Deck 19: Kidney Clinical Assessment and Diagnostic Procedures

Question 1

Loss of albumin from the vascular space may result in

A) peripheral edema.
B) extra heart sounds.
C) hypertension.
D) hyponatremia.

Answer 1

peripheral edema.

Question 2

A patient has been on complete bed rest for 3 days.The health care provider has ordered for the patient to sit at the bedside for meals.The patient complains of feeling dizzy and faint while sitting at the bedside.The nurse anticipates that the patient is experiencing

A) orthostatic hypertension.
B) orthostatic hypotension.
C) hypervolemia.
D) electrolyte imbalance.

Answer 2

orthostatic hypotension.

Question 3

When calculating the anion gap, the predominant cation is

A) sodium.
B) potassium.
C) chloride.
D) bicarbonate.

Answer 3

sodium.

Question 4

A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The nurse would expect to see elevated values in the following laboratory results: (Select all that apply).

A) BUN.
B) creatinine.
C) glucose.
D) hemoglobin and hematocrit.
E) protein.

Question 5

Differentiating ascites from distortion caused by solid bowel contents in the distended abdomen is accomplished by

A) assessing for bowel sounds in four quadrants.
B) palpation of the liver margin.
C) measuring abdominal girth.
D) the presence of a fluid wave.

Question 6

A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The nurse is assessing the peripheral edema.The nurse presses two fingers over the tibial area, and it takes 1 minute before the indention disappears.The nurse would chart the following result:

A) +1 pitting edema.
B) +2 pitting edema.
C) +3 pitting edema.
D) +4 pitting edema.

Question 7

Percussion of kidneys is usually done to

A) assess the size and shape of the kidneys.
B) detect pain in the renal area.
C) elicit a fluid wave.
D) evaluate fluid status.

Question 8

A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.Which of the following diagnostic tests would give the best information about the internal kidney structures, such as the parenchyma, calyces, pelvis, ureters, and bladder?

A) Kidney-ureter-bladder (KUB)
B) Intravenous pyelography (IVP)
C) Renal ultrasonography (ECHO)
D) Renal angiography

Question 9

A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The nurse suspects the main cause of ascites is

A) hypervolemia.
B) dehydration.
C) volume overload.
D) liver damage.

Question 10

The most important assessment parameters for evaluating the patient's fluid status is to measure

A) daily weights.
B) urine and serum osmolality.
C) intake and output.
D) hemoglobin and hematocrit levels.

Question 11

A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The patient urinalysis has a specific gravity of 1.040.What could be the potential cause for this value?

A) Volume overload
B) Volume deficit
C) Acidosis
D) Urine ketones

Question 12

The patient complains of a metallic taste and loss of appetite.The nurse is concerned that the patient has developed

A) glycosuria.
B) proteinuria.
C) myoglobin.
D) uremia.

Question 13

Which of the following assessment findings would indicate fluid volume excess?

A) Venous filling of the hand veins greater than 5 seconds
B) Distended neck veins in the supine position
C) Presence of orthostatic hypotension
D) Third heart sound

Question 14

Which of the following may be present in the patient with significant fluid volume overload?

A) S₃ or S₄ may develop.
B) Distention of the hand veins will disappear if the hand is elevated.
C) When testing the quality of skin turgor, the skin will not return to the normal position for several seconds.
D) Tachycardia with hypotension may be present.
E) Dependent edema may be present.

Question 15

Which of the following parameters is indicative of volume overload?

A) Central venous pressure of 4 mm Hg
B) Pulmonary artery occlusion pressure (PAOP) of 18 mm Hg
C) Cardiac index of 2.5 L/min/m2
D) Mean arterial pressure of 40 mm Hg

Question 16

Which of the following auscultatory parameters may exist in the presence of hypovolemia?

A) Hypertension
B) Third or fourth heart sound
C) Orthostatic hypotension
D) Vascular bruit

Question 17

As serum osmolality rises, intravascular fluid equilibrium will be maintained by the release of

A) ketones.
B) glucagon.
C) antidiuretic hormone.
D) potassium.

Question 18

A patient is admitted to the critical care unit in congestive heart failure secondary to renal insufficiency.The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites.A diagnosis of renal failure is made.The patient weight upon admission was 176 lb.The patient's weight the next day is 184 lb.What is the approximate amount of fluid retained with this weight gain?

A) 800 mL
B) 2200 mL
C) 3600 mL
D) 8000 mL

Question 19

Which of the following urine values reflects a decreased ability of the kidneys to concentrate urine?

A) pH of 5.0
B) Specific gravity of 1.000
C) No casts
D) Urine sodium of 140 mEq/24 hr