Deck 36: Urinary System Function, Assessment, and Therapeutic Measures

Question 1

When collecting a urine specimen from a female patient, which of these actions should the nurse take?

A)Direct the patient to wash her perineum before collecting the urine specimen.
B)Have the patient void, throw that urine away, and then collect another specimen at least 1 hour later.
C)Obtain the first voided urine of the day.
D)Have the patient urinate into a bedpan, then pour the urine into the specimen container.

Answer 1

Direct the patient to wash her perineum before collecting the urine specimen.

Question 2

The nurse is reviewing a urinalysis report. What should the nurse recognize as the normal average pH of urine?

A)2
B)4.2
C)6
D)7.4

Answer 2

6

Question 3

The nurse is collecting data for a patient with kidney disease. Which adventitious lung sound is the nurse most likely to note from fluid overload?

A)Wheezes
B)Crackles
C)Stridor
D)Pleural friction rub

Answer 3

Crackles

Question 4

The nurse is to obtain an orthostatic blood pressure measurement for a patient on dialysis for end-stage renal disease. Which of these would the nurse do to obtain this measurement?

A)Obtain blood pressure while the patient is lying, sitting, and standing.
B)Check blood pressure every minute three times for four readings.
C)Take blood pressure before and after dialysis treatments.
D)Monitor blood pressure before and after an antihypertensive medication is given.

Question 5

The nurse is collecting data for a patient with kidney disease. When reviewing a urinalysis report, what would the nurse recognize as normal specific gravity of urine?

A)0.080 to 0.100
B)1.002 to 1.035
C)2.600 to 3.000
D)4.612 to 5.030

Question 6

The nurse is helping to prepare a patient for a renal biopsy. What position should the nurse help the patient assume?

A)Sims'
B)Fowler's
C)Supine
D)Prone

Question 7

The nurse is reviewing a patient's urinalysis results: white blood cells (WBC) 100+/hpf; red blood cells (RBC) 4/hpf; bacteria, moderate amount; nitrite, positive; specific gravity, 1.025; urine, cloudy. What would the nurse recognize these finding as indicating?

A)Dehydration
B)Urinary tract infection
C)Contamination of the specimen from bacteria on the perineum
D)Contamination from menstruation

Question 8

The nurse is collecting data for a patient who has stress incontinence. Which of these findings would the nurse document?

A)The patient is unable to reach the bathroom and urinates in underwear.
B)The patient loses small amounts of urine when he or she coughs or sneezes.
C)The patient is unable to hold urine when under emotional stress.
D)The patient is unable to tell when there is the need to urinate.

Question 9

The nurse contributes to the plan of care for a patient who has edema. Which of the following is the best indicator of a patient's fluid volume status?

A)Intake and output
B)Vital signs
C)Daily weight
D)Skin turgor

Question 10

The nurse is collecting data for a patient who has kidney disease. How much urine will the nurse need to collect for a urinalysis?

A)5 mL
B)10 mL
C)20 mL
D)50 mL

Question 11

The nurse is caring for a patient who is scheduled for a cystoscopy with basket (C&P) extraction of a stone. What is the most important postoperative care after this surgery for the nurse to provide?

A)Measuring urine output
B)Monitoring daily weights
C)Observing for acute kidney injury
D)Limiting fluid intake

Question 12

The nurse is caring for a patient who has kidney disease and an acid-base imbalance. In what way do the kidneys help maintain acid-base balance in the body?

A)Conserving or excreting bicarbonate ions
B)Conserving or excreting potassium ions
C)Promoting excretion of carbon dioxide
D)Promoting retention of proteins.

Question 13

The nurse is caring for a male patient who has functional incontinence. What actions should the nurse take to help prevent incontinence?

A)Give the patient cranberry juice to keep the urine acidic.
B)Teach the patient to increase the time between voiding.
C)Teach the patient how to do Kegel exercises.
D)Ensure that the patient has ready access to the urinal.

Question 14

A patient is scheduled for an intravenous pyelogram (IVP). The nurse would evaluate the patient as understanding preprocedure teaching if the patient reported that which of these would be restricted as part of the preparation for an IVP?

A)Use of tobacco
B)Physical activities
C)Salt intake
D)Fluid intake

Question 15

Which structure is the capillary network in each nephron?

A)Glomerulus
B)Corpuscles
C)Renal tubules
D)Bowman's capsule

Question 16

What is the structural and functional unit of the kidney?

A)Cortex
B)Medulla
C)Pyramid
D)Nephron

Question 17

The nurse is caring for a patient who is admitted with pneumonia. The nurse notes a blood urea nitrogen (BUN) of 32 mg/dL and creatinine of 0.8 mg/dL. What is the most probable explanation for this finding?

A)The patient has kidney damage.
B)The patient has septicemia.
C)The patient is dehydrated.
D)The patient is malnourished.

Question 18

What value represents a normal glomerular filtration rate (GFR)?

A)25 to 50 mL/min
B)60 to 90 mL/min
C)100 to 125 mL/min
D)150 to 200 mL/min

Question 19

The nurse is caring for a patient who has kidney disease. How does the nurse end a 24-hour urine test at the end of the 24 hours?

A)The patient voids at the end of 24 hours, adding it to the collection container.
B)The final voiding before 24 hours is discarded.
C)100 mL of collected urine is placed into a specimen cup and sent to the laboratory.
D)The patient voids, and the first and last specimens from 24 hours are sent to the laboratory.

Question 20

The nurse is reviewing the patient's history and physical report. What is the term used to describe waste products building up in the blood?

A)Nitrosemia
B)Proteinemia
C)Septicemia
D)Uremia

Question 21

The nurse is collecting data for a patient who has suspected kidney disease. A high specific gravity of urine is associated with which of the following? (Select all that apply.?

A)Dehydration
B)Diabetes insipidus
C)Diabetes mellitus
D)Fluid volume excess
E)Heart failure
F)Nephrosis

Question 22

A minimum creatinine clearance of ________________mL per minute is needed to live without dialysis.

Question 23

Normally, the bladder contains less than ________________mL after urination.

Question 24

Normal urinary output is ________________to 2,000 mL per 24 hours.

Question 25

Which of the following hormones affects kidney function? (Select all that apply.?

A)Estrogen
B)Thyroid stimulating hormone (TSH)
C)Antidiuretic hormone (ADH)
D)Parathyroid hormone
E)Aldosterone
F)Atrial natriuretic hormone (ANH)

Question 26

The nurse is caring for a patient who has an elevated uric acid level. Which of the following could cause this elevated uric acid level? (Select all that apply.?

A)Gastrointestinal bleeding
B)Kidney disease
C)Steroid use
D)Leukemia
E)Malnutrition
F)Use of thiazide diuretics

Question 27

Which of these, if stated by a patient, indicates to the nurse correct understanding of how to obtain a midstream urine specimen for culture and sensitivity for a female patient? (Select all that apply.?

A)"A second-voided specimen is preferred."
B)"The labia should be kept separated while voiding."
C)"When urine starts to flow, collect it in the clean container provided."
D)"A 24-hour urine specimen is needed."
E)"The genitalia should be thoroughly cleaned with the towelettes provided."
F)"I should wash from the back to the front."

Question 28

The nurse is caring for a patient who has a urinary catheter inserted. Which of the following instructions should the nurse provide to help prevent development of a urinary tract infection? (Select all that apply.?

A)Limit fluid intake to decrease the flow of urine.
B)Wash the perineum with an antibacterial soap every 8 hours.
C)Keep the catheter securely taped to prevent catheter movement.
D)Use aseptic technique when emptying the drainage bag.
E)Position the tubing to allow free flow of the urine.
F)Empty the urinary bag every 4 hours to prevent stagnation of urine.

Question 29

The nurse is caring for a patient with an indwelling catheter. Which of the following would be included in routine nursing care? (Select all that apply.?

A)Encourage fluid intake.
B)Use sterile technique when emptying the drainage bag.
C)Secure the catheter to the patient's leg.
D)Maintain a closed system.
E)Clamp the catheter for 1 hour each shift.
F)Remove the catheter as soon as possible.

Question 30

The nurse contributes to the plan of care for an older patient. The nurse recognizes which of the following occur with aging to plan care? (Select all that apply.?

A)Bladder size increases
B)Glomerular filtration rate increases
C)Detrusor muscle tone decreases
D)Number of nephrons decreases
Completion
Complete each statement.

Question 31

What interventions, in addition to monitoring vital signs, should the nurse plan for in a patient returning from a renal arteriogram? (Select all that apply.?

A)A pressure dressing and sandbag used to apply pressure.
B)Check distal pulses in leg every 30 to 60 minutes.
C)Encourage the patient to ambulate as soon as possible.
D)Implement bedrest for 12 hours, and instruct the patient not to bend leg.
E)Raise the head of the bed to 90 degrees.
F)Check vital signs twice daily.

Question 32

Which of these is an abnormal component of urine? (Select all that apply.?

A)Urea
B)Protein
C)Water
D)Ammonia
E)Red blood cells
F)Hormones

Question 33

The nurse contributes to the plan of care for a patient who has had radiological studies of the renal system and has a nursing diagnosis of Impaired Urinary Elimination. Which outcome indicates that the nursing interventions have been effective?

A)Patient voids 10 mL/hour of reddish urine.
B)Patient voids an average of 15 mL/hour of dark-colored urine.
C)Patient voids 30 mL/hour of cloudy urine.
D)Patient voids 35 mL/hour of clear urine.Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 34

The nurse is caring for a patient who has a renal biopsy. For which complication would the nurse monitor the patient during the 24 hours after the procedure?

A)Bleeding
B)Infection
C)Urinary obstruction
D)Polyuria

Question 35

The nurse is reviewing data for a patient with acute kidney injury. Which of the following diagnostic test results would the nurse recognize as being indicative of kidney injury? (Select all that apply.?

A)Blood urea nitrogen 40 mg/100 mL
B)Serum creatinine 4.2 mg/dL
C)Uric acid 8 ng/dL
D)Hematocrit 20%
E)Fixed urine specific gravity of 1.010
F)Urine output of 100 mL in 24 hours

Question 36

The nurse is collecting data for a patient with kidney disease. Which of the following would indicate a normal urinalysis finding? (Select all that apply.?

A)Amber color
B)pH 3.5
C)Specific gravity of 1.010
D)Small quantities of enzymes
E)Red blood cells of 8/hpf
F)Small amount of nitrite