CH 53 Assessment of Kidney and Urinary Function (E5)
A nurse is preparing a patient diagnosed with benign prostatic hypertrophy (BPH) for a lower urinary tract cystoscopic examination. The nurse informs the patient that the most common temporary complication experienced after this procedure is what? A) Urinary retention B) Bladder perforation C) Hemorrhage D) Nausea
A
A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test? A) Ultrasound B) X-ray C) Computed tomography (CT) D) Nuclear scan
A
The nurse is preparing to collect an ordered urine sample for urinalysis. The nurse should be aware that this test will include what assessment parameters? SELECT ALL THAT APPLY. A) Specific gravity of the patient's urine B) Testing for the presence of glucose in the patient's urine C) Microscopic examination of urine sediment for RBCs D) Microscopic examination of urine sediment for casts E) Testing for BUN and creatinine in the patient's urine
A, B, C, D
A nurse is caring for a client who has type 2 diabetes mellitus and will have excretory urography. Prior to the procedure, which of the following actions should the nurse take? SELECT ALL THAT APPLY. A) Identify an allergy to seafood. B) Withhold metformin for 24 hr. C) Administer an enema. D) Obtain a blood coagulation profile. E) Assess for asthma.
A, B, C, E
A nurse is caring for a patient with impaired renal function. A creatinine clearance measurement has been ordered. The nurse should facilitate collection of what samples? A) A fasting serum potassium level and a random urine sample B) A 24-hour urine specimen and a serum creatinine level midway through the urine collection process C) A BUN and serum creatinine level on three consecutive mornings D) A sterile urine specimen and an electrolyte panel, including sodium, potassium, calcium, and phosphorus values
B
A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A) Infection B) Hemorrhage C) Hematuria D) Pain
B
A patient with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid-base balance? A) Sequestering free hydrogen ions in the nephrons B) Returning bicarbonate to the body's circulation C) Returning acid to the body's circulation D) Excreting bicarbonate in the urine
B
A patient 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? A) Hematocrit B) Hemoglobin C) Erythrocyte sedimentation rate (ESR) D) Serum creatinine
B
A patient with renal failure secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of renal failure for which the nurse should monitor the patient? A) Accumulation of wastes B) Retention of potassium C) Depletion of calcium D) Lack of BP control
B
The nurse caring for a patient with suspected renal dysfunction calculates that the patient's weight has increased by 5 pounds in the past 24 hours. The nurse estimates that the patient has retained approximately how much fluid? A) 1,300 mL of fluid in 24 hours B) 2,300 mL of fluid in 24 hours C) 3,100 mL of fluid in 24 hours D) 5,000 mL of fluid in 24 hours
B
The nurse is caring for a patient who describes changes in his voiding patterns. The patient 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 a great deal of urine flow." What would the nurse expect this patient's physical assessment to reveal? A) Hematuria B) Urine retention C) Dehydration D) Renal failure
B
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? A) "If possible, try to drink at least 4 liters of fluid daily." B) "Ensure that you avoid replacing water with other beverages." C) "Remember to drink frequently, even if you don't feel thirsty." D) "Make sure you eat plenty of salt in order to stimulate thirst."
C
A patient is scheduled for diagnostic testing to address prolonged signs and symptoms of genitourinary dysfunction. What signs and symptoms are particularly suggestive of urinary tract disease? SELECT ALL THAT APPLY. A) Petechiae B) Pain C) Gastrointestinal symptoms D) Changes in voiding E) Jaundice
B, C, D
Dipstick testing of an older adult patient's urine indicates the presence of protein. Which of the following statements is true of this assessment finding? SELECT ALL THAT APPLY. A) This finding needs to be considered in light of other forms of testing. B) This finding is a risk factor for urinary incontinence. C) This finding is likely the result of an age-related physiologic change. D) This result confirms that the patient has diabetes.
B, C, D
A nurse is reviewing the results of a client's urinalysis. The findings indicate the urine is positive for leukocyte esterase and nitrates. Which of the following actions should the nurse take? A) Repeat the test early the next morning. B) Start a 24 hr urine collection for creatinine clearance. C) Obtain a clean-catch urine specimen for culture and sensitivity. D) Insert an indwelling catheter urinary catheter to collect a urine specimen.
C
A nurse administered captopril to a client during a renal scan. Which of the following actions should the nurse take? A) Assess for hypertension. B) Limit the client's fluid intake. C) Monitor for orthostatic hypotension. D) Encourage early ambulation.
C
Diagnostic testing of an adult patient reveals renal glycosuria. The nurse should recognize the need for the patient to be assessed for what health problem? A) Diabetes insipidus B) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) C) Diabetes mellitus D) Renal carcinoma
C
The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse interprets the presence of which substances in the urine as most suggestive of pathology? A) Potassium and sodium B) Bicarbonate and urea C) Glucose and protein D) Creatinine and chloride
C
The nurse is caring for a patient 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 patient's kidneys will compensate by secreting what substance? A) Antidiuretic hormone (ADH) B) Aldosterone C) Renin D) Angiotensin
C
A geriatric nurse is performing an assessment of body systems on an 85-year-old patient. The nurse should be aware of what age-related change affecting the renal or urinary system? A) Increased ability to concentrate urine B) Increased bladder capacity C) Urinary incontinence D) Decreased glomerular filtration rate
D
A nurse is teaching a client who will have an x-ray of the kidneys, ureters, and bladder. Which of the following statements should the nurse include in the teaching? A) "You will receive contrast dye during the procedure." B) "An enema is necessary before the procedure." C) "You will need to lie in a prone position during the procedure." D) "The procedure determines whether you have a kidney stone."
D
A patient's most recent laboratory findings indicate a glomerular filtration rate (GFR) of 58 mL/min. The nurse should recognize what implication of this diagnostic finding? A) The patient is likely to have a decreased level of blood urea nitrogen (BUN). B) The patient is at risk for hypokalemia. C) The patient is likely to have irregular voiding patterns. D) The patient is likely to have increased serum creatinine levels.
D
The care team is considering the use of dialysis in a patient whose renal function is progressively declining. Renal replacement therapy is indicated in which of the following situations? A) When the patient's creatinine level drops below 1.2 mg/dL (110 mmol/L) B) When the patient's blood urea nitrogen (BUN) is above 15 mg/dL C) When approximately 40% of nephrons are not functioning D) When about 80% of the nephrons are no longer functioning
D
The nurse is caring for a patient who has a fluid volume deficit. When evaluating this patient's urinalysis results, what should the nurse anticipate? A) A fluctuating urine specific gravity B) A fixed urine specific gravity C) A decreased urine specific gravity D) An increased urine specific gravity
D
What nursing action should the nurse perform when caring for a patient undergoing diagnostic testing of the renal-urologic system? A) Withhold medications until 12 hours post-testing. B) Ensure that the patient knows the importance of temporary fluid restriction after testing. C) Inform the patient of his or her medical diagnosis after reviewing the results. D) Assess the patient's understanding of the test results after their completion.
D
