Chapter 44

D

When a patient reports acute, severe, renal colic pain in the lower abdomen, the nurse suspects that the patient is most likely to have an obstruction at which area? Kidney Urethra Bladder Ureterovesical junction

B

A patient has sought care because of recent difficulties in establishing and maintaining a urine stream as well as pain that occasionally accompanies urination. How should the nurse document this abnormal assessment finding? Anuria Dysuria Oliguria Enuresis

C

A patient informs the nurse that they are having burning on urination, dysuria, and frequency. What is the best response by the nurse? "Drink less fluid so you don't have to void so often." "Take some acetaminophen to decrease the discomfort." "Come in so we can check a clean-catch urine specimen." "Avoid caffeine and spicy food to decrease inflammation."

D

A patient in the intensive care unit is receiving gentamicin for treatment of pneumonia from Pseudomonas aeruginosa. What assessment results should the nurse report to the health care provider? Decreased weight Increased appetite Increased urinary output Elevated creatinine level

A

A patient with suspected renal insufficiency is scheduled for a creatinine clearance diagnostic test. Which instructions would be appropriate for the nurse to provide to the patient? "Empty your bladder and discard the urine; then save all urine for 24 hours." "Your blood creatinine level will be tested after you eat a high-protein meal." "This test should not be performed if you have allergies to iodine or shellfish." "A sterile container must be used to store the urine during the collection period.

ABD

In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions important to the maintenance of homeostasis. Which physiologic processes are performed by the kidneys (select all that apply.)? Production of renin Activation of vitamin D Carbohydrate metabolism Erythropoietin production Hemolysis of old red blood cells (RBCs)

C

The nurse is caring for an older adult patient taking bumetanide. What age-related changes does the nurse inform the patient that may be experienced? Benign enlargement of prostatic tissues Decreased sensation of bladder capacity Decreased function of the loop of Henle Less absorption in the Bowman's capsule

B

The nurse is performing an assessment for a patient and preparing to palpate the kidneys. How should the nurse position the patient for this assessment? Prone Supine Seated at the edge of the bed Standing, facing away from the nurse

A

The nurse is preparing a patient for an intravenous pyelogram (IVP). What is a priority action by the nurse? Administer a cathartic or enema. Assess patient for allergies to penicillin. Keep the patient NPO for 4 hours preprocedure. Advise the patient that a metallic taste may occur during procedure.

C

The nurse prepares a patient for discharge after a cystoscopy. It is most important for the nurse to provide additional information in response to which patient statement? "I should drink plenty of fluids to prevent complications." "If my urine is cloudy, I should contact my health care provider." "Bright red bleeding is normal for a few days after the procedure." "Sitz baths and acetaminophen will help to reduce my discomfort."

C

A nurse is caring for a patient with a history of chronic obstructive pulmonary disease (COPD) admitted for pneumonia. What laboratory finding would be consistent with decreased kidney function in this patient? Serum uric acid of 5.2 mg/dL Urine specific gravity of 1.040 Serum creatinine 2.3 of mg/dL Blood urea nitrogen (BUN) of 10 mg/dL

A

A patient underwent a surgical procedure has a urinary catheter. Eight hours after catheter removal and drinking fluids, the patient has not been able to void. What is the nurse's first action to assess for urinary retention? Bladder scan Cystometrogram Residual urine test Kidneys, ureters, bladder (KUB) x-ray

A

A patient was admitted 2 weeks ago after multiple traumatic injuries in a motor vehicle collision. The patient now has a serum creatinine at 3.9 mg/dL and blood urea nitrogen (BUN) of 100 mg/dL. Which medication, if ordered by the health care provider, should the nurse question? Gentamicin Nitrofurantoin Acetaminophen Morphine sulfate

A

A patient with a history of recurrent urinary tract infections has been scheduled for a cystoscopy. What teaching point should the nurse emphasize before the procedure? "You might have pink-tinged urine and burning after your cystoscopy." "You'll need to refrain from eating or drinking after midnight the day before the test." "The morning of the test, you will drink some water that contains a contrast solution." "You'll require a urinary catheter inserted before the cystoscopy, and it will be in place for a few days."

A

The nurse is caring for a patient after a right kidney biopsy. Which position would be the most appropriate for this patient immediately after the procedure? Right lateral side-lying position Reverse Trendelenburg position Supine with lower extremities elevated High Fowler's position with arms supported

D

The nurse obtained a urine specimen from a patient. What result should the nurse recognize as an abnormal finding? pH of 6.0 Amber yellow color Specific gravity of 1.025 White blood cells (WBCs) 9/hpf