Nursing 406 - Adult Health Care » Spring 2020 » Chapter 53 Quiz
Need help with your exam preparation?
Get Answers to this exam for $6 USD.
Get Answers to all exams in [ Nursing 406 - Adult Health Care ] course for $25 USD.
Existing Quiz Clients Login here
Question #1
The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following?
A.
Dehydration
B.
Bleeding
C.
Allergic reaction
D.
Infection
Question #2
The nurse is completing a full exam of the renal system. Which assessment finding best documents the need to offer the use of the bathroom?
A.
The ingestion of 8 oz of water
B.
A dull sound when percussing over the bladder
C.
Tenderness over the kidneys
D.
Bruits noted over the abdominal area
Question #3
The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?
A.
Urinary frequency
B.
Urinary stasis
C.
Urinary urgency
D.
Urinary incontinence
Question #4
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.
Blood urea nitrogen level
C.
Creatinine clearance level
D.
Serum potassium level
Question #5
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure?
A.
At 8:00 am, with or without a specimen
B.
After discarding the 8:00 am specimen
C.
6 hours after the urine is discarded
D.
With the first specimen voided after 8:00 am
Question #6
A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact?
A.
The kidneys are situated just above the adrenal glands.
B.
The kidneys lie between the 10th and 12th thoracic vertebrae.
C.
The average kidney is approximately 5 cm (2 in.) long and 2 to 3 cm (0.8 to 1.2 in.) wide.
D.
The left kidney usually is slightly higher than the right one.
Question #7
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.
client discomfort.
B.
incorrect urine output values.
C.
microorganism transfer.
D.
prostate irritation.
Question #8
The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective?
A.
“I should remove all jewelry before the test.”
B.
I should let the staff know if I feel claustrophobic.”
C.
“I will feel a warm sensation as the dye is injected.”
D.
“I will need to drink all of the dye as quickly as possible.”
Question #9
Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?
A.
Angiography
B.
Radiography
C.
Computed tomography (CT scan)
D.
Cystoscopy
Question #10
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?
A.
Acute renal failure
B.
Obstruction of the lower urinary tract
C.
Infection
D.
Nephrotic syndrome
Question #11
Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse?
A.
Provide analgesics to the client.
B.
Enable the client to sit up and ambulate.
C.
Assess the patient's back and shoulder areas for signs of internal bleeding.
D.
Distract the client's attention from the pain.
Question #12
Urine specific gravity is a measurement of the kidney’s ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Which is an example of how urine concentration is affected?
A.
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.
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.
On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity.
Question #13
The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish?
A.
Cystoscopy
B.
Radiography
C.
Computed tomography with contrast
D.
Bladder ultrasonography
Question #14
The nurse is instructing a 3-year-old’s mother regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?
A.
Enuresis
B.
Hematuria
C.
Anuria
D.
Dysuria
Question #15
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.
Have you noticed any vaginal bleeding?”
C.
Have you had a recent urinary tract infection?”
D.
“Do you take multiple vitamin preparations?”
Question #16
Retention of which electrolyte is the most life-threatening effect of renal failure?
A.
Phosphorous
B.
Sodium
C.
Potassium
D.
Calcium
Question #17
Which nursing assessment finding indicates the client has not met expected outcomes?
A.
The client consumes 75% of lunch following an intravenous pyelogram
B.
The client has blood-tinged urine following brush biopsy.
C.
The client reports a pain rating of 3 two hours post-kidney biopsy.
D.
The client voids 75 cc four hours post cystoscopy.
Question #18
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?
A.
Evaluate the client for periorbital edema.
B.
Monitor the client for signs of electrolyte and water imbalance.
C.
Monitor the client for an allergy to iodine contrast material.
D.
Assess the client's mental changes.
Question #19
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.
Synthesis of vitamin K
C.
Control of water balance
D.
Secretion of enzymes
Question #20
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.
“A contrast medium will be used to help see the structures better.”
C.
An x-ray will be done to view your kidneys, ureters, and bladder.”
D.
“You don't need to do any fasting before this noninvasive test.”
Question #21
The client asks the nurse about the functions of the kidney. Which should the nurse include when responding to the client? Select all that apply.,,
A.
Secretion of prostaglandins
B.
Vitamin B production
C.
Regulation of blood pressure
D.
Vitamin D synthesis
E.
Secretion of insulin
Question #22
Which of the following hormones is secreted by the juxtaglomerular apparatus?
A.
Renin
B.
Antidiuretic hormone (ADH)
C.
Calcitonin
D.
Aldosterone
Question #23
The most frequent reason for admission to skilled care facilities includes which of the following?
A.
Congestive heart failure
B.
Myocardial infarction
C.
Urinary incontinence
D.
Stroke
Question #24
A client is having a blood urea nitrogen (BUN) test. BUN level is:
A.
increased in renal disease and urinary obstruction.
B.
decreased in nephrotic syndrome.
C.
decreased in renal disease and urinary obstruction.
D.
unchanged in renal disease.
Question #25
A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?
A.
Check the patient's urine for hematuria.
B.
Keep the patient on bed rest for 72 hours.
C.
Apply moist heat, every 4 hours for the first 48 hours to aid healing.
D.
Place a bed board under the mattress to add support.
Question #26
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.
Unusually smooth skin
B.
Increased alertness
C.
Hypoventilation
D.
Pruritus
Question #27
After undergoing renal arteriogram, in which the left groin was accessed, a client complains of left calf pain. Which intervention should the nurse perform first?
A.
Assess for anaphylaxis.
B.
Exercise the leg and foot.
C.
Assess peripheral pulses in the left leg.
D.
Place cool compresses on the calf.
Question #28
The term used to describe total urine output less than 0.5 mL/kg/hr is
A.
nocturia.
B.
dysuria.
C.
anuria.
D.
oliguria.
Question #29
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.
Increased serum albumin
B.
Increased serum creatinine
C.
Decreased potassium
D.
Decreased blood urea nitrogen (BUN)
Question #30
Which of the following describes awakening at night to urinate?
A.
Nocturia
B.
Dysuria
C.
Polyuria
Question #31
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.
notify the health care team if bloody urine is noted.
C.
carefully handle urine because it is radioactive.
D.
drink liberal amounts of fluids.
Question #32
Which value does the nurse recognize as the best clinical measure of renal function?
A.
Circulating ADH concentration
B.
Urine-specific gravity
C.
Creatinine clearance
D.
Volume of urine output
Question #33
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?
A.
When the urine output is between 300 and 500 mL/h
B.
When the urine output is about 100 mL/h
C.
When the urine output is between 500 and 1,000 mL/h
D.
When the urine output is less than 30 mL/h
Question #34
The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find?
A.
Suprapubic pain
B.
Perineal pain
C.
Pain after voiding
D.
Costovertebal angle tenderness
Question #35
The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse?
A.
"I do not have a pacemaker, artificial heart valve, or artificial joints."
B.
"I did not take my multivitamin this morning."
C.
"I had my last cigarette 3 hours ago with my morning coffee."
D.
I took my blood pressure medication with my morning coffee an hour ago."
Question #36
In which of the following renal disorders would one suspect a decreased urine specific gravity? Select all that apply,,
A.
Fluid deficits
B.
Diabetes
C.
Glomerulonephritis
D.
Severe renal damage
E.
Diabetes insipidus
Question #37
A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine?
A.
chloride
B.
glucose
C.
creatinine
D.
potassium
Question #38
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.
Kidney stones
C.
Fistula
D.
Neurogenic bladder
Question #39
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client’s kidneys for tenderness?
A.
Above the symphysis pubis
B.
The upper abdominal quadrants on the left and right side
C.
Around the umbilicus
D.
The costovertebral angle
Question #40
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.
Blood urea nitrogen
B.
Osmolality
C.
Creatinine
D.
Hemoglobin
Question #41
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition?
A.
Glomerulonephritis
B.
Diabetes insipidus
C.
Increased fluid intake
D.
Decreased fluid intake
Question #42
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
Question #43
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure?
A.
At 8:00 am, with or without a specimen
B.
After discarding the 8:00 am specimen
C.
With the first specimen voided after 8:00 am
D.
6 hours after the urine is discarded
Question #44
A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change?
A.
Therapeutic index
B.
Liver function studies
C.
Creatinine clearance
D.
GI absorption rate
Question #45
Which is an effect of aging on upper and lower urinary tract function?
A.
More prone to develop hypernatremia
B.
Acid-base balance
C.
Increased blood flow to the kidneys
D.
Increased glomerular filtration rate
Question #46
The nurse is admitting a client who is to undergo an open renal biopsy. About which of the following comments by the client should the nurse be most concerned?
A.
"I took my usual dose of Coumadin last night."
B.
I brought a copy of my living will with me."
C.
"I have not eaten since 8 pm last night."
D.
"I signed the consent form in the physician's office."
Question #47
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 multiple vitamin preparations?”
B.
Do you take phenytoin daily?”
C.
Have you had a recent urinary tract infection?”
D.
Have you noticed any vaginal bleeding?”
Question #48
The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder?
A.
Kidney stone formation
B.
Chronic kidney disease
C.
Neurogenic bladder
D.
Proteinuria
Question #49
While reviewing a client’s chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question?
A.
Is it painful when you urinate?”
B.
Do you urinate while sleeping?”
C.
Do you have a strong desire to void?”
D.
Does it burn when you urinate?”
Question #50
The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator?
A.
Uric acid level
B.
Creatinine clearance level
C.
BUN to creatinine ratio
D.
Blood urea nitrogen (BUN)
Question #51
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.
palpate the client's bladder before and after voiding.
B.
confirm all of the medications and supplements normally taken.
C.
confirm which beverages the client normally consumes.
D.
assess the client's usual intake of sodium.
Question #52
Which value represents a normal BUN-to-creatinine ratio?
A.
3:01
B.
6:01
C.
10:01
D.
4:01
Question #53
Which hormone causes the kidneys to reabsorb sodium?
A.
Antidiuretic hormone
B.
Aldosterone
C.
Growth hormone
D.
Prostaglandins
Question #54
A client presents at the testing center for an intravenous pyelogram. What question should the nurse ask to ensure the safety of the client?
A.
“Do you have any allergies?”
B.
Have you any artificial joints?”
C.
Who has come with you today?”
D.
Do you have a pacemaker?”
Question #55
A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?
A.
Glomerulus
B.
Nephron
C.
Renal pelvis
D.
Parenchyma
Question #56
A client has a full bladder. Which sound would the nurse expect to hear on percussion?
A.
Resonance
B.
Tympany
C.
Flatness
D.
Dullness
Question #57
The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration?
A.
Metronidazole
B.
phenazopyridine hydrochloride
C.
Phenytoin
D.
Infection
Question #58
Which is an effect of aging on upper and lower urinary tract function?
A.
Acid-base balance
B.
Susceptibility to develop hypernatremia
C.
Increased glomerular filtration rate
D.
Increased blood flow to the kidney
Question #59
A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?
A.
Check the patient's urine for hematuria.
B.
Keep the patient on bed rest for 72 hours.
C.
Place a bed board under the mattress to add support
D.
Apply moist heat, every 4 hours for the first 48 hours to aid healing.
Question #60
The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure?
A.
Vasopressin
B.
Renin
C.
Cortisol
D.
Albumin
Question #61
The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions?
A.
I should increase my fluid intake for the rest of the day."
B.
If I have difficulty urinating, I should contact my physician."
C.
I can resume my usual activities without restriction."
D.
It is normal for my urine to be blood-tinged."
Question #62
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.
Detrusor
B.
Connective tissue
C.
Adventitia
D.
Mucosal
Question #63
In a diagnosis of an upper urinary tract infection, which structures could be affected? Select all that apply.,,
A.
kidney
B.
bladder
C.
urethra
D.
ureter
Question #64
The nurse is completing a full exam of the renal system. Which assessment finding best documents the need to offer the use of the bathroom?
A.
Bruits noted over the abdominal area
B.
The ingestion of 8 oz of water
C.
Tenderness over the kidneys
D.
A dull sound when percussing over the bladder
Question #65
A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing:
A.
Urethral infection.
B.
pyelonephritis.
C.
ureteral stones.
D.
cystitis.
Need help with your exam preparation?
Get Answers to this exam for $6 USD.
Get Answers to all exams in [ Nursing 406 - Adult Health Care ] course for $25 USD.
Existing Quiz Clients Login here