Chapter 26: Assessing Renal System
13) The nurse suspects a patient is experiencing a distended bladder. Which patient statement did the nurse use to make this determination? 1. "I am in pain, and it is worse when I press on my abdomen." 2. "My back is killing me." 3. "It feels like someone is stabbing me in the abdomen with a knife." 4. "It hurts constantly with spasms once in a while."
1. "I am in pain, and it is worse when I press on my abdomen." Explanation: 1. The patient with a distended bladder experiences constant pain increased by any pressure over the bladder.
27) A patient who is scheduled to have a renal angiogram asks why pulses are being checked in the feet. What should the nurse respond to this patient? 1. "I feel your pulses there. I can check that the blood is flowing properly to your legs and feet." 2. "Why do you ask?" 3. "It is a nursing thing." 4. "A needle is inserted in your femoral artery so the circulation to your extremity could be compromised during this test."
1. "I feel your pulses there. I can check that the blood is flowing properly to your legs and feet." Explanation: 1. For this test, a contrast medium is injected into the femoral artery. Afterward, the integrity of the artery is assessed by checking peripheral pulses in the feet.
31) During a home visit the nurse asks the patient for a specimen for a urinalysis. Which patient statement indicates that the nurse needs to provide additional teaching about the specimen? 1. "I will get the specimen the next time I void." 2. "I won't touch the inside of the cup or lid." 3. "I will refrigerate the specimen until it is picked up tomorrow." 4. "I will give the laboratory a list of the medications I am taking."
1. "I will get the specimen the next time I void." Explanation: 1. An early morning specimen is preferred.
24) The nurse is reviewing teaching with a patient who is scheduled for an intravenous pyelogram. Which patient statement indicates that additional teaching is required? 1. "I will not drink any fluids for at least 12 hours before the procedure." 2. "I will start the bowel prep with a suppository the night before the procedure." 3. "I will take the prescribed laxative the morning of the procedure." 4. "I will not eat solid food for at least 8 hours before the procedure."
1. "I will not drink any fluids for at least 12 hours before the procedure." Explanation: 1. Clear liquids are allowed.
12) The parent of a child with a urinary tract infection is concerned that the child may develop a genetic kidney problem in the future. What information provided by the parent should the nurse use to determine the child's risk for a genetic kidney disorder? 1. "My mother had lots of cysts on her kidneys." 2. "I have a bladder infection at least once a year." 3. "The child's father has Parkinson's disease." 4. "My father had kidney cancer."
1. "My mother had lots of cysts on her kidneys." Explanation: 1. When conducting a health assessment interview and physical assessment, it is important for the nurse to consider genetic influences on health. During the health assessment interview, ask about family members with health problems affecting kidney function, or of family members diagnosed with polycystic disease. A grandmother with polycystic kidney disease increases the grandchild's risk for having the disorder.
23) A patient who has prescriptions for renal tests plans to have an intravenous pyelogram before a barium enema. Which response should the nurse make to the patient? 1. "Please make your appointments as you have indicated." 2. "Please clarify with your primary healthcare provider which should be completed first." 3. "Please reverse the order of your planned appointments." 4. "The order of the tests is irrelevant. You may change the order to meet your needs."
1. "Please make your appointments as you have indicated." Explanation: 1. Schedule an IVP prior to any ordered barium test or gallbladder studies using contrast material, as residual contrast material from the barium enema or gallbladder studies may interfere with the IVP results.
9) The nurse is reviewing the reabsorption of glucose and amino acids with a patient newly diagnosed with kidney disease. Which patient comment indicates that teaching has been effective? 1. "The nutrients move from blood to filtrate, then back to the blood." 2. "The nutrients move from filtrate to blood, then back to the filtrate." 3. "The nutrients remain in the kidneys at all times." 4. "The nutrients are large molecules and remain in the blood at all times."
1. "The nutrients move from blood to filtrate, then back to the blood." Explanation: 1. Reabsorption may be active or passive. Substances move from the blood into the filtrate, then are reclaimed into the blood.
10) A patient who is a healthcare provider at another facility states the need to micturate. How should the nurse respond to this patient? 1. "There is a restroom at the end of the hallway." 2. "Have you been taking your medication on a daily basis?" 3. "Do you have a supply of sterile catheters?" 4. "Do you have someone who can drive you home?"
1. "There is a restroom at the end of the hallway." Explanation: 1. Micturition is the act of urinating or voiding. The best response is to direct the patient to a restroom.
25) A patient is scheduled for an MRI of the kidneys. Which question should the nurse avoid when preparing the patient for this test? 1. "When did you last have anything to eat or drink?" 2. "Have you ever been treated for chest pain?" 3. "Do you have any tattoos?" 4. "Is there any possibility you could be pregnant?"
1. "When did you last have anything to eat or drink?" Explanation: 1. There are no restrictions regarding food or fluids for this test.
7) A patient being treated for peritonitis from a ruptured appendix is concerned about developing a kidney infection. How should the nurse respond to this patient? 1. "Your kidneys are located outside the peritoneum, the sack that encloses the appendix." 2. "Good thinking. Infections in the abdomen can spread to other organs." 3. "You need to speak with your primary healthcare provider about your concern." 4. "We can check your urine daily to make sure the infection is not spreading."
1. "Your kidneys are located outside the peritoneum, the sack that encloses the appendix." Explanation: 1. The two kidneys are located outside the peritoneal cavity and on either side of the vertebral column at the levels of T12 through L3.
8) A patient with an altered myogenic mechanism of the renal blood vessels asks why blood pressure control is important. How should the nurse respond to the patient? 1. "Your kidneys may have difficulty protecting themselves from high blood pressure." 2. "Your blood pressure medication is toxic to your kidneys in high doses." 3. "If not controlled, the condition will require an indwelling urinary catheter." 4. "High blood pressure increases your risk for kidney stones."
1. "Your kidneys may have difficulty protecting themselves from high blood pressure." Explanation: 1. The myogenic mechanism, one factor in renal autoregulation, responds to pressure changes in the renal blood vessels, controlling the diameter of afferent arterioles. An increase in systemic blood pressure causes the renal vessels to constrict, whereas a decrease in blood pressure causes the afferent arterioles to dilate. These changes adjust the glomerular hydrostatic pressure and, indirectly, maintain the GFR. An alteration in this system exposes the kidneys to pressures that are too high for proper long-term kidney function.
4) An older patient is being evaluated for a renal health problem. Which serum creatinine level should the nurse expect for this patient? 1. 0.3 mg/dL 2. 2.4 mg/dL 3. 4.8 mg/dL 4. 6.4 mg/dL
1. 0.3 mg/dL Explanation: 1. Serum creatinine level reflects the by-product of muscle breakdown, and an older adult with less muscle mass can be expected to have a lower-than-normal level such as 0.3 mg/dL. The normal creatinine range for adults is 0.5-1.5 mg/dL.
36) During a health history the nurse learns that a newly married female patient has a family history of both type 1 and type 2 diabetes mellitus. Which type of referral should the nurse consider for this patient? 1. A genetic counselor 2. A home health nurse 3. An obstetrician 4. A physical therapist
1. A genetic counselor Explanation: 1. When conducting a health assessment interview and physical assessment, it is important to consider genetic influences on adult health. During the health assessment interview, ask about family members with health problems affecting kidney function or those diagnosed with polycystic disease or diabetes mellitus. During the physical assessment, assess for manifestations that might indicate a genetic disorder. If data indicate the presence of genetic risk factors or alterations, ask about genetic testing and refer for appropriate genetic counseling and evaluation.
3) A patient recovering from surgery is prescribed a postvoiding residual urine test. What supplies should the nurse gather to complete this test? 1. A urine collecting device and a straight urinary catheter 2. A urine collecting device and a voiding diary 3. An indwelling urinary catheter and an insertion kit 4. A peripheral IV insertion kit and a urine collecting device
1. A urine collecting device and a straight urinary catheter Explanation: 1. For a postvoiding residual urine test, the nurse needs a urine collection device and a straight catheter.
5) The nurse is assessing a patient scheduled for a CT scan of the kidneys. Which finding should the nurse report to the primary healthcare provider? 1. Allergy to iodine and seafood 2. Urinary output of 1200 mL in 24 hours 3. Last bowel movement one day ago 4. Height 5'8" and weight 160 pounds
1. Allergy to iodine and seafood Explanation: 1. Allergy to iodine and seafood is correct because a CT scan of the kidneys requires the injection of a radiopaque dye that contains iodine.
6) An older female patient is experiencing episodes of urinary incontinence. What should this indicate to the nurse? 1. An abnormal finding requiring further testing 2. The presence of a urinary infection 3. A normal outcome of the aging process 4. The result of having several children
1. An abnormal finding requiring further testing Explanation: 1. Incontinence is not a normal finding and will require further investigation to identify the cause.
33) The nurse is reviewing the results of a patient's urinalysis. Which finding indicates that a pathological process might be occurring with this patient? 1. Appearance: cloudy 2. Odor: aromatic 3. pH: 5.2 4. Glucose: negative
1. Appearance: cloudy Explanation: 1. Cloudy urine indicates bacteria, pus, RBCs, WBCs, phosphates, prostatic fluid spermatozoa, or urates.
2) When preparing a patient for an intravenous pyelogram (IVP), the nurse reviews diagnostic data. Which finding should the nurse report to the healthcare provider before sending the patient for the test? 1. Blood urea nitrogen (BUN) 55 mg/dL 2. Serum creatinine 1.3 mg/dL 3. Urine culture <10,000 organisms/mL 4. Residual urine of 80 mL
1. Blood urea nitrogen (BUN) 55 mg/dL Explanation: 1. Blood urea nitrogen (BUN) of 55 mg/dL indicates that there might be a problem of renal function. Normal value is 5-25 mg/dL. The healthcare provider will need to be notified because an IVP involves the injection of dye that must eventually be cleared by the kidney; if there is already compromised renal function, the test may not be administered.
19) The nurse is providing preoperative teaching for a patient recovering from a cystogram. For which reason should the patient be instructed to contact the healthcare provider? 1. Bloody urine 2. Thirst 3. Muscle cramps 4. Hunger
1. Bloody urine Explanation: 1. Some blood is expected in the urine following the procedure. The patient should be instructed to immediately notify the physician if the urine remains bloody for more than three voidings after the procedure, or if bright bleeding develops.
39) A patient is prescribed diagnostic tests to determine renal functioning. What test should the nurse review to determine the patient's glomerular filtration rate (GFR)? 1. Creatinine clearance 2. Blood urea nitrogen (BUN) 3. Intravenous pyelogram (IVP) 4. Renal ultrasound
1. Creatinine clearance Explanation: 1. Creatinine clearance measures the ability of the kidney to clear a given amount of creatinine out of the plasma within a given time period. Creatinine is a substance produced from the breakdown of muscle and is cleared by the kidney at a constant rate. This test is used to determine the glomerular filtration rate or the ability of the kidney to clear substances out of the plasma.
14) A patient injured in the home and unable to receive help or healthcare for 48 hours has a blood urea nitrogen level of 50 mg/dL and serum creatinine level of 1.0 mg/dL. For which problem should the nurse plan care for first for this patient? 1. Dehydration 2. Anxiety 3. Pain 4. Poor nutrition
1. Dehydration Explanation: 1. To assess whether the patient's elevated blood urea nitrogen is caused by dehydration or renal failure, the nurse assesses the serum creatinine value. The patient's serum creatinine is normal, which does not indicate kidney failure. This patient is dehydrated.
26) A patient has a portable ultrasonic bladder scan. Which finding should the nurse identify as being within normal limits? 1. Less than 100 mL of urine in the bladder. 2. Between 100 and 150 mL of urine in the bladder. 3. Between 150 and 200 mL of urine in the bladder. 4. More than 200 mL of urine in the bladder.
1. Less than 100 mL of urine in the bladder. Explanation: 1. A normal ultrasonic bladder scan finding is less than 100 mL for a residual voiding.
22) The nurse is creating a teaching plan for a patient who is taking the oral hypoglycemic agent metformin (Glucophage). For which reason should the nurse instruct the patient to contact the healthcare provider? 1. Need a diagnostic test that uses iodinated contrast. 2. Urine becomes orange or red-tinted. 3. Urine becomes more concentrated. 4. Need an intermittent or indwelling urinary catheterization.
1. Need a diagnostic test that uses iodinated contrast. Explanation: 1. Oral hypoglycemic agents are contraindicated for use with iodinated contrast, as the combination of the two can precipitate renal failure. Patients should be taught to inform all healthcare providers if they have a prescription for an oral hypoglycemic agent.
40) A patient is concerned because the urine has changed to red-brown in color since starting a new medication. Which medication should the nurse suspect is causing this patient's change in urine color? 1. Phenytoin (Dilantin) 2. Amitriptyline (Elavil) 3. Injectable iron 4. Phenazopyridine (Pyridium)
1. Phenytoin Explanation: 1. Red-brown urine can occur when taking phenytoin (Dilantin).
29) A patient with an allergy to iodine is scheduled to have diagnostic tests. For which test should the nurse notify the healthcare provider? 1. Renal angiogram 2. Renal scan 3. Voiding cystogram 4. Portable ultrasonic bladder scan
1. Renal angiogram Explanation: 1. An angiogram includes the use of contrast dye, which often contains iodine. The nurse should contact the primary healthcare provider to report the iodine allergy.
11) The nurse is reviewing risk factors for bladder infections with a female patient. Which patient statement indicates that teaching has been effective? 1. The urinary meatus in females is closer to the bladder than in most males. 2. The urinary meatus in females is farther from the anus than most males. 3. The pH of the female urethra is more conducive to infection. 4. Females urinate more frequently than males, increasing risk.
1. The urinary meatus in females is closer to the bladder than in most males. Explanation: 1. In females, the urethra is approximately 1.5 inches (3 to 5 cm) long, and the urinary meatus is anterior to the vaginal orifice.
37) An 80-year-old patient has decreased renal cortexes, atherosclerosis of the renal arteries, and hypo-osmolality of urine. What should the nurse consider first as an explanation for this patient's renal status? 1. These are typical changes associated with aging. 2. These are signs of chronic renal failure. 3. These are signs of acute renal failure. 4. These are signs of a genetic renal disorder.
1. These are typical changes associated with aging. Explanation: 1. Typical age-related changes of the renal system include a decreased size of the renal cortex, atherosclerosis of the renal arteries, and hypo-osmolality.
16) The nurse is reviewing laboratory data for a patient who had a voiding cystogram that revealed an urge to void at 100 mL. For which potential problem should the nurse plan care for this patient? 1. Urinary incontinence 2. Alteration in integumentary status 3. Inability to provide self-care 4. Urinary retention
1. Urinary incontinence Explanation: 1. A patient who has a sensation of an urge to void at 100 mL is at risk for urinary incontinence.
38) The nurse completes an assessment of renal and urinary function with an older male patient. Which finding should the nurse report to the healthcare provider? 1. Urinary incontinence 2. Urinary frequency 3. Urinary urgency 4. Nocturia
1. Urinary incontinence Explanation: 1. Urinary incontinence is not a normal part of aging and requires immediate nursing intervention.
1) A patient has urine that is cloudy and foul-smelling. Which diagnostic test should the nurse anticipate being prescribed for this patient? 1. Urine culture 2. Blood urea nitrogen (BUN) 3. Creatinine clearance 4. Residual urine
1. Urine culture Explanation: 1. The patient's manifestations indicate a urinary tract infection. A urine culture is conducted to identify the causative organism of a UTI.
30) A patient scheduled for a renal ultrasound asks if the procedure is going to be painful. What should the nurse do to help the patient prepare for this diagnostic test? 1. Describe the typical experience of a patient having a renal ultrasound. 2. Discuss feelings associated with painful experiences. 3. Explain pain medications available during this procedure. 4. Describe the typical experience of a patient using conscious sedation.
1.. Describe the typical experience of a patient having a renal ultrasound. Explanation: 1. A renal ultrasound is a noninvasive test conducted to detect renal or perirenal masses, identify obstructions, and diagnose renal cysts and solid masses. It is done by applying a conductive gel to the skin and placing a small external ultrasound probe on the patient's skin. Sound waves are recorded on a computer as they are reflected off tissues.
34) The nurse is reviewing teaching materials prepared to obtain midstream clean catch urine for culture. Which information within this plan needs to be corrected by the nurse? 1. Male patients should retract the foreskin and cleanse the glans with three cotton sponges saturated with cleansing solution, using a circular motion. 2. Female patients should separate the labia with one hand and clean the labia with the other, using sterile cotton swabs saturated with a cleansing solution, wiping back to front. 3. After cleansing, patients should start voiding and then begin to collect the specimen. 4. Patients should start taking prescribed antibiotics only after the specimen is collected.
2. Female patients should separate the labia with one hand and clean the labia with the other, using sterile cotton swabs saturated with a cleansing solution, wiping back to front. -The female patient should cleanse the perineum with a front-to-back motion to avoid contaminating the urethral meatus with fecal bacteria.
28) A patient is recovering from a renal biopsy. Which action should the nurse complete while caring for this patient? 1. Apply pressure to site for 15 minutes after procedure. 2. Instruct the patient to avoid eating for 8 to 12 hours. 3. Teach the patient to restrict oral fluid intake. 4. Direct the patient to expect to have decreased urination.
2. Instruct the patient to avoid eating for 8 to 12 hours. -The patient needed to take nothing by mouth for 8 to 12 hours before the procedure, not after.
32) A patient is experiencing burning with urination and urgency. Which laboratory test result should the nurse monitor for this patient's manifestations? 1. Serum creatinine 2. Urine osmolality 3. BUN 4. Urine culture
4. Urine culture -The patient is demonstrating signs of a urinary tract infection. A urine culture is conducted to identify the causative organism of a UTI.
20) The nurse is providing discharge teaching to a patient recovering from a cystogram. What should the nurse include in this teaching? Select all that apply. 1. Take a sitz bath. 2. Increase oral fluid intake. 3. Take acetaminophen for minor pain. 4. Apply heat to the lower back. 5. Drink one ounce of brandy or rum with warm water.
Answer: 1, 2 Explanation: 1. Appropriate techniques for relieving pain after a cystogram include taking a sitz bath. 2. Appropriate techniques for relieving pain after a cystogram include increasing oral fluid intake.
18) A patient is scheduled for a cystogram. What information in the patient's history should the nurse bring to the healthcare provider's attention as potentially causing a problem with the patient? Select all that apply. 1. Cystitis 2. Prostatitis 3. Hypersensitivity to anesthetics 4. Right-sided hemiplegia 5. Chronic pain
Answer: 1, 2, 3 Explanation: 1. A history of cystitis could result in sepsis after the procedure. 2. A history of prostatitis could result in sepsis after the procedure. 3. A history of hypersensitivity to anesthetics could result in problems after the procedure.
17) The nurse is teaching a patient about a voiding cystogram. Which patient statement indicates that teaching has been effective? Select all that apply. 1. "A urinary catheter will be placed in my bladder." 2. "My bladder will be filled with fluid." 3. "I will tell you when my bladder feels full." 4. "A peripheral IV will be inserted in my arm." 5. "I will be sedated for the procedure."
Answer: 1, 2, 3 Explanation: 1. During this procedure, a urinary catheter will be placed in the bladder so that fluid can be instilled directly into the bladder. 2. During this procedure, the bladder will be filled. 3. During this procedure, when the bladder is being filled the patient will be asked to describe the first urge to void, and the sensation of being unable to delay urination any longer.
42) While conducting a physical assessment, the nurse suspects that a male patient has a urinary tract or sexually transmitted infection. What did the nurse assess to make this clinical decision? Select all that apply. 1. Redness of the urinary meatus 2. Swelling from the urinary meatus 3. Discharge from the urinary meatus 4. Urinary meatus on the dorsal surface 5. Urinary meatus on the ventral surface
Answer: 1, 2, 3 Explanation: 1. Increased redness of the urinary meatus may indicate UTI or sexually transmitted infection. 2. Swelling of the urinary meatus may indicate UTI or sexually transmitted infection. 3. Discharge from the urinary meatus may indicate UTI or sexually transmitted infection.
15) The nurse is reviewing the serum creatinine laboratory results for a group of patients. Which patient should the nurse identify as being at risk for having falsely altered serum creatinine levels? Select all that apply. 1. Patient with rhinovirus taking 10,000 mg of vitamin C daily 2. Patient with Parkinson disease and a prescription for methyldopa 3. Patient with bipolar disorder and a prescription for lithium carbonate 4. Patient with acne vulgaris and a prescription for tetracycline 5. Patient with insomnia taking over-the-counter melatonin
Answer: 1, 2, 3 Explanation: 1. Vitamin C (ascorbic acid) can affect the serum creatinine level. 2. Methyldopa can affect the serum creatinine level. 3. Lithium carbonate can affect the serum creatinine level.
45) A male patient is admitted for renal colic. When conducting this patient's physical assessment, on which area should the nurse focus to determine the type and amount of pain? Select all that apply. 1. Flank 2. Testes 3. Urethra 4. Bladder 5. Umbilicus
Answer: 1, 2, 3, 4 Explanation: 1. Renal colic is pain associated with renal calculi moving through the ureter. This pain is severe, sharp, stabbing, and excruciating and is often felt in the flank. 2. Renal colic is pain associated with renal calculi moving through the ureter. This pain is severe, sharp, stabbing, and excruciating and is often felt in the testes. 3. Renal colic is pain associated with renal calculi moving through the ureter. This pain is severe, sharp, stabbing, and excruciating and is often felt in the urethra. 4. Renal colic is pain associated with renal calculi moving through the ureter. This pain is severe, sharp, stabbing, and excruciating and is often felt in the bladder.
21) The nurse is reviewing the laboratory results for a patient. Which information should the nurse identify as being used to determine the patient's estimated glomerular filtration rate? Select all that apply. 1. Serum creatinine 2. Patient's age 3. Patient's gender 4. Patient's racial origin 5. Serum blood urea nitrogen
Answer: 1, 2, 3, 4 Explanation: 1. The EGFR is calculated based on the serum creatinine. 2. The EGFR is calculated based on the patient's age. 3. The EGFR is calculated based on the patient's gender. 4. In some instances, the EGFR is calculated based on racial origin.
35) The nurse instructs a patient about adult polycystic kidney disease (APKD). Which patient statement indicates that teaching has been effective? Select all that apply. 1. "This disorder can be cured if I take my medication carefully." 2. "APKD is inherited from parent to child." 3. "The problem that causes this disease is in the cell chromosomes." 4. "Many fluid-filled sacs are found in the kidneys." 5. "This disorder can cause my kidneys to work poorly."
Answer: 2, 3, 4, 5 2. Adult polycystic kidney disease (APKD) is linked to a familial chromosome 16 disorder. 3. Adult polycystic kidney disease (APKD) is linked to a familial chromosome 16 disorder. 4. The disease is characterized by large cysts in one or both kidneys. 5. The disease is characterized by a gradual loss of kidney tissue with resultant chronic renal failure.
47) A patient has a history of urinary tract infections (UTIs). What should the nurse instruct this patient to help maintain acid urine? Select all that apply. 1. Reduce the intake of water. 2. Avoid drinking fruit juices. 3. Take vitamin C supplements. 4. Avoid excess milk consumption. 5. Drink two glasses of low sugar cranberry juice each day.
Answer: 2, 3, 4, 5 2. Suggesting measures to maintain acid urine include avoid drinking fruit juices. 3. Suggesting measures to maintain acid urine include taking vitamin C supplements. 4. Suggesting measures to maintain acid urine include avoiding excess milk consumption. 5. Suggesting measures to maintain acid urine include drinking two glasses of low sugar cranberry juice each day.
46) The nurse is preparing a teaching tool on bladder health for a community fair. Which disease process should the nurse identify as the focus of bladder health promotion? Select all that apply. 1. Kidney stones 2. Bladder cancer 3. Prostate cancer 4. Urinary incontinence 5. Urinary tract infections (UTIs)
Answer: 2, 4, 5 2. Bladder health promotion focuses on the prevention of bladder cancer.4. Bladder health promotion focuses on the prevention of urinary incontinence. 5. Bladder health promotion focuses on the prevention of urinary tract infections (UTIs).
44) During a health history the nurse is concerned that a male patient is at risk for developing bladder cancer. Which information from the history caused the nurse to have this concern? Select all that apply. 1. Plays tennis twice a week 2. Smokes 1 ppd of cigarettes 3. Sleeps 7 to 8 hours each night 4. Eats a salad several times a week 5. Works in a steel manufacturing plant
Answer: 2, 5 2. Smoking is a risk factor for bladder cancer. 5. Exposure to industrial chemicals is a risk factor for bladder cancer.
41) The nurse is preparing to indirectly percuss a patient's kidneys. In which order should the nurse perform this assessment? Place in order the steps of the process. Choice 1. Stand behind the patient. Choice 2. Curl the dominant hand into a fist. Choice 3. Assist the patient to a sitting position. Choice 4. Place nondominant hand over the costovertebral angle. Choice 5. Strike the back of the nondominant hand with the dominant hand.
Answer: 3, 1, 2, 4, 5 Explanation: Choice 1. The nurse should stand behind the patient after assisting to a sitting position. Choice 2. The nurse should curl the dominant hand into a fist after standing behind the seated patient. Choice 3. The nurse should first assist the patient to a sitting position. Choice 4. The nurse should place the nondominant hand over the patient's costovertebral angle after curling the patient's dominant hand into a fist. Choice 5. The nurse should strike the back of the nondominant hand with the dominant hand that is curled into a fist.
43) While reviewing the results of a patient's urinalysis, the nurse suspects that a patient has kidney disease. Which finding caused the nurse to come to this conclusion? Select all that apply. 1. pH 6.2 2. +3 ketones 3. Colorless urine 4. Protein 7 mg/dL 5. Specific gravity 1.001
Answer: 3, 4, 5 3. Colorless urine indicates very dilute urine as seen in kidney disease. 4. Protein > 5mg/dL occurs in kidney disease. 5. Specific gravity <1.005 occurs in kidney disease.
