MLQ Ch. 53
The term used to describe total urine output less than 0.5 mL/kg/hour is A. dysuria. B. oliguria. C. nocturia. D. anuria.
B
An appropriate nursing intervention for the client following a nuclear scan of the kidney is to: A. Strain all urine for 48 hours. B. Encourage high fluid intake. C. Apply moist heat to the flank area. D. Monitor for hematuria.
B
The most frequent reason for admission to skilled care facilities includes which of the following? A. Myocardial infarction B. Urinary incontinence C. Congestive heart failure D. Stroke
B
To assess circulating oxygen concentration, the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which diagnostic test? A. Hematocrit B. Hemoglobin C. Arterial blood gases D. Serum iron concentration
B
A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?
150 mL
A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine? A. glucose B. potassium C. creatinine D. chloride
A
A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: A. renal calculi. B. acute prostatitis. C. interstitial cystitis. D. an overdistended bladder.
A
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? A. Infection B. Acute renal failure C. Nephrotic syndrome D. Obstruction of the lower urinary tract
A
A creatinine clearance test has been ordered. The nurse prepares to: A. Collect the client's urine for 24 hours. B. Insert a straight catheter for a specimen. C. Obtain a blood specimen. D. Obtain a clean catch urine.
A
Common tests of renal function include which of the following? Select all that apply. A. Blood urea nitrogen (BUN) B. Creatinine clearance C. Arterial blood gas analysis D. Serum creatinine E. Renal concentration test
A, B, D, E
When the bladder contains 400 to 500 mL of urine, this is referred to as A. renal clearance. B. functional capacity. C. anuria. D. specific gravity.
B
Which is an effect of aging on upper and lower urinary tract function? A. Increased glomerular filtration rate B. More prone to develop hypernatremia C. Increased blood flow to the kidneys D. Acid-base balance
B
Which of the following hormones is secreted by the juxtaglomerular apparatus? A. Antidiuretic hormone (ADH) B. Renin C. Aldosterone D. Calcitonin
B
The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable? A. Clients have frequent urinary tract infections. B. Clients have chronic renal failure. C. Clients develop a neurogenic bladder. D. Clients have urinary frequency.
B
The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following? A. Allergic reaction B. Bleeding C. Dehydration D. Infection
B
A client has a full bladder. Which sound would the nurse expect to hear on percussion? A. Resonance B. Dullness C. Flatness D. Tympany
B
A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should: A. keep the client's knee on the affected side bent for 6 hours. B. check the client's pedal pulses frequently. C. apply pressure to the puncture site for 30 minutes. D. remove the dressing on the puncture site after vital signs stabilize.
B
A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing: A. pyelonephritis. B. ureteral stones. C. cystitis. D. Urethral infection.
B
A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? A. Hemoglobin B. Creatinine C. Osmolality D. Blood urea nitrogen
B
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? A. Decreased potassium B. Increased serum creatinine C. Increased serum albumin D. Decreased blood urea nitrogen (BUN)
B
While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? A. "Do you have a strong desire to void?" B. "Do you urinate while sleeping?" C. "Does it burn when you urinate?" D. "Is it painful when you urinate?"
B
A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters? A. Parenchyma B. Glomerulus C. Renal pelvis D. Nephron
C
A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? A. Serum potassium level B. Blood urea nitrogen level C. Creatinine clearance level D. Uric acid level
C
A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? A. Cystography B. Nuclear scan C. Bladder ultrasonography D. IV urography
C
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present? A. When the urine output is between 500 and 1,000 mL/h B. When the urine output is about 100 mL/h C. When the urine output is less than 30 mL/h D. When the urine output is between 300 and 500 mL/h
C
The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following? A. Allergic reaction B. Infection C. Bleeding D. Dehydration
C
Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? A. Radiography B. Cystoscopy C. Angiography D. Computed tomography (CT scan)
C
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? A. Assess the client's mental changes. B. Evaluate the client for periorbital edema. C. Monitor the client for signs of electrolyte and water imbalance. D. Monitor the client for an allergy to iodine contrast material.
D
The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated? A. The specific gravity will equal to one B. The specific gravity will be low C. The specific gravity will be inversely proportional D. The specific gravity will be high.
D
The wall of the bladder is comprised of four layers. Which of the following is the layer responsible for micturition? A. Inner layer of epithelium B. Submucosal layer of connective tissue C. Adventitia (connective tissue) D. Detrusor muscle
D
When fluid intake is normal, the specific gravity of urine should be: A. 1.000 B. Less than 1.010 C. Greater than 1.025 D. 1.010 to 1.025
D
Which value represents a normal BUN-to-creatinine ratio? A. 4:1 B. 6:1 C. 8:1 D. 10:1
D
While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? A. "Does it burn when you urinate?" B. "Is it painful when you urinate?" C. "Do you have a strong desire to void?" D. "Do you urinate while sleeping?"
D
A nurse is caring for a client diagnosed with acute renal failure. The nurse notes on the intake and output record that the total urine output for the previous 24 hours was 35 mL. Urine output that's less than 50 ml in 24 hours is known as: A. anuria. B. polyuria. C. hematuria. D. oliguria.
A
Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse? A. Assess the patient's back and shoulder areas for signs of internal bleeding. B. Enable the client to sit up and ambulate. C. Distract the client's attention from the pain. D. Provide analgesics to the client.
A
The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure? A. Renin B. Cortisol C. Albumin D. Vasopressin
A
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness? A. The costovertebral angle B. Above the symphysis pubis C. Around the umbilicus D. The upper abdominal quadrants on the left and right side
A
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? A. Decreased fluid intake B. Glomerulonephritis C. Increased fluid intake D. Diabetes insipidus
A
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? A. Decreased fluid intake B. Increased fluid intake C. Diabetes insipidus D. Glomerulonephritis
A
The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions? A. "I can resume my usual activities without restriction." B. "I should increase my fluid intake for the rest of the day." C. "If I have difficulty urinating, I should contact my physician." D. "It is normal for my urine to be blood-tinged."
A
The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to A. drink liberal amounts of fluids. B. carefully handle urine because it is radioactive. C. maintain bed rest for 2 hours. D. notify the health care team if bloody urine is noted.
A
The nurse recognizes that a referral for genetic counseling is inappropriate for the client with: A. Renal calculi B. Wilms' tumor C. Alport syndrome D. Polycystic kidney disease
A
A patient is scheduled for a test with contrast to determine kidney function. What statement made by the patient should the nurse inform the physician about prior to testing? A. "I don't like needles." B. "I have had a test similar to this one in the past." C. "I take medication to help me sleep at night." D. "I am allergic to shrimp."
D
A nurse is collecting a health history on a client who's to undergo a renal angiography. Which statement by the client should be the priority for the nurse to address? A. "I haven't eaten since midnight." B. "I'm allergic to shellfish." C. "My physician diagnosed me with hypertension 3 months ago." D. "I've had diabetes for 4 years."
B
A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? A. Uric acid level B. Blood urea nitrogen level C. Serum potassium level D. Creatinine clearance level
D
An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: A. palpate the client's bladder before and after voiding. B. assess the client's usual intake of sodium. C. confirm which beverages the client normally consumes. D. confirm all of the medications and supplements normally taken.
D
As women age, many experience an increased sense of urgency to void, as well as an increased risk of incontinence. This is usually the result of age-related changes in which part of the renal system? A. Tubule system B. Nephron C. Kidney D. Bladder
D
Retention of which electrolyte is the most life-threatening effect of renal failure? A. Calcium B. Sodium C. Phosphorous D. Potassium
D
The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? A. Kidney stones B. Chronic renal failure C. Neurogenic bladder D. Fistula
A
A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact? A. The kidneys lie between the 10th and 12th thoracic vertebrae. B. The left kidney usually is slightly higher than the right one. C. The kidneys are situated just above the adrenal glands. D. The average kidney is approximately 5 cm (2 in.) long and 2 to 3 cm (0.8 to 1.2 in.) wide.
B
A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract? A. Pelvic floor muscles B. Ureters C. Urethra D. Bladder
B
A patient has an increase in blood osmolality when the nurse reviews the laboratory work. What can this increase indicate for the patient? A. Less reabsorption of water B. Diuresis C. An increase in urine volume D. ADH stimulation
D
A patient who complains of a dull, continuous pain in the suprapubic area that occurs with, and at the end of, voiding would most likely be diagnosed with which of the following? A. Prostatic cancer B. A kidney stone C. Acute pyelonephritis D. Interstitial cystitis
D