HESI Renal Quiz Grab Bag

What part of the kidney produces erythropoietin? What does it do?

-Kidney parenchyma -Erythropoietin stimulates the bone marrow to make red blood cells

After reviewing the urinalysis reports of a client with a renal disorder, the nurse concludes that the client may have a urinary tract infection. Which urinary laboratory findings enabled the nurse to make this conclusion? Select all that apply. -pH: 8.5 -Specific gravity: 1.010 -Red blood cells: 3/hpf -Osmolality: 1500 mOsm/kg (1500 mmol/kg) -White blood cells: 6/hpf

-pH 8.5 -WBCs 6/hpf (pH>8.0 indicates a UTI; normal WBC in urine<5/hpf)

Cup-like structure that collects urine and is located at the end of each papilla

Calyx

Disease of the kidney that is associated with manifestations of systemic circulatory overload

Chronic glomerulonephritis

A condition of increased glomerular permeability characterized by severe proteinuria

Nephrotic syndrome

Purpose of peritoneal dialysis

Removing toxins & metabolic wastes (uses the peritoneum as a selectively permeable membrane for diffusion of toxins and wastes from the blood into the dialyzing solution. Peritoneal dialysis acts as a substitute for kidney function)

What hormone influences kidney function?

Aldosterone (released from adrenal cortex)

Which part of the kidney produces the hormone bradykinin? What does bradykinin do?

-Juxtaglomerular cells of the arterioles -Increases blood flow & vascular permeability

A client with end-stage renal disease is hospitalized. For which complications should the nurse monitor the client? Select all that apply. -Anemia -Hyperexcitability -Jaundice -Dyspnea -Hypophosphatemia

-Anemia (d/t decreased erythropoietin production by kidneys) -Dyspnea (d/t excess fluid volume) (Hyperphosphatemia, hyperkalemia, and hypocalcemia occur in ESRD)

The urinalysis results of a female client shows the 17-ketosteroids value as 25 mg/24 hr. Which condition should the nurse monitor for in this client? -Addison disease -Cushing syndrome -Ovarian neoplasms -Ovarian dysfunction

-Cushing syndrome (Urinary steroids such as 17-ketosteroids range from 6 to 17 mg/24 hr in females. Higher levels may indicate possible Cushing syndrome, increased androgen or cortisol production, and severe stress. Decreased levels of 17-ketosteroids indicate possible Addison disease and hypopituitarism)

Which urodynamic study provides information on bladder capacity, bladder pressure, and voiding reflexes? -Radiography -Renal arteriography -Electromyography (EMG) -Cystometrography (CMG)

-Cystometography (Cystometrography (CMG) is an urodynamic study that provides information on bladder capacity, bladder pressure, and voiding reflexes)

What is the physiologic reason that a pt. with renal failure would need to take Vitamin D and calcium supplements? -Decrease in the inactive forms of vitamin D in the body -Decrease in the active metabolite of vitamin D in the body -Increased conversion of skin cholesterol into vitamin D -Increase in the vitamin D associated intestinal absorption of calcium.

-Decrease in the active metabolite of vitamin D in the body (Renal failure results in a decrease in the active metabolite of vitamin D because inactive vitamin D gets activated in the liver followed by the kidneys; vitamin D helps intestinal absorption of calcium)

A client is scheduled for a kidney ultrasound. Which instructions given by the nurse to the client would be most beneficial? Select all that apply. -Drink plenty of fluids -Eat foods high in fiber -Do not urinate before the procedure -Lie perfectly flat and still during the procedure -You may need a temporary catheter during the procedure

-Drink plenty of fluids -Do not urinate -Lie flat and still (A kidney ultrasound requires a full bladder. Asking the client to drink plenty of fluids will increase the volume of blood, thereby increasing the volume of urine collected in the urinary bladder. Because of this, the client should be advised not to urinate prior to the exam. The client lies flat with the abdomen exposed in the supine position)

After a prostatectomy the client reports that the urinary catheter tubing is pulling too tightly on the leg. The nurse observes that the indwelling catheter tubing is taut and is taped properly to the thigh. Which action should the nurse take? -Explain that the traction helps control bleeding. -Adjust tension on the catheter to relieve pressure. -Untape the catheter and retape it closer to the urinary meatus. -Assess the degree of tension on the catheter and contact the primary healthcare provider.

-Explain that the traction helps control bleeding (Traction on the indwelling catheter pulls the balloon tight against the prostatic fossa, which promotes hemostasis. The tension on the catheter must be maintained until the primary healthcare provider determines that there is no longer a risk of bleeding)

A client with a history of excessive alcohol use develops hepatic portal hypertension and an elevated serum aldosterone level. For which complications should the nurse assess this client?

-Sodium and water retention and excretion of potassium

A patient with invasive cancer of the bladder, has brachytherapy scheduled. What indicates success of this therapy? Decrease in urine output Increase in pulse strength Shrinkage of tumor on scanning Increase in #'s of WBCs

Shrinkage of tumor on scanning (isotope seeds are implanted in the tumor, interferes with cell multiplication, which should control the growth and metastasis of cancerous tumors; type of radiation)

A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening the client's urinary output is much less than the intake. When it is confirmed that the bladder is not distended, what should the nurse suspect developed? -Oliguria -Hydroureter -Renal shutdown -Urethral obstruction

Hydroureter (Calculi may obstruct the flow of urine to the bladder, allowing the urine to distend the ureter, causing hydroureter)

Which drug prescribed to a client with a urinary tract infection (UTI) turns urine reddish-orange in color? Amoxacillin Ciprofloxacin Nitrofurantoin Phenazopyridine

Phenazopyradine (a topical anesthetic that is used to treat pain or burning sensation associated with urination)

Diffuse, pyogenic infection of the pelvis and parenchyma of the kidney that causes flank pain, chills, fever, & weakness

Pyleonephritis

Kidney hormones

Renin Bradykinin Erythropoietin

To prepare for hemodialysis, a client with end-stage kidney disease is scheduled for surgery, specifically for the creation of an internal arteriovenous fistula in one arm and placement of an external arteriovenous shunt in the other arm. When considering care for these sites, which difference will the nurse consider? -The graft is more subject to hemorrhage, clotting, and infection than the fistula is. -Blood pressure readings can be taken in the arm with the fistula but not in the one with the shunt. -Intravenous (IV) fluids can be administered in the arm with the shunt but not in the one with the fistula. -The fistula should be covered with a light dressing, and the shunt should be covered thoroughly with a heavy dressing

The graft is more subject to hemorrhage, clotting, & infection than the fistula is (The external shunt may come apart with possible hemorrhage; clotting is a potential hazard. Frequent handling increases risk of infection. Blood pressure readings should not be obtained in the extremity that has a shunt or fistula because of the pressure exerted on the circulatory system during the procedure. IVs should not be infused in the extremity with the shunt or the fistula to avoid pressure from the tourniquet and to lessen the chance of phlebitis. The ends of the shunt cannula should be left exposed for rapid reconnection in the event of disruption)

The nurse is developing a postprocedure plan of care for a client with a continuous bladder irrigation after a transurethral vaporization of the prostate. What should the nurse include in the plan? -Measure output hourly -Irrigate with NS three times daily -Exclude the amount of irrigant from the output -Monitor specific gravity of the urine

-Exclude the amount of irrigant from the output

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for which complication? -Peritonitis -Hepatitis B -Renal calculi -Bladder infection

-Hepatitis B (Hepatitis type B is transmitted by blood or blood products. The hemodialysis and routine transfusions needed for a client in end-stage renal failure constitute a high risk for exposure)

A nurse is providing dietary instructions to a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis. Which should the nurse include when discussing what the client needs? -Low-calorie foods -High-quality protein -Increased fluid intake -Foods rich in potassium

-High-quality protein (Proteins eaten should be high quality to replace those lost during dialysis)

A client with acute kidney injury moves into the diuretic phase after 1 week of therapy. For which clinical indicators during this phase should the nurse assess the client? Select all that apply. -Hypovolemia -Hyperkalemia -Dehydration -Metabolic alkalosis -Skin rash

-Hypovolemia -Dehydration (In the diuretic phase, fluid retained during the oliguric phase is excreted and may reach 3 to 5 L daily; dehydration and hypovolemia may occur unless fluids are replaced. Hyperkalemia & metabolic acidosis develops in the oliguric phase when glomerular filtration is inadequate)

A client with a left ureteral calculus is scheduled for a transurethral ureterolithotomy. During the preoperative assessment, how does the nurse expect the client to report pain? -It is a boring-type pain that is located in the left flank -It is dull and constant and located in the costovertebral angle -It is located at the level of the kidneys and occurs with each urination -It is spasmodic and located in the left side and radiating to the suprapubic area.

-It is spasmodic and located in the left side and radiating to the suprapubic area (Pain with ureteral stones is caused by spasm (renal colic) and is excruciating and intermittent; it follows the path of the ureter to the bladder down to the groin. Pain is spasmodic and excruciating, not boring, dull, or constant. Pain intensifies as the calculus lodges in the ureter and spasms occur in an attempt to dislodge it)

A nurse is caring for a client with a diagnosis of benign prostatic hyperplasia (BPH). Which information about this condition is important for the nurse to consider when caring for this client? -It is a congenital abnormality -It predisposes the patient for hydronephrosis -Prostate-specific antigen decreases -A malignancy usually results

-It predisposes the patient to hydronephrosis (Inability to empty the bladder as a result of pressure exerted by the enlarging prostate on the urethra causes a backup of urine into the ureters and finally the kidneys)

What part of the kidney produces prostaglandins? What do they do?

-Kidney tissues -Prostaglandins regulate internal blood flow by vasodilation or vasoconstriction

A client's urine specific gravity is being measured. For which condition should the nurse conduct a focused assessment when a client's specific gravity is increased? -Diabetes insipidus -Polyuria -Fluid overload -Low-grade fever

-Low-grade fever (Elevated body temp can lead to dehydration which concentrates urine and causes increased specific gravity)

The nurse is providing care to a client who has had a transurethral resection of the prostate (TURP). Which goal is the priority? -Maintain patency of the cystostomy tube -Prevent wound hemorrhage and infection -Maintain patency of the indwelling catheter -Prevent the abdominal dressing from draining

-Maintain patency of the indwelling catheter (Indwelling catheter patency promotes bladder decompression, which prevents distention and bleeding; continuous flow of an irrigant limits clot formation and promotes hemostasis)

A nurse instructs a client with a history of frequent urinary tract infections to drink cranberry juice. Which goal is the nurse trying to achieve with this suggestion? -Exert a bactericidal effect against the bacteria -Prevent bacterial attachment to the bladder wall -Improve glomerular filtration rate -Relieve the symptoms of dysuria

-Prevent bacterial attachment to the bladder wall

A client who is 5 feet, 8 inches tall (173 cm) and weighs 220 lb (99.8 kg) is admitted to the hospital with ureteral colic, blood in the urine, and a blood pressure of 150/90 mm Hg. Which is the priority objective of nursing care for this client? -Reduce weight -Reduce hematuria -Reduce pain -Reduce BP

-Reduce pain (Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is associated with ureteral distention and must be relieved)

A nurse is notified that the latest potassium level for a client in acute kidney injury is 6.2 mEq (6.2 mmol/L). Which action should the nurse take first? -Alert the cardiac arrest team. -Call the laboratory to repeat the test. -Take vital signs and notify the primary healthcare provider. -Obtain an electrocardiogram (ECG) strip and obtain an antiarrhythmic medication

-Take vital signs and notify the primary HCP (Vital signs monitor the cardiopulmonary status; the primary healthcare provider must treat this hyperkalemia to prevent cardiac dysrhythmias)

A penicillin form that could cause pseudomembranous colitis as a complication

Amoxacillin

A quinolone antibiotic used for treating UTIs and can cause serious cardiac dysrhythmias and sunburns

Ciprofloxacin

Condition that causes hematuria, frequency, urgency, and pain on urination. Which diagnosis is most likely? Chronic glomerulonephritis Nephrotic syndrome Pyleonephritis Cystitis

Cystitis (inflammation of the bladder)