Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

Chapter 14
The Kidneys and Regulation of Water and Inorganic Ions
 

Multiple Choice Questions

 

1. Functions of the kidneys include 

A. The regulation of body salt and water balance
B. Hydrogen ion homeostasis
C. The regulation of blood glucose concentration
D. The regulation of body salt and water balance and hydrogen ion homeostasis
E. All of the choices are correct

Bloom's Level: 1. Remember

Section 14A.01
Topic: Urinary System
 

2. Which of the following does not correctly describe kidney function? The kidneys 
A. Contribute significantly to long-term regulation of arterial blood pressure by maintaining
the proper plasma volume
B. Produce urine of a fixed composition in order to maintain homeostasis of extracellular fluid
C. Excrete metabolic waste products
D. Assist in maintaining proper acid-base balance in the body
E. Secrete hormones

Bloom's Level: 1. Remember

Section 14A.01
Topic: Urinary System
 

3. Basic renal processes include 

A. Filtration from Bowman's capsule into the glomerulus
B. Secretion from the tubule into the peritubular capillaries
C. Reabsorption from the capillaries into the tubular lumen
D. Filtration from Bowman's capsule into the glomerulus and secretion from the tubule into
the peritubular capillaries
E. None of the choices are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

4. The amount of a substance that is excreted in the urine is equal to the amount that is
________ plus the amount that is ________ minus the amount that is ________. 
A. Filtered; reabsorbed; secreted
B. Reabsorbed; filtered; secreted
C. Secreted; reabsorbed; filtered
D. Filtered; secreted; reabsorbed
E. Reabsorbed; secreted; filtered

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

5. Which of the following does not normally appear in the glomerular filtrate? 
A. Glucose
B. Plasma protein
C. Sodium
D. Urea
E. Bicarbonate ion

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

6. Each of the following substances is initially present in proximal tubular fluid in the kidney.
Which one is not normally present in urine? 
A. Calcium ion
B. Hydrogen ion
C. Potassium ion
D. Phosphate ion
E. Glucose

Bloom's Level: 2. Understand

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

7. The kidneys regulate, or help to regulate, the plasma concentration of each of the following
except 
A. Water
B. Sodium ion
C. Potassium ion
D. Phosphate ion
E. Glucose

Bloom's Level: 2. Understand

Section 14A.03
Topic: Urinary System
 

8. The juxtaglomerular apparatus is 

A. Composed of parts of the ascending limb of the loop of Henle and the efferent arteriole
B. Composed of juxtaglomerular cells and the macula densa
C. The site of renin secretion
D. Composed of parts of the ascending limb of the loop of Henle and the efferent arteriole and
composed of juxtaglomerular cells and the macula densa
E. Composed of juxtaglomerular cells and the macula densa and the site of renin secretion

Bloom's Level: 1. Remember

Section 14A.02
Topic: Urinary System
 

9. The composition of the glomerular filtrate 

A. Is identical to that of blood plasma
B. Is identical to that of urine
C. Changes as the filtrate passes through the tubule
D. Is both is identical to that of blood plasma and is identical to that of urine
E. Is both is identical to that of blood plasma and changes as the filtrate passes through the
tubule

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

10. Which of the following statements concerning the process of glomerular filtration is

correct? 
A. The hydrostatic pressure in Bowman's space opposes filtration
B. The glomerular filtration rate is limited by a transport maximum
C. All of the plasma that enters the glomerulus is filtered
D. Both the hydrostatic pressure in Bowman's space opposes filtration and the glomerular
filtration rate is limited by a transport maximum are correct
E. Both the hydrostatic pressure in Bowman's space opposes filtration and all of the plasma
that enters the glomerulus is filtered are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

11. Which of the following statements regarding glomerular filtration is correct? 

A. It will occur when the hydrostatic pressure in the glomerulus exceeds the sum of the fluid
pressure in the capsule plus the osmotic force due to proteins in the plasma
B. GFR is increased by sympathetic stimulation of afferent glomerular arterioles
C. GFR increases in response to decreasing plasma volume
D. Both it will occur when the hydrostatic pressure in the glomerulus exceeds the sum of the
fluid pressure in the capsule plus the osmotic force due to proteins in the plasma and GFR is
increased by sympathetic stimulation of afferent glomerular arterioles are correct
E. Both it will occur when the hydrostatic pressure in the glomerulus exceeds the sum of the
fluid pressure in the capsule plus the osmotic force due to proteins in the plasma and GFR
increases in response to decreasing plasma volume are correct

Bloom's Level: 2. Understand

Section 14A.03
Topic: Urinary System
 

14-5
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

12. Constriction of the ________ decreases hydrostatic pressure in the nephron's filtering

structures; the _________. 
A. Afferent arterioles, glomerular capillaries
B. Efferent arterioles, proximal convoluted tubules
C. Renal vein, peritubular capillaries
D. Renal arteries, juxtaglomerular apparatus
E. Vasa recta, ascending loop of Henle

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

13. Tubular reabsorption of 

A. Glucose is active
B. Glucose is saturable
C. Urea would not occur if water were not being reabsorbed simultaneously
D. Both glucose is active and glucose is saturable are correct
E. All of the choices are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

14. Tubular reabsorption 
A. Involves the movement of substances from the peritubular capillaries into the tubular fluid
B. Occurs only in the proximal tubule
C. Involves transepithelial transport that may have a combination of active and passive
components
D. Both involves the movement of substances from the peritubular capillaries into the tubular
fluid and occurs only in the proximal tubule are correct
E. Both involves the movement of substances from the peritubular capillaries into the tubular
fluid and involves transepithelial transport that may have a combination of active and passive
components are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

15. Renal tubular cells may 

A. Actively transport molecules across their basolateral membranes in order to secrete the
molecules into the tubular lumen
B. Synthesize substances in order to secrete them into the tubular lumen
C. Secrete protein into the tubular lumen
D. Both actively transport molecules across their basolateral membranes in order to secrete
the molecules into the tubular lumen and synthesize substances in order to secrete them into
the tubular lumen are correct
E. Both synthesize substances in order to secrete them into the tubular lumen and secrete
protein into the tubular lumen are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

16. Which of the following substances undergo renal tubular secretion? 

A. Calcium ion
B. Sodium ion
C. Potassium ion
D. Both calcium ion and sodium ion are correct
E. All of the choices are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

17. A person who is in balance for total body water 

A. Must ingest more water than is lost in the urine
B. Must ingest more water than is lost by all output pathways combined
C. Will have a balanced intake and output so that total body water will stay the same
D. Both must ingest more water than is lost in the urine and will have a balanced intake and
output so that total body water will stay the same are correct
E. Both must ingest more water than is lost by all output pathways combined and will have a
balanced intake and output so that total body water will stay the same are correct

Bloom's Level: 2. Understand

Section 14B.01
Topic: Water, Electrolyte, and Acid-Base Balance
 

18. Both water and sodium are 

A. Filtered at the glomerulus
B. Actively reabsorbed by the tubule
C. Secreted by the tubule
D. Both filtered at the glomerulus and actively reabsorbed by the tubule are correct
E. Both filtered at the glomerulus and secreted by the tubule are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

19. The active transport of sodium 

A. In all segments of the tubule is dependent upon Na, K-ATPase pumps in the luminal
membrane
B. In all segments of the tubule follows passive transport of sodium into the epithelial cells
C. In the proximal tubule allows for secondary active cotransport of hydrogen ion and
countertransport of glucose and amino acids
D. Both in all segments of the tubule is dependent upon Na,K-ATPase pumps in the luminal
membrane and in all segments of the tubule follows passive transport of sodium into the
epithelial cells are correct
E. Both in all segments of the tubule follows passive transport of sodium into the epithelial
cells and in the proximal tubule allows for secondary active cotransport of hydrogen ion and
countertransport of glucose and amino acids are correct

Bloom's Level: 2. Understand

Section 14A.03
Topic: Urinary System
 

20. The tubular fluid is ________ to plasma as it enters Bowman's space, ______ to plasma at
the beginning of the loop of Henle, ______ to plasma at the tip of the loop and ________ to
plasma as it leaves the loop to enter the distal convoluted tubule. 
A. Isosmotic; hyperosmotic; hyperosmotic; isosmotic
B. Isosmotic; isosmotic; hypoosmotic; hypoosmotic
C. Isosmotic; isosmotic; hyperosmotic; hypoosmotic
D. Isosmotic; isosmotic; hypoosmotic; hyperosmotic
E. Isosmotic; isosmotic; hyperosmotic; isosmotic

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

21. Water is reabsorbed from the kidney filtrate at 

A. The proximal tubule
B. The ascending limb of the loop of Henle
C. The distal convoluted tubule and the collecting ducts
D. The proximal tubule and the distal convoluted tubule and the collecting ducts
E. All of the choices are correct

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

22. In terms of the amount of water lost or conserved through urine formation, which
region(s) of the renal tubule demonstrate the highest degree of variability? 
A. The glomerulus
B. Proximal convoluted tubule
C. Loop of Henle
D. Distal convoluted tubule
E. Cortical and medullary collecting ducts

Bloom's Level: 2. Understand

Section 14B.02
Topic: Urinary System
 

23. The countercurrent multiplier system of the kidney 

A. Allows the kidneys to form hypertonic urine
B. Requires that the collecting ducts be near the loops of Henle
C. Requires active transport of sodium and chloride out of the ascending limb of the loop of
Henle
D. Would not function if the ascending limb of the loop of Henle were freely permeable to
water
E. Is described by all of these choices

Bloom's Level: 2. Understand

Section 14B.02
Topic: Urinary System
 

14-12
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

24. Because of the countercurrent multiplier system in the loop of Henle and the proximity to
it of the medullary collecting ducts, 
A. Hyperosmotic urine is generated by active salt reabsorption through membranes that are
relatively impermeable to water and the diffusion of water through membranes responsive to
vasopressin
B. Hypoosmotic urine is generated by active salt reabsorption through membranes
impermeable to water and the diffusion of water through membranes responsive to
vasopressin
C. Hyperosmotic urine is generated by active salt secretion into the loop of Henle and into the
medullary collecting ducts
D. Hypoosmotic urine is generated by active salt secretion into the loop of Henle and into the
medullary collecting ducts
E. The body must excrete a dilute urine

Bloom's Level: 2. Understand

Section 14B.02
Topic: Urinary System
 

25. Water, reabsorbed into the blood returns to the bloodstream via 

A. The vasa recta
B. Afferent arterioles
C. Efferent arterioles
D. Peritubular capillaries
E. Collecting ducts

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

26. With the condition known as diabetes mellitus 

A. An individual's blood plasma glucose concentration exceeds 180 mg./100ml
B. The status of blood can be correctly described as hypoglycemic
C. Plasma glucose concentration is less than the transport maximum by the nephrons
D. The ability of tissue cells to take up glucose is dramatically increased beyond normal
E. All of the choices are correct

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

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Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

27. Vasopressin/antidiuretic hormone 
A. Is a peptide hormone released from the adrenal gland
B. Triggers insertion of aquaporins into the luminal membranes of collecting ducts
C. Promotes the excretion of water into urine
D. Promotes the secretion of potassium into urine
E. All of the choices are correct

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

28. A person who is unable to synthesize vasopressin 

A. Is unable to reabsorb water in the proximal tubule
B. Will excrete glucose in the urine
C. Will excrete a hypotonic urine
D. Will excrete up to 180 L of urine per day
E. Will do all of these things

Bloom's Level: 3. Apply

Section 14B.02
Topic: Urinary System
 

29. Diabetes insipidus is a disease that is associated with a deficiency of 

A. ACTH
B. Vasopressin
C. Atrial natriuretic factor
D. Angiotensin II
E. Insulin

Bloom's Level: 1. Remember

Section 14B.02
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-15
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

30. Which of the following most accurately describes the renal transport of sodium ion? 
A. Sodium ion is actively transported in all segments of the tubule
B. Primary active transport of sodium ion allows for secondary active transport of glucose and
hydrogen ions in the proximal tubule
C. Most of the sodium transport occurs in the distal convoluted tubule and collecting ducts
D. All of the choices are correct
E. None of the choices are correct

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

31. About 2/3 of the reabsorption of sodium and chloride takes place in the structure of the
nephron known as the 
A. Renalron
B. Glomerulus
C. Proximal convoluted tubule
D. Distal convoluted tubule
E. Collecting duct

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

32. A decrease in the total body content of sodium causes 

A. A concurrent increase in plasma volume, which induces an increase in GFR and sodium
reabsorption
B. A concurrent decrease in plasma volume, which induces an increase in GFR and sodium
reabsorption
C. A concurrent increase in plasma volume, which induces an increase in GFR and a decrease
in sodium reabsorption
D. A concurrent decrease in plasma volume, which induces a decrease in GFR and sodium
reabsorption
E. A concurrent decrease in plasma volume, which induces a decrease in GFR and an increase
in sodium reabsorption

Bloom's Level: 3. Apply

Section 14B.03
Topic: Urinary System
 

14-16
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-17
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

33. The rate-limiting (regulated) step for stimulating the secretion of aldosterone is 
A. Conversion of angiotensin I to angiotensin II in the blood
B. Secretion of angiotensinogen by the liver
C. Conversion of angiotensinogen to angiotensin I in the blood
D. Secretion of ACTH by the anterior pituitary
E. Secretion of angiotensin II by the kidney

Bloom's Level: 1. Remember

Section 14B.03
Topic: Urinary System
 

34. Which of the following statements regarding renal handling of sodium ion is correct? 
A. In the proximal tubule, sodium ion is actively transported across the luminal membrane of
the tubular epithelial cells
B. Atrial natriuretic factor increases sodium ion reabsorption
C. In the absence of aldosterone, no sodium ion reabsorption will occur in the cortical
collecting ducts
D. Reabsorption of sodium ion in the proximal tubule is not regulated by hormones
E. None of the choices are true

Bloom's Level: 2. Understand

Section 14B.03
Topic: Urinary System
 

35.  Renin  
A.  Is secreted by juxtaglomerular cells in renal afferent arterioles
B.  Secretion is enhanced by high levels of Na+ in the macula densa
C.  Secretion is stimulated by elevated blood pressure in the renal afferent arterioles
D.  Acts on the adrenal cortex to stimulate aldosterone secretion
E.  Is described by all of these things

Bloom's Level: 1. Remember

Section 14B.03
Topic: Urinary System
 

14-18
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

36.  Which of the following organs participate in regulating aldosterone levels in the blood?  
A.  Kidneys and liver
B.  Adrenal glands
C.  Systemic and pulmonary blood vessels
D.  Both kidneys and liver and adrenal glands are correct
E.  All of the choices are correct

Bloom's Level: 2. Understand

Section 14B.03
Topic: Urinary System
 

37. Which of the following would be likely to increase GFR? 

A. Increasing sympathetic stimulation of afferent arteriolar smooth muscle
B. Increasing efferent arteriolar vasoconstriction
C. Decreasing plasma volume
D. Increasing the concentration of plasma proteins
E. Increasing secretion of renin

Bloom's Level: 2. Understand

Section 14B.03
Topic: Urinary System
 

38. Following ingestion of a large amount of salt, 

A. Urine osmolarity would increase
B. Secretion of atrial natriuretic factor would increase
C. Firing by hypothalamic osmoreceptors would decrease
D. Both urine osmolarity would increase and secretion of atrial natriuretic factor would
increase would occur
E. All of these things would occur

Bloom's Level: 3. Apply

Section 14B.03
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-19
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

39. In the presence of aldosterone, most of the reabsorption of sodium occurs in the 
A. Proximal tubule
B. Macula densa
C. Descending limb of the loop of Henle
D. Distal convoluted tubule
E. Cortical collecting duct

Bloom's Level: 2. Understand

Section 14B.03
Topic: Urinary System
 

40. Which of the following would increase the excretion of sodium and water? 
A. Increased hydrostatic pressure in the afferent renal arterioles
B. Increased mean arterial blood pressure
C. Increased atrial distension
D. Both increased hydrostatic pressure in the afferent renal arterioles and increased mean
arterial blood pressure are correct
E. All of the choices are correct

Bloom's Level: 3. Apply

Section 14B.03
Topic: Water, Electrolyte, and Acid-Base Balance
 

41.  Formation of a highly concentrated urine is dependent upon  

A.  Elevated levels of vasopressin in the plasma
B.  Elevated levels of aldosterone in the plasma
C.  Active transport of Na+ and Cl- by the descending limb of the loops of Henle
D.  Elevated levels of vasopressin in the plasma and elevated levels of aldosterone in the
plasma
E.  All of the choices are correct

Bloom's Level: 2. Understand

Section 14B.04
Topic: Urinary System
 

14-20
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

42. Stimuli for vasopressin secretion include 

A. Increased plasma osmolarity
B. Increased plasma volume
C. Ingestion of alcohol
D. Increased plasma osmolarity and increased plasma volume
E. All of the choices are true

Bloom's Level: 1. Remember

Section 14B.04
Topic: Water, Electrolyte, and Acid-Base Balance
 

43. The loss of 0.5 L of sweat would stimulate a greater increase in vasopressin secretion than
the loss of an equal amount of blood plasma over the same period of time. This statement is 
A. True because sweat is hyperosmotic to plasma
B. True because sweat is hypoosmotic to plasma
C. False because sweat is hypoosmotic to plasma
D. False because sweat is isosmotic to plasma
E. False because sweat is hyperosmotic to plasma

Bloom's Level: 3. Apply

Section 14B.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

44. After prolonged exertion in a hot climate, baroreceptors would ________ firing, leading to
________ secretion of ________ and thus ________ renal reabsorption of ________. 
A. Increase; increased; renin; increased; sodium ion
B. Decrease; increased; renin; decreased; sodium ion
C. Decrease; increased; vasopressin; increased; water
D. Increase; decreased; vasopressin; decreased; water
E. Decrease; decreased; vasopressin; increased; water

Bloom's Level: 3. Apply

Section 14B.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-21
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

45.  Which of the following most accurately describes the actions of aldosterone?  
A.  Aldosterone increases Na+ secretion and K+ reabsorption in the cortical collecting ducts
B.  Aldosterone increases Na+ reabsorption and K+ secretion in the proximal tubule
C.  Aldosterone decreases Na+ reabsorption and K+ secretion in the cortical collecting ducts
D.  Aldosterone increases Na+ secretion and K+ reabsorption in the proximal tubule
E.  Aldosterone increases Na+ reabsorption and K+ secretion in the cortical collecting ducts

Bloom's Level: 1. Remember

Section 14B.03
Topic: Urinary System
 

46.  Stimuli for the increased secretion of aldosterone include  

A.  Increased potassium ion concentration in adrenal cortical arterial blood
B.  Increased angiotensin II concentration in adrenal cortical arterial blood
C.  Decreased sodium ion concentration in adrenal cortical arterial blood
D.  Both increased potassium ion concentration in adrenal cortical arterial blood and increased
angiotensin II concentration in adrenal cortical arterial blood
E.  All of the choices are correct

Bloom's Level: 2. Understand

Section 14B.03
Topic: Water, Electrolyte, and Acid-Base Balance
 

47. Which of the following drugs is not likely to decrease blood pressure? 

A. Drug that interferes with aldosterone synthesis
B. Drug that is an agonist of atrial natriuretic factor
C. Drug that decreases sympathetic stimulation of renal arterioles
D. Drug that enhances the activity of angiotensin-converting enzyme
E. Drug that decreases liver production of angiotensinogen

Bloom's Level: 3. Apply

Section 14B.03
Topic: Urinary System
 

14-22
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

48. The reabsorption of calcium from the kidney filtrate is accomplished mostly (60%) by the
_____, but is then supplemented and further controlled under the influence of parathyroid
hormone at the ______. 
A. Proximal convoluted tubule, distal convoluted tubule
B. Distal convoluted tubule, proximal convoluted tubule
C. Proximal convoluted tubule, cortical and medullary collecting ducts
D. Distal convoluted tubule, cortical and medullary collecting ducts
E. Distal convoluted tubule, renal corpuscle

Bloom's Level: 1. Remember

Section 14B.08
Topic: Urinary System
 

49. Which of the following symptoms would a patient with a deficiency of parathyroid

hormone be most likely to experience? 
A. Low plasma calcium levels and decreased muscular excitability
B. Low plasma calcium levels and increased muscular excitability
C. Elevated plasma calcium levels and decreased muscular excitability
D. Elevated plasma calcium levels and increased muscular excitability
E. None of the choices are correct

Bloom's Level: 3. Apply

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

50.  The kidneys help restore lowered Ca2+ levels in the blood by  
A.  Increasing 1,25-dihydroxyvitamin D3 formation, decreasing phosphate reabsorption, and
increasing Ca2+ reabsorption
B.  Increasing 1,25-dihydroxyvitamin D3 formation and increasing phosphate and Ca2+
reabsorption
C.  Decreasing 1,25-dihydroxyvitamin D3 formation and increasing phosphate and Ca2+
reabsorption
D.  Increasing 1,25-dihydroxyvitamin D3 formation and increasing secretion of parathyroid
hormone
E.  Increasing secretion of parathyroid hormone and increasing bone resorption

Bloom's Level: 2. Understand

Section 14B.08
Topic: Urinary System
 

14-23
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-24
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

51.  Which of the following statements regarding calcium homeostasis is true?  

A.  Parathyroid hormone directly stimulates calcium reabsorption by the kidneys
B.  Parathyroid hormone directly stimulates calcium absorption from the GI tract
C.  In the absence of parathyroid hormone, plasma calcium ion levels would be abnormally
low, resulting in the hyperpolarization of nerve and muscle membranes
D.  Both parathyroid hormone directly stimulates calcium reabsorption by the kidneys and
parathyroid hormone directly stimulates calcium absorption from the GI tract are true
E.  Both parathyroid hormone directly stimulates calcium reabsorption by the kidneys and in
the absence of parathyroid hormone, plasma calcium ion levels would be abnormally low,
resulting in the hyperpolarization of nerve and muscle membranes are true

Bloom's Level: 1. Remember

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

52. A decrease in plasma calcium ion levels in an otherwise normal person will lead to 
A. An increase in plasma parathyroid hormone levels
B. An increase in plasma 1,25-dihydroxyvitamin D3 levels
C. An increase in nerve and muscle excitability
D. An increase in plasma parathyroid hormone levels and an increase in plasma 1,25-
dihydroxyvitamin D3 levels
E. All of the choices are correct

Bloom's Level: 3. Apply

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

53.  Renal regulation of extracellular H+ concentration is dependent upon regulating  

A.  The amount of hydrogen ion filtered by the kidneys
B.  The amount of hydrogen ion secreted by the kidneys
C.  The amount of bicarbonate ion excreted by the kidneys
D.  The amount of hydrogen ion filtered by the kidneys and the amount of hydrogen ion
secreted by the kidneys
E.  The amount of hydrogen ion secreted by the kidneys and the amount of bicarbonate ion
excreted by the kidneys

Bloom's Level: 1. Remember

Section 14C.01
Topic: Urinary System
 

14-25
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-26
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

54. Which of the following statements about renal control of blood acid/base balance is true? 
A. Increased metabolism of glutamine by renal tubular cells increases the plasma bicarbonate
concentration
B. Excretion in the urine of hydrogen bound to phosphate buffers decreases plasma
bicarbonate concentration
C. Hydrogen ion that binds to filtered bicarbonate in the tubular fluid is excreted in the urine
D. Both increased metabolism of glutamine by renal tubular cells increases the plasma
bicarbonate concentration and excretion in the urine of hydrogen bound to phosphate buffers
decreases plasma bicarbonate concentration are correct
E. Both increased metabolism of glutamine by renal tubular cells increases the plasma
bicarbonate concentration and hydrogen ion that binds to filtered bicarbonate in the tubular
fluid is excreted in the urine are correct

Bloom's Level: 2. Understand

Section 14C.04
Topic: Urinary System
 

55. Compared to a normal person, a person experiencing metabolic acidosis will have 

A. Increased renal secretion of hydrogen ion
B. Increased renal reabsorption of bicarbonate ion
C. Increased arterial .
D. Increased renal secretion of hydrogen ion and increased renal reabsorption of bicarbonate
ion
E. All of the choices are correct

Bloom's Level: 3. Apply

Section 14C.05
Topic: Urinary System
 

56. Hypoventilation is a cause of 

A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
E. None of these things

Bloom's Level: 1. Remember

Section 14C.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-27
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-28
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

57.  The kidneys respond to hypoventilation by  

A.  Increasing their secretion of H+ and increasing their reabsorption of HCO3-
B.  Increasing their secretion of H+ and decreasing their reabsorption of HCO3-
C.  Decreasing their secretion of H+ and increasing their reabsorption of HCO3-
D.  Decreasing their secretion of H+ and decreasing their reabsorption of HCO3-
E.  None of these choices

Bloom's Level: 2. Understand

Section 14C.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

58.  Compared to a blood sample from a normal person who is breathing normally, a blood
sample from a patient with pulmonary disease that resulted in hypoventilation would probably
show  
A.  Elevated plasma [H+], elevated plasma , and increased plasma [HCO3-]
+
B.  Elevated plasma [H ], elevated plasma , and decreased plasma [HCO3-]
+
C.  Elevated plasma [H ], decreased plasma , and decreased plasma [HCO3-]
D.  Decreased plasma [H+], elevated plasma , and decreased plasma [HCO3-]
+
E.  Decreased plasma [H ], decreased plasma , and decreased plasma [HCO3-]

Bloom's Level: 3. Apply

Section 14C.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

59.  A man with hypertension takes a non-potassium sparing diuretic and does not increase his
ingestion of potassium. Which of the following symptoms would he be likely to have?  
A.  Increased excitability of nerve and muscle cells
B.  Decreased excitability of nerve and muscle cells
C.  Cardiac arrythmias

Bloom's Level: 3. Apply

Section 14B.10
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-29
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

60. Urge incontinence of the urinary bladder can be controlled by administering drugs that 
A. Mimic the effects of the parasympathetic nervous system on the detrusor muscle
B. Block the action of the parasympathetic nervous system in emptying the urinary bladder
C. Promote the binding of norepinephrine to adrenergic receptors in the uretheral sphincters
D. Have potential side effects consistent with reduced activities mediated by the
parasysmpathetic nervous system
E. Have potential side effects consistent with reduced activities associated with the
sympathetic nervous system

Bloom's Level: 3. Apply

Section 14A.05
Topic: Urinary System
 
 

True / False Questions

 

61. The anatomic arrangement of nephrons in the kidneys is such that the glomerulus,
proximal tubule, and distal convoluted tubule are in the renal cortex, while the loop of Henle
and collecting ducts lie mainly in the renal medulla. 
TRUE

Bloom's Level: 1. Remember

Section 14A.02
Topic: Urinary System
 

62. The distal convoluted tubules drain into the renal pelvis, which in turn drains into the
ureter, a tube that carries urine to the bladder. 
FALSE

Bloom's Level: 1. Remember

Section 14A.02
Topic: Urinary System
 

14-30
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

63. The three basic processes of kidney function are filtration from the glomerulus to the
capsule, secretion from the tubule to the peritubular capillaries, and reabsorption from the
capillaries into the tubular lumen. 
FALSE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

64. Only substances that are filtered by the kidneys can be excreted by them. 
FALSE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

65. Large amounts of protein in a person's urine indicate that the person is eating a high-
protein diet. 
FALSE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

66. The filtered load of water is 180 L/day. 

TRUE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

67. Water, sodium, and glucose all undergo tubular reabsorption, but urea does not. 
FALSE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

14-31
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-32
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

68. The kidneys regulate the plasma concentrations of water, sodium, and glucose. 
FALSE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

69. If water intake (ingestion) is decreased, the kidney can decrease the amount of water
excreted in urine by increasing the amount of water reabsorbed at the renal corpuscle. 
FALSE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

70. In healthy individuals, the amount of glucose present in urine will be always be nil
because the amount of glucose reabsorption to the blood prevents this. 
TRUE

Bloom's Level: 1. Remember

Section 14A.03
Topic: Urinary System
 

71. The spinal reflex for micturition involves stretch receptors in the wall of the bladder that
send messages about distension to sympathetic, parasympathetic, and motor neurons in the
spinal cord. 
TRUE

Bloom's Level: 1. Remember

Section 14A.05
Topic: Urinary System
 

14-33
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

72. Voluntary control of micturition involves controlling motor input to the muscles of the
external urethral sphincter. 
TRUE

Bloom's Level: 1. Remember

Section 14A.05
Topic: Urinary System
 

73. Total-body balance of water and sodium ion is largely maintained by regulating urinary
loss of these molecules. 
TRUE

Bloom's Level: 1. Remember

Section 14B.01
Topic: Urinary System
 

74. Most of the body's water is located inside cells, whereas most of the body's sodium ion is
in the interstitial fluid and plasma. 
TRUE

Bloom's Level: 1. Remember

Section 14B.01
Topic: Water, Electrolyte, and Acid-Base Balance
 

75. The concentration of water in the extracellular fluid is dependent upon the concentration
of sodium in the extracellular fluid. 
FALSE

Bloom's Level: 1. Remember

Section 14B.01
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-34
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

76. Water movement passively follows the active transport of sodium into the interstitial fluid
outside the tubule, where both kinds of molecules then diffuse into the peritubular capillaries. 
FALSE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

77. A consequence of lack of vasopressin is excretion of sugar in the urine, diabetes mellitus. 
FALSE

Bloom's Level: 1. Remember

Section 14B.04
Topic: Water, Electrolyte, and Acid-Base Balance
 

78. A person lacking vasopressin would have to drink up to 180 L of water per day to make up
for the water lost in the urine. 
FALSE

Bloom's Level: 1. Remember

Section 14B.04
Topic: Water, Electrolyte, and Acid-Base Balance
 

79. The countercurrent mechanism of the kidney allows for the formation of hypertonic
urine. 
TRUE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

80. The walls of the ascending limb of the loop of Henle are freely permeable to water. 
FALSE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

14-35
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-36
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

81. The fluid entering the distal convoluted tubule is hypotonic with respect to plasma. 
TRUE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

82. At the bend in the loop of Henle, the osmolarity of the tubular fluid is more than four
times greater than that of the glomerular filtrate. 
TRUE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

83. The main force responsible for water reabsorption from the collecting ducts is the low
hydrostatic pressure in the surrounding interstitial space. 
FALSE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

84. Unlike the renal cortical interstitial fluid, the interstitial fluid of the medulla is
hyperosmotic. 
TRUE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

85. In the absence of vasopressin, urine is isosmotic with plasma. 

FALSE

Bloom's Level: 1. Remember

Section 14B.04
Topic: Urinary System
 

14-37
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-38
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

86. Increasing the GFR will increase the excretion rate of sodium. 

TRUE

Bloom's Level: 1. Remember

Section 14B.03
Topic: Urinary System
 

87. The loss of 0.5 L of sweat would stimulate a greater increase in ADH secretion than the
loss of an equal amount of blood plasma over the same period of time. 
TRUE

Bloom's Level: 1. Remember

Section 14B.04
Topic: Water, Electrolyte, and Acid-Base Balance
 

88. Atrial distension is a stimulus for the secretion of atrial natriuretic factor, which stimulates
the reabsorption of sodium by the kidneys. 
FALSE

Bloom's Level: 1. Remember

Section 14B.03
Topic: Urinary System
 

89. Following hemorrhage, vasopressin secretion increases because of increased firing of

hypothalamic osmoreceptors. 
FALSE

Bloom's Level: 1. Remember

Section 14B.04
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-39
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

90. Because fluid lost as sweat is isosmotic, the baroreceptor reflexes are more important than
osmoreceptor activity in restoring extracellular fluid volume after sweating. 
FALSE

Bloom's Level: 1. Remember

Section 14B.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-40
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

91. A fall in the osmolarity of the blood supplying the hypothalamus is a powerful stimulus
for thirst. 
FALSE

Bloom's Level: 1. Remember

Section 14B.06
Topic: Water, Electrolyte, and Acid-Base Balance
 

92. Regulation of extracellular potassium is not particularly important because only about two
percent of the total body potassium is in the extracellular fluid. 
FALSE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Water, Electrolyte, and Acid-Base Balance
 

93. Cardiac arrhythmias may be a clinical sign of either potassium depletion or potassium

excess. 
TRUE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Water, Electrolyte, and Acid-Base Balance
 

94. Both sodium (Na) and chloride (Cl) freely filter from the glomerular capillaries into
Bowman's space, with no secretion along the renal tubule. 
TRUE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

14-41
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

95. The reabsorption of water in the nephron is accomplished as it follows the diffusion

gradient created by sodium reabsorption. 
TRUE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

96. In the proximal convoluted tubule the reabsorption of sodium is unaffected by the
presence or absence of other molecules such as glucose or hydrogen ions in the filtrate
passing through it. 
FALSE

Bloom's Level: 1. Remember

Section 14B.02
Topic: Urinary System
 

97. Unlike sodium, potassium is secreted by the nephron tubules. 

TRUE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Urinary System
 

98. Ingestion of large amounts of potassium triggers reflexes to limit the amount of potassium
reabsorbed by the cortical collecting ducts. 
FALSE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Urinary System
 

14-42
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

99. Stimuli that cause increased sodium reabsorption decrease potassium secretion. 

FALSE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-43
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

100. A stimulus for increased aldosterone secretion is decreased plasma potassium

concentration. 
FALSE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Water, Electrolyte, and Acid-Base Balance
 

101. A substance that interferes with the active transport of sodium in the cortical collecting
ducts will also interfere with potassium reabsorption. 
FALSE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Urinary System
 

102. A stimulus for increased aldosterone secretion is increased plasma levels of potassium. 
TRUE

Bloom's Level: 1. Remember

Section 14B.07
Topic: Water, Electrolyte, and Acid-Base Balance
 

103. A clinical sign of too little calcium in the extracellular fluid is muscle spasms. 
TRUE

Bloom's Level: 1. Remember

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

104. Regulation of calcium balance, like that of sodium and potassium balance, is primarily
effected by the kidneys. 
FALSE

Bloom's Level: 1. Remember

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

14-44
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-45
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

105. Parathyroid hormone stimulates resorption of calcium and phosphate from bone and
reabsorption of these minerals in the kidneys. 
FALSE

Bloom's Level: 1. Remember

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

106. Bone is a storage depot for calcium ion. 

TRUE

Section 14B.08
Topic: Water, Electrolyte, and Acid-Base Balance
 

107. Most of the hydrogen ion excreted in the urine is bound to bicarbonate ion. 
FALSE

Bloom's Level: 1. Remember

Section 14C.04
Topic: Urinary System
 

108. One response to increased hydrogen ion production in the body is decreased reabsorption
of bicarbonate ion by the kidneys. 
FALSE

Bloom's Level: 1. Remember

Section 14C.04
Topic: Urinary System
 

109. Bicarbonate ions are secreted into the urine by the tubular cells. 
FALSE

Bloom's Level: 1. Remember

Section 14C.04
Topic: Urinary System
 

14-46
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

14-47
Chapter 14 - The Kidneys and Regulation of Water and Inorganic Ions

110. The kidneys work to rectify metabolic acidosis and alkalosis but have no effect on
respiratory acidosis and alkalosis. 
FALSE

Bloom's Level: 1. Remember

Section 14C.05
Topic: Urinary System
 

111. A consequence of an episode of severe vomiting is an increased breathing rate. 

FALSE

Bloom's Level: 1. Remember

Section 14C.05
Topic: Water, Electrolyte, and Acid-Base Balance
 

112. A diuretic is any drug that increases the volume of urine excreted as a result of inhibiting
sodium reabsorption. 
FALSE

Bloom's Level: 1. Remember

Section 14B.10
Topic: Urinary System
 

113. People taking diuretics that do not spare potassium should increase their ingestion of
sodium. 
FALSE

Bloom's Level: 1. Remember

Section 14B.10
Topic: Urinary System
 

14-48