Chapter 47 Prep U

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

A patient who complains of a dull, continuous pain in the suprapubic area that occurs with, and at the end of, voiding would most likely be diagnosed with which of the following? A kidney stone interstitial cystitis acute pyelonephritis prostatic cancer

Interstitial cystitis

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? - Kidney stones - Neurogenic bladder - Chronic renal failure - Fistula

Kidney Stones

The term used to describe total urine output less than 0.5 mL/kg/hour is - oliguria. - anuria. - nocturia. - dysuria.

Oliguria

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.

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? - "Have you noticed any vaginal bleeding?" - "Do you take phenytoin daily?" - "Do you take multiple vitamin preparations?" - "Have you had a recent urinary tract infection?"

"Do you take multiple vitamin preparations?"

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 creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? BUN, Cr, Osmolality, Hgb

Creatinine

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.

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

A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?

150 mL

The nurse is reviewing the results of a client's renal function study. The nurse understands that which value represent a normal BUN-to-creatinine ratio?

8:1 / 10:1

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

Serum sodium plays a major role in maintaining fluid and electrolyte balance. Choose all the correct statements that apply. The normal serum sodium level is 90 to 120 mmol/L. Aldosterone causes renal reabsorption of sodium. About 45% of sodium in the renal filtrate is absorbed. Angiotensin II controls the release of aldosterone. Renin, an enzyme released by the kidneys, activates the RAS system to ensure adequate filtration.

Aldosterone causes renal reabsorption of sodium. Angiotensin II controls the release of aldosterone. Renin, an enzyme released by the kidneys, activates the RAS system to ensure adequate filtration.

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

Angiography

Following a cystoscopy, the client has a nursing diagnosis of acute pain related to the trauma of the procedure to the urinary tract. An appropriate nursing intervention is to: Administer prescribed antibiotics. Monitor for urinary retention. Apply moist heat to the flank area. Assist with warm sitz baths.

Assist with warm sitz baths.

As women age, many experience an increased sense of urgency to void, as well as an increased risk of incontinence. This is usually the result of age-related changes in which part of the renal system? Kidney, Nephron, Tubule system, Bladder

Bladder

A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? Bladder ultrasonography Nuclear scan Cystography IV urography

Bladder ultrasonography

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness?

CVA (costovertebral angle)

The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find? - CVA Tenderness - Suprapubic pain - pain after voiding d. Perineal Pain

CVA Tenderness

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? - Client reports increasing fatigue. - Client rates pain at a 3 on a scale of 0 to 10. - Client denies frequency and urgency. - Urine output is 100 ml/hr.

Client reports increasing fatigue.

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client be assessed for an allergy to iodine? - Radiography - Computed tomography with contrast - Cystoscopy - Bladder ultrasonography

Computed tomography with contrast

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

Control of Water Balance

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

Cr 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?

Cr level clearance

A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact? - The left kidney usually is slightly higher than the right one. - The kidneys are situated just above the adrenal glands. - The average kidney is approximately 5 cm (2 in.) long and 2 to 3 cm (0.8 to 1.2 in.) wide. - The kidneys lie between the 10th and 12th thoracic vertebrae.

The left kidney usually is slightly higher than the right one.

A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? "An x-ray will be done to view your kidneys, ureters, and bladder." "A contrast medium will be used to help see the structures better." "You don't need to do any fasting before this noninvasive test." "You'll have a pressure dressing on your groin after the test."

"You don't need to do any fasting before this noninvasive test."

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? - Infection - Acute Renal Failure - Obstruction of the lower urinary tract - Nephrotic syndrome

Infection

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. Specific gravity compares the density of urine to the density of distilled water. Which is an example of how urine concentration is affected?

On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

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.

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

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

A client has a full bladder. Which sound would the nurse expect to hear on percussion?

Dullness

Retention of which electrolyte is the most life-threatening effect of renal failure?

Potassium

When diagnostic testing reveals renal glycosuria, the nurse should recognize the need for the client to be assessed for what health problem?

Diabetes Mellitus

A client in moderate pain is admitted for possible kidney stones. The client appears diaphoretic and has frequent periods of nausea and vomiting. The client reports sudden oliguria and initial portable bladder ultrasound shows 300 mL in the bladder after the client voided 50 mL. Which action should the nurse anticipate performing first for this client?

Urinary Catheter

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 medications and supplements normally taken assess the client's usual intake of sodium confirm which beverages the clients normally consume palpate the client's bladder before and after voiding

confirm all medications and supplements normally taken

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract?

Ureters

When the bladder contains 400 to 500 mL of urine, this is referred to as - anuria. - specific gravity. - functional capacity. - renal clearance.

functional capacity

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

The wall of the bladder is comprised of four layers. Which of the following is the layer responsible for micturition? Adventitia (connective tissue) Detrusor muscle Submucosal layer of connective tissue Inner layer of epithelium

Detrusor Muscle

The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to: drink liberal amounts of fluids. maintain bed rest for 2 hours. carefully handle urine because it is radioactive. notify the health care team if bloody urine is noted.

Drink liberal amount of fluids

An appropriate nursing intervention for the client following a nuclear scan of the kidney 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 client is experiencing some renal secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed in urine? glucose, potassium, creatinine, chloride

Glucose

A client undergoes renal angiography. The nurse prepares the client for the test and provides postprocedure care. Which intervention should the nurse provide to the client after renal angiography? - Encourage the client to void - Monitor the client for signs and symptoms of pyelonephritis - Palpate the pulses in the legs and feet - Assess for signs of electrolyte and water imbalance

Palpate the pulses in legs and feet

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

Pruritis

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: - renal calculi. - an overdistended bladder. - interstitial cystitis. - acute prostatitis.

Renal calculi

Which of the following hormones is secreted by the juxtaglomerular apparatus? Renin Aldosterone Antidiuretic hormone (ADH) Calcitonin

Renin

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 of 1.035