Chapter 32 Pathophysiology NCLEX-Style Review Questions

The nurse is analyzing the results of a client's urinalysis. Which results require the nurse to follow up as they represent abnormal results? Select all that apply. -Leukocyte esterase negative -Amber-colored urine -Specific gravity 1.010 -Casts present -Bilirubin positive

Casts present, Bilirubin positive

The nurse would be most concerned when the glomerular filtrate contains: -Water -Protein -Sodium -Potassium

Protein

In the presence of aldosterone in the distal tube, what action would occur? -There would be no change in sodium. -Sodium would not be reabsorbed. -The urine would be nearly sodium-free. -Sodium would be excreted in the urine.

The urine would be nearly sodium-free.

A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be: -Abnormal glomerular filtration -Urinary tract infection -Poor fluid intake -Decrease in antidiuretic hormone

Abnormal glomerular filtration

An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test. -BUN 40 mg/dL (14.28 mmol/L) to creatinine 2 mg/dL (176.80 μmol/L) -BUN 25 mg/dL (8.92 mmol/L) to creatinine 1 mg/dL (88.40 μmol/L) -BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 μmol/L) -BUN 30 mg/dL (10.71 mmol/L) to creatinine 2.5 mg/dL (221.0 μmol/L)

BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 μmol/L)

The nurse is performing palpation of the kidney during assessment of the client on the urology unit. The nurse plans to palpate in which area? -Between the 12th thoracic and 3rd lumbar vertebrae -Lower abdomen in the suprapubic area -Right costal margin, anterior abdomen -Upper abdomen, under the costal margins

Between the 12th thoracic and 3rd lumbar vertebrae

When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which substance in the blood? -Iric acid -Bicarbonate -Erythropoietin -Blood urea nitrogen

Blood urea nitrogen

The nurse is assigned multiple clients with anemia. Which client may be experiencing a failure of the body to produce erythropoietin and thus may require supplemental injections of this hormone? -Client living at a high altitude -Client who recently had surgery and is scheduled for a follow-up visit -Client with a recent wound that bled a large amount but is now healing well -Client with impaired oxygenation related to chronic obstructive pulmonary disease (COPD) -Client with history of chronic kidney failure

Client with history of chronic kidney failure

Which client(s) is likely experiencing an increase in renal blood flow (RBF) and an increase in glomerular filtration rate (GFR) related to their current health status? Select all that apply. -Client on a low-calorie, low-fat diet -Client with uncontrolled diabetes mellitus -Client who exercises at least 1 hour/day -Client on a "keto" diet plan -Client with chronic obstructive pulmonary disease (COPD)

Client with uncontrolled diabetes mellitus, Client on a "keto" diet plan

A nurse is evaluating a client's morning laboratory values. Which result requires that the nurse notify the health care provider? -Creatinine: 10.6 mg/dL (937.04 μmol/L) -Sodium: 148 mEq/L (148 mmol/L) -Blood urea nitrogen: 20.0 mg/dL (7.14 mmol/L) -Potassium: 3.4 mEq/L (3.4 mmol/L)

Creatinine: 10.6 mg/dL (937.04 μmol/L)

Which diagnostic study would be effective in determining direct visualization of the bladder and ureters? -Renal angiography -Ultrasonography -Cystoscope -MRI

Cystoscope

Which occurrence is most likely to cause increased urination? -Increased secretion of aldosterone -Decrease in antidiuretic hormone -Activation of angiotensin -Decrease in glomerular filtration rate

Decrease in antidiuretic hormone

The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which finding does the nurse anticipate? -Retention of sodium -Retention of chloride -Low blood pressure -Excessive urine output

Excessive urine output

A client has developed gout and is experiencing a "flare-up" with excruciating pain in the feet and toes. The client provides a list of recent new medications to treat worsening heart failure. The nurse's concern is that one may cause retention of uric acid. Which drug should the nurse ask the health care provider about? -Isosorbide mononitrate, a nitrate -Furosemide, a loop diuretic -Spironolactone, an aldosterone receptor antagonist -Lisinopril, an ACE-inhibitor

Furosemide, a loop diuretic

Which condition causes an elevation in the level of blood urea nitrogen (BUN)? -Pituitary disease -Heart disease -Gastrointestinal bleeding -Excessive fluid intake

Gastrointestinal bleeding

The nurse is caring for a client with heart failure and left atrial enlargement. Which physiologic consequence does the nurse anticipate when atrial natriuretic peptide (ANP) is released due to atrial stretch? -Excretion of hydrogen ions -Deamination of ammonia -Inhibition of aldosterone -Retention of hydrogen ions

Inhibition of aldosterone

The major sites where aldosterone exerts its action on sodium reabsorption and potassium regulation occur in which tubule location? -Proximal tubule and a thin descending segment of tubule -Late distal and cortical collecting tubule -Thin ascending tubule and the thick descending tubule -Juxtamedullary area and the elbow-diluting segment of distal tubule

Late distal and cortical collecting tubule

A nurse is teaching a client about the functions of the kidney. Which would be the most appropriate information for the nurse to provide? Select all that apply. -Regulates pH of body fluids through reabsorption and conservation -Regulates osmolality of intracellular fluid through action of antidiuretic hormone (ADH) -Regulates calcium and phosphorus conservation and elimination -Regulates blood pressure through the renin-aldosterone mechanism -Eliminates metabolic wastes -Maintains homeostasis of red blood cells by production of estrogen

Regulates pH of body fluids through reabsorption and conservation, Regulates calcium and phosphorus conservation and elimination, Regulates blood pressure through the renin-aldosterone mechanism, Eliminates metabolic wastes

The nurse is caring for a client who has produced an average of 20 mL/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output? -The normal kidney produces an average 3000 mL of urine daily. -The kidneys should produce about 1.5 L of urine each day. -The kidneys should produce a minimum of 10 mL/hr over one day. -This represents normal urinary output for 24 hours.

The kidneys should produce about 1.5 L of urine each day.

Gout and the development of kidney stones are often attributed to high levels of what compound? -Albumin -Protein -Uric acid -Urea

Uric acid