Deck 68: Assessment of the Renalurinary System

Question 1

A client's urine specific gravity is 1.018.Which is the nurse's best action?

A) Ask the client for a 24-hour recall of liquid intake.
B) Document the finding in the client's chart.
C) Obtain a specimen for culture.
D) Notify the health care provider.

Answer 1

Document the finding in the client's chart.

Question 2

A client was admitted for a myocardial infarction and cardiogenic shock.Two days later,which laboratory test results does the nurse expect to see?

A) Blood urea nitrogen (BUN) of 52 mg/dL
B) Creatinine of 2.3 mg/dL
C) BUN of 10 mg/dL
D) BUN-creatinine ratio of 8:1

Answer 2

Blood urea nitrogen (BUN) of 52 mg/dL

Question 3

A client's urinalysis results reveal a urine osmolarity of 1200 mOsm/L.Which action by the nurse is most appropriate?

A) Initiate a fluid restriction.
B) Prepare to administer a diuretic.
C) Institute seizure precautions.
D) Encourage the client to increase fluid intake.

Answer 3

Encourage the client to increase fluid intake.

Question 4

A client scheduled for intravenous urography informs the nurse of the following allergies.Which one does the nurse report to the health care provider immediately?

A) Seafood
B) Penicillin
C) Bee stings
D) Red food dye

Question 5

Two hours after a closed percutaneous kidney biopsy,the client reports a dramatic increase in pain.What is the nurse's best first action?

A) Reposition the client on the operative side.
B) Administer the prescribed opioid analgesic.
C) Assess the pulse rate and blood pressure.
D) Check the Foley catheter for kinks.

Question 6

Which assessment maneuver does the nurse perform first when assessing the renal system at the same time as the abdomen?

A) Abdominal percussion
B) Abdominal auscultation
C) Abdominal palpation
D) Renal palpation

Question 7

The nurse is reviewing a client's urinalysis and notes a positive glucose.Which action by the nurse is best?

A) Document the finding and call the health care provider.
B) Collect and send another urinalysis sample to the laboratory.
C) Review the client's recent dietary selections.
D) Perform a finger stick blood glucose on the client.

Question 8

A client scheduled to have intravenous urography has diabetes and is taking the antidiabetic agent metformin (Glucophage).What does the nurse tell this client?

A) "Call your diabetes doctor and tell him or her that you are having an intravenous urogram performed using dye."
B) "Do not take your metformin the morning of the test because you are not going to be eating anything and you could become hypoglycemic."
C) "You must start on an antibiotic before this test because your risk of infection is greater as a result of your diabetes."
D) "You must take your metformin immediately before the test is performed because the IV fluid and the dye contain significant amounts of sugar."

Question 9

Which is the result of stimulation of erythropoietin production in the kidney tissue?

A) Increased blood flow to the kidney
B) Inhibition of vitamin D and loss of bone density
C) Increased bone marrow production of red blood cells
D) Inhibition of active transport of sodium and hyponatremia

Question 10

A client's urine specific gravity is 1.040.Which action by the nurse is best?

A) Obtain a urine culture and sensitivity.
B) Place the client on restricted fluids.
C) Review the client's creatinine level.
D) Increase the client's fluid intake.

Question 11

A client has an increased BUN/creatinine ratio.Which action by the nurse is most appropriate?

A) Assess the client's dietary habits.
B) Inquire about the use of NSAIDs.
C) Hold the client's metformin (Glucophage).
D) Notify the health care provider immediately.

Question 12

Which condition would trigger the release of antidiuretic hormone (ADH)?

A) Overhydration
B) Dehydration
C) Hemorrhage
D) Edema

Question 13

Which condition is associated with oversecretion of renin?

A) Alzheimer's disease
B) Hypertension
C) Diabetes mellitus
D) Diabetes insipidus

Question 14

A client is scheduled to have renography (kidney scan).The client voices concern about discomfort during the procedure.Which is the nurse's best response?

A) "Before the test, you will be given a sedative to reduce any pain."
B) "A local anesthetic agent will be used, so you won't feel any pain."
C) "No more discomfort is felt with the scan than with an ordinary x-ray."
D) "The only pain will occur when you have your IV line started."

Question 15

The nursing assistant is using a bladder scanner on a client.Which action by the nursing assistant requires further education on the use of this device?

A) Consistently choosing the female icon for all female clients
B) Consistently choosing the male icon for all male clients
C) Applying ultrasound gel to the scanning head and removing it when finished
D) Taking at least two readings by using the aiming icon to place the scanning head.

Question 16

The female client's urinalysis shows all the following results.Which does the nurse document as abnormal?

A) pH 5.6
B) Ketone bodies present
C) Specific gravity of 1.030
D) Two white blood cells per high-power field

Question 17

A client's urinalysis results show a protein level of 1.8 mg/dL.Which action by the nurse is best?

A) Inform the health care provider.
B) Ask the client about his or her protein intake.
C) Obtain the client's weight.
D) Document the finding in the chart.

Question 18

The nurse is palpating a client's kidneys.The client's right kidney is easily palpated,but the nurse cannot palpate the left kidney.What is the nurse's interpretation of this finding?

A) The problem involves the right kidney.
B) The problem involves the left kidney.
C) Both kidneys are in the normal position.
D) The client is at increased risk for kidney impairment.

Question 19

A client is going home after urography.Which instruction or precaution does the nurse teach this client?

A) "Avoid direct contact with the urine for 24 hours until the radioisotope clears."
B) "You may have some dribbling of urine for several weeks after this procedure."
C) "Be sure to drink at least 3 liters of fluids today to help eliminate the dye faster."
D) "Your skin may become slightly yellow from the dye used in this procedure."

Question 20

The nurse is reviewing a client's laboratory test results and notes a blood urea nitrogen (BUN)of 35 mg/dL and a creatinine of 1.0 mg/dL.What new order does the nurse anticipate?

A) Increase the client's IV fluids.
B) Prepare the client for dialysis.
C) Place the client on a fluid restriction.
D) Obtain urine for culture and sensitivity.

Question 21

To obtain a sterile urine specimen from a client with a Foley catheter,the nurse begins by applying a clamp to the drainage tubing distal to the injection port.What does the nurse do next?

A) Clamp another section of the tube to create a fixed sample section for retrieval.
B) Insert a syringe into the injection port and aspirate the quantity of urine required.
C) Clean the injection port cap of the drainage tubing with povidone-iodine solution.
D) Withdraw 10 mL of urine and discard it; then withdraw 10 mL more for the sample.

Question 22

Which results are normal in a urinalysis?

A) pH, 6
B) Specific gravity, 1.015
C) Protein, 1.2 mg/dL
D) Glucose, negative
E) Nitrate, small
F) Leukocyte esterase, positive