Urinary quiz 1

The term used to describe painful or difficult urination is which of the following? a) Dysuria b) Anuria c) Nocturia d) Oliguria

A. dysuria

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which of the following? a) Decreased fluid intake b) Diabetes insipidus c) Glomerulonephritis d) Increased fluid intake

A. decreased fluid intake

A client with a suspected urinary tract infection is asked to collect a 24-hour urine specimen for culture. Which of the following measures can the nurse suggest to the client that may help prevent the urine specimen from becoming contaminated? a) Refrigerate the specimen until it is taken to the laboratory. b) Store the collected urine away from sunlight. c) Collect the voided urine sample primarily before 5 a.m. d) Use the same receptacle for voiding and defecation.

A. Refrigerate the specimen until it is taken to the laboratory.

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess: a) Trousseau's sign. b) Goodell's sign. c) Hegar's sign. d) Homans' sign.

A. Trousseau's sign

The client in your clinic has been asked to bring you 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. a) Wash your 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 toilet, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash your hands. b) Wash your 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 toilet, 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 your hands. c) Wash your 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 toilet, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash your hands. Open the antiseptic towelette package and cleanse the urethral area. d) Wash your 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 toilet, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash your hands.

A. Wash your 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 toilet, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash your hands.

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? a) Alkaline b) Basic c) Acidic d) Neutral

A. acidic

A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority should be to assess her: a) electrocardiogram (ECG) results. b) respiratory rate. c) bowel sounds. d) neuromuscular function.

A. electrocardiogram (ECG) results.

The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient the nurse recalls that several substances are filtered from the blood by the glomerulus and these substances are then excreted in the urine. The nurse identifies the presence of which substances in the urine as abnormal findings? a) Glucose and protein b) Creatinine and chloride c) Potassium and sodium d) Bicarbonate and urea

A. glucose and protein

Which set of arterial blood gas (ABG) results requires further investigation? a) pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L b) pH 7.44, PaCO2 43 mm Hg, PaO2 99 mm Hg, and HCO3- 26 mEq/L c) pH 7.38, partial pressure of arterial carbon dioxide (PaCO2) 36 mm Hg, partial pressure of arterial oxygen (PaO2) 95 mm Hg, bicarbonate (HCO3-) 24 mEq/L d) pH 7.35, PaCO2 40 mm Hg, PaO2 91 mm Hg, and HCO3- 22 mEq/L

A. pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? a) Potassium b) CO2 c) Chloride d) Sodium

A. potassium

A patient in the ICU starts complaining of being "short of breath." An arterial blood gas (ABG) is drawn. The ABG has the following values: pH = 7.21, PaCO2 = 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect? a) Respiratory acidosis b) Metabolic alkalosis c) Respiratory alkalosis d) Metabolic acidosis

A. respiratory acidosis

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? a) Obstruction of the lower urinary tract b) Acute renal failure c) Infection d) Nephrotic syndrome

C. infection

A 42-year-old client has chronic hypo natremia, which requires weekly blood labs to keep him from lapsing into convulsions or a coma. What is the level of serum sodium below which convulsions or coma can occur? a) 140 mEq/L b) 135 mEq/L c) 142 mEq/L d) 147 mEq/L

B. 135 mEq/L

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? a) Sodium: 138 mEq/L b) Potassium: 5.8 mEq/L c) Magnesium:2 mEq/L d) Calcium: 10 mg/dL

B. Potassium: 5.8 mEq/L

A client is to begin collecting a 24-hour urine sample. Which of the following would the nurse instruct the client to do? a) Keep the collection bottle at room temperature. b) Start collecting urine for 24 hours after discarding the initial specimen. c) Collect all the urine passed for a complete 24 hours. d) Collect the first voided urine specimen for two consecutive mornings.

B. Start collecting urine for 24 hours after discarding the initial specimen.

Which of the following are the insensible mechanisms of fluid loss? a) Urination b) Breathing c) Nausea d) Bowel elimination

B. breathing

A client has undergone diagnostic testing that involved the insertion of a lighted tube with a telescopic lens. The nurse identifies this test as which of the following? a) Intravenous pyelography b) Cystoscopy c) Renal angiography d) Excretory urogram

B. cystoscopy

You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect? a) Hypermagnesemia b) Hypocalcemia c) Hypophosphatemia d) Hyperkalemia

B. hypocalcemia

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? a) Fistula b) Kidney stones c) Chronic renal failure d) Neurogenic bladder

B. kidney stones

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? a) Assess for dehydration. b) Limit sodium and water intake. c) Give medications that promote fluid retention. d) Teach client behaviors that decrease urination.

B. limit sodium and water intake

A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145 mEq/l. Should the nurse start salt tablets when caring for this client? a) Yes, along with the hypotonic IV. b) No, sodium intake should be restricted. c) Yes, this will correct the sodium deficit. d) No, start with the sodium chloride IV.

B. no, sodium intake should be restricted

Russell Thompkins, a 77-year-old retired male, visits your general practice office twice monthly to maintain control of his congestive heart failure. He measures his weight daily and phones it to your office for his medical record. In a 24-hour period, how much fluid is Russell retaining if his weight increases by two pounds? a) 1500 ml b) One liter c) 1250 ml d) 500 ml

B. one liter

Which of the following is considered an isotonic solution? a) Dextran in NS b) 3% NaCl c) 0.9% normal saline d) 0.45% normal saline

C. 0.9% normal saline

When fluid intake is normal, the specific gravity of urine should be which of the following? a) >1.025. b) <1.010. c) 1.010 to 1.025. d) 1.000.

C. 1.010 to 1.025

The nursing instructor is teaching the students assessment skills in the lab. Where would the instructor teach the students to assess for pain at the costovertebral angle? a) At the umbilicus and the right lower quadrant of the abdomen b) At the suprapubic region and the umbilicus c) At the lower border of the 12th rib and the spine d) At the 7th rib and the xyphoid process

C. At the lower border of the 12th rib and the spine

The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following? a) Allergic reaction b) Infection c) Bleeding d) Dehydration

C. bleeding

In starting your new job as a nurse with a group of renal specialists, you begin your orientation with a thorough review of renal function. While the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which of the following is NOT a function of the kidneys? a) Regulating blood pressure b) Stimulating RBC production c) Excreting protein d) Excreting nitrogen waste products

C. excreting protein

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? a) Increased serum albumin b) Decreased potassium c) Increased serum creatinine d) Decreased blood urea nitrogen (BUN)

C. increased serum creatinine

During a routine assessment, the patient states; "I wake up all night long to go the bathroom." The nurse will document this finding as which of the following? a) Oliguria b) Polyuria c) Nocturia d) Dysuria

C. nocturia

Retention of which electrolyte is the most life-threatening effect of renal failure? a) Phosphorous b) Calcium c) Potassium d) Sodium

C. potassium

A 57-year-old homeless female with a history of alcohol abuse has been admitted to your hospital unit. She was admitted with signs and symptoms of hypovolemia - minus the weight loss. She exhibits a localized enlargement of her abdomen. What condition could she be presenting? a) Pitting edema b) Anasarca c) Third-spacing d) Hypovolemia

C. third spacing

The nurse is explaining the steps for collecting a clean catch urine specimen to a client. Which statement by the client indicates effective teaching? a) "I need to collect at least 100 mL of urine for the specimen." b) "I need to use one antiseptic wipe to clean the sides and down the middle." c) "After I clean the area, I can let go of my labia to hold the container." d) "I'll start to urinate for a few seconds and then start to collect the specimen."

D. "I'll start to urinate for a few seconds and then start to collect the specimen."

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? a) Monitor the client for signs of electrolyte and water imbalance. b) Evaluate the client for periorbital edema. c) Assess the client's mental changes. d) Monitor the client for an allergy to iodine contrast material.

D. Monitor the client for an allergy to iodine contrast material.

A priority nursing intervention for a client with hypervolemia involves which of the following? a) Drawing a blood sample for typing and crossmatching. b) Encouraging the client to consume sodium-free fluids. c) Establishing I.V. access with a large-bore catheter. d) Monitoring respiratory status for signs and symptoms of pulmonary complications.

D. Monitoring respiratory status for signs and symptoms of pulmonary complications.

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? a) Computed tomography (CT scan) b) Cystoscopy c) Radiography d) Angiography

D. angiography

When describing the functions of the kidney to a client, which of the following would the nurse include? a) Secretion of enzymes b) Synthesis of vitamin K c) Regulation of white blood cell production d) Control of water balance

D. control of water balance

You are caring for a patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion. Your patient has specific gravities ordered every 4 hours. What does this test detect? a) Nutritional deficit b) Hyperkalemia c) Hypercalcemia d) Fluid volume status

D. fluid volume status

An elderly client takes 40 mg of Lasix twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? a) Hypernatremia b) Hypophosphatemia c) Hyperkalemia d) Hypokalemia

D. hypokalemia

Which of the following is a correct route of administration for potassium? a) IV (intravenous) push b) Intramuscular c) Subcutaneous d) Oral

D. oral

Translocation is a term used to describe the general movement of fluid and chemicals within body fluids. In every client's body, fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? a) Evaporation b) Active transport c) Filtration d) Osmosis

D. osmosis