Chapter 65 Adaptive Quiz Renal Assessment
A nurse is caring for a patient who will undergo a kidney, ureter, and bladder x-ray (KUB) procedure. What statement by the nurse is appropriate when teaching the patient about the procedure? 1 "You should fast at least 4 hours prior to this test." 2 "You do not need any special preparation for this test." 3 "You need to be able to lie flat on your abdomen for this test." 4 "You should not take your diabetic medication prior to this test."
"You do not need any special preparation for this test."
A nurse is planning care for a 75-year-old African American patient who is being treated for chronic kidney disease. When planning appropriate interventions for this patient, what variations in physiology does the nurse recognize as contributing factors of kidney disease among African American older adult patients? Select all that apply. 1 African Americans have less blood flow to the kidneys than do other populations. 2 African Americans have fewer nephrons within the kidneys than do other populations. 3 African Americans have greater clearance of sodium by the kidneys than do other populations. 4 African Americans have greater age-related changes in the GFR than do other populations. 5 African Americans have greater responses to aldosterone than do other populations.
1 African Americans have less blood flow to the kidneys than do other populations. African Americans have greater age-related changes in the GFR than do other populations.
Identify the function that is affected by the production of renin by the kidneys. 1 Blood pressure 2 Vitamin D activation 3 Fluids and electrolytes 4 Red blood cell formation
Blood pressure
The nurse suspects gastrointestinal (GI) bleeding in a 62-year-old patient with kidney disease. Which finding in the patient's blood report supports the nurse's suspicion? 1 Serum creatinine value of 0.7 mg/dL 2 Serum creatinine value of 1.1 mg/dL 3 Blood urea nitrogen (BUN) value of 25 mg/dL 4 Blood urea nitrogen (BUN)/creatinine ratio of 24
Blood urea nitrogen (BUN) value of 25 mg/dL
A patient who is on a high-protein diet consumes only 2 liters of fluids daily. What is the possible risk in this patient? 1 Nocturia 2 Calculi formation 3 Urinary tract infection 4 Urinary incontinence
Calculi formation
A patient is prescribed urine tests to determine kidney function. To which diagnostic test does the nurse refer to obtain the glomerular filtration rate (GFR)? 1 Urine osmolarity 2 Urine electrolytes 3 Creatinine clearance 4 Total catecholamines
Creatinine clearance
Which age-related change can cause nocturia? 1 Increased secretion of aldosterone 2 Decreased ability to concentrate urine 3 Increased production of erythropoietin 4 Decreased production of antidiuretic hormone
Decreased ability to concentrate urine
Which factor may cause nephrogenic systemic fibrosis? 1 Exposure to gases 2 Exposure to certain dyes 3 Exposure to hydrocarbons 4 Exposure to gadolinium-enhanced MRI
Exposure to gadolinium-enhanced MRI
Which age-related changes to the glomerular filtration rate (GFR) will the nurse keep in mind while reviewing the laboratory results of an older adult patient with a renal impairment? Select all that apply. 1 GFR will increase with age. 2 GFR will decrease with age. 3 GFR increases with age but is not noticeable until late in life. 4 Age-related changes to the GFR increase risk for fluid deficit. 5 Age-related changes to the GFR increase risk for fluid excess.
GFR will decrease with age. Age-related changes to the GFR increase risk for fluid excess.
The nurse is performing a physical assessment of the kidneys and bladder of a patient. How does the nurse perform this assessment? 1 Inspect for asymmetry in the costovertebral angle (CVA). 2 Start percussion from the umbilicus to the lower abdomen. Incorrect3 Begin by lightly palpating the areas of pain and tenderness. 4 Palpate lightly the left kidney with the patient in a supine position.
Inspect for asymmetry in the costovertebral angle (CVA).
Which anatomical structure or function of the kidney is unaffected by aging? 1 Tubule length 2 Thickened blood vessels 3 Glomerular filtration rate Correct 4 Juxtamedullary nephron functions
Juxtamedullary nephron functions
Which condition would the nurse suspect in a patient whose laboratory results show a serum creatinine level of 1.8 mg/dL? 1 Kidney impairment 2 Severe hepatic damage 3 Decreased muscle mass 4 Decreased kidney perfusion
Kidney impairment
A patient is scheduled for radiography of the kidneys, ureters, and bladder (KUB). What is the purpose of this examination? 1 Determine post-void residual 2 Measure the size of both kidneys 3 Detect the presence of urinary reflux 4 Stage a tumor detected through palpation
Measure the size of both kidneys
When caring for a patient with uremia, the nurse assesses for which symptom? 1 Insomnia 2 Cyanosis of the skin Correct3 Nausea and vomiting 4 Tenderness at the costovertebral angle (CVA)
N/V
A nurse is caring for a patient in the emergency department who has a severely elevated serum creatinine level. Other than kidney disease, what pathological condition may increase the serum creatinine level? 1 Liver failure with severe ascites Incorrect2 Diabetes with uncontrolled glucose regulation 3 Vascular disease with damage to the endothelium 4 No condition increases this level other than kidney disease.
No condition increases this level other than kidney disease.
Which diagnostic test is safe for patients with kidney failure to determine the functional ability of the kidney? 1 Radiography 2 Nuclear renal scan 3 Computed tomography 4 Magnetic resonance imaging
Nuclear renal scan
What symptoms does the nurse associate with internal bleeding or a hematoma in a patient after a kidney biopsy? 1 Voiding pink-tinged urine 2 Increase in urine output 3 Increased blood pressure 4 Pain radiating to the flank
Pain radiating to the flank
Which patient is at risk if a kidney palpation is performed? 1 Patient with an enlarged kidney 2 Patient with a tumor in the kidney 3 Patient with a low body mass index 4 Patient with a thin abdominal musculature
Patient with a tumor in the kidney
The nurse has these patient assignments. Which patient does the nurse encourage to consume 2-3 liters of fluid each day? 1 Patient with heart failure 2 Patient with hyperparathyroidism 3 Patient with chronic kidney disease 4 Patient with complete bowel obstruction
Patient with hyperparathyroidism
Which percussion technique does the nurse use to assess a patient who reports flank pain? 1 Quickly tap the flank area with cupped hands. Incorrect2 Place outstretched fingers over the flank area and percuss with the fingertips. 3 Place one hand with the palm up over the flank area and cup the other hand to percuss the hand on the flank. t4 Place one hand with the palm down flat over the flank area and use the other fisted hand to thump the hand on the flank.
Place one hand with the palm down flat over the flank area and use the other fisted hand to thump the hand on the flank.
A nurse is caring for a female patient who presents to the outpatient clinic with complaints of right flank pain. What action by the nurse is appropriate when percussing the patient's flank area? 1 Position the patient in an upright position, form hand into a cupped position and firmly strike the patient's costovertebral area. Incorrect2 Position the patient in a prone position, and place a flattened hand on the patient's costovertebral area. 3 Position the patient in a standing position, clench hand into a fist and firmly thump the patient's costovertebral area. 4 Position the patient in sitting position, clench hand into a fist and firmly thump the patient's costovertebral area.
Position the patient in sitting position, clench hand into a fist and firmly thump the patient's costovertebral area
Which kidney hormone regulates intrarenal blood flow by vasodilation or vasoconstriction? 1 Renin 2 Bradykinins 3 Erythropoietin 4 Prostaglandins
Prostaglandins
A patient who is a bodybuilder is prescribed several diagnostic tests. For which diagnostic test does the nurse expect a higher than normal value without reflecting a kidney function problem? 1 Urinary pH 2 Serum creatinine 3 Blood osmolarity 4 Serum blood urea nitrogen (BUN)
Serum creatinine
What changes related to aging does the nurse expect in the kidneys of an older patient? 1 The medulla shrinks in size. 2 The tubules increase in length. 3 The kidney loses cortical tissue. 4 The glomerular linings become thin.
The kidney loses cortical tissue.
Which finding in a patient's kidney, ureter, and bladder (KUB) x-ray indicates an abnormality? 1 The kidneys are located on either side of the spine. Correct2 The left kidney is much larger than the right kidney. 3 The left kidney is slightly longer than the right kidney. 4 The right kidney is slightly broader than the left kidney.
The left kidney is much larger than the right kidney.
The nurse is caring for a patient with kidney disease whose glomerular filtration rate (GFR) is recorded to be 45 ml/min. What is the best nursing intervention in this situation? 1 To encourage urine v 2 To maintain an adequate fluid intake 3 To report to the primary health care provider 4 To consider it normal and not take any action
To maintain an adequate fluid intake
A nurse is caring for a patient suspected of having pyelonephritis. What is the best position for the nurse to place the patient in when performing auscultation of the renal vessels? 1 Prone 2 Supine 3 Left lateral recumbent 4 Right lateral recumbent
supine
