quiz 1
Diagnostic testing of an adult client reveals renal glycosuria. The nurse should recognize the need for the client to be assessed for what health problem? Diabetes insipidus Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Diabetes mellitus Renal carcinoma
Diabetes mellitus
The nurse is caring for a client who is going to have an open renal biopsy. What nursing action should the nurse prioritize when preparing this client for the procedure? Discuss the client's diagnosis with the family. Bathe the client before the procedure with antiseptic skin wash. Administer antivirals before sending the client for the procedure. Keep the client NPO prior to the procedure.
Keep the client NPO prior to the procedure
Retention of which electrolyte is the most life-threatening effect of renal failure? Calcium Sodium Potassium Phosphorous
Potassium
The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: Specific gravity 1.035 Creatinine 0.7 mg/dL Protein 15 mg/dL Bright yellow urine
Specific gravity 1.035
Which is an effect of aging on upper and lower urinary tract function? Increased glomerular filtration rate Susceptibility to develop hypernatremia Increased blood flow to the kidney Acid-base balance
Susceptibility to develop hypernatremia
The nurse is caring for a client who describes changes in his voiding patterns. The client states, "I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesn't seem to be much urine flow." What would the nurse expect this client's physical assessment to reveal? Hematuria Urine retention Dehydration Kidney injury
Urine Retention
A client is scheduled for a creatinine clearance test. The nurse should explain that this test is done to assess the kidneys' ability to remove a substance from the plasma in: 1 minute. 30 minutes. 1 hour. 24 hours.
1 minute
When fluid intake is normal, the specific gravity of urine should be: 1.000 Less than 1.010 Greater than 1.025 1.010 to 1.025
1.010 to 1.025
Which value represents a normal BUN-to-creatinine ratio? 4:1 6:1 8:1 10:1
10:1
The nurse is caring for a client scheduled for renal angiography following a motor vehicle accident. What client preparation should the nurse most likely provide before this test? Administration of IV potassium chloride Administration of a laxative Administration of Gastrografin Administration of a 24-hour urine test
Administration of a laxative
A nurse is caring for a client diagnosed with acute renal failure. The nurse notes on the intake and output record that the total urine output for the previous 24 hours was 35 mL. Urine output that's less than 50 ml in 24 hours is known as: oliguria. polyuria. anuria. hematuria.
Anuria
A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient reports severe pain in the back, arms, and shoulders. Which intervention should be offered by the nurse? Assess the patient's back and shoulder areas for signs of internal bleeding. Distract the patient's attention from the pain. Provide analgesics to the patient. Enable the patient to sit up and ambulate.
Assess the patient's back and shoulder areas for signs of internal bleeding.
The nurse is performing a focused genitourinary and renal assessment of a client. Where should the nurse assess for pain at the costovertebral angle? At the umbilicus and the right lower quadrant of the abdomen At the suprapubic region and the umbilicus At the lower border of the 12th rib and the spine At the 7th rib and the xiphoid process
At the lower border of the 12th rib and the spine
The nurse is reviewing the electronic health record of a client with a history of incontinence. The nurse reads that the health care provider assessed the client's deep tendon reflexes. What condition of the urinary/renal system does this assessment address? Renal calculi Bladder dysfunction Benign prostatic hyperplasia (BPH) Recurrent urinary tract infections (UTIs)
Bladder dysfunction
A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should: keep the client's knee on the affected side bent for 6 hours. apply pressure to the puncture site for 30 minutes. check the client's pedal pulses frequently. remove the dressing on the puncture site after vital signs stabilize.
Check the client's pedal pulses frequently
A creatinine clearance test has been ordered. The nurse prepares to: Collect the client's urine for 24 hours. Obtain a clean catch urine. Obtain a blood specimen. Insert a straight catheter for a specimen.
Collect the client's urine for 24 hours
Which value does the nurse recognize as the best clinical measure of renal function? Creatinine clearance Circulating ADH concentration Volume of urine output Urine-specific gravity
Creatinine clearance
A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? Blood urea nitrogen level Creatinine clearance level Serum potassium level Uric acid level
Creatinine clearance level
The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator? Creatinine clearance level Uric acid level Blood urea nitrogen (BUN) BUN to creatinine ratio TAKE ANOTHER QUIZ
Creatinine clearance level
Regulation of electrolyte balance is a management goal for patients suffering from renal disease. Which of the following lab results is considered the most life-threatening effect of renal failure? Hyperkalemia Hypocalcemia Hypernatremia Hyperphosphatemia
Hyperkalemia
A nurse is working with a client who will undergo invasive urologic testing. The nurse has informed the client that slight hematuria may occur after the testing is complete. The nurse should recommend what action to help resolve hematuria? Increased fluid intake following the test Use of an over-the-counter (OTC) diuretic after the test Gentle massage of the lower abdomen Activity limitation for the first 12 hours after the test
Increased fluid intake following the test
The nurse is providing preprocedure teaching about an ultrasound. The nurse informs the client that in preparation for an ultrasound of the lower urinary tract the client will require what? Increased fluid intake to produce a full bladder IV administration of radiopaque contrast agent Sedation and intubation Injection of a radioisotope
Increased fluid intake to produce a full bladder
A client is having a blood urea nitrogen (BUN) test. BUN level is: increased in renal disease and urinary obstruction. decreased in nephrotic syndrome. decreased in renal disease and urinary obstruction. unchanged in renal disease.
Increased in renal disease and urinary obstruction.
The nurse observes that the client's urine is orange. Which additional assessment would be important for this client? Bleeding Intake of medication such as phenazopyridine hydrochloride Intake of multiple vitamin preparations Infection
Intake of medication such as phenazopyridine hydrochloride
Which is an effect of aging on upper and lower urinary tract function? Increased glomerular filtration rate More prone to develop hypernatremia Increased blood flow to the kidneys Acid-base balance
More prone to develop hypernatermia
Which of the following describes awakening at night to urinate? Nocturia Polyuria Oliguria Dysuria
Nocturia
The nurse is caring for a client with a nursing diagnosis of deficient fluid volume. The nurse's assessment reveals a BP of 98/52 mm Hg. The nurse should recognize that the client's kidneys will compensate by secreting what substance? Antidiuretic hormone (ADH) Aldosterone Renin Angiotensin
Renin
Which of the following hormones is secreted by the juxtaglomerular apparatus? Renin Aldosterone Antidiuretic hormone (ADH) Calcitonin
Renin
Which nursing assessment finding indicates the client has not met expected outcomes? The client voids 75 cc four hours post cystoscopy. The client reports a pain rating of 3 two hours post-kidney biopsy. The client has blood-tinged urine following brush biopsy. The client consumes 75% of lunch following an intravenous pyelogram.
The client voids 75 cc four hours post cystoscopy
The nurse is assessing a client's bladder by percussion. The nurse elicits dullness after the client has voided. How should the nurse interpret this assessment finding? The client's bladder is not completely empty. The client has kidney enlargement. The client has a ureteral obstruction. The client has a fluid volume deficit.
The client's bladder is not completely empty
A client admitted to the medical unit with impaired renal function is complaining of severe, stabbing pain in the flank and lower abdomen. The client is being assessed for renal calculi. The nurse recognizes that the stone is most likely in what anatomic location? Meatus Bladder Ureter Urethra
Ureter
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present? When the urine output is less than 30 mL/h When the urine output is about 100 mL/h When the urine output is between 300 and 500 mL/h When the urine output is between 500 and 1,000 mL/h
When the urine output is less than 30 mL/h
While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? "Do you have a strong desire to void?" "Do you urinate while sleeping?" "Does it burn when you urinate?" "Is it painful when you urinate?"
"Do you urinate while sleeping?"
A nurse is aware of the high incidence and prevalence of fluid volume deficit among older adults. What related health education should the nurse provide to an older adult? "If possible, try to drink at least 4 liters of fluid daily." "Ensure that you avoid replacing water with other beverages." "Remember to drink frequently, even if you don't feel thirsty." "Make sure you eat plenty of salt in order to stimulate thirst."
"Remember to drink frequently, even if you don't feel thirsty."
The nurse is assessing a patient upon admission to the hospital. What significant nursing assessment data is relevant to renal function? Select all that apply. Any voiding disorders The patient's occupation The presence of hypertension or diabetes The patient's financial status The ability of the patient to manage activities of daily living
Any voiding disorders The patient's occupation The presence of hypertension or diabetes
A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions? Keep the patient on bed rest for 72 hours. Place a bed board under the mattress to add support. Check the patient's urine for hematuria. Apply moist heat, every 4 hours for the first 48 hours to aid healing.
Check the patient's urine for hematuria
A geriatric nurse is performing an assessment of body systems on an 85-year-old client. The nurse should be aware of what age-related change affecting the renal or urinary system? Increased ability to concentrate urine Increased bladder capacity Urinary incontinence Decreased glomerular filtration rate
Decreased glomerular filtration rate
Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys? excreting protein excreting nitrogen waste products regulating blood pressure stimulating RBC production
Excreting protein
The nurse is caring for a client suspected of having renal dysfunction. When reviewing laboratory results for this client, the nurse interprets the presence of which substances in the urine as most suggestive of pathology? Potassium and sodium Bicarbonate and urea Glucose and protein Creatinine and chloride
Glucose and protein
The nurse is preparing an education program on risk factors for kidney disorders. Which of the following risk factors would be inappropriate for the nurse to include in the teaching program? Hypotension Diabetes mellitus Neuromuscular disorders Pregnancy
Hypotension
A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 mL. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of: microorganism transfer. prostate irritation. client discomfort. incorrect urine output values.
Microorganism transfer
A client is undergoing a renal angiogram after a traumatic accident. What post-procedural assessments would the nurse perform on the client? Select all that apply. Monitor hypersensitivity response. Palpates the pulses in the legs and feet. Monitor site condition. Apply a warm compress to site. Administer an enema.
Monitor site condition. Palpates the pulses in the legs and feet. Monitor hypersensitivity response.
A client with recurrent urinary tract infections has just undergone a cystoscopy and reports slight hematuria during the first void after the procedure. What is the nurse's most appropriate action? Administer a STAT dose of vitamin K, as prescribed. Reassure the client that this is not unexpected and then monitor the client for further bleeding. Promptly inform the health care provider of this assessment finding. Position the client supine and insert a Foley catheter, as prescribed.
Reassure the client that this is not unexpected and then monitor the client for further bleeding.
A client with kidney injury secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of kidney injury for which the nurse should monitor the client? Accumulation of wastes Retention of potassium Depletion of calcium Lack of BP control
Retention of potassium
A client with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid-base balance? Sequestering free hydrogen ions in the nephrons Returning bicarbonate to the body's circulation Returning acid to the body's circulation Excreting bicarbonate in the urine
Returning the bicarbonate to the body's circulation
A nurse is caring for a 73-year-old client with a urethral obstruction related to prostatic enlargement. When planning this client's care, the nurse should be aware of the risk of what complication? Urinary tract infection Enuresis Polyuria Proteinuria
Urinary tract infection
A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing: ureteral stones. pyelonephritis. cystitis. Urethral infection.
Ureteral stones
The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective? "I will feel a warm sensation as the dye is injected." "I should remove all jewelry before the test." "I should let the staff know if I feel claustrophobic." "I will need to drink all of the dye as quickly as possible."
"I will feel a warm sensation as the dye is injected."
A nurse is caring for a client with impaired renal function. A creatinine clearance measurement has been ordered. The nurse should facilitate collection of what samples? A fasting serum potassium level and a random urine sample A 24-hour urine specimen and a serum creatinine level midway through the urine collection process A BUN and serum creatinine level on three consecutive mornings A sterile urine specimen and an electrolyte panel, including sodium, potassium, calcium, and phosphorus values
A 24-hour urine specimen and a serum creatinine level midway through the urine collection process
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? After discarding the 8:00 am specimen At 8:00 am, with or without a specimen 6 hours after the urine is discarded With the first specimen voided after 8:00 am
After discarding the 8:00 am specimen
The nurse discusses a care plan with a male patient who is to be discharged after a biopsy. He is instructed to maintain limited activity and report signs of systemic infection, urinary tract infection, or bleeding. Which additional instructions should the nurse include in the care plan? Complete the prophylactic antibiotic therapy. No physical activity. Decrease the intake of iodine or seafood. Assess the dressing frequently.
Complete the prophylactic antibiotic therapy
A nurse is preparing a client diagnosed with benign prostatic hyperplasia (BPH) for a lower urinary tract cystoscopic examination. The nurse should caution the client about what common temporary complication of this procedure? Urinary retention Bladder perforation Hemorrhage Nausea
Urinary retention
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? Decreased fluid intake Increased fluid intake Glomerulonephritis Diabetes insipidus
Decreased fluid intake
Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to: Encourage high fluid intake. Strain all urine for 48 hours. Apply moist heat to the flank area. Monitor for hematuria.
Encourage high fluid intake
A nurse, when caring for a client, notes that the specific gravity of the client's urine is low. What could have led to the low specific gravity of urine? Frequent vomiting Excess fluid intake Repeated diarrhea Urine retention
Excess fluid intake
A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine? glucose potassium creatinine chloride
Glucose
A client with a history of incontinence will undergo urodynamic testing in the health care provider's office. Because voiding in the presence of others can cause situational anxiety, the nurse should perform what action? Administer diuretics as prescribed. Push fluids for several hours prior to the test. Discuss possible test results as the client voids. Help the client to relax before and during the test.
Help the client relax before and during the test.
A client with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value? Hematocrit Hemoglobin Erythrocyte sedimentation rate (ESR) Serum creatinine
Hemoglobin
A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? Increased alertness Hypoventilation Pruritus Unusually smooth skin
Pruritus
Results of a client's 24-hour urine sample indicate osmolality of 510 mOsm/kg (510 mmol/kg), which is within reference range. What conclusion can the nurse draw from this assessment finding? The client's kidneys are capable of maintaining acid-base balance. The client's kidneys reabsorb most of the potassium that the client ingests. The client's kidneys can produce sufficiently concentrated urine. The client's kidneys are producing sufficient erythropoietin.
The client's kidneys can produce sufficiently concentrated urine.
Dipstick testing of an older adult client's urine indicates the presence of protein. Which statement is true of this assessment finding? This finding needs to be considered in light of other forms of testing. This finding is a risk factor for urinary incontinence. This finding is likely the result of an age-related physiologic change. This result confirms that the client has diabetes.
This finding needs to be considered in light of other forms of testing.
A client has been asked to provide a clean-catch midstream urine specimen. It is important that the instructions are clear and that things are done in the proper order. Select the proper sequence of events for obtaining a specimen from a client. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Open the antiseptic towelette package and cleanse the urethral area. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Open the antiseptic towelette package and cleanse the urethral area. Carefully replace the lid, dry the container if necessary, and wash hands. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Begin voiding into the toilet. Open the antiseptic towelette package and cleanse the urethral area. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands. Wash hands and remove the lid from the specimen container without touching the inside of the lid. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands. Open the antiseptic towelette package and cleanse the urethral area.
Wash hands and remove the lid from the specimen container without touching the inside of the lid. Open the antiseptic towelette package and cleanse the urethral area. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands.
The care team is considering the use of dialysis in a client whose renal function is progressively declining. Renal replacement therapy is indicated in which of the following situations? When the client's creatinine level drops below 1.2 mg/dL (110 mmol/L) When the client's blood urea nitrogen (BUN) is above 15 mg/dL When approximately 40% of nephrons are not functioning When about 80% of the nephrons are no longer functioning
When approximately 40% of nephrons are not functioning
An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: confirm all of the medications and supplements normally taken. assess the client's usual intake of sodium. confirm which beverages the client normally consumes. palpate the client's bladder before and after voiding.
confirm all of the medications and supplements normally taken.
