NUR334 PrepU: Chapter 24 - Structure and Function of the Kidney

Select the percentage of cardiac output that perfuses the kidneys.

20% to 25%.

The nurse recognizes that ADH, antidiuretic hormone, exerts its effects in which of these locations?

Loop of Henle.

The nurse is caring for a client in emergent fluid overload requiring rapid diuresis. Which diuretic should the nurse be prepared to administer?

Loop.

When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which of these substances in the blood?

Blood urea nitrogen.

A nurse is evaluating a patient's morning laboratory values. Which of the following results requires that the nurse notify the health care provider?

Creatinine: 10.6 mg/dL.

Select the option that identifies the function of the kidneys in maintaining normal composition of internal body fluids.

Filtration and reabsorption of physiologically essential substances.

When teaching the client with gout about the cause of the disease, which of these should the nurse relate?

Increased levels of uric acid in the blood cause gout.

In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:

Innervation of the sympathetic nervous system causing constriction of the afferent arteriole.

The nurse has delegated obtaining a urine specimen for testing to the nursing assistant. Which of these does the nurse emphasize the assistant should do to ensure accuracy of testing?

Obtain a freshly voided specimen.

A patient in a hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine collection test. He asks the nurse why the test is necessary since he provided a single urine sample two days ago. How could the nurse best respond to the patient's question?

"Often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."

The nurse is teaching a group of nursing students about the major functions of the kidney. Which of these should the nurse include in the discussion? Select all that apply.

-Elimination of water. -Removal of waste products. -Removal of excess electrolytes.

Which client lab results would be associated with abnormalities in kidney function? Select all that apply:

-Increased creatinine levels. -Detectable levels of glucose in a urine sample. -Elevated cystatin-C level.

The nurse is teaching a group of nursing students about the formation of urine in the nephron. Which of these components does the nurse teach are components of the nephron? Select all that apply.

-Proximal convoluted tubule. -Collecting tubule. -Loop of Henle. -Distal convoluted tubule.

A new client on hemodialysis is watching his blood being filtered through a dialyzer. He asks the nurse how much blood typically passes through the kidney every minute? The nurse responds:

1000-1300 mL/minute.

Urine is a amber, light-yellow fluid that is 5% dissolved solid. What percent of it is water?

95%.

Following an automobile accident where the patient had a traumatic amputation of their lower leg and lost >40% of their blood volume, they are currently not producing any urine output. The nurse bases this phenomena on which of the following humoral substances responsible for causing severe vasoconstriction of the renal vessels?

Angiotensin II and ADH.

Which substance, released by the atria, causes vasodilation of the afferent and efferent arterioles, which results in an increase in renal blood flow and glomerular filtration rate (GFR)?

Atrial natriuretic peptide (ANP).

An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test.

BUN 10 mg/dL to creatinine 1 mg/dL.

The nurse is performing palpation of the kidney during assessment of the client on the urology unit. The nurse plans to palpate in which of these areas?

Between the 12th thoracic and 3rd lumbar vertebrae.

The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:

Concentrate urine.

A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will

Decrease.

The nurse collects a urine sample but forgets the sample in the client's room for several hours. What is the nurse's best action?

Discard the sample and recollect in the morning.

The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which of these findings does the nurse anticipate?

Excessive urine output.

When caring for the client with proteinuria, the nurse recognizes dysfunction in which of these structures of the kidney allows protein to leak into the urine?

Glomerulus.

The nurse is teaching a group of nursing students about antidiuretic hormone. The nurse should include which of these points about the site of ADH production in the discussion?

Hypothalamus.

The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?

Increased creatinine and blood urea nitrogen (BUN) levels.

To treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. Which rationale for this treatment is the most likely?

It removes water from the filtrate and returns it to the vascular compartment.

The nurse and nursing student are caring for a client with a condition causing deficiency of ADH. The nurse recognizes that the student understands the origin of this process when the student states ADH is produced in which of these areas?

Pituitary gland.

A nursing student studying pharmacology is learning how angiotensin converting enzyme inhibitors (ACE) work. The student is correct when the student states the mechanism of action of ACE inhibitors is which of these?

Prevent conversion of angiotensin I to II.

The nurse is teaching a group of nursing students about the physiologic consequences of hypotension and reduced perfusion to the kidney. Which of these compensatory mechanisms occurs immediately after renin release from the kidney?

Production of angiotensin I.

The nurse would be most concerned when the glomerular filtrate contains:

Protein.

When teaching a pharmacology class the nurse relates that 65 percent of all reabsorptive and secretory processes that occur in the tubular system take place in which of these areas?

Proximal tubules.

An elderly man is brought into the clinic by his daughter who states, "My father hasn't been himself lately. Now I think he looks a little yellow." What test would the nurse expect to have ordered to check this man's creatinine level?

Serum creatinine.

The nurse is caring for a client with Addison's disease who has an absence of aldosterone. When reviewing the client's diagnostic test results, which of these consequences of low aldosterone levels does the nurse anticipate?

Serum potassium of 7.3 mEq/L.

The nurse is analyzing the results of a client's urinalysis. Which of these findings does the nurse need to follow up because they are abnormal results?

Specific gravity 1.034.

The nurse is caring for a client with kidney disease who has an estimated glomerular filtration rate of 75 ml/minute. The nurse interprets this data in which of the following way?

The client has reduced glomerular filtration reflecting damage to the kidney.

The nurse teaches the client with end-stage kidney disease who has developed anemia that the reason anemia has developed is which of these?

The damaged kidney is unable to produce erythropoietin.

Which function of the kidneys helps to maintain the pH balance in the body?

The kidneys conserve base bicarbonate and eliminate hydrogen ions.

The nurse is caring for a client who has produced an average of 20 ml/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output?

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

The nurse is caring for a client with left-sided heart failure being treated with both a thiazide diuretic and an aldosterone antagonist. What effect on potassium will the nurse anticipate with this treatment?

The medications have the opposite effect on potassium levels.

While assessing a patient with urosepsis, the ICU nurse notes the patient's BP is 80/54; HR 132; RR 24; pulse Ox 89% on 6 lpm O2. Over the last hour, the patients urine output is 15 mL. When explaining to a new graduate nurse, the nurse will emphasize that the patients status may relate to:

The patients sympathetic nervous system has been stimulated which has resulted in vasoconstriction of the afferent arteriole which causes a decrease in renal blood flow.

The nurse is teaching a group of nursing students about the mechanism of action of common diuretics. Which of these best reflects the mechanism of these drugs?

They block the reabsorption of sodium and chloride in the nephron.

The nurse is caring for a client who is diagnosed with gout. Which of these laboratory studies does the nurse monitor to monitor this condition?

Uric acid levels.

Which of the following substances is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms?

Water.