NU310: (prepU: assessment of kidney and urinary function)
An appropriate nursing intervention for the client following a nuclear scan of the kidney is to: A) Strain all urine for 48 hours. B) Monitor for hematuria. C) Encourage high fluid intake. D) Apply moist heat to the flank area.
C) Encourage high fluid intake.
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) Neurogenic bladder B) Fistula C) Kidney stones D) Chronic renal failure
C) Kidney stones
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) Assess the client's mental changes. C) Monitor the client for an allergy to iodine contrast material. D) Evaluate the client for periorbital edema.
C) Monitor the client for an allergy to iodine contrast material.
The term used to describe total urine output less than 0.5 mL/kg/hour is A) anuria. B) dysuria. C) oliguria. D) nocturia.
C) oliguria.
Renal function results may be within normal limits until the GFR is reduced to less than which percentage of normal? A) 20% B) 30% C) 40% D) 50%
D) 50%
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
The nurse is completing a full exam of the client's renal system. Which assessment finding best documents the need to offer the use of the bathroom? A) A dull sound when percussing over the bladder B) The ingestion of 8 oz of water C) Bruits noted over the abdominal area D) Tenderness over the kidneys
A) A dull sound when percussing over the bladder
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? A) Creatinine clearance level B) Uric acid level C) Serum potassium level D) Blood urea nitrogen level
A) Creatinine clearance level
The wall of the bladder is comprised of four layers. Which of the following is the layer responsible for micturition? A) Detrusor muscle B) Inner layer of epithelium C) Submucosal layer of connective tissue D) Adventitia (connective tissue)
A) Detrusor muscle
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? A) Pruritus B) Unusually smooth skin C) Increased alertness D) Hypoventilation
A) Pruritus
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? A) Ureters B) Pelvic floor muscles C) Bladder D) Urethra
A) Ureters
A client is having a blood urea nitrogen (BUN) test. BUN level is: A) increased in renal disease and urinary obstruction. B) unchanged in renal disease. C) decreased in nephrotic syndrome. D) decreased in renal disease and urinary obstruction.
A) increased in renal disease and urinary obstruction.
A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 mL. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of: A) microorganism transfer. B) incorrect urine output values. C) client discomfort. D) prostate irritation.
A) microorganism transfer.
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? A) "Do you take phenytoin daily?" B) "Do you take multiple vitamin preparations?" C) "Have you noticed any vaginal bleeding?" D) "Have you had a recent urinary tract infection?"
B) "Do you take multiple vitamin preparations?"
The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following? A) Infection B) Bleeding C) Allergic reaction D) Dehydration
B) Bleeding
Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? A) Client rates pain at a 3 on a scale of 0 to 10. B) Client reports increasing fatigue. C) Client denies frequency and urgency. D) Urine output is 100 ml/hr.
B) Client reports increasing fatigue.
When describing the functions of the kidney to a client, which of the following would the nurse include? A) Regulation of white blood cell production B) Control of water balance C) Secretion of enzymes D) Synthesis of vitamin K
B) Control of water balance
A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? A) GI absorption rate B) Creatinine clearance C) Liver function studies D) Therapeutic index
B) Creatinine clearance
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? A) Uric acid level B) Creatinine clearance level C) Serum potassium level D) Blood urea nitrogen level
B) Creatinine clearance level
The wall of the bladder has four layers. Which of the following layers contains a membrane that prevents reabsorption of urine stored in the bladder? A) Connective tissue B) Mucosal C) Detrusor D) Adventitia
B) Mucosal
The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated? A) The specific gravity will be low B) The specific gravity will be high. C) The specific gravity will equal to one D) The specific gravity will be inversely proportional
B) The specific gravity will be high.
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? A) Bladder ultrasonography B) Radiography C) Computed tomography with contrast D) Cystoscopy
C) Computed tomography with contrast
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? A) Hemoglobin B) Blood urea nitrogen C) Creatinine D) Osmolality
C) Creatinine
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? A) On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. B) When the kidneys are diseased, the ability to concentrate urine may be impaired, and the specific gravity may vary widely. C) On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity. D) A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity.
C) On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.
The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: A) Protein 15 mg/dL B) Bright yellow urine C) Specific gravity 1.035 D) Creatinine 0.7 mg/dL
C) Specific gravity 1.035
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? A) Pelvic floor muscles B) Urethra C) Ureters D) Bladder
C) Ureters
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: A) confirm which beverages the client normally consumes. B) assess the client's usual intake of sodium. C) confirm all of the medications and supplements normally taken. D) palpate the client's bladder before and after voiding.
C) confirm all of the medications and supplements normally taken.
The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to A) maintain bed rest for 2 hours. B) carefully handle urine because it is radioactive. C) notify the health care team if bloody urine is noted. D) drink liberal amounts of fluids.
D) drink liberal amounts of fluids.
A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? A) "You'll have a pressure dressing on your groin after the test." B) "An x-ray will be done to view your kidneys, ureters, and bladder." C) "A contrast medium will be used to help see the structures better." D) "You don't need to do any fasting before this noninvasive test."
D) "You don't need to do any fasting before this noninvasive test."
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? A) Increased fluid intake B) Diabetes insipidus C) Glomerulonephritis D) Decreased fluid intake
D) Decreased fluid intake
A client has a full bladder. Which sound would the nurse expect to hear on percussion? A) Flatness B) Resonance C) Tympany D) Dullness
D) Dullness
Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to: A) Apply moist heat to the flank area. B) Strain all urine for 48 hours. C) Monitor for hematuria. D) Encourage high fluid intake.
D) Encourage high fluid intake.
The nurse observes that the client's urine is orange. Which additional assessment would be important for this client? A) Infection B) Bleeding C) Intake of multiple vitamin preparations D) Intake of medication such as phenazopyridine hydrochloride
D) Intake of medication such as phenazopyridine hydrochloride
