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NSG5003 UROLOGY EXAM QUESTIONS WITH COMPLETE SOLUTIONS
1. Patients with chronic kidney disease are not likely to develop hyperkalemia as long as they secrete
adequate levels of:
A) antidiuretic hormone
B) Renin
C) Aldosterone
D) Natriuretic peptide: Aldosterone
2. In the Randall's plaque pathway for kidney stone formation, the stone is:
A) attached to plugs protruding from the opening of Bellini ducts
B) fixed to the surface of a renal papilla at sites of interstitial apatite plaque
C) formed in free solution in the renal system collection
D) formed in the interstitial or tubular compartment of the renal medulla: fixed to the surface of a
renal papilla at sites of interstitial apatite plaque
3. Which of the following is NOT associated with renal stone development?
A) high urine protein
B) low urine citrate
C) high urine calcium
D) low urine volume: High urine protein
4. The kidneys help regulate acid-base balance by:
A) secreting carbon dioxide
B) producing ammonia
C) reabsorbing phosphates
D) secreting sodium chloride: Producing ammonia
5. The volume of blood that the kidneys can clear of creatinine in 1 minutes is:
A) tubular reabsorption
B) tubular secretion
C) glomerular filtration rate
D) creatinine clearance: Creatinine clearance
6. Which of the following laboratory values is an amino acid breakdown that represents the
glomerular filtration rate and metabolism in muscles?
A) uric acid
B) creatinine
C) nitrate
D) phosphate: Creatinine
7. Which of the following is NOT a vital function of the kidney?
A) Erythropoiesis
B) Regulation of calcium formation
B) Overflow incontinence
C) Urge incontinence
D) Idiopathic incontinence: Urge incontinence. (Bladder dysfunction can develop as a result of several
neurological conditions, including peripheral neuropathy) Dys- function can result from debris or over activity or bladder outlet obstruction and result in urge urinary incontinence or stress incontinence. Diabetic neuropathy is the most common cause of peripheral neuropathy associated bladder dysfunction. Overflow incontinence results from impaired detrusor contractility. Functional incontinence is a results of a physical or mental impairment preventing successful voiding Idiopathic incontinence develops suddenly as a result of disease.
11. Aldosterone helps regulate water reabsorption by regulating which one of the following
electrolyte?
A) Phosphate
B) Chloride
C) Calcium
D) Sodium: Sodium. Aldosterone regulates water reabsorption by the distal tubules and changes urine
concentration by increasing sodium reabsorption. A high plasma aldosterone concentration increases sodium and water reabsorption by the tubules and decreases sodium and water excretion in the urine. A low plasma aldosterone concentration promotes sodium and water excretion.
12. Which enzyme is formed in the liver as a byproduct of protein metabolism and in eliminated
entirely by the kidney?
A) Creatinine
B) Uric acid
C) Urea
D) Phosphate: Urea. Urea is eliminated entirely by the kidneys. Blood urea nitrate (BUN) is related to
the glomerular filtration rate, and it is influenced by protein intake and hydration status. In a state of dehydration, BUN levels rise as a results of urea concentration. Two thirds of renal function is lost before a significant rise in the BUN level occurs.
13. Bone disease secondary to chronic kidney disease is due to alteration in levels of:
A) Potassium
B) Phosphorus
C) Sodium
D) Magnesium: Phosphorous. Renal bone disease is a common complication of chronic kidney
disease. Chronic kidney disease mineral and bone disor- der (CKD-MBD) involves biochemical abnormalities related to bone metabolism. CKD-MBD may result from alteration in levels of phosphorus, parathyroid hormone, vitamin D, and alkaline phosphates.
14. The most common type of renal calculator is formed by an increased concentration of:
A) Calcium
B) Magnesium
C) Phosphate
D) Cystine: Calcium. Calcium sones associated with increased calcium in the blood and urine. Excess
B) 8 years
C) 12 years
D) 18 years: 3 years Glomerular filtration rate (GFR) increases with age and is calculated differently
from the GFR in adults. Adjusted for body surface area, the GFR reaches adult levels at 2-3 years. Aspects of pediatric kidney function and the measure of creatinine are important in the treatment of patients of all ages.
18. Continuous urinary leaking or dribbling in the setting of incomplete blad- der emptying is
referred to as:
A) Stress incontinence
B) Over incontinence
C) Urge incontinence
D) Functional incontience: Over incontinence
19. Dysregulation of antidiuretic hormone and aldosterone in the kidneys may lead to:
A) renal stones
B) Anura
C) hypertension
D) edema: Hypertension Antidiuretic hormones and aldosterone are partially re- sponsible for
helping the kidneys maintain fluid balance. ADH (vasopressin) pro- motes reabsorption of water by collecting ducts in the kidney and is produced by the pituitary gland. Aldosterone is produced by the adrenal cortex and promotes absorption of sodium by the kidneys. In concert with ADH, water and
fluid balance is maintained. Altered ADH and aldosterone concentration may cause fluctuations in sodium and potassium concentration, and these may lead to hypertension
20. The hormone that helps control the kidney's role in fluid balance is:
A) vasopressin
B) epinephrine
C) oxytocin
D) antidiuretic: Antidiuretic
21. In which of the following patient is pyelonephritis most likely?
A) A 10 year old premenstrual girl
B) An 18 year old woman with amenorrhea
C) A 32 year old pregnant woman
D) A 55 year old woman with urge incontinence: A 32 year old pregnant woman. Physiologic changes
in pregnancy make a pregnant woman the most likely choices to experience pyelonephritis. The organisms that cause bacteriuria and UTIs in pregnant women are of the Sam species and have similar virulence factors as those in non pregnant women.
22. In children, the glomerular filtration rate is adjusted for:
A) temperature
B) body surface area
C) age
B) Struvite stone
C) Uric acid stone
D) Cristina: Uric acid stone. They are crystalline structures and pH between 5.1 and 5.9). The most
common cause for their formation is supersaturation of urine by sub- stance such as cystine, calcium and oxalate. A high prevalence of obesity, diabetes and hypertension is company associated with urine acid nephrolithiasis (Stones). These are conditions that increase the risk of gout. Gout is a well established factor for kidney stone formation.
26. The kidneys help regulate blood pressure by producing angiotensin, which is formed from the
enzyme:
A) Urease
B) trypsin
C) creating kinase
D) renin: Renin
27. The most common type of anemia in patients with chronic kidney disease is:
A) normochromic microcytic
B) hyperchromic macrocytic
C) hypochromic microcytic
D) normochromic normocytic: normochromic normocytic
28. The involuntary loss of urine during coughing or sneezing is:
A) stress incontinence
B) urge incontinence
C) overflow incontinence
D) spastic bladder: Stress incontinence. Stress incontince occur during coughing, laughing, sneezing
or lifting. It occurs as a result of increased abdominal pressure on the bladder. Reduced muscle tone associated with aging, childbirth, or surgical procedure can cause weakness in the pelvic floor muscles and result in stress incontinence by damaging the posterior urethrovesical angle.
29. Protein passes into the urine instead of being reabsorbed when the:
A) glomeruli are damaged
B) distal convoluted tubules are inflamed
C) loop of Henle is overstimulated
D) collecting tubule releases urine to quickly: Glomeruli are damaged. When the glomeruli are
damaged, protein appears in the urine (proteinuria) because the large protein molecules pass into the urine instead of being reabsorbed. The amount of a substance reabsorbed or secreted depends on the maximum tubular transport capacity of the substance. The maximum tubular transport capacity is the maximum amount of a substance that can be reabsorbed or secreted in 1 minute without saturating the renal system.
32. Mycoplasma genitalium is associated with which disease presentation in men?
A) Benign prostatic hyperplasia
B) Urethritis
C) Epididymitis
D) Urinary tract infection: Urethritis. M. Genitalium infection is common in men with persistent or
recurrent urethritis. A specialized terminal tip like structure allows M. genitalium to attach to and adhere to the surface of, and enter cells. Upon entry into the epithelia cell, M. genitalium evades the host immune response through modu- lation of the immune system, including suppression and stimulation of lymphocytes and up regulation of cytokine expression.
33. The mineralocorticoid that is produced by the adrenal cortex and helps to regulate blood
pressure is:
A) vasopressin
B) angiotensin
C) aldosterone
D) renin: Aldosterone. Aldosterone is the principle regulator of salt and water and helps regulate
blood pressure
34. A 65 year old woman who cannot make it to the bathroom in time to urinate into the toilet is
experiencing:
A) stress incontinence
B) urge incontinence
C) overactive bladder
D) functional incontinence: Urge incontinence. Urge incontinence is a sponge an sudden urge to
urinate by involuntary leakage of urine.
35. The most common cause of urethritis is:
A) Haemophilus influenza
B) Staphylococcus aureus
C) Neisseria gonorrhoea
D) Candida albicans: Neisseria gonorrhea. The most common cause of urethritis is infection via sexual
transition of N. Gonorrhoeae which is a gram negative diplodocus that interacts with noncillated epithelia cells.
36. Metabolic acidosis results from a reduction in:
A) carbonic acid
B) oxygen
C) carbon dioxide
D) bicarbonate: Bicarbonate. Metabolic acidosis results from a reduction in bicar- bonate (HCO3-),
typically accompanied by a reduction in carbon dioxide partial pressure (pCO@).
37. A 58 year old man is experiencing possible urinary retention. Which diag- nostic test should be
performed to confirm this finding?
A) Maximum urine flow rate
B) Ultrasound of the prostate
39. Which one of the following is NOT affected when urinary retention is present?
A) The urethra
B) The hypogastric nerve
C) The urethral sphincter
D) The pelvic floor: Urethra. Urinary retention is not related to urethral function. Normal voiding
requires coordinated urethral and pelvic floor muscle relaxation followed by bladder contraction.
40. Renal stones are most likely composed of:
A) calcium oxalate
B) potassium chloride
C) magnesium sulfate
D) thiamine: Calcium oxalate. Account for 80% of all stones. Uric acid (UA) accounts fo 9%, struvite
(magnesium ammonium phosphate hexahydrate) from infection by bacterial account for 10% only 1% are cystine.
41. When antidiuretic hormone (ADH) is elevated in the serum, the collecting tubules int eh kidney
become more permeable to H2), meaning the urine will have a:
A) high specific gravity
B) low specific gravity
C) higher pH
D) lower pH: Higher specific gravity. The ADH alters the collection tubules' per- meability to water.
When ADH concentration in serum is high, the tubules are more permeable to water. This cause more water to be absorbed, creating a highly concentrated but small volume of urine that has a high specific gravity.
42. Bacterial invasion if the renal parenchyma is termed:
A) urinary tract infection
B) bacterial vaginosis
C) pyleonephritis
D) epididymitis: Pyelonephritis. Acute pyelonephritis results from bacterial invasion of the renal
parenchyma. Bacterial usually reach the kidney by ascending from the lower urinary tract.
43. Infection of the upper urinary tract and renal parenchyma is called:
A) pyelonephritis
B) cystitis
C) nephrolithiasis
D) urinary retention: Pyelonephritis. Acute pyelonephritis is an infection of the upper urinary tract and
renal parenchyma. It is usually uncomplicated, but if it is not managed appropriately, it can lead to bacteremia, scarring, and death. The primary source of infection, accounting form 75% of cases, is E. Coli.
44. A 50% rise in plasma creatinine represent a nephron mass loss of:
A) Lactobacillus
B) Escherichia Coli
C) Staphylococcus
D) Klebsiella: Lactobacillus. Isolation of more than one species, or the presence of Lactobacillus or
Cutibacterium, indicate that the specimen was contaminated by vaginal or skin flora. Echerichia coli is the most common pathogen in UTI's. Less common are Staphylococcus and Klebsiella
48. In a normal functioning kidney, the majority of glucose is reabsorbed in the:
A) renal corpuscle
B) glomerulus
C) proximal convoluted tubule
D) loop of Henle: Proximal convoluted tubule is a small tubular structure within the nephron of the
kidney. The PCT connects Bowman's capsule with the proximal
straight tubule, and it is essential for the reabsorption of water and solutes from filtrate within the nephrons.
49. Which one of the following statements is NOT true about calcium phos- phate involvement in
renal stone production?
A) Calcium phosphate precipitates the membrane of the loop of Henle
B) Calcium phosphate erodes into the interstitium
C) Calcium phosphate accumulates in the sub epithelial space of the renal papilla
D) Calcium phosphate builders up in the water: Calcium phosphate builds up in the ureter.
50. What is the primary risk factor for calcium phosphate renal stones?
A) low urine volume
B) High urine calcium
C) Low urine specific gravity
D) High urine pH: High urine pH Is observed in half of patients who develop idiopathic calcium
phosphate renal sones.
51. Which of the following assessment finding is common in pyelonephritis?
A) Suprapubic tenderness
B) Cervical motion tenderness
