Concepts 3610 Urinary System

C

A patient has a urinalysis ordered. When is the best time for the nurse to collect the specimen? A. In the evening B. After a meal C. In the morning D. After a fluid bolus

C

A 24-hour urine specimen is required from a patient. Which strategy is best to ensure that all the urine is collected for the full 24-hour period? A. Instruct the unlicensed assistive personnel to collect all the urine B. Put a bedpan or commode next to the bed as a reminder C. Place a sign in the bathroom reminding everyone to save the urine D. Verbally remind the patient about the test

D

A client in the community health clinic is prescribed trimethroprim/sulfamethoxazole for cystitis. The client reports developing hives to "something called Septra." What is the nurse's best action? A. Reassure the client that Septra is not trimethoprim/sulfamethoxazole B. Highlight this important information in the client's medical record C. Place an allergy alert band on the client's wrist D. Notify the prescriber immediately

B

A 60-year-old African-American client is newly diagnosed with mild chronic kidney disease. She has a history of diabetes, and her current A1C is 8.0%. She asks the nurse whether any of the following factors could have caused this problem. Which factor should the nurse indicate may have influenced the development of CKD? A. She heavily salted her food as a child and teenager but added no extra salt to her food as an adult B. Her chronic hyperglycemia causes blood vessel changes in the kidney that can damage kidney tissue C. Her paternal grandparents had type 2 diabetes and hypertension D. She drinks 2 cups of coffee with cream daily

A

A 65-year-old client is seeing his primary care provider for an annual examination. Which assessment finding alerts the nurse to an increased risk for bladder cancer? A. Smoking B. Urine with a high specific gravity C. Recurrent urinary tract infections D. History of cancer in another organ or tissue

B

A patient has agreed to try a bladder training program. What is the priority nursing intervention in starting this therapy? A. Start a schedule for voiding (e.g., every 2-3 hours) B. Teach the patient how to be alert, aware, and able to resist the urge to urinate C. Convince the patient that the bladder issues are controlling his/her lifestyle D. Give a thorough explanation of the problem of stress incontinence

D

A healthy female patient has no physical symptoms, but urinalysis results reveal a protein level of >0.8 mg/dL and a white blood cell count of 4 per high-powered field. What question would the nurse ask the patient in order to assist the health care provider to correctly interpret the urinalysis results? A. "Have you ever been treated for a urinary tract infection?" B. "Do you have a family history of cardiac or biliary disease?" C. "Are you sexually active and if so, do you use condoms?" D. "Have you recently performed any strenuous exercise?"

A

A patient is diagnosed with a urethral stricture. The nurse prepares the patient for which temporary treatment? A. Dilation of the urethra B. Antibiotic therapy C. Fluid restriction D. Urinary diversion

B

A patient is diagnosed with renal artery stenosis. Which sound does the nurse expect to hear by auscultation when a bruit is present in a renal artery? A. Quiet, pulsating sound B. Swishing sound C. Faint wheezing D. No sound at all

B

Which hormone is released from the posterior pituitary and makes the distal convoluted tubule and the collecting duct permeable to water to maximize reabsorption and produce concentrated urine? A. Aldosterone B. Vasopressin C. Bradykinins D. Natriuretic

B, C, D, E, F

A daughter is considering donating a kidney to her mother for organ transplant. What information does the nurse give to the daughter about the criteria for donation? (Select all that apply) A. Age limit is at least 21-years-old B. Systemic disease and infection must be absent C. There must be no history of cancer D. Hypertension or kidney disease must be absent E. There must be adequate kidney function as determined by diagnostic studies F. The donor must understand the surgery and be willing to give up the organ

C, D, E

A healthy 34-year-old male with no physical complaints has a BUN of 26 mg/dL. Which questions would the nurse ask to identify non-renal factors that could be contributing to this laboratory result? (Select all that apply) A. "Did you drink a lot of extra fluid before the blood sample was drawn?" B. "Have you been on a severe protein- or calorie-restricted diet?" C. "Are you taking or have you recently taken any steroid medications?" D. "Have you recently experienced any physical or emotional stress?" E. "Have you noticed any blood in the stool or have you vomited any blood?"

B

A male college student comes to the clinic reporting burning or difficulty with urination and a discharge from the urethral meatus. Based on the patient's chief complaint, what is the most logical question for the nurse to ask about the patient's past medical history? A. "Do you have a history of a narrow urethra or a stricture?" B. "Could you have been exposed to a sexually transmitted disease?" C. "Do you have a history of kidney stones?" D. "Have you been drinking an adequate amount of fluids?"

A

A patient had a cystoscopy. After the procedure, what does the nurse expect to see in this patient? A. Pink-tinged urine B. Bloody urine C. Very dilute urine D. Decreased urine output

A, B, C, D, F

A middle-aged woman has urinary stress incontinence related to weak pelvic muscles. The patient is highly motivated to participate in self-care. Which interventions does the nurse include in the treatment plan? (Select all that apply) A. Suggest keeping a detailed diary of urine leakage, activities, and foods eaten B. Suggest wearing absorbent undergarments during the assessment process C. Teach pelvic floor (Kegel) exercise therapy D. Teach about vaginal cone therapy E. Encourage drinking orange juice every day for 4 to 6 weeks F. Refer to a nutritionist for diet therapy for weight reduction

B

A patient had a renal scan. What is included in the postprocedural care for this patient? A. Administer laxatives to cleanse the bowel B. Encourage oral fluids to assist excretion of isotope C. Administer captopril (Capoten) to increase blood flow D. Insert a urinary catheter to measure urine output

D

A patient has AKI related to nephrotoxins. In order to maintain cell integrity, improve GFR, and improve blood flow to the kidneys, which type of medication does the nurse anticipate the health care provider will prescribe? A. Loop diuretics B. Alpha-adrenergic blockers C. Beta blockers D. Calcium channel blockers

D

A patient has UTI symptoms but there are no bacteria in the urine. The health care provider suspects interstitial cystitis. The nurse prepares patient teaching material for which diagnostic test? A. Urography B. Abdominal sonography C. Computed tomography D. Cystoscopy

B

A patient and family are trying to plan a scheduled that coordinates with the patient's dialysis regimen. The patient asks, "How often will I have to go and how long does it take?" What is the nurse's best response? A. "If you are compliant with the diet and fluid restrictions, you spend less time in dialysis; about 12 hours a week B. "Most patients require about 12 hours per week; this is usually divided into three 4-hour treatments." C. "It varies from patient to patient. You will have to call your health care provider for specific instructions." D. "If you gain a large amount of fluid weight, a longer treatment time may be needed to prevent severe side effects."

D

A patient appears very uncomfortable with the nurse's questions about urinary functions and patterns. What is the best technique for the nurse to use to elicit relevant information and decrease the patient's discomfort? A. Defer the questions until a later time B. Direct the questions toward a family member C. Use anatomic or medical terminology D. Use the patient's own terminology

A, B, D

A patient can develop intrarenal kidney injury from which causes? (Select all that apply) A. Vasculitis B. Pyelonephritis C. Stenuous exercise D. Exposure to nephrotoxins E. Bladder cancer

D

A patient comes to the clinic and reports severe flank pain, bladder distention, and nausea and vomiting with increasingly smaller amounts of urine with frank blood. The patient states, "I have kidney stones and I just need a prescription for pain medication." What is the nurses's priority concern? A. Controlling the patient's pain B. Checking the quantity of blood in the urine C. Flushing the kidneys with oral fluids D. Determining if there is an obstruction

D

A patient has been diagnosed with AKI, but the cause is uncertain. The nurse prepares patient educational material about which diagnostic test? A. Flat plate of the abdomen B. Renal ultrasonography C. Computed tomography D. Kidney biopsy

B

A patient has been performing Kegel exercises for 2 months. How does the nurse know whether the exercises are working? A. Incontinence is still present, but the patient states that it is less B. The patient is able to stop the urinary stream C. There are no complaints of urgency from the patient D. The patient is using absorbent undergarments for protection

A

A patient has been receiving erythropoietin. Which statement by the patient indicates that the therapy is producing the desired effect? A. "I can do my housework with less fatigue." B. "I have been passing more urine that I was before." C. "I have less pain and discomfort now." D. "I can swallow and eat much better than before."

D

A patient has been started on oxybutynin (Ditropan) for urinary incontinence. What is the major action of this medication? A. Increases blood flow to the urethra B. Blocks acetylcholine receptors C. Causes slight numbing of the bladder D. Relaxes bladder muscles

D

A patient has had a bladder suspension and a suprapubic catheter is in place. The patient wants to know how long the catheter will remain in place. What is the nurse's best response? A. "Typically it remains for 24 hours postoperatively." B. "It will be removed at your first clinic visit." C. "When you can void on your own, it will be removed." D. "It will be removed when you can void and residual urine is less that 50 mL."

D

A patient has had surgery for bladder cancer. To prevent recurrence of superficial bladder cancer, the nurse anticipates that the health care provider is likely to recommend which treatment? A. No treatment is needed for this benign condition B. Intravesical instillation of single-agent chemotherapy C. Radiation therapy to the bladder, ureters, and urethra D. Intravesical instillation of bacille Calmette-Guerin

C

A patient has recently started PD therapy and reports some mild pain when the dialysate is flowing in. What does the nurse do next? A. Immediately report the pain to the health care provider B. Try warming the dialysate in the microwave oven C. Reassure that pain should subside after the first week or two D. Assess the connection tubing for kinking or twisting

A

A patient has returned to the medical-surgical unit after having a dialysis treatment. The nurse notes that the patient is also scheduled for an invasive procedure on the same day. What is the primary rationale for delaying the procedure for 4 to 6 hours? A. The patient was heparinized during dialysis B. The patient will have cardiac dysrhythmias after dialysis C. The patient will be incoherent and unable to give consent D. The patient needs routine medications that were delayed

B

A patient has sustained a minor kidney injury. Which structure must remain functional in order to form urine from blood? A. Medulla B. Nephron C. Calyx D. Capsule

A, D, E, F

A patient has undergone a kidney biopsy. In the immediate postprocedural period, the nurse notifies the health care provider about which findings? (Select all that apply) A. Hematuria with blood clots B. Localized pain at the site C. "Tamponade effect" D. Decreasing urine output E. Flank pain F. Decreasing blood pressure

B

A patient has undergone a kidney biopsy. What does the nurse monitor for in the patient related to this procedure? A. Nephrotoxicity B. Hemorrhage C. Urinary retention D. Hypertension

B

A patient is admitted for an elective orthopedic surgical procedure. The patient also has a personal and family history for urolithiasis. Which circumstance creates the greatest risk for recurrent urolithiasis? A. Giving the patient milk with every meal tray B. Keeping the patient NPO for extended periods C. Giving the patient an opioid narcotic for pain D. Inserting an indwelling catheter for the procedure

D

A patient is considering vaginal cone therapy, but is a little hesitant because she does not understand how it works. What does the nurse tell her about how vaginal cone therapy improves incontinence? A. It mechanically obstructs urine loss from the urethra B. It repositions the bladder to reduce compression C. It increases the normal flora of the perineum D. It strengthens pelvic floor muscles

C

A patient is diagnosed with a fungal UTI. Which drug does the nurse anticipate the patient will be treated with? A. Trimethoprim/sulfamethoxazole (Bactrim) B. Ciprofloxacin (Cipro) C. Fluconazole (Diflucan) D. Amoxicillin (Amoxil)

C

A patient is diagnosed with renal osteodystrophy. What does the nurse instruct the UAP to do in relation to this patient's diagnosis? A. Assist the patient with toileting every 2 hours B. Gently wash the patient's skin with a mild soap and rinse well C. Handle the patent gently because of risk for fractures D. Assist the patient with eating because of loss of coordination

C

A patient is diagnosed with urethral stricture. What findings does the nurse expect to see documented in the patient's chart for this condition? A. Pain on urination B. Pain on ejaculation C. Overflow incontinence D. Hematuria and pyuria

B

A patient is in the diuretic phase of AKI. During this phase, what is the nurse mainly concerned about? A. Assessing for hypertension and fluid overload B. Monitoring for hypovolemia and electrolyte loss C. Adjusting the dosage of diuretic medications D. Balancing diuretic therapy with intake

A

A patient is scheduled for a computed tomography with iodinated contrast medium. Which medication is discontinued 24 hours before the procedure and for at least 48 hours until kidney function has been reevaluated? A. Glucophage (Metformin) B. Morphine C. Furosemide (Lasix) D. Oral acetylcysteine (Mucomyst)

D

A patient is scheduled for retrograde urethrography. Postprocedural care is similar to postprocedural care given for which test? A. Ultrasonography B. Computed tomography C. Renal angiogram D. Cystoscopy

C

A patient is scheduled to have an intravenous pyelogram. Which of the following information is most important for the nurse to obtain prior to the procedure? A. The date of the patient's last electrocardiogram B. The time of the patient's last meal C. The patient's history of allergies D. The patient's response to emetics

A

A patient is undergoing a dialysis treatment and exhibits a progression of symptoms which include headache, nausea, and vomiting; and fatigue. How does the nurse interpret these symptoms? A. Mild dialysis disequilibrium syndrome B. Expected manifestations in end-stage kidney disease C. Transient symptoms in a new dialysis patient D. Adverse reaction to the dialysate

B

A patient received an antibiotic prescription several hours ago and has started the medication, but requests "some relief from the burning." What comfort measures does the nurse suggest to the patient? A. Take over-the-counter acetaminophen B. Sit in a sitz bath and urinate into the warm water C. Place a cold pack over the perineal area D. Rest in a recumbent position with legs elevated

B

A patient receives dialysis therapy and the health care provider has ordered sodium restriction to 3 g daily. What does the nurse teach the patient? A. Add smaller amounts of salt at the table or during cooking B. Identify foods that are high in sodium (e.g., bacon, potato chips, fast foods). C. Avoid foods that have a metallic, salty, or bitter taste D. Eat larger amounts of bland foods with very minimal amount of spicing

D

A patient reports flank pain and tenderness. What technique does the nurse use to assess for costovertebral angle tenderness? A. Percuss the nontender flank and assess for rebound B. Thump the CVA area with the flat surface of the hand C. Thump the CVA are with a clenched fist D. Place one palm over the CVA area, thump with other fist

A

A patient reports intense urgency, frequency, and bladder pain. Urinalysis results show white blood cells and red blood cells and urine culture results are negative for infection. How does the nurse interpret these findings? A. Interstitial cystitis B. Urethritis C. Bacteriuria D. Infectious cystitis

C

A patient reports severe flank pain. The report indicates that urine is turbid, malodorous, and rust-colored; RBCs, WBCs, and bacteria are present; and microscopic analysis shows crystals. What does this data suggest? A. Pyuria and cystitis B. Staghorn calculus with infection C. Urolithiasis and infection D. Dysuria and urinary retention

A

A patient reports symptoms indicating a UTI. Results from which diagnostic test will verify a UTI? A. Urinalysis to test for leukocyte esterase and nitrate B. Urinalysis for glucose and red blood cells C. Urinalysis to test for ketones and protein D. Urinalysis for pH and specific gravity

D

A patient reports the loss of small amounts of urine during coughing, sneezing, jogging, or lifting. Which type of incontinence do these symptoms describe? A. Urge B. Overflow C. Functional D. Stress

B

A patient return to the unit after a renal scan. Which instruction about the patient's urine does the nurse give to the UAP caring for the patient? A. It is radioactive, so it should be handles with special biohazard precautions B. It does not place anyone at risk because of the small amount of radioactive material C. Its radioactivity is dangerous only to those who are pregnant D. It is potentially dangerous if allowed to sit for prolonged periods in the commode

A

A patient returns to the medical-surgical unit after having shock wave lithotripsy. What is an appropriate nursing intervention for the postprocedural care of this patient? A. Strain the urine to monitor the passage of stone fragments B. Report bruising that occurs on the flank of the affected side C. Continuously monitor electrocardiogram for dysrhythmias D. Apply a local anesthetic cream to the skin of the affected side

A

A patient sustained extensive burns and depletion of vascular volume. The nurse expects which changes in vital signs and urinary function? A. Decreased urine output, hypotension, tachycardia B. Increased urine output, hypertension, tachycardia C. Bradycardia, hypotension, polyuria D. Dysrhythmias, hypertension, oliguria

A

A patient with AKI has a high rate of catabolism. What is this related to? A. Increased levels of catecholamines, coritsol, and glucagon B. Inability to excrete excess electrolytes C. Conversion of body fat into glucose D. Presence of retained nitrogenous wastes

D

A patient with AKI is ill and has a poor appetite. What would the health care team try first? A. IV normal saline to prevent dehydration B. Familiar foods brought by the family C. Nasogastric tube for enteral feedings D. Oral supplements designed for kidney patients

A

A patient with AKI is receiving total parenteral nutrition. What is the therapeutic goal of using TPN? A. Preserve lean body mass B. Promote tubular reabsorption C. Create a negative nitrogen balance D. Prevent infection

A

A patient with CKD develops severe chest pain, an increased pulse, low-grade fever, and a pericardial friction rub with a cardiac dysrhythmia and muffled heart tones. The nurse immediately alerts the health care provider and prepares for which emergency procedure? A. Pericardiocentesis B. CVVH C. Kidney dialysis D. Endotracheal intubation

A

A patient with CKD has a potassium level of 8 mEq/L. The nurse notifies the health care provider after assessing for which signs/symptoms? A. Cardiac dysrhythmias B. Respiratory depression C. Tremors or seizures D. Decreased urine output

B

A patient with CKD is restless, anxious, and short of breath. The nurse hears crackles that begin at the base of the lungs. The pulse rate is increased and the patient has frothy, blood-tinged sputum. What does the nurse do first? A. Facilitate transfer to the ICU for aggressive treatment B. Place the patient in a high-Fowler's position C. Continue to monitor vital signs and assess breath sounds D. Administer a loop diuretic such as furosemide

A, B, D, E, F

A patient with CKD is taking digoxin (Lanoxin). Which signs of digoxin toxicity does the nurse vigilantly monitor for? (Select all that apply) A. Nausea and vomiting B. Visual changes C. Respiratory depression D. Restlessness or confusion E. Headache or fatigue F. Tachycardia

low sodium, low protein

A patient with CKD should be on what type of diet?

D

A patient with a history of kidney stones presents with severe flank pain, nausea, vomiting, pallor, and diaphoresis. He reports freely passing urine, but it is bloody. The priority for nursing care is to monitor for which patient problem? A. Possible dehydration B. Impaired tissue perfusion C. Impaired urinary elimination D. Severe pain

D

A patient with chronic kidney disease develops anorexia, nausea and vomiting, muscle cramping, and pruritus. How does the nurse interpret these findings? A. Oliguria B. Azotemia C. Anuria D. Uremia

B

A patient with prerenal azotemia is administered a fluid challenge. In evaluating response to the therapy, which outcome indicates that the goal was met? A. Patient reports feeling better and indicates an eagerness to go home B. Patient produces urine soon after the initial bolus C. The therapy is completed without adverse effects D. The health care provider orders a diuretic when the challenge is completed

B

A patient with urinary incontinence is prescribed oxybutynin (Ditropan). What precautions or instructions does the nurse provide related to this therapy? A. Avoid aspirin or aspirin-containing products B. Increase fluids and dietary fiber intake C. Report any unusual vaginal bleeding D. Change positions slowly, especially in the morning

C

A patient's laboratory results show an elevated creatinine level. The patient's history reveals no risk factors for kidney disease. Which question does the nurse ask the patient to shed further light on the laboratory result? A. "How many hours of sleep did you get the night before the test?" B. "How much fluid did you drink before the test?" C. "Did you take any type of antibiotics before taking the test?" D. "When and how much did you last urinate before having the test?"

A

A patient's recurrent cystitis appears to be related to sexual intercourse. The patient seems uncomfortable talking about the situation. What communication technique does the nurse use to assist the patient? A. Have a frank and sensitive discussion with the patient B. Give the patient reading material with instructions to call with any questions C. Call the patient's partner and invite the partner to discuss the problem D. Talk about other topics until the patient feels more comfortable disclosing

C

A young female patient reports experiencing burning with urination. What question does the nurse ask to differentiate between a vaginal infection and a urinary infection? A. "Have you noticed any blood in the urine?" B. "Have you had recent sexual intercourse?" C. "Have you noticed any vaginal discharge?" D. "Have you had fever or chills?"

A, D, E

A young woman tells the nurse that she gets frequent UTIs that seem to follow sexual intercourse. Which questions would the nurse ask? (Select all that apply) A. "Do you use a diaphragm or spermicides for contraception?" B. "Do you feel guilty or embarrassed about your sexual activities?" C. "Have you considered abstaining form intercourse?" D. "Do you and your partner(s) wash the perineal area before intercourse?" E. "Some positions cause more irritation during sex. Have you noticed this?"

C

An older adult patient with a cognitive impairment is living in an extended-care facility. The patient is incontinent, but as the family points our, "he will urinate in the toilet if somebody helps him." Which type of incontinence does the nurse suspect in this patient? A.. Urge B. Overflow C. Functional D. Stress

A

An older male comes to the emergency room with a history of urinary frequency, urgency, and low back pain. The nurse recognizes that these are symptoms of which of the following? A. Benign prostatic hypertrophy B. Herniated intervertebral disk C. Kidney stones D. Renal failure

A

An older male patient complains to the physician of urinary frequency, urgency, and dysuria. A cystoscopy is performed. After the cystoscopy, which of the following nursing actions has the highest priority? A. Obtain the patient's vital signs B. Report any nausea to the physician C. Review the patient's written discharge instructions D. Administer a sedative

A

Teaching intermittent self-catheterization for incontinence is appropriate for which patient? A. 25-year-old male patient with paraplegia B. 35-year-old female patient with stress incontinence C. 70-year-old patient who wears absorbent briefs D. 18-year-old patient with a severe head injury

A

According to the RIFLE classification (Risk, Injury, Failure, Loss, End-stage kidney failure), how would the nurse interpret the following data? Serum creatinine increased x 1.5 or glomerular filtration rate decrease >25%; urine output is <0.5 mL/kg/hr for >6 hours. A. Risk stage B. Injury stage C. Failure stage D. End-stage kidney disease

D

All patients with hypertension or diabetes should have yearly screenings for which factor? A. Creatinine B. BUN C. Glycosuria D. Microalbuminuria

A

An 84-year-old male client is being admitted after surgery to remove a section of his bowel following a diagnosis of colon cancer. His urine output from an indwelling urinary catheter after 3 hours in the postanesthesia care unit plus the amount in the bag on admission to the medical-surgical unit total 100 mL. The urine id cloudy and dark yellow. He also has a history of hypertension. After evaluating the patency of the collection device, what is the most appropriate action for the nurse to perform? A. Notify the health care provider of the low urine output B. Increase the rate of IV fluids until urine output is .5 mL/kg/hr C. Continue to assess the client and re-evaluate urine output in 4 hours D. Ask about his typical voiding patterns and about any previous episodes or urinary problems

A

An elderly patient has been in bed for several days after a fall. The nurse encourages ambulation to stimulate the movement of urine through the ureter by what phenomenon? A. Peristalsis B. Gravity C. Pelvic pressure D. Backflow

B

An older adult male patient has a history of an enlarged prostate. The patient is most likely to report which symptom associated with this condition? A. Inability to sense the urge to void B. Difficulty starting the urine stream C. Excreting large amount of very dilute urine D. Burning sensation when urinating

B

As a patient with end-stage kidney disease experiences isosthenuria, what must the nurse be alert for? A. The diuretic stage B. Fluid volume overload C. Dehydration D. Alkalosis

B

As a result of kidney failure, excessive hydrogen ions cannot be excreted. With acid retention, the nurse is most likely to observe what type of respiratory compensation? A. Cheyne-Stokes respiratory pattern B. Increased depth of breathing C. Decreased respiratory rate and depth D. Increased arterial carbon dioxide levels

A, B, C

Based on the nurse's knowledge of the normal function of the kidney, which large particles are not found in the urine because they are too large to filter through the glomerular capillary walls? (Select all that apply) A. Blood cells B. Albumin C. Other proteins D. Electrolytes E. Water

B

Damage to which renal structure or tissues can change the actual production of urine? A. Kidney parenchyma B. Convoluted tubules C. Calyces D. Ureters

B, C, D, E

During PD, the nurse notes slowed dialysate outflow. What does the nurse do to troubleshoot the system? (Select all that apply) A. Ensure that the drainage bag is elevated B. Inspect the tubing for kinking or twisting C. Ensure that clamps are open D. Turn the patient to the other side E. Make sure the patient is in good body alignment F. Instruct the patient to stand or cough

D

During peritoneal dialysis, a patient suddenly begins to breathe more rapidly. Which of the following actions should the nurse take first? A. Discontinue the dialysis procedure B. Check the patient's vital signs C. Notify the physician D. Elevate the head of the bed

B

During the day, the nursing student is measuring urine output and observing for urine characteristics in a patient. Which abnormal finding is the most urgent, which must be reported to the supervising nurse? A. Specific gravity is decreased B. Output is decreased C. pH is decreased D. Color has changed

B

For a patient who needs an indwelling catheter for at least 2 weeks, which intervention would help reduce the bacterial colonization along the catheter? A. Secure the catheter to the female patient's thigh B. Consider the use of a coated catheter C. Wash the urine bag and outflow tube every day D. Apply antiseptic ointment to the catheter tubing

C

For a patient with AKI, the nurse would consider questioning the order for which diagnostic test? A. Kidney biopsy B. Ultrasonography C. Computed tomography with contrast dye D. Kidney, ureter, bladder x-ray

C

For which hospitalized client does the nurse recommend the ongoing use of a urinary catheter? A. 36-year-old woman who is blind and is receiving diuretics B. 46-year-old man who has paraplegia and is admitted for asthma management C. 56-year-old woman who is admitted with a vaginal-rectal fistula and has diabetes D. 66-year-old man who has severe osteoarthritis and is a high risk for falling

A

Impairment in the thirst mechanism associated with aging makes an older adult patient more vulnerable to which disorder? A. Hypernatremia B. Hypocalcemia C. Hyperkalemia D. Hypoglycemia

C

In addition to kidney disease, which patient condition causes the BUN to rise above the normal range? A. Anemia B. Asthma C. Infection D. Malnutrition

A, B, C, E

In collaboration with the registered dietitian, the nurse teaches the patient about which diet recommendations for management of CKD? (Select all that apply) A. Controlling protein intake B. Limiting fluid intake C. Restricting potassium D. Increasing sodium E. Restricting phosphorus F. Reducing calories

A

In order to assist a patient in the prevention of osteodystrophy, which intervention does the nurse perform? A. Administer phosphate binders with meals B. Encourage high-quality protein foods C. Administer iron supplements D. Encourage extra milk at mealtimes

B

In which circumstance is the regulatory role of aldosterone most important in order for the person to maintain homeostasis? A. Person is having pain related to a kidney stone B. Person has been hiking in the desert for several hours C. Person experiences stress incontinence when coughing D. Person experiences a burning sensation during urination

D

In which patient circumstance would the nurse question the order for the insertion of an indwelling catheter? A. Patient is critically ill and at risk for hypovolemic shock B. Patient has urinary retention with beginnings of hydronephrosis C. Patient was in a car accident and has a possible spinal cord injury D. Patient has functional incontinence related to Alzheimer's disease

D

Increased BUN and creatinine, hyperkalemia, and hypernatremia are all characteristics of which stage of kidney disease? A. Stage 1 CKD B. Mild CKD C. Moderate CKD D. End-stage kidney disease

C

Ketones in the urine may indicate which occurrence or process? A. Increased glomerular membrane permeability B. Chronic kidney infection C. Body's use of fat for cellular energy D. Urinary tract infection

A

Limiting fluid intake would have what effect on urine? A. Increases the concentration of urine B. Makes the urine less irritating C. Decreases the risk for urine infection D. Decreases the pH of urine

A

Mastering voluntary micturition is a normal developmental task for which person? A. A healthy 20-month old toddler B. A 56-year-old woman with stress incontinence C. A healthy 8-year-old child D. A 25-year-old with a spinal cord injury

130 +/- 20, 120 +/- 15

Normal GFR for men is ____ mL/min and ____ mL/min for women

serum creatinine

Only kidney disease will increase what lab value?

A

Patients who have central nervous system lesions from stroke, multiple sclerosis, or parasacral spinal cord lesions may have which type of urinary incontinence? A. Detrusor hyperreflexia B. Mixed C. Stress D. Functional

B, C, E, F

Postrenal kidney injury can result from which conditions? (Select all that apply) A. Septic shock B. Cervical cancer C. Nephrolithiasis or ureterolithiasis D. Heart failure E. Neurogenic bladder F. Prostate cancer

1.5

Serum creatinine of greater than ___ mg/dL means that there is kidney injury

C

Several patients are scheduled for testing to diagnose potential kidney problems. which test requires a patient to have a urinary catheter inserted before the test? A. Urine stream testing B. Computed tomography C. Cystography D. Renal scan

C, D, E

Several patients at the clinic have just been diagnosed with UTIs. Which patients may need longer antibiotic treatment (7 to 21 days) or different agents than the typical first-line medications? (Select all that apply) A. Postmenopausal patient B. Patient with urethritis C. Diabetic patient D. Immunosuppressed patient E. Pregnant patient

1.005 - 1.030

Specific gravity normal range is ____.

A

The advanced-practice nurse is performing a digital rectal examination and notes that the rectal sphincter contracts on digital insertion. How does the nurse interpret this finding? A. Nerve supply to the bladder is most likely intact B. There is adequate strength in the pelvic floor C. A rectocele is placing pressure on the bladder D. Abnormal function for the bladder is unlikely

35

The nurse and the dietitian are planning dietary intake for a patient with AKI who is currently not on dialysis therapy. The dietitian informs the nurse that 0.6 g/kg of body weight of protein are needed. The patient weighs 130 pounds. How many grams of protein should the patient receive? (Round grams to the nearest whole number)

B

The client arrives at the primary health care clinic with a problem of new abdominal pain and blood in her urine. She is afebrile. Which information is most important for the nurse to obtain from the client's history? A. Kidney cancer in the client's family B. Injury or trauma to the abdomen or pelvis C. Treatment for a urinary tract infection in the past 12 months D. Recent exposure to heavy metals, drugs, or other nephrotoxins

D

The client had a transurethral resection of the prostate. On the third postoperative day, the urinary catheter is removed. Later on that day, the client reports uncontrolled dribbling after urination. The nurse's response is based upon which statement? A. Urinary incontinence is abnormal only if pus appears in the urine B. Urinary control should rapidly return to normal after catheter removal C. Urinary incontinence results from premature catheter removal, and replacement is indicated D. Temporary urinary incontinence is not unusual following catheter removal

A

The client has a transurethral resection of the prostate. 24 hours later, the nurse notices the client's urine is bright red. Which nursing action is most appropriate? A. Contact the health care provider B. Continue to monitor the client C. Irrigate the catheter D. Remove the catheter

A

The client is admitted to the hospital with a diagnosis of acute kidney injury. The nurse understands which explanation is the most accurate description of the client's condition? A. A sudden loss of kidney function due to failure of the renal system circulation or to glomerular or tubular damage B. A progressive deterioration in kidney function that ends fatally when uremia develops C. An inflammation of the kidney pelvis, tubules, and interstitial tissues of one or both kidneys D. An inflammation process precipitated by chemical changes in the glomeruli of both kidneys

C

The client passes a urinary stone that laboratory analysis indicates is composed of calcium oxalate. Based on this analysis, which instruction does the nurse specifically include for dietary prevention of the problem? A. "Increase your intake of meat, fish, and cranberry juice." B. "Avoid citrus fruits and citrus juices such as oranges." C. "Avoid dark green leafy vegetable such as spinach." D. "Decrease your intake of dairy products, especially milk."

B

The client reports a fever for several days prior to admission to the hospital. The client's temperature is 101 degrees F, and the client is started on penicillin therapy. It is essential for the nurse to monitor the client for which finding? A. Increased blood urea nitrogen B. Allergic reaction C. Anemia D. Decreased appetite

A

The client undergoes a transurethral resection of the prostate. In the immediate postoperative period, which characteristic does the nurse expect when observing the urinary drainage? A. Bloody B. Purulent C. Clear D. Bright yellow

D

The client with a history of kidney disease is admitted to the hospital reporting weakness and lethargy. The client's electrocardiogram shows sinus bradycardia with a prolonged PR interval. Which lab value does the nurse expect to find? A. Potassium 3.0 mEq/L B. Potassium 3.5 mEq/L C. Potassium 5.0 mEq/L D. Potassium 8.5 mEq/L

D

The client's urinalysis shows all of these abnormal results. Which result does the nurse report to the health care provider immediately? A. pH 7.8 B. Protein 31mg C. Sodium 15 mEq/L D. Leukoesterase and nitrate positive

A

The community health nurse is designing programs to reduce kidney problems and kidney injury among the general public. In order to do so, the nurse targets health promotion and compliance with therapy for people with which conditions? A. Diabetes mellitus and hypertension B. Frequent episodes of sexually transmitted disease C. Osteoporosis and other bone diseases D. Gastroenteritis and poor eating habits

C

The cystoscopy results for a patient include a small-capacity bladder, the presence of Hunner's ulcers, and small hemorrhages after bladder distention. How does the nurse interpret this report? A. Urosepsis B. Complicated cystitis C. Interstitial cystitis D. Urethritis

B

The employee health nurse is conducting a presentation for employees who work in a paint manufacturing plant. In order to protect against bladder cancer, the nurse advises that everyone who works with chemicals should do what? A. Shower with mild soap and rinse well before they come to work B. Use personal protective equipment such as gloves and masks C. Limit their exposure to chemicals and fumes at all times D. Avoid hobbies such as furniture refinishing that further expose to chemicals

C

The health care provider has ordered intraperitoneal heparin for a patient with a new PD catheter to prevent clotting of the catheter by blood and fibrin formation. How does the nurse advise the patient? A. Watch for bruising or bleeding from the gums B. Make a follow-up appointment for coagulation studies C. Intraperitoneal heparin does not affect clotting times D. Heparin will be given with a small subcutaneous needle

A

The health care provider has recommended intermittent self-catheterization for a patient with long-term problems of incomplete bladder emptying. Which information does the nurse give the patient about the procedure? A. Perform proper handwashing and cleaning of the catheter to reduce the risk for infection B. Use a large-lumen catheter and good lubrication for rapid emptying of the bladder C. Catheterize yourself whenever the bladder gets distended D. Use sterile techniques, especially if catheterization is done by a family member

B

The health care provider informs the nurse that there is a change in orders because the patient has a decrease in creatinine clearance rate. What change does the nurse anticipate? A. Fluid restriction B. Reduction of drug dosage C. Limitations on activity level D. Modification of diet

D

The health care provider orders a diet low in protein for the client with chronic kidney disease. The nurse understands this diet is prescribed for which reason? A. To decrease fluid retention B. To prevent diaphoresis C. To prevent shock D. To prevent hyperkalemia

D

The health care provider verbally informs the nurse that the patient needs a fluoroquinolone antibiotic to treat a UTI. The pharmacy delivers gabapentin (Neurontin). What should the nurse do first? A. Administer the mediation as ordered B. Call the pharmacist and ask for a read back of the order C. Call the health care provider for clarification of the order D. Look at the written order to clarify the name of the medication

B

The home care nurse visits a client reporting symptoms of a urinary tract infection. The nurse is ordered to obtain a midstream urine specimen. On arrival to the home, the client states the specimen was collected 2 hours ago and left sitting in the bathroom. Which action by the nurse is best? A. Label the specimen and send it to the laboratory. B. Discard the specimen and obtain a new midstream specimen C. Determine if the client used appropriate technique to clean the urethral meatus D. Determine if the specimen collected was voided midstream

A

The nurse instructs a patient about how to prevent urinary tract infections. Which of the following statements, if made by the patient to the nurse, requires further investigation? A. "I can go all day without emptying my bladder." B. "I drink 2 L of fluid every day." C. "I do not use bubble bath." D. "I drink cranberry juice each day."

A

The home health nurse is assessing an older adult patient who refuses to leave the house to see friends or participate in usual activities. She reports taking a bath several times a day and becomes very upset when she has an incontinent episode. What is the priority problem for this patient? A. Negative self-image B. Stress urinary incontinence C. Social isolation D. Potential for skin breakdown

A

The home health nurse is evaluating the home setting for a patient who wishes to have in-home hemodialysis. What is important to have in the home setting to support this therapy? A. Specialized water treatment system to provide a safe, purified water supply B. Large dust-free space to accommodate and store the dialysis equipment C. Modified electrical system to provide high voltage to power the equipment D. Specialized cooling system to maintain strict temperature control

A, D, E, F

The home health nurse is reviewing the medication list of a patient with CKD. The nurse calls the health care provider as a reminder that the patient might need which nutritional supplements? (Select all that apply) A. Iron B. Magnesium C. Phosphorus D. Calcium E. Vitamin D F. Water-soluble vitamins

A

The home health nurse is visiting a patient who independently performs PD. Which question does the nurse ask the patient to assess for the major complication associated with PD? A. "Have you noticed any signs or symptoms of infection?" B. "Are you having any pain during the dialysis treatments?" C. "Is the dialysate fluid slow or sluggish?" D. "Have you noticed any leakage around the catheter?"

C

The home health nurse reads in the patient's chart that the patient has asymptomatic bacterial urinary tract infection. Which intervention will the nurse perform? A. Obtain an order for urinalysis and urine culture and sensitivity B. Check the patient's medication list for appropriate antibiotic order C. Closely monitor for conditions that cause progression to acute infection D. Ask the patient when the ABUTI first started and when it was diagnosed

C

The intensive care nurse is caring for the kidney transplant patient who was just transferred from the recovery unit. Which finding is the most serious within the first 12 hours after surgery and warrant immediate notification of the transplant surgeon? A. Diuresis with increased output B. Pink and bloody urine C. Abrupt decrease in urine D. Small clots in bladder irrigation fluid

B

The night shift nurse sees a patient with kidney failure sitting up in bed. The patient states, "I feel a little short of breath at night or when I get up to walk to the bathroom." What assessment does the nurse do? A. Check for orthostatic hypotension because of potential volume depletion B. Auscultate the lungs for crackles, which indicate fluid overload C. Check the pulse and blood pressure for possible decreased cardiac output D. Assess for normal sleep pattern and need for a PRN sedative

C

The nurse and nutritionist are evaluating the diet and nutritional therapies for a patient with kidney problems. Blood urea nitrogen levels for this patient are tracked because of the direct relationship to the intake and metabolism of which substance? A. Lipids B. Carbohydrates C. Protein D. Fluids

A

The nurse instructs the client diagnosed with chronic kidney disease about the appropriate diet. The nurse determines teaching is effective if the client makes which statement? A. "I find lemon ice very refreshing." B. "My spouse fixes the best pork chops." C. "I have a cheese sandwich every day for lunch." D. "I eat yogurt for breakfast almost every day."

C

The nurse cares for a patient after a transurethral resection of the prostate. The physician has ordered a continuous bladder irrigation, with the irrigating solution infusing at 30 ml/hour. At the end of 24 hours, the patient's total output is 2,500 ml. The nurse calculates that the patient's actual urine output is which of the following? A. 1,870 ml B. 1,850 ml C. 1,780 ml D. 1,720 ml

C

The nurse cares for a patient immediately after a complete cystectomy and ileal conduit. The nurse is most concerned if which of the following is observed? A. The nursing output is 60 ml per hour B. The stoma appears red in color C. The stoma is edematous D. There is a small amount of serosanguineous drainage

D

The nurse cares for patients in a residential care facility. The nurse notes that a patient is suddenly disoriented to person, place, and time, and is falling. Which of the following actions should the nurse take first? A. Obtain an order for a vest restraint B. Frequently orient the patient to person, place, and time C. Instruct the patient to call the nurses before ambulating D. Assess for signs and symptoms of a urinary tract infection

B

The nurse cares for the client diagnosed with Alzheimer's disease and urinary incontinence. When implementing the plan for urinary habit training, which action does the nurse take first? A. Provides privacy for the client to toilet B. Establishes the client's voiding pattern C. Assists the client to the toilet every 2 hours D. Turns on the water faucet when the client is on the toilet

B

The nurse cares for the client reporting sudden onset of severe right flank pain. The client is diagnosed with urinary calculi. Which nursing action has the highest priority? A. Ensure the client remains NPO B. Strain all the urine through strainer or several layers of guaze C. Assess the client's grip strength and pupil reactivity D. Obtain a clean-catch urine specimen

A

The nurse cares for the client with suspected cancer of the bladder. The nurse knows that which finding is most common in the client with a diagnosis of bladder cancer? A. Hematuria B. Potassium 5.9 mEq/L C. Painful urination D. Left flank pain

D

The nurse is assessing the skin of a patient with end-stage kidney disease. Which clinical manifestation is considered a sign of very late, premorbid, advanced uremic syndrome? A. Ecchymoses B. Sallowness C. Pallor D. Uremic frost

B

The nurse hears in report that the patient is being treated for a fungal UTI. In addition to performing routine care and assessments, the nurse is extra-vigilant for signs/symptoms of which systemic disorder that may underlie the funal UTI? A. Chronic cardiac disease B. Immune system compromise C. Respiratory system dysfunction D. Connective tissue disorder

A

The nurse hears in report that the patient is having renal colic pain. When performing the physical assessment of this patient during a severe pain episode, what additional sign/symptom may the nurse expect to observe? A. Diaphoresis B. Redness over the flank C. Jaundice D. Bruit in the renal artery

C

The nurse if planning the care for several patients who are undergoing diagnostic testing. Which patient is likely to need the most time for postprocedural care? A. Will have a kidney, ureter, and bladder x-ray B. Needs a kidney ultrasound C. Will have a cystoscopy D. Needs urine for culture and sensitivity

B

The nurse in interviewing a 35-year-old woman who needs evaluation for a potential kidney problem. The woman reports she has been pregnant twice and has two healthy children. What would the nurse ask about health problems that occurred during pregnancy? A. "How much weight did you gain during the pregnancy?" B. "Were you treated for gestational diabetes?" C. "Did both of your pregnancies go to full-term?" D. "Did you have a urinary catheter inserted during labor?"

B

The nurse in the outpatient clinic counsels the client who states that she is having difficulty with stress incontinence. The client is 78-years-old, 5ft 2in tall, weighs 180 pounds, and had 4 live births. Which statement by the nurse is most appropriate? A. "There are some very good adult diapers available." B. "Let's talk about ways to reduce your weight." C. "You should drink less water." D. "Incontinence is to be expected at your age."

A

The nurse instructs the client diagnosed with urolithiasis how to prevent calcium calculi. Which client statement indicates teaching is successful? A. "I will drink at least 3,000 mL of fluid each day." B. "I will eat two servings of meat or cheese each day." C. "I will drink at least two glasses of cranberry juice daily." D. "I will eat a large amount of citrus fruit each day."

A

The nurse is assessing a patient for bladder distention. What technique does the nurse use? A. Gently palpate for the outline of the bladder, percuss the lower abdomen, continue toward the umbilicus until dull sounds are no longer produced B. Gently palpate for the outline of the bladder, auscultate for sounds in the lower abdomen C. Place one hand under the back and palpate with the other hand over the bladder, percuss the lower abdomen until tympanic sounds are no longer produced. D. Use the hand to depress the bladder as the patient takes a deep breath, then percuss

D

The nurse is assessing a patient who has just returned from hemodialysis. Which assessment finding is cause for greatest concern? A. Feeling of malaise B. Headache C. Muscle cramps in the legs D. Bleeding at the access site

B, D, E

The nurse is assessing a patient with a chronic kidney problem. The nurse notes that the patient has pedal edema and periorbital edema. What additional assessments will the nurse make to assess for fluid overload? (Select all that apply) A. Obtain a urine specimen B. Compare current blood pressure to baseline C. Measure the residual urine with a bladder scanner D. Weigh the patient and compare to baseline E. Auscultate lung fields to determine if fluid is present

C

The nurse is assessing a patient with kidney injury and notes a marked increase in the rate and depth of breathing. The nurse recognizes this as Kussmaul respiration, which is the body's attempt to compensate for which condition? A. Hypoxia B. Alkalosis C. Acidosis D. Hypoxemia

A, B, C, D, E

The nurse is assessing a patient with uremia. Which gastrointestinal changes does the nurse expect to find? (Select all that apply) A. Halitosis B. Hiccups C. Anorexia D. Nausea E. Vomiting F. Salivation

B

The nurse is assessing a patient's extremity with an arteriovenous graft. The nurse notes a thrill and a bruit, and the patient reports numbness and a cool feeling in the fingers. How does the nurse interpret this information in regard to the graft? A. The graft is functional and these symptoms are expected B. The patient has "steal syndrome" and may need surgical intervention C. The graft is patent, but the blood is flowing in the wrong direction D. The patient needs to increase active use of hands and fingers

D

The nurse is assisting an inexperienced health care provider to assess a patient who has an aneurysm. The nurse would intervene if the provider performed which action? A. Inspected the flank for bruising or redness B. Listened for a bruit over the renal artery C. Auscultated the abdomen for bowel sounds D. Palpated deeply to locate masses or tenderness

A

The nurse is caring for a patient with AKI who does not have signs or symptoms of fluid overload. A fluid challenge is performed to promote kidney perfusion by doing what? A. Administering normal saline 500 to 1000 mL infused over 1 hour B. Administering drugs to suppress aldosterone release C. Instilling warm, sterile normal saline into the bladder D. Having the patient drink several large glasses of water

A, C, D

The nurse is caring for a patient in the intensive care unit who sustained blood loss during a traumatic accident. For early identification of signs and symptoms that would suggest the development of kidney dysfunction, what does the nurse observe for? (Select all that apply) A. Hypotension B. Bradycardia C. Decreased urine output D. Decreased cardiac output E. Increased central venous pressure

A, B, C

The nurse is caring for a patient receiving gentamicin. Because this drug has potential for nephrotoxicity, which laboratory results does the nurse monitor? (Select all that apply) A. Blood urea nitrogen (BUN) B. Creatinine C. Drug peak and trough levels D. Prothrombin time (PT) E. Platelet count F. Hemoglobin and hematocrit

A

The nurse is caring for a patient requiring PD. In order to monitor the patient's weight, what does the nurse do? A. Check the weight after a drain and before the next fill to monitor the patient's "dry weight" B. Calculate the "dry weight" by weighing the patient every day and comparing the measurements to baseline C. Determine "dry weight" by comparing the patient's weight to a standard weight chart based on height and age D. Weigh the patient each day and count fluid intake and dialysate volume to determine the patient's "dry weight"

A

The nurse is caring for a patient who had hypovolemic shock secondary to trauma in the emergency department 2 days ago. Based on the pathophysiology of hypovolemia and prerenal azotemia, what does the nurse assess at least every hour? A. Urinary output B. Presence of edema C. Urine color D. Presence of pain

C

The nurse is caring for a patient who has an indwelling catheter and subsequently developed a UTI. The patient has been receiving antibiotics for several days, but develops hypotension, a rapid pulse, and confusion. The nurse suspects urosepsis and alerts the health care provider. Which diagnostic test is the provider most likely to order to confirm urosepsis? A. Culture of the drainage bag B. Culture of the catheter tip C. Blood culture D. Repeat urinalysis

B

The nurse is caring for a patient who sustained major injuries in an automobile accident. Which blood pressure will result in compromised kidney function, in particular the glomerular filtration rate? A. 150/70 B. 70/40 C. 80/60 D. 140/80

A

The nurse is caring for a patient with AKI and notes a trend of increasingly elevated BUN levels. How does the nurse interpret this information? A. Breakdown of muscle for protein which leads to an increase in azotemia B. Sign of urinary retention and decreased urinary output C. Expected trend that can be reversed by increasing dietary protein D. Ominous sign of impending irreversible kidney failure

B

The nurse is caring for a patient with AKI that developed after a severe anaphylactic reaction. What is the primary treatment goal of the initial phase that will help to prevent permanent kidney damage for this patient? A. Correct fluid volume by administering IV normal saline B. Maintain a mean arterial pressure of 65 mm Hg C. Prevent kidney infections by administering antibiotics D. Give antihistamines to prevent allergic response

C

The nurse is caring for a patient with CKD. The family asks about when renal replacement therapy will begin. What is the nurse's best response? A. "As early as possible to prevent further damage in stage I." B. "When there is reduced kidney function and metabolic wastes accumulate." C. "When the kidneys are unable to maintain a balance in body functions." D. "It will be started with diuretic therapy to enhance the remaining function."

D

The nurse is caring for a patient with an arteriovenous fistula. What instructions are given to the UAP regarding the care of this patient? A. Palpate for thrills and auscultate for bruits every 4 hours B. Check for bleeding at needle insertion sites C. Assess the patient's distal pulses and circulation D. Do not take blood pressure readings in the arm with the fistula

B, C, E

The nurse is caring for a patient with an arteriovenous fistula. What is included in the nursing care for this patient? (Select all that apply) A. Keep small clamps handy by the bedside B. Encourage routine range-of-motion exercises C. Avoid venipuncture or IV administration on the arm with the access device D. Instruct the patient to carry heavy objects to build muscular strength E. Assess for manifestations of infection of the fistula F. Instruct the patient to sleep on the side with the affected arm in the dependent position

A

The nurse is caring for a patient with an indwelling catheter. What intervention does the nurse use to minimize catheter-related infections? A. Assess the patient daily to determine need for catheter B. Irrigate the catheter daily with sterile solution to remove debris C. Use sterile technique when opening system to obtain urine samples D. Apply antiseptic solutions or antibiotic ointments to the perineal area

B

The nurse is caring for a patient with dehydration. Which laboratory test results does the nurse anticipate to see for this patient? A. BUN and creatinine ratio stay the same B. BUN rises faster than creatinine level C. Creatinine rises faster that BUN D. BUN and creatinine have a direct relationship

B

The nurse is caring for a patient with end-stage kidney disease and dialysis has been initiated. Which drug order does the nurse question? A. Erythropoietin B. Diuretic C. ACE inhibitor D. Calcium channel blocker

D

The nurse is caring for a patient with functional incontinence. The UAP reports that "the linens have been changed four times within the past 6 hours, but the patient refuses to wear a diaper." What does the nurse do next? A. Thank the UAP for the hard work and advise to continue to change the linens B. Call the health care provider to obtain an order for an indwelling catheter C. Instruct the UAP to stop using the word "diaper" and instead use "incontinence pants." D. Assess the patient for any new urinary problems and ask about toileting preferences

D

The nurse is caring for a patient with urolithiasis. Which medication is likely to be given in the acute phase to relieve the patient's severe pain? A. Ketorolac (Toradol) B. Oxybutynin chloride (Ditropan) C. Propantheline bromide (Pro-Banthine) D. Morphine sulfate (Astramorph)

A

The nurse is caring for a postoperative patient and is evaluating the patient's intake and output as a measure to prevent AKI. The patient weighs 60 kg and has produced 180 mL of urine in the past 4 hours. What should the nurse do? A. Perform other assessments related to fluid status and record the output B. Call the health care provider and obtain an order for a fluid bolus C. Encourage the patient to drink more fluid, so that the output is increased D. Compare the patient's weight to baseline to determine fluid retention

C

The nurse is caring for an obese older adult patient with dementia. The patient is alert and ambulatory, but has functional incontinence. Which nursing intervention is best for this patient? A. Help the patient to lose weight B. Help the patient apply an estrogen cream C. Offer assistance with toileting every 2 hours D. Intermittently catheterize the patient

C

The nurse is caring for an older adult patient with urinary incontinence. The patient is alert and oriented, but refuses to use the call bell and has fallen several times while trying to get to the bathroom. What is the nurse's priority concern for this patient? A. Managing noncompliance B. Accurately measuring urinary output C. Providing fall prevention measures D. Managing urinary incontinence

A

The nurse is caring for several patients on a medical-surgical unit. None of the patients currently has any acute or chronic kidney problems. Which patient has the greatest risk to develop AKI? A. 73-year-old male who has hypertension and peripheral vascular disease B. 32-year-old female who is pregnant and has gestational diabetes C. 49-year-old male who is obese and has a history of skin cancer D. 23-year-old female who has been treated for a UTI

D

The nurse is caring for the kidney transplant patient in the immediate postoperative period. During this initial period, the nurse will assess the urine output at least every hour for how many hours? A. First 8 hours B. First 12 hours C. First 24 hours D. First 48 hours

B

The nurse is caring for the kidney transplant patient who is 3 days postsurgery. The nurse notes a sudden and abrupt decrease in urine. The nurse alerts the health care provider because this is a sign of which anomaly? A. Rejection B. Thrombosis C. Stenosis D. Infection

C

The nurse is completing documentation for a client with acute kidney injury who is being discharged today. The nurse notices that the client has a serum potassium level of 5.8 mEq/L. Which is the priority nursing action? A. Asking the client to drink an extra 500 mL of water to dilute the electrolyte concentration and then re-checking the serum potassium level B. Encouraging the client to eat potassium-binding foods and to contact his or her primary care provider within 24 hours C. Checking the remaining values on the electrolyte panel and informing the primary care provider of all results before the client is discharged D. Applying a cardiac monitor and evaluating the client's muscle strength and muscle irritability

A

The nurse is counseling a patient with recurrent symptomatic UTIs about dietary therapy. What information does the nurse give to the patient? A. Drink 50 mL of concentrated cranberry juice every day B. Low consumption of protein may prevent recurrent UTIs C. Caffeine, carbonated beverages, and tomato products cause UTI D. Cranberry tablets are more effective than juice or fluids

A

The nurse is designing a habit training bladder program for an older adult patient who is alert but mildly confused. What task associated with the training program is delegated to the UAP? A. Tell the patient it is time to go to the toilet and assist him to go on a regular schedule B. Help the patient record the incidents of incontinence in a bladder diary C. Change the patient's incontinence pants (or pad) every 4 hours D. Gradually encourage independence and increase the intervals between voidings

C

The nurse is determining whether a patient has a history of hypertension because of the potential for kidney problems. Which question is best to elicit this information? A. "Do you have high blood pressure?" B. "Do you take any blood pressure medications?" C. "Have you ever been told that your blood pressure was high?" D. "When was the last time you had your blood pressure checked?"

A

The nurse is evaluating a patient's treatment response to erythropoietin (Epogen). Which hemoglobin reading indicates that the goal is being met? A. Around 10 g/dL B. Greater thatn 20 g/dL C. Upward trend D. At baseling for gender

C

The nurse is evaluating outcome criteria for a patient being treated for urge incontinence. Which statement indicates the treatment has been successful? A. "I'm following the prescribed therapy, but I think surgery is my best choice." B. "I still lose a little urine when I sneeze, but I have been wearing a thin pad." C. "I had trouble at first, but now I go to the toilet every 3 hours." D. "I have been using the bladder compression technique and it works."

C

The nurse is monitoring a patient's PD treatment. The total outflow is slightly less than the inflow. What does the nurse do next? A. Instruct the patient to ambulate B. Notify the health care provider C. Record the difference as intake D. Put the patient on fluid restriction

B

The nurse is performing an assessment of the renal system. What is the first step in the assessment process? A. Percuss the lower abdomen; continue toward the umbilicus B. Observe the flank region for asymmetry or discoloration C. Listen for a bruit over each renal artery D. Lightly palpate the abdomen in all quadrants

D

The nurse is performing an assessment on a patient with probable stress incontinence. Which assessment technique does the nurse use to validate stress incontinence? A. Assess the abdomen to estimate bladder fullness B. Check for residual urine using a portable ultrasound C. Catheterize the patient immediately after voiding D. Ask the patient to cough while wearing a perineal pad

D

The nurse is teaching a man about how to prevent UTIs. What information does the nurse include? A. "Have a minimal fluid intake of 5 L daily, unless contraindicated." B. "Empty your bladder before and after sexual intercourse." C. "Make sure that spermicides are used with condoms." D. "Gently wash the genital area before intercourse."

D

The nurse is teaching a patient a behavioral intervention for bladder compression. In order to correctly perform the Crede method, what does the nurse teach the patient to do? A. Insert the fingers into the vagina and gently push against the vaginal wall B. Breathe in deeply and direct the pressure toward the bladder during exhalation C. Empty the bladder, wait a few minutes, and attempt a second bladder emptying D. Apply firm and steady pressure over the bladder area with the palm of the hand

B

The nurse is preparing to assess a female patient's urethra prior to the insertion of a Foley catheter. In addition to gloves, which equipment does the nurse obtain to perform the initial assessment? A. Glass slide B. Good light source C. Speculum D. Cotton ball

A

The nurse is providing postdialysis care for a patient. In comparing vital signs and weight measurements to the predialysis data, what does the nurse expect to find? A. Blood pressure and weight are reduced B. Blood pressure is increased and weight is reduced C. Blood pressure and weight are slightly increased D. Blood pressure is low and weight is the same

B

The nurse is teaching a patient about performing PD at home. In order to identify the earliest manifestation of peritonitis, what does the nurse instruct the patient to do? A. Monitor temperature before starting PD B. Check the effluent for cloudiness C. Be aware of feelings of malaise D. Monitor for abdominal pain

A

The nurse is reviewing a care plan for a patient who has functional incontinence. There is a note that containment is recommended, especially at night. What is the major concern with this approach? A. Skin integrity B. Cost of care and materials C. Self-esteem of the patient D. Fall risk

B

The nurse is reviewing a patient's laboratory results. In the early phase of CKD, the patient is at risk for which electrolyte abnormality? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hypokalemia

A

The nurse is teaching a patient about self-care measures to prevent UTIs. Which daily fluid intake does the nurse recommend to the patient to prevent a bladder infection? A. 2 to 3 L of water B. 3 to 6 glasses of iced tea C. 4 to 6 cups of electrolyte fluid D. 3 to 4 glasses of juice

B

The nurse is reviewing the laboratory results for an older adult patient with an indwelling catheter. The urine culture is pending, but the urinalysis shows greater than 10^5 colony-forming units, and the differential WBC count shows a "left shift". How does the nurse interpret these findings? A. Interstitial cystitis B. Urosepsis C. Complicated cystitis D. Radiation-induced cystitis

B

The nurse is reviewing the medication list and appropriate dose adjustments made for a patient with CKD. The nurse would question the use and/or dosage adjustment of which type of medication? A. Antibiotics B. Magnesium antacids C. Oral antidiabetics D. Opioids

A

The nurse is reviewing the results of a patient's ultrasound of the kidney. The report reveals an enlarged kidney which suggests which possible problem? A. Polycystic kidney B. Kidney infection C. Renal carcinoma D. Chronic kidney disease

A

The nurse is reviewing urinalysis results for a patient who is in the early stages of CKD. What results might the nurse expect to see? A. Excessive protein, glucose, red blood cells, and white blood cells B. Increased specific gravity with a dark amber discoloration C. Dramatically increased urine osmolarity D. Pink-tinged urine with obvious small blood clots

B

The nurse is teaching a patient scheduled for an ultrasonography. What preprocedural instruction does the nurse give the patient? A. Void just before the test begins B. Drink water to fill the bladder C. Stop routine medications D. Have nothing to eat or drink after midnight

B

The nurse is teaching a patient with urge incontinence about dietary modifications. What is the best information the nurse gives to the patient about fluid intake? A. Drink at least 2000 mL per day unless contraindicated B. Drink 120 mL every hour or 240 mL every 2 hours and limit fluids after dinner C. Drink fluid freely in the morning hours, but limit intake before going to bed D. Drinking water is especially good for bladder health

A, C, D, F

The nurse is taking a history of a patient at risk for kidney failure. What does the nurse ask the patient about during the interview? (Select all that apply) A. Exposure to nephrotoxic chemicals B. Increased appetite C. History of diabetes mellitus, hypertension, systemic lupus erythematosus D. Recent surgery, trauma, or transfusions E. Leakage of urine when coughing or laughing F. Recent or prolonged use of antibiotics and NSAIDs

B

The nurse is taking a history on a 55-year-old patient who denies any serious chronic health problems. Which sudden onset sign/symptom suggests possible kidney disease in this patient? A. Weakness B. Hypertension C. Confusion D. Dysrhythmia

A, B, E

The nurse is taking a history on a patient with a change in urinary patterns. In addition to the medical and surgical history, what does the nurse ask the patient about to complete the assessment? (Select all that apply) A. Occupational exposure to toxins B. Use of illicit substances, such as cocaine C. Financial resources for payment of treatments D. Likelihood of complying with treatment recommendations E. Recent travel to geographic regions that pose infectious disease risks

D

The nurse is taking a history on a patient with diabetes and hypertension. Because of the patient's high risk for developing kidney problems, which early sign of chronic kidney disease does the nurse assess for? A. Decreased output with subjective thirst B. Urinary frequency of very small amounts C. Pink or blood-tinged urine D. Increased output of very dilute urine

C

The nurse is taking a nutritional history on a patient. The patient states, "I really don't drink as much water as I should." What is the nurse's best response? A. "We should probably all drink more water than we do." B. "It's an easy thing to forget; just try to remember to drink more." C. "What would encourage you to drink the recommended 2 liters per day?" D. "I'd like you to read this brochure about kidney health and fluids."

C

The nurse is talking to a 68-year-old male patient who has lifestyle choices and occupational exposure that put him at high risk for bladder cancer. The nurse is most concerned about which urinary characteristic? A. Frequency B. Nocturia C. Painless hematuria D. Incontinence

C

The nurse is talking to a group of healthy young students about maintaining good kidney health and preventing AKI. Which health promotion point is the nurse most likely to emphasize with this group? A. "Have your blood pressure checked regularly." B. "Find out if you have a family history of diabetes." C. "Avoid dehydration by drinking at least 2 to 3 L of water daily." D. "Have annual testing for microalbuminuria and urine protein."

A

The nurse is talking to a group of older women about changes in the urinary system related to aging. What symptom is likely to be the common concern for this group? A. Incontinence B. Hematuria C. Retention D. Dysuria

A

The nurse is talking to a patient with end-stage kidney disease. The patient frequently displays weight gain and increased blood pressure beyond the baseline measurements. Which question is the nurse most likely to ask to determine if the patient is doing something that is contributing to these assessment findings? A. "Are you controlling your salt intake?" B. "Are you following the protein restrictions?" C. "Have you been eating a lot of sweets?" D. "Have you been exercising regularly?"

B

The nurse is talking to an older adult male patient who is reasonably healthy for his age, but has benign prostatic hyperplasia (BPH). Which condition does the BPH potentially place him at risk for? A. Prerenal acute kidney injury B. Postrenal acute kidney injury C. Polysystic kidney disease D. Acute glomerulonephritis

A

The nurse is teaching a woman how to prevent UTIs. What information does the nurse include? A. Clean the perineal area from front to back? B. Always use a condom if spermicides are used for contraception C. Obtain prescription for oral estrogen for vaginal dryness D. Avoid urinary stasis by urinating every 6 to 8 hours

A, B, C, E

The nurse is teaching self-care measures to a patient who had lithotripsy for kidney stones. What information does the nurse include? (Select all that apply) A. Finish the entire prescription of antibiotics to prevent UTIs B. Balance regular exercise with sleep and rest C. Drink at least 3 L of fluid a day D. Watch for and immediately report bruising after lithotripsy E. Urine may be bloody for several days F. Pain in the region of the kidneys or bladder is expected

C

The nurse is working in a long-term care facility. Which circumstance is cause for greatest concern, because the facility has a large number of residents who are developing UTIs? A. Residents are not drinking enough fluids with meals B. Unlicensed personnel are not assisting with toileting in a timely fashion C. A large percentage of residents have indwelling urinary catheters D. Many residents have severe dementia and functional incontinence

A

The nurse monitors a CKD patient's daily weights because of the risk for fluid retention. What instructions does the nurse give to the UAP? A. Weigh the patient daily at the same time each day, same scale, with the same amount of clothing B. Weigh the patient daily and add 1 kg of weight for the intake of each liter of fluid C. Weigh the patient in the morning before breakfast and weigh the patient at night just before bedtime D. Ask the patient what his or her normal weight is and then weigh the patient before and after each voiding

C

The nurse notes an abnormal laboratory test finding for a patient with CKD and alerts the health care provider. The nurse also consults with the registered dietitian because an excessive dietary protein intake is directly related to which factor? A. Elevated serum creatinine level B. Protein presence in the urine C. Elevated BUN level D. Elevated serum potassium level

C

The nurse notes that a patient with a Foley catheter complains of discomfort, has a moderately distended bladder, and has had 20 mL of urinary drainage in the past hour. What is the first action the nurse should take? A. Irrigate the catheter B. Gently massage the bladder in a distal direction C. Inspect the catheter tubing D. Briefly raise the drainage bag above the level of the bladder

A

The nurse performs a dipstick urine test for a patient being evaluated for kidney problems. Glucose is present in the urine. How does the nurse interpret this result? A. Blood glucose level is greater than 220 mg/dL B. The kidneys are failing to filter any glucose C. The patient is at risk for hypoglycemia D. The renal threshold has not been exceeded

B

The nurse reads in the patient's chart that he has acute-on-chronic kidney disease. How does the nurse interpret this information? A. Kidney disease has progressed to the need for dialysis or transplant B. Patient has chronic kidney disease and has sustained an acute kidney injury C. Acute kidney injury requires aggressive management to prevent chronic disease D. The condition could be acute or chronic; further diagnostic testing is needed

B

The nurse reads int he assessment note made by the advanced-practice nurse that the "left kidney cannot be palpated." How does the nurse interpret this notation? A. The left kidney is smaller than normal, which indicated CKD B. The left kidney is normally deeper and often cannot be palpated C. The palpation of kidneys should be repeated by another provider D. The patient is too obese for this type of examination

B

The nurse requests a dietary consult to address the patient's high rate of catobolism. Which nutritional element is directly related to this metabolic process? A. Carbohydrates B. Proteins C. Liquids D. Fats

B

The nurse sees that an older patient has a blood osmolarity of 303 mOsm/L. Which additional assessment will the nurse make before notifying the health care provider about the laboratory results? A. Patient's mental status B. Signs of dehydration C. Patient's temperature D. Odor of the urine

B

What is an advantage of a renal scan compared to CT scan for diagnosing the perfusion, function, and structure of the kidneys? A. Renal scan is more readily tolerated by elderly patients and small children B. Renal scan is preferred if the patient is allergic to iodine or has impaired kidney function C. Renal scans are more likely to detect pathologic changes that CT scans do not detect D. Renal scan requires less pre- and postprocedural care than CT scan

A

The nurse supervises a staff member insert an indwelling urinary catheter in the female client. The nurse notes the catheter is inserted into the client's vagina. Which action does the nurse take first? A. Leaves the catheter in place and obtains a new catheterization kit B. Instructs the staff member about the correct way to insert a catheter C. Removes the catheter and inserts a new catheter D. Completes an incident report

A

The nurse understands which is the goal of a diet for clients with chronic kidney disease? A. Lowered intake of protein to decrease BUN B. Lowered intake of sugars to decrease blood glucose C. Lowered intake of fats to decrease blood triglycerides D. Lowered intake of amino acids to decrease triglycerides and serum albumin

D

The nursing student is explaining principles of hemodialysis to the nursing instructor. Which statement by the student indicates a need for additional study and research on the topic? A. "Dialysis works as molecules from an area of higher concentration move to an area of lower concentration." B. "Blood and dialyzing solution flow in opposite directions across an enclosed semi-permeable membrane." C. "Excess water, waste products, and excess electrolytes are removed from the blood." D. "Bacteria and other organisms can also pass through the membrane, so the dialysate must be kept sterile."

B

The nursing student sees an order for a urinalysis for a patient with frequency, urgency, and dysuria. In order to collect the specimen, what does the student do? A. Use sterile technique to insert a small-diameter catheter B. Instruct the patient on how to collect a clean-catch specimen C. Tell the patient to urinate approximately 10 mL into a specimen cup D. Take the urine from a bedpan and transfer it into a specimen cup

A

The patient with CKD reports chronic fatigue and lethargy with weakness and mild shortness of breath with dizziness when rising to a standing position. In addition, the nurse notes pale mucous membranes. Based on the patient's illness and the presenting symptoms, which laboratory result does the nurse expect to see? A. Low hemoglobin and hematocrit B. Low white cell count C. Low blood glucose D. Low oxygen saturation

B

The physician prescribes phenazopyridine hydrochloride (Pyridium) and trimethoprim/sulfamethoxazole (Septra) for a patient. It is most important for the nurse to make which of the following statements to the patient? A. "You may experience dizziness and lethargy." B. "Your urine will become bright orange in color." C. "You will notice that your urine will be more dilute." D. "You may experience some pain when urinating."

B

What is the average urine output of a healthy adult for a 24-hour period? A. 500mL to 1000mL B. 1500mL to 2000mL C. 3000mL to 5000mL D. 5000mL to 7000mL

A

The urine output of a patient with a kidney stone has decreased from 40 mL/hr to 5 mL/hr. What is the nurse's priority action? A. Ensure IV access and notify the health care provider B. Perform the Crede maneuver on the patient's bladder C. Test the urine for ketone bodies D. Document the finding and continue monitoring

B

Vitamin D is converted to its active form in the kidney. If this function fails, which electrolyte imbalance will occur? A. Hyperkalemia B. Hypocalcemia C. Hypernatremia D. Hypoglycemia

B, D, E

What are common causes of prerenal kidney injury? (Select all that apply) A. Urethral cancer B. Hypovolemic shock C. Enlarged prostate gland D. Sepsis E. Severe burns

eliminate waste, maintain fluid volume, blood pressure regulation, acid/base balance, erythropoietin, and vitamin D activation

What are the 6 functions of the kidneys?

B, C, D

What are the characteristics of continuous venovenous hemofiltration? (Select all that apply) A. Requires placement of arterial and venous access B. Uses a pump to drive blood from the patient catheter into the dialyzer C. Risk of air embolus D. More commonly used for patients who are critically ill E. Most convenient method for home care patients

C

What does an increase in the ratio of BUN to serum creatinine indicate? A. HIghly suggestive of kidney dysfunction B. Definitive for kidney infection C. Suggest nonkidney factors causing an elevation in BUN D. Suggests nonkidney factors causing an elevation in serum creatinine

A

What does the BUN test measure? A. Kidney excretion of urea nitrogen B. Urine osmolality C. Creatinine clearance D. Urine output

A, C, D, E, F

What does the nurse include in the care plan for a patient who had pyelolithotomy? (Select all that apply) A. Monitor the amount of bleeding from incisions B. Restrict fluids to prevent edema and fluid overload C. Strain the urine to monitor the passage of stone fragments D. Encourage fluids to avoid dehydration and supersaturation E. Monitor changes in urine output F. Administer antibiotics to eliminate or prevent infections

antidiuretic hormone

What hormone is released when blood osmolarity is high?

A, B, D, E

Which characteristics are associated with end-stage kidney disease? (Select all that apply) A. Severe fluid overload B. Renal osteodystrophy C. Nephrons compensate D. Dialysis or transplant needed to maintain homeostasis E. Excessive waste products

A

What is the best description of continuous ambulatory peritoneal dialysis? A. Daily infusion of four 2 L exchanges of dialysate every 4 to 6 hours while awake B. Is a form of automated dialysis that uses an automated cycling machine C. Functions of the cycling machine are programmed to the patient's needs D. This form decreases the risk of peritonitis and poor dialysate flow

contrast angiography

What is the definitive diagnostic test for renal insufficiency?

4.6-8

What is the normal pH range for urine?

10-20 mg/dL

What is the normal range for BUN?

A, B, E

What might the nurse notice if the patient is experiencing reduced perfusion and altered urinary elimination related to AKI? (Select all that apply) A. Hemodynamic instability, especially persistent hypotension and tachycardia B. Urine output of less than 0.5 mL/kg/hour for 6 or more hours C. Serum creatinine below baseline or admission values D. Urine may be clear or have a pale yellow color E. Abnormal serum and urine potassium and sodium values

D

What role does drug therapy have as an intervention for reflex (overflow) urinary incontinence? A. Captopril (Capoten) is given to lower urine cystine levels B. Levofloxacin (Levaquin) is given to prevent UTIs with this type of incontinence C. Midorine (ProAmatine) is given to increase the contractile force of the bladder D. Bethanechol chloride (Urecholine) may be used short-term after surgery

C

What type of breath odor is most likely to be noted in a patient with CKD? A. Fruity smell B. Fecal smell C. Smells like urine D. Smells like blood

ACE inhibitors, ARBs, and diuretics

What types of blood pressure medications would a patient with CKD be taking? (3)

220

When blood sugar is over ___, then glucose will spill over into the urine.

B

When patients have problems with the kidneys or urinary tract, what is the most common symptom that prompts them to seek medical attention? A. Change in the frequency or amount of urination B. Pain in flank or abdomen or pain when urinating C. Noticing a change in the color or odor of the urine D. Exposure to a nephrotoxic substance

B

When preparing a patient for peritoneal dialysis, which of the following nursing actions should be taken first? A. Assess for bruit B. Warm the dialysate C. Position the patient on the left side D. Insert a Foley catheter

A, B, E

When shock or other problems cause an acute reduction in blood flow to the kidneys, how do the kidneys compensate? (Select all that apply) A. Constrict blood vessels in the kidneys B. Activate the renin-angiotensin-aldosterone pathway C. Release beta blockers D. Dilate blood vessels throughout the body E. Release antidiuretic hormones

D

Which abnormal finding would be associated with chronic kidney disease? A. Hematuria B. Pus in the urine C. Blood at the urethral meatus D. Decreased urine specific gravity

A, B, C

Which are the most accurate ways to monitor kidney function in the patient with CKD? (Select all that apply) A. Monitoring intake and output B. Checking urine specific gravity C. Reviewing BUN and serum creatinine levels D. Reviewing x-ray reports E. Consulting the dietitian's notes

C

Which assessments are most important for the nurse to perform when monitoring a client who return to the medical-surgical unit after a dye-enhanced CT scan? A. Body temperature and urine color B. Kidney tenderness and flank pain C. Urine volume and color D. Specific gravity and pH

C

Which behavior is the strongest indicator that a patient with end-stage kidney disease is not coping well with the illness and may need a referral for psychological counseling? A. Displays irritability when the meal tray arrives B. Refuses to take one of the drugs because it causes nausea C. Repeatedly misses dialysis appointments D. Seems distracted when the health care provider talks about the prognosis

B

Which clinical manifestation indicates to the nurse that interventions for the patient's renal colic are effective? A. Urine is pink-tinged B. Patient reports that pain is relieved C. Urine output is 50 mL/min D. Bladder scan shows no residual urine

C

Which combination of drugs is the most nephrotoxic? A. ACE inhibitors and aspirin B. ARBs and antacids C. Aminoglycoside antibiotics and NSAIDS D. Calcium channel blockers and antihistamines

C

Which diagnostic test incorporates contrast dye, but does not place a patient at risk for nephrotoxicity? A. Renal scan B. Renal angiography C. Voiding cystourethrogram D. Computed tomography

C

Which dietary changes does the nurse suggest to a patient with urge incontinence? A. Limit fluid intake to no more than 2 L/day B. Peel all fruit before consuming C. Avoid alcohol and caffeine D. Avoid smoked or salted foods

A

Which disorder could be a complication from AKI? A. Heart failure B. Diabete mellitus C. Kidney cancer D. Compartment syndrome

D

Which event is most likely to trigger renin production? A. Patient participates in strenuous exercise B. Patient becomes anxious and nervous C. Patient has urge to urinate during the night D. Patient sustains significant blood loss

D

Which finding in the urine of the client diagnosed with chronic kidney disease is expected by the nurse? A. Hematuria B. Polyuria C. Dysuria D. Oliguria

B

Which group has the highest prevalence of urinary tract infections? A. Young men B. Older women C. Older men D. School-aged girls

D

Which hematologic disorder is most likely to occur if the hormonal function of the kidneys is not working properly? A. Leukemia B. Thrombocyopenia C. Neutropenia D. Anemia

B

Which of the following approaches describes the correct technique for the nurse to obtain a urine specimen from a patient who has an indwelling Foley catheter? A. Empty the contents of the drainage bag, wait 10 minutes, and take a specimen of urine from the drainage bag B. Clamp the drainage tube below the port and, using a sterile needle, aspirate a specimen of urine via the port C. Swab the tubing where the catheter connects to the drainage bag with Betadine, disconnect the tubing, and collect a specimen of urine directly from the catheter D. Take a random specimen of urine from the drainage bag

C

Which of the following urine outputs best indicates to the nurse that a patient's kidneys are functioning normally? A. 555 mL in 2 hours B. 30 mL in 1 hour C. 1,500 mL in 24 hours D. 800 mL in 24 hours

D

Which over-the-counter product used by a patient does the nurse further explore for potential impact on kidney function? A. Mouthwash with alcohol B. Fiber supplement C. Vitamin C D. Acetaminophen

C

Which patient has the highest risk for bladder cancer? A. 60-year-old male patient with malnutrition secondary to chronic alcoholism and self-neglect B. 25-year-old male patient with type 1 diabetes mellitus, who is noncompliant with therapeutic regimen C. 60-year-old female patient who smokes two packs of cigarettes per day and works in a chemical factory D. 25-year-old female patient who has had three episodes of bacterial cystitis in the past year

B

Which patient has the highest risk for developing a complicated UTI? A. 26-year-old woman who is sexually active, but not currently pregnant B. 22-year-old man who has a neurogenic bladder due to spinal cord injury C. 35-year-old woman who had three full-term pregnancies and a miscarriage D. 53-year-old woman who is having some menstrual irregularities

A

Which patient is most likely to exceed the renal threshold if there is noncompliance with the prescribed therapeutic regimen? A. Has recurrent kidney stone formation B. Has type 2 diabetes mellitus C. Has functional urinary incontinence D. Has biliary obstruction

A

Which patient is most likely to have a decreased calcium level? A. Patient with kidney disease B. Patient with cystitis C. Patient with a Foley catheter D. Patient with urinary retention

A

Which patient is most likely to produce urine with a specific gravity of less that 1.005? A. Takes diuretic medication everyday B. Has dehydration secondary to vomiting C. Is hypovolemic due to blood loss D. Has syndrome of inappropriate antidiuretic hormone

A

Which patient is mostly likely to have mixed incontinence? A. 54-year-old woman who had four full-term pregnancies B. 52-year-old man who had a stroke with neurologic deficits C. 76-year-old man with benign prostatic hyperplasia D. 25-year-old woman who has a pelvic fracture

C

Which patient is the most likely candidate for CVVH? A. Patient with fluid volume overload B. Patient who needs long-term management C. Patient who is critically ill D. Patient who is ready for discharge to home

C

Which patient narrative describes the symptom of dysuria? A. "I have to pee all the time." B. "I have to wait before the pee starts." C. "It burns when I pee." D. "It feels like I am going to pee in my pants."

D

Which patient should not be advised to take cranberry juice? A. 26-year-old pregnant woman with a history of uncomplicated UTI B. 23-year-old man with history of recurrent kidney stones C. 65-year-old man with urinary retention secondary to enlarged prostate D. 33-year-old woman with dysuria associated with interstitial cystitis

B

Which patient with incontinence is most likely to benefit from a surgical intervention? A. Patient with vaginal atrophy and altered urethral competency B. Patient with reflex (overflow) incontinence caused by obstruction C. Patient with functional incontinence related to musculoskeletal weakness D. Patient with urge incontinence or overactive bladder

D

Which patient with kidney problems is the best candidate for peritoneal dialysis (PD)? A. Patient with peritoneal adhesions B. Patient with a history of extensive abdominal surgery C. Patient with peritoneal membrane fibrosis D. Patient with a history of difficulty with anticoagulants

B, C

Which patients are likely to be excluded from receiving a transplant? (Select all that apply) A. Patient who had breast cancer 6 years ago B. Patient with advanced and uncorrectable heart disease C. Patient with a chemical dependency D. Patient who is 70-years-old and has a living related donor E. Patient with diabetes mellitus

A, C, D, E

Which patients with CKD are candidates for intermittent hemodialysis? (Select all that apply) A. Patient with fluid overload who does not respond to diuretics B. Patient with injury stage according to the RIFLE classification C. Patient with symptomatic toxin ingestion D. Patient with uremic manifestations, such as decreased cognition E. Patient with symptomatic hyperkalemia and calciphylaxis

B

Which personal action is most likely to cause the kidneys to produce and release erythropoietin? A. Person moves to a low desert area where the humidity is very low B. Person moves to a high-altitude area where atmospheric oxygen is low C. Person drinks an excessive amount of fluid that results in fluid overload D. Person eats a large high-protein meal after a rigorous exercise workout

A, B, C, E

Which problems occur with acute kidney injury (AKI)? (Select all that apply) A. Decreased peristalsis B. Anemia C. Metabolic acidosis D. Hypokalemia E. Peripheral edema

A

Which renal change associated with aging does the nurse expect an older adult patient to report? A. Nocturnal polyuria B. Micturition C. Hematuria D. Dysuria

A, C, D

Which signs/symptoms does the nurse expect to see in the patient with AKI that has progressed in severity? (Select all that apply) A. Oliguria B. Hypotension C. Shortness of breath D. Pulmonary crackles E. Weight loss

C

Which statement by a patient indicates effective coping with a Kock's pouch? A. "I don't have any discomfort, but the pouch frequently overflows." B. "My wife has been irrigating the pouch daily. She likes to do it." C. "I check the pouch every 2 to 3 hours depending on my fluid and diet." D. "I never undress in front of anyone anymore, but I guess that is okay."

A

Which task related to care of patients who have indwelling catheters can be delegated to unlicensed assistive personnel? A. Perform daily catheter care by washing the perineum and proximal portion of the catheter with soap and water B. Use sterile technique when inserting the urinary catheter or when opening the system to obtain urine samples C. Determine whether use of condom catheters is appropriate for male patients and apply the devices accordingly D. Keep urine collection bag in a place that is readily visible to the patient, so that the patient is reassured of kidney function

B

Which test is the best indicator of kidney function? A. Urine osmolarity B. Serum creatinine C. Urine pH D. BUN

A

Which urine characteristic listed on a urinalysis report arouses the nurse's suspicion of a problem in the urinary tract? A. Cloudiness B. Straw color C. Ammonia odor D. One cast per high-powered field

D

Which urine characteristic suggests that the patient is drinking a sufficient amount of fluid? A. Urine pH is between 6 to 6.5 B. Urine has a high specific gravity C. Urine has a faint ammonia odor D. Urine is a pale yellow color

wasting

With kidney disease, the patient should be taking a potassium (sparing/wasting) diuretic.

kidney failure

____ is when there is 10-25% kidney function.

end-stage kidney disease

____ is when there is less than 10% kidney function.

azotemia

____ is when there is nitrogenous waste products in the blood.