Urinary Exam
Which hormone causes the kidney to reabsorb sodium? a) Aldosterone b) Prostaglandins c) Growth hormone d) Antidiuretic hormone (ADH)
A. aldosterone
Which of the following terms is used to refer to inflammation of the renal pelvis? a) Pyelonephritis b) Urethritis c) Interstitial nephritis d) Cystitis
A. pyelonephritis
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a) Risk for infection b) Activity intolerance c) Toileting self-care deficit d) Impaired urinary elimination
A. risk for infection
A nurse is caring for an acutely ill patient. The nurse understands that the most accurate indicator of fluid loss or gain in an acutely ill patient is which of the following? a) Weight b) Edema c) Pulse rate d) Blood pressure
A. weight
Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? a) Assess for dehydration. b) Limit sodium and water intake. c) Give medications that promote fluid retention. d) Teach client behaviors that decrease urination.
B. limit sodium and water intake
You are caring for a patient who is experiencing elevated intracranial pressure following neurosurgery. The physician orders an osmotic diuretic to reduce pressure. Which of the following agents would the physician select? a) Furosemide (Lasix) b) Mannitol (Osmitrol) c) Spironolactone (Aldactone) d) Bumetanide (Bumex)
B. mannitol (osmitrol)
What disease of the kidney is genetic in nature and leads to kidney failure? a) Acute glomerulonephritis b) Polycystic kidney disease c) Nephritic syndrome d) Nephrotic syndrome
B. polycystic kidney disease
A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant? a) Previous episode of acute pyelonephritis b) Recent history of streptococcal infection c) History of hyperparathyroidism d) History of osteoporosis
B. recent history of streptococcal infection
Which of the following hormones is secreted by the juxtaglomerular apparatus? a) Antidiuretic hormone (ADH) b) Renin c) Aldosterone d) Calcitonin
B. renin
Which nursing intervention should the nurse caring for the client with pyelonephritis implement? a) Restrict fluid intake to 1 liter per day. b) Teach client to increase fluid intake up to 3 liters per day. c) Straight catheterize the client every 4 to 6 hours. d) Administer acetaminophen (Tylenol).
B. teach the client to increase fluid intake up to 3 liters per day
A group of students are 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) Ureters c) Bladder d) Urethra
B. ureters
A client comes to the Emergency Department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? a) Acute glomerulonephritis b) Urinary calculi c) Renal cell carcinoma d) Ureteral stricture
B. urinary calculi
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) "You don't need to do any fasting before this noninvasive test." c) "An x-ray will be done to view your kidneys, ureters, and bladder." d) "A contrast medium will be used to help see the structures better.
B. you don't need to do any fasting before this noninvasive test
Which of the following diuretics exerts its effect by inhibiting the enzyme carbonic anhydrase? (Choose one a) Spironolactone (Aldactone) b) Acetazolamide (Diamox) c) Hydrochlorothiazide (Microzide) d) Furosemide (Lasix)
B. Acetazolamide (Diamox)
The nurse is caring for a patient complaining of orange-colored urine. The nurse suspects which of the following as the cause of the urine discoloration? a) Phenytoin (Dilantin) b) Pyridium (phenazopyridium HCl) c) Infection d) Metronidazole (Flagyl)
B. Pyridium (phenazopyridium HCl)
he nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include: a) glucose trace b) WBC 50 c) RBC 3 d) proteinuria
B. WBC 50
Which of the following would be a contraindication to the use of carbonic anhydrase inhibitors? a) Respiratory acidosis b) Allergy to sulfonamides c) Chronic obstructive pulmonary disease d) Adrenocortical insufficiency
B. allergy to sulfonamides
An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? a) Exercises to promote sphincter control b) Application of an ostomy pouch c) Intermittent catheterizations d) Irrigating the urinary diversion
B. application of an ostomy pouch
The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important? a) Record the volume of urine obtained. b) Catheterize the client immediately after the client voids. c) Check for residual after the client reports the urge to void. d) Set up a routine schedule of every 4 hours to check for residual urine.
B. catheterize the client immediately after the client voids
A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication? a) Obstruction of urine flow from the kidneys b) Decrease in the blood flow through the kidneys c) Structural damage occurred in the nephrons of the kidneys d) Blood clot formed in the kidneys interfered with the flow
B. decrease in blood flow through the kidneys
A client is being discharged home after a radical cystectomy and creation of ureterosigmoidoscopy. Which of the following must be avoided? a) Stoma irritation b) Enemas c) Intermittent self-catheterization d) Sodium intake
B. enemas
The patient is taking Spirinolactone (Aldactone). What response determines successful teaching? a) "I need to take the drug on an empty stomach." b) "I need to make sure I don't eat too many high potassium foods." c) "I can still use my salt substitute if I want to." d) "I should take the medicine around dinnertime for the best effect."
B. i need to make sure i don't eat too many high potassium foods
You are caring for a 68-year-old female client with type 1 diabetes mellitus whose physician has ordered hydrochlorothiazide. As a consequence of taking the diuretic, the client may need to a) decrease her consumption of potassium-rich foods. b) increase her insulin dose c) increase her consumption of sodium-rich foods d) decrease her insulin dose.
B. increase her insulin dose
A patient with glaucoma has been prescribed a diuretic as treatment of her disease process. What drug does the nurse suspect that the patient will be prescribed? a) Spironolactone (Aldactone) b) Chlorthalidone (Hygroton) c) Acetazolamide (Diamox) d) Bendroflumethiazide (Naturetin)
C. Acetazolamide (Diamox)
The nurse has implemented a bladder retraining program in a 65-year-old woman after the removal of an indwelling urinary catheter from this patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient has 50 mL of urine remaining in her bladder after voiding. What would be the nurse's best response to this finding? a) Place an indwelling urinary catheter b) Perform a straight catheterization on this patient c) Avoid further interventions at this time, as this is an acceptable finding d) Press on the patient's bladder in an attempt to encourage complete emptying
C. avoid further interventions at this time, as this is an acceptable finding
The nurse is caring for a patient with a medical history of sickle cell anemia. The nurse understands this predisposes the patient to which of the following possible renal or urologic disorders? a) Proteinuria b) Neurogenic bladder c) Chronic kidney disease d) Kidney stone formation
C. chronic kidney disease
John Ericsson, a 57-year-old railroad worker, is a client on the hospital unit where you practice nursing. As a result of trauma, Mr. Ericsson has developed urinary incontinence and is beginning bladder training to regain control over his urine elimination. What is the initial step to begin bladder training for a client with an indwelling catheter? a) Perform catheter care b) Remove the catheter c) Clamp the catheter d) Unclamp the catheter
C. clamp the catheter
Susan Hopkins, a 32-year-old administrative assistant, is being seen by a physician with the urology practice where you practice nursing. She has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What can Mrs. Hopkins consume to decrease the likelihood of bladder infection? a) Red meat b) Prune juice c) Cranberry juice d) Increased protein
C. cranberry juice
In starting your new job as a nurse with a group of renal specialists, you begin your orientation with a thorough review of renal function. While the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which of the following is NOT a function of the kidneys? a) Regulating blood pressure b) Excreting nitrogen waste products c) Excreting protein d) Stimulating RBC production
C. excreting protein
Which of the following is used to decrease potassium level seen in acute renal failure? a) Sorbitol b) Calcium supplements c) Kayexalate d) IV dextrose 50%
C. kayexalate
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? a) Low oxalate b) High sodium c) Low purine d) High protein
C. low purine
An older client is receiving prolonged doses of nephrotoxic drugs. Which of the following would the nurse need to report? a) Decreased blood urea nitrogen (BUN) levels b) Increased chloride levels c) Oliguria d) Decreased serum creatinine levels
C. oliguria
Which finding is an early indicator of bladder cancer? a) Dysuria b) Nocturia c) Painless hematuria d) Occasional polyuria
C. painless hematuria
A patient is receiving patient education prior to beginning continuous ambulatory peritoneal dialysis. What would the nurse teach the patient that the most common complication associated with this procedure is? a) Constipation b) Blood loss c) Peritonitis d) Dehydration
C. peritonitis
A diabetic patient with renal failure has been admitted to your unit. What is the most life-threatening effect of renal failure you will monitor for? a) Lack of blood pressure control b) Depletion of calcium c) Retention of potassium d) Accumulation of wastes
C. retention of potassium
Within the urology group where you practice nursing, clients with urinary tract infections are frequently seen by physicians. In a diagnosis of a lower urinary tract infection, which structures could be affected? Choose all correct options. a) Kidney b) Bladder c) Urethra d) Ureter
C. urethra B. bladder
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? a) Blood urea nitrogen (BUN) level of 22 mg/dl b) Serum creatinine level of 1.2 mg/dl c) Urine output of 250 ml/24 hours d) Temperature of 100.2° F (37.8° C)
C. urine output of 250 ml/ 24 hours
Which of the following medications may be ordered to relieve discomfort associated with a UTI? a) Ciprofloxacin (Cipro) b) Nitrofurantoin (Furadantin) c) Levofloxacin (Levaquin) d) Phenazopyridine (Pyridium)
D. Phenazopyridine (Pyridium)
Which of the following is a term used to describe excessive nitrogenous waster in the blood, as seen in acute glomerulonephritis? a) Hematuria b) Proteinuria c) Bacteremia d) Azotemia
D. azotemia
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which of the following? a) Increased fluid intake b) Diabetes insipidus c) Glomerulonephritis d) Decreased fluid intake
D. decreased fluid intake
An older adult male client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises him to wear barrier garments such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity? a) Using scented sprays or perfumes. b) Avoiding using an electric room deodorizer. c) Avoiding the application of moisture sealant. d) Exposing the affected area to air.
D. exposing the affected area to air
A 42-year-old client is being seen by an urologist in the group where you practice nursing. She is experiencing some secretion abnormalities, for which diagnostics are being performed. Which of the following substances are typically reabsorbed and not secreted in urine? a) Creatinine b) Chloride c) Potassium d) Glucose
D. glucose
The nurse caring for a patient with acute glomerulonephritis would expect the patient's urine to what? a) Contain renal calculi b) Be copious in amount c) Have fibrinous threads d) Have a cola-color
D. have a coca cola color
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? a) Decreased blood urea nitrogen (BUN) b) Increased serum albumin c) Decreased potassium d) Increased serum creatinine
D. increased serum creatinine
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) Chronic renal failure b) Fistula c) Neurogenic bladder d) Kidney stones
D. kidney stones
A patient is brought to the renal unit from the PACU status post resection of a renal tumor. What would be a priority nursing action in the care of this patient? a) Increase oral intake b) Decrease urine output c) Increase mobility d) Management of postoperative pain
D. management of postoperative pain
The nurse is caring for a patient with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which of the following nursing actions is contraindicated? a) Placing the patient's watch on the left wrist b) Palpating the fistula for a "thrill" c) Obtaining blood samples from the left arm d) Obtaining a blood pressure reading from the right arm
D. obtaining a blood pressure reading from the right arm
A 42-year-old woman comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware this is what type of incontinence? a) Overflow incontinence b) Functional incontinence c) Reflex incontinence d) Stress incontinence
D. stress incontinence
A client regularly recognizes the sensation of needing to void but cannot control voiding in time to reach a toilet. How would the nurse document this type of incontinence? a) Total b) Overflow c) Reflex d) Urge
D. urge
The nurse is caring for a patient who describes his changes in 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 does not seem to be a great deal of urine flow." What would the nurse expect this patient's physical assessment will likely reveal? a) Hematuria b) Renal failure c) Dehydration d) Urine retention
D. urine retention
You are caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours postoperatively the patient verbalizes that the stoma is a dark purplish color. This nurse is aware of what? a) The stoma is healthy. b) The stoma is infected. c) The ostomy appliance around the stoma is too loose. d) Vascular supply to the stoma may be compromised.
D. vascular supply to the stoma may be compromised
The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. Which of the following methods should the nurse use to accurately assess the client's fluid volume status? a) Weighing the client daily, once in the morning, on the same scale, with similar clothing b) Weighing the client daily, at the same time, using a different scale every time, with similar clothing c) Weighing the client daily, at the same time, on the same scale, with only minimal clothing d) Weighing the client daily, at the same time, on the same scale, with similar clothing
D. weighing the client daily, at the same time, on the same scale, with similar clothing
Question: A nursing instructor is reviewing with the class the steps in urine formation. Place in the correct order from first to last the sequence the instructor would present. 1. Plasma is filtered by the glomerulus. 2. Filtrate moves through the tubular system of the nephron and is either reabsorbed or excreted as urine. 3. Formed urine drains from the collecting tubules, into the renal pelvis, and down each ureter to the bladder. 4. Filtrate enters Bowman's capsule.
1. plasma is filtered by the glomerulus 2. filtrate enters the bowman's capsule 3. filtrate moves through the tubular system of the nephron and is either reabsorbed or excreted as urine 4. formed urine drains from the collecting tubules, into the renal pelvis, and down each ureter to the bladder
A 10-year-old child has edema caused by a heart defect. The patient is taking furosemide (Lasix). The dosage is 6 mg/kg per day. The child weighs 76 pounds. How many mg does the child receive in each dose? a) 210 mg b) 50 mg c) 105 mg d) 20 mg
A. 210 mg
Ron Davidson, a 45-year-old editor, is a client on the rehab unit where you practice nursing. Ron was involved in an MVA, which left him with paraplegia, and he is working toward living at home with his wife. He is currently developing an individualized CIC schedule, as he prefers to not wear a leg bag. What is the maximum amount of urine he should allow to collect before catheterization? a) 350 mL b) 100 mL c) 600 mL d) 500 mL
A. 350ml
A 32-year-old client has been admitted to the renal unit of the hospital with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. What signs and symptoms would you expect the client to exhibit? a) All options are correct. b) Malaise c) Elevated temperature d) Flank pain
A. all options are correct
The nurse is caring for a patient who is not allowed oral intake of fluid or food. When evaluating this patient's urinalysis, what would the nurse anticipate? a) An increased urine specific gravity b) A fixed urine specific gravity c) A decreased urine specific gravity d) A fluctuating urine specific gravity
A. an increased urine specific gravity
Which type of medication may be used in the treatment of a patient with incontinence to inhibit contraction of the bladder? a) Anticholinergic agent b) Tricyclic antidepressants c) Estrogen hormone d) Over-the-counter decongestant
A. anticholinergic agent
Which of the following would be included in a teaching plan for a patient diagnosed with a urinary tract infection? a) Drink liberal amount of fluids b) Void every 4 to 6 hours c) Use tub baths as opposed to showers d) Drink coffee or tea to increase diuresis
A. drink liberal amounts of fluid
A group of students are reviewing the various classes of diuretics. The students demonstrated understanding of the information when they identify which of the following as a loop diuretic? a) Furosemide (Lasix) b) Indapamide c) Triamterene d) Mannitol (Osmitrol)
A. furosemide (lasix)
Which of the following is a characteristic of a normal stoma? a) Pink color b) Dry in appearance c) No bleeding when cleansing stoma d) Painful
A. pink color
A 40-year-old client has just been diagnosed with acute pyelonephritis. What client education would you offer Mr. McDermott regarding fluids? a) Significantly increase fluid intake b) No change in fluids needed c) Increase caffeinated beverages d) Significantly decrease fluid intake
A. significantly increase fluid intake
James Roth, a 63-year-old accountant, is a client on the hospital unit where you practice nursing. Mr. Roth has developed urinary incontinence and is beginning bladder training to regain control over his urine elimination. Why is the catheter being clamped and unclamped? a) To promote normal bladder function b) To prevent bladder distention c) To promote urine production d) To prevent urinary retention
A. to promote normal bladder function
You are providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include? a) To weigh themselves on the same scale, at the same time of day, in the same clothing b) Restrict fluids to 500 cc per day to limit the need to urinate c) Measuring their intake and output of urine d) Decrease exercise to conserve energy
A. to weight themselves on the same scale, at the same time of day, in the same clothing
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? a) Urine output of 20 ml/hour b) Temperature of 99.2° F (37.3° C) c) Serum sodium level of 135 mEq/L d) Serum potassium level of 4.9 mEq/L
A. urine output of 20 ml/hour
A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate? a) "Try washing clothes with a strong detergent to ensure that all impurities are gone." b) "When you shower, use really warm water and an antibacterial soap." c) "Keep your showers brief, patting your skin dry after showering." d) "Liberally apply alcohol to the areas of your skin where you itch the most."
C. "Keep your showers brief, patting your skin dry after showering."
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? a) Uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75% b) Increased serum levels of potassium, magnesium, and calcium c) Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl d) Increased pH with decreased hydrogen ions
C. Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl
A patient has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this patient? a) A thiazide diuretic will reabsorb potassium in the distal tubule b) A thiazide diuretic will be excreted in more than 72 hours c) A thiazide diuretic will be ineffective for immediate diuresis d) A thiazide diuretic will provide peak effects in 2 hours
C. a thiazide diuretic will be ineffective for immediate diuresis
The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is: a) "Genetic testing will determine the best treatment for your condition." b) "Draining of the cysts and antibiotic therapy will cure your disease." c) "As the disease progresses, you will most likely require renal replacement therapy." d) "Dietary changes can reverse the damage that has occurred in your kidneys."
C. as the disease progresses, you will most likely require renal replacement therapy
Which of the following is the most effective intravesical agent for recurrent bladder cancer? a) Cisplatin b) Vinblastine c) Methotrexate d) Bacillus Calmette-Guérin (BCG)
D. Bacillus Calmette-Guérin (BCG)
