Nursing 406 - Adult Health Care » Spring 2020 » Chapter 53 Quiz
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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.
Infection
B.
Dehydration
C.
Bleeding
D.
Allergic reaction
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.
Bruits noted over the abdominal area
B.
Tenderness over the kidneys
C.
The ingestion of 8 oz of water
D.
A dull sound when percussing over the bladder
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 incontinence
B.
Urinary urgency
C.
Urinary stasis
D.
Urinary frequency
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 left kidney usually is slightly higher than the right one.
D.
The average kidney is approximately 5 cm (2 in.) long and 2 to 3 cm (0.8 to 1.2 in.) wide.
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.
incorrect urine output values.
B.
client discomfort.
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.
Computed tomography (CT scan)
B.
Angiography
C.
Radiography
D.
Cystoscopy
Question #10
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?
A.
Obstruction of the lower urinary tract
B.
Infection
C.
Acute renal failure
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.
Assess the patient's back and shoulder areas for signs of internal bleeding.
C.
Enable the client to sit up and ambulate.
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.
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.
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.
D.
On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high 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.
Computed tomography with contrast
B.
Cystoscopy
C.
Radiography
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.
Dysuria
B.
Enuresis
C.
Hematuria
D.
Anuria
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.
Have you had a recent urinary tract infection?”
B.
“Do you take multiple vitamin preparations?”
C.
Have you noticed any vaginal bleeding?”
D.
“Do you take phenytoin daily?”
Question #16
Retention of which electrolyte is the most life-threatening effect of renal failure?
A.
Sodium
B.
Calcium
C.
Phosphorous
D.
Potassium
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 reports a pain rating of 3 two hours post-kidney biopsy.
C.
The client has blood-tinged urine following brush 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.
Assess the client's mental changes.
B.
Monitor the client for an allergy to iodine contrast material.
C.
Monitor the client for signs of electrolyte and water imbalance.
D.
Evaluate the client for periorbital edema.
Question #19
When describing the functions of the kidney to a client, which of the following would the nurse include?
A.
Synthesis of vitamin K
B.
Secretion of enzymes
C.
Control of water balance
D.
Regulation of white blood cell production
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 don't need to do any fasting before this noninvasive test.”
B.
You'll have a pressure dressing on your groin after the 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.”
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 insulin
B.
Secretion of prostaglandins
C.
Regulation of blood pressure
D.
Vitamin D synthesis
E.
Vitamin B production
Question #22
Which of the following hormones is secreted by the juxtaglomerular apparatus?
A.
Aldosterone
B.
Antidiuretic hormone (ADH)
C.
Calcitonin
D.
Renin
Question #23
The most frequent reason for admission to skilled care facilities includes which of the following?
A.
Stroke
B.
Myocardial infarction
C.
Urinary incontinence
D.
Congestive heart failure
Question #24
A client is having a blood urea nitrogen (BUN) test. BUN level is:
A.
unchanged in renal disease.
B.
decreased in nephrotic syndrome.
C.
increased in renal disease and urinary obstruction.
D.
decreased in renal disease and urinary obstruction.
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.
Apply moist heat, every 4 hours for the first 48 hours to aid healing.
B.
Check the patient's urine for hematuria.
C.
Place a bed board under the mattress to add support.
D.
Keep the patient on bed rest for 72 hours.
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.
Pruritus
B.
Increased alertness
C.
Hypoventilation
D.
Unusually smooth skin
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.
Exercise the leg and foot.
B.
Place cool compresses on the calf.
C.
Assess for anaphylaxis.
D.
Assess peripheral pulses in the left leg.
Question #28
The term used to describe total urine output less than 0.5 mL/kg/hr is
A.
anuria.
B.
nocturia.
C.
dysuria.
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.
Decreased potassium
B.
Increased serum creatinine
C.
Decreased blood urea nitrogen (BUN)
D.
Increased serum albumin
Question #30
Which of the following describes awakening at night to urinate?
A.
Polyuria
B.
Dysuria
C.
Nocturia
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.
notify the health care team if bloody urine is noted.
B.
carefully handle urine because it is radioactive.
C.
drink liberal amounts of fluids.
D.
maintain bed rest for 2 hours.
Question #32
Which value does the nurse recognize as the best clinical measure of renal function?
A.
Creatinine clearance
B.
Urine-specific gravity
C.
Volume of urine output
D.
Circulating ADH concentration
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 less than 30 mL/h
B.
When the urine output is between 500 and 1,000 mL/h
C.
When the urine output is about 100 mL/h
D.
When the urine output is between 300 and 500 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.
Perineal pain
B.
Pain after voiding
C.
Suprapubic pain
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.
Severe renal damage
B.
Fluid deficits
C.
Glomerulonephritis
D.
Diabetes
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.
potassium
B.
creatinine
C.
glucose
D.
chloride
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.
Fistula
B.
Kidney stones
C.
Chronic renal failure
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.
The upper abdominal quadrants on the left and right side
B.
Around the umbilicus
C.
The costovertebral angle
D.
Above the symphysis pubis
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.
Creatinine
B.
Osmolality
C.
Hemoglobin
D.
Blood urea nitrogen
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.
Decreased fluid intake
D.
Increased 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.
Serum potassium level
C.
Uric acid 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.
With the first specimen voided after 8:00 am
C.
After discarding the 8:00 am specimen
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.
GI absorption rate
B.
Therapeutic index
C.
Creatinine clearance
D.
Liver function studies
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 signed the consent form in the physician's office."
B.
"I took my usual dose of Coumadin last night."
C.
I brought a copy of my living will with me."
D.
"I have not eaten since 8 pm last night."
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.
Have you had a recent urinary tract infection?”
C.
Have you noticed any vaginal bleeding?”
D.
Do you take phenytoin daily?”
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.
Proteinuria
B.
Chronic kidney disease
C.
Neurogenic bladder
D.
Kidney stone formation
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.
Do you have a strong desire to void?”
B.
Does it burn when you urinate?”
C.
Do you urinate while sleeping?”
D.
Is it painful 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.
Creatinine clearance level
B.
Uric acid 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.
assess the client's usual intake of sodium.
C.
confirm all of the medications and supplements normally taken.
D.
confirm which beverages the client normally consumes.
Question #52
Which value represents a normal BUN-to-creatinine ratio?
A.
10:01
B.
6:01
C.
3:01
D.
4:01
Question #53
Which hormone causes the kidneys to reabsorb sodium?
A.
Aldosterone
B.
Prostaglandins
C.
Growth hormone
D.
Antidiuretic hormone
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.
Who has come with you today?”
B.
Do you have a pacemaker?”
C.
Have you any artificial joints?”
D.
“Do you have any allergies?”
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.
Renal pelvis
B.
Glomerulus
C.
Parenchyma
D.
Nephron
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.
Infection
B.
Metronidazole
C.
Phenytoin
D.
phenazopyridine hydrochloride
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 blood flow to the kidney
D.
Increased glomerular filtration rate
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.
Place a bed board under the mattress to add support
C.
Keep the patient on bed rest for 72 hours.
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.
Renin
B.
Cortisol
C.
Vasopressin
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.
It is normal for my urine to be blood-tinged."
D.
I can resume my usual activities without restriction."
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.
Adventitia
B.
Mucosal
C.
Connective tissue
D.
Detrusor
Question #63
In a diagnosis of an upper urinary tract infection, which structures could be affected? Select all that apply.,,
A.
urethra
B.
bladder
C.
kidney
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.
A dull sound when percussing over the bladder
C.
Tenderness over the kidneys
D.
The ingestion of 8 oz of water
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.
cystitis.
B.
pyelonephritis.
C.
ureteral stones.
D.
Urethral infection.
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