Question 1

The nurse is assessing the skin of a client diagnosed with renal insufficiency. Which of the following is the nurse most likely going to assess in this client?

Accepted Answer

Renal insufficiency can lead to the accumulation of waste products in the blood, which can cause pruritus (itching). This often results in evidence of scratching on the skin of affected individuals.

Question 2

A client diagnosed with a kidney disorder is scheduled for a diagnostic test that uses a contrast agent. Which of the following can be done to protect this client's kidney functioning?
0)9% normal saline through an intravenous access device.

Accepted Answer

Administering acetylcysteine as prescribed can help protect kidney functioning during a diagnostic test that uses a contrast agent. Acetylcysteine has been shown to reduce the risk of contrast-induced nephropathy, a type of kidney damage that can occur as a result of contrast agent use. While 0.9% normal saline may be used to maintain hydration, restricting fluids and maintaining bed rest are not recommended interventions to protect kidney functioning.

Question 3

A nurse is assessing a client for signs of decreased kidney function. Which of the following are symptoms of possible decreased kidney function? (Select all that apply.)

Accepted Answer

B,C,D,F

Question 4

A client is scheduled for a renal ultrasound and a barium swallow. The nurse realizes that which of the following should be done regarding these diagnostic tests?

Accepted Answer

The renal ultrasound should be completed first as the barium from the swallow can interfere with the accuracy of the renal ultrasound. Waiting 8 hours after the barium swallow is not necessary, as completing the ultrasound first avoids any potential interference. Completing the barium swallow before or immediately after the renal ultrasound is also not a recommended option.

Question 5

The nurse is assessing the renal system of an elderly client. Which of the following is not an age-related change seen in the renal system?

Accepted Answer

Prostatic hypoplasia, which refers to underdevelopment of the prostate gland, is not an age-related change seen in the renal system. Age-related changes typically include decreased glomerular filtration rate, changes in the urinary tract's muscle tone and elasticity, and an increased tendency for nocturia. Prostatic hypertrophy or hyperplasia, not hypoplasia, is common in elderly males and can affect urinary function.

Question 6

The nurse realizes that a client diagnosed with kidney disease is at risk for acid-base imbalances. Which of the following explains how the kidney contributes to acid-base balance? (Select all that apply.)

Accepted Answer

The kidneys help maintain acid-base balance by secreting hydrogen ions, reabsorbing bicarbonate, and generating new bicarbonate. These processes help regulate the pH of the blood.

Question 7

The nurse has provided basic information to a client about the kidneys. Which of the following client statements would indicate that additional instruction would be needed?

Accepted Answer

A person can survive with just one kidney. Many people live healthy lives with only one kidney, and kidney donation is a common practice. The other statements are accurate: kidneys are about 4.5 inches long, located in the retroperitoneal space, and the right kidney is indeed lower than the left due to the presence of the liver.

Question 8

A client with an alteration in the renal system is demonstrating inconsistent blood pressure control. The nurse realizes that the substance produced by the kidneys that assists in blood pressure control is:

Accepted Answer

Renin is produced and released by the kidneys and helps to regulate blood pressure by converting angiotensinogen to angiotensin I, which is then converted to angiotensin II, a potent vasoconstrictor.

Question 9

A nurse is collecting a 24-hour urine sample from a client without an indwelling urinary catheter. Which of the following are steps for collecting the sample? (Select all that apply.)

Accepted Answer

The answer of A nurse is collecting a 24-hour urine...

Question 10

A client has a disorder that is affecting the reabsorption ability of the kidney. Which of the following does the renal tubule usually reabsorb to support body functions? (Select all that apply.)

Accepted Answer

The renal tubule is responsible for the reabsorption of several important substances including water, glucose, amino acids, vitamins, and calcium in order to maintain normal body functions. Ammonia is not typically reabsorbed by the renal tubule.

Question 11

A client has had a sudden 5-kg weight gain. The nurse calculates the client's fluid retention as being:

Accepted Answer

It typically takes about 1 kg of weight gain to equal 1 L of retained fluid. Therefore, a sudden 5-kg weight gain indicates approximately 5 L of retained fluid. Choice B is the only option that reflects this calculation. Choices A, C, and D are too low or too high based on this estimation.

Question 12

A client has sustained trauma to the trigone portion of the bladder. The nurse realizes that which of the following will be affected in this client?

Accepted Answer

The trigone portion of the bladder is located near the ureters (the tubes that transport urine from the kidneys to the bladder) and the urethra (the tube that leads urine out of the body). Trauma to this area can affect the functioning of these structures. Option B (nephrons) refers to the functional units of the kidneys and are not directly related to the bladder. Option C (detrusor muscle spasms) can occur in response to various conditions, but trauma to the trigone may not necessarily result in this symptom. Option D (inability to concentrate urine) is related to the functioning of the kidneys rather than the bladder.

Question 13

The nurse needs to collect a urine specimen for culture from a client who does not have an indwelling urinary catheter. Which of the following instructions would the nurse provide the client regarding how to collect this sample?

Accepted Answer

Using a wipe and cup for the sample is the most appropriate method for collecting a urine specimen for culture in a client who does not have an indwelling urinary catheter. This method is non-invasive and allows for sterile collection of the urine for culture. Instructing the client to decrease water intake could lead to inaccurate test results, and catheterizing the client should only be done if necessary. Asking the client to call when using the urinal may not be practical, depending on the client's mobility and ability to communicate.

Question 14

The nurse is reviewing the results of serum laboratory tests conducted on a client. Which of the following results should be reported?

Accepted Answer

A potassium level of 6.1 mEq/L is elevated and could indicate potential kidney problems or medication side effects, and should be reported to the healthcare provider for further evaluation and management. The other results are within the normal range.

Question 15

A client is recovering from a renal biopsy. After this procedure, the nurse should instruct the client to notify the nurse for which of the following? (Select all that apply.)

Accepted Answer

After a renal biopsy, the client should be monitored for complications such as bleeding, infection, and urinary issues. Problems voiding, obvious blood in the urine, increased pain, fever, and painful urination are all potential signs of complications that should be reported to the nurse. Constipation is not directly related to the biopsy procedure.

Question 16

The nurse is collecting a 24-hour urine specimen from a client with an indwelling urinary catheter. How should the nurse collect this specimen?

Accepted Answer

The correct method is to keep the catheter bag on ice and regularly empty it into a collection bottle that is also kept on ice to ensure the urine is preserved properly for the 24-hour collection period.

Question 17

A client, diagnosed with renal calculi, is experiencing extreme pain. The nurse explains to the client that the cause of the pain is due to the:

Accepted Answer

The buildup of pressure in the ureters as the stone tries to pass through them can cause extreme pain. The other options are incorrect as the stone does not touch kidney tissue directly, does not reach the bladder before causing pain, and urethral spasms are not typically associated with renal calculi pain.

Question 18

A client with chronic renal disease asks the nurse why she needs to receive erythropoietin injections. Which of the following should the nurse respond to this client?

Accepted Answer

Erythropoietin is a hormone that stimulates the production of red blood cells in the bone marrow. In chronic renal disease, the kidneys are unable to produce enough erythropoietin, resulting in anemia. Erythropoietin injections can help to correct this anemia. The other options are not correct, as erythropoietin does not affect vitamin D production, waste product removal, or ammonia removal.

Question 19

The nurse is reviewing a client's current medication list for those that can be nephrotoxic. Which of the following medications can be nephrotoxic? (Select all that apply.)

Accepted Answer

Amphotericin B, Gentamicin, Tobramycin, and Vancomycin can all be nephrotoxic, meaning they can cause kidney damage or dysfunction. Chloroquine and Erythromycin are not known to be nephrotoxic.

Quiz 52: Assessment of Renal Function