction. Polydipsia can occur secondarily, but it is not as characteristic a primary assessment finding as increased urine output in early CKD.

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