Question 1

The nurse reviews the process to obtain a midstream urine specimen for culture and sensitivity with a female patient.Which patient statements indicate understanding of this process? (Select all that apply.)

Accepted Answer

Female patients should be told to separate the labia with one hand and keep it separated while washing with provided towelettes and collecting the specimen to decrease the risk of contamination of the specimen.B.The first morning specimen is best,but collection can occur at any time.E.The container must be sterile for a culture.A.A 24-hour specimen is not needed.C.Women should wash from the front to the back.

Question 2

The nurse is collecting data for a patient who has suspected kidney disease.What health problems should the nurse consider as being associated with a high urine specific gravity? (Select all that apply.)

Accepted Answer

A high specific gravity may occur from diabetes mellitus and high sugar concentrations in the urine,nephrosis,congestive heart failure,and dehydration.E.F.Specific gravity measurements are most likely lower in diabetes insipidus and fluid volume excess.

Question 3

A patient is recovering from a renal arteriogram.What actions should the nurse take when caring for this patient? (Select all that apply.)

Accepted Answer

Patient care following angiography includes bedrest for up to 12 hours to prevent bleeding at the injection site.Pressure dressing is applied,and a sandbag is used to apply pressure.Distal pulses in the leg are checked every 30 to 60 minutes.B.D.The patient is instructed not to bend the leg,and the head of the bed is not raised more than 45 degrees.A.Vital signs,dressing,and pulses in the affected extremity are monitored frequently.

Question 4

The nurse is reviewing data for a patient with acute kidney injury.Which diagnostic test results should the nurse recognize that indicate kidney injury? (Select all that apply.)

Accepted Answer

A serum creatinine level above 1.5 mg/dL means there is kidney dysfunction.The higher the creatinine level,the more impaired the kidney function.A fixed urine specific gravity is also indicative of renal compromise and impending failure.Normal urinary output is 1000 to 2000 mL per 24 hours.Individuals with acute kidney injury experience oliguria (reduced output).A.B.D.These test results are not consistent with a renal injury.

Question 5

The nurse determines that a patient's urine output is normal.How many mL of urine did the patient void within the last 24 hours?

Accepted Answer

Normal urinary output is 1000 to 2000 mL per 24 hours.A.B.C.These volumes represent inadequate amounts of urine output for 24 hours.

Question 6

The nurse is collecting data for a patient with kidney disease.Which information should the nurse identify as being normal urinalysis findings? (Select all that apply.)

Accepted Answer

Straw to amber color,specific gravity 1.002 to 1.028,small quantities of enzymes,and hormones would all indicate a normal analysis finding.A.Normal pH is 4.6 to 8.D.Red blood cells should be 0 to 4/hpf.C.Nitrite is negative.

Question 7

The nurse is caring for a patient with an elevated uric acid level.Which health problems should the nurse consider as potentially causing this patient's elevation? (Select all that apply.)

Accepted Answer

An elevated uric acid level can be caused by kidney disease,malnutrition,leukemia,and use of thiazide diuretics.B.F.Elevated uric acid levels are not associated with steroid use or gastrointestinal bleeding.

Question 8

The nurse is caring for a patient recovering from a renal biopsy.For which complication should the nurse monitor the patient during the 24 hours after the procedure?

Accepted Answer

Grossly bloody urine,falling blood pressure,and rising pulse are signs of bleeding and are reported immediately.A.C.D.Polyuria,infection,and urinary obstruction are not complications typically associated with a renal biopsy.

Question 9

A female patient is embarrassed because of not being able to walk to the bathroom in time before become incontinent of urine.Which type of incontinence should the nurse plan care for this patient?

Accepted Answer

Urge incontinence is the involuntary loss of urine associated with an abrupt and strong desire to void.The patient typically reports being "unable to make it to the bathroom in time." B.Total incontinence is a continuous and unpredictable loss of urine.It usually results from surgery,trauma,or a malformation of the ureter.C.Stress incontinence is the involuntary loss of less than 50 mL of urine associated with increasing abdominal pressure during coughing,sneezing,laughing,or other physical activities.D.Functional incontinence is the inability to reach the toilet because of environmental barriers,physical limitations,loss of memory,or disorientation.

Question 10

During an assessment,the nurse notes that a patient has crystals deposited on the skin.What should this finding indicate to the nurse?

Accepted Answer

The presence of crystals on the skin is called uremic frost and is a late sign of waste products building up in the blood (uremia).When the waste products are not filtered by the kidneys or with treatment,they can come out through the skin and look like a coating of frost in the winter.A.C.D.Crystal deposits on the skin do not indicate gout,poor hygiene,or metabolic alkalosis.

Question 11

The nurse is reviewing normal kidney function with a patient experiencing an acute kidney injury.Which hormones should the nurse include that affect kidney function? (Select all that apply.)

Accepted Answer

Hormones that affect kidney function include aldosterone,which promotes reabsorption of sodium ions from the filtrate to the blood and excretion of potassium ions into the filtrate; ADH,which promotes reabsorption of water from the filtrate to the blood; ANH,which decreases reabsorption of sodium ions,which remain in the filtrate; and parathyroid hormone,which promotes reabsorption of calcium ions from the filtrate to the blood and excretion of phosphate ions into the filtrate.A.F.Estrogen and TSH do not affect renal function.

Question 12

The nurse is catheterizing a patient after voiding to determine the amount of residual urine in the bladder.What should the nurse consider as being the normal amount of urine within the bladder after urination?

Accepted Answer

Normally,the bladder contains less than 50 mL after urination.B.C.D.These represent excessive amounts of residual urine after voiding.

Question 13

The nurse is caring for a patient with an indwelling urinary catheter.Which instructions should the nurse provide to help prevent development of a urinary tract infection? (Select all that apply.)

Accepted Answer

The nurse should instruct to position the tubing to allow free flow of urine,use aseptic technique when emptying the drainage bag,and keep the catheter securely taped or fastened to the leg.A.Fluids should be encouraged.D.The perineum should be washed daily and prn.F.The drainage bag does not need to be emptied every 4 hours.

Question 14

The nurse is contributes to the plan of care for an older patient.What should the nurse recognize as normal signs of aging within the renal system? (Select all that apply.)

Accepted Answer

With age,the number of nephrons in the kidneys decreases,often to half the original number by age 70 or 80.E.The GFR also decreases; this is in part a consequence of arteriosclerosis and diminished renal blood flow.A.The urinary bladder decreases in size.D.The tone of the detrusor muscle decreases.B.The urethra does not change position with aging.

Question 15

The nurse learns that a patient has a urine pH of 7.9.What question should the nurse ask the patient after learning of this laboratory value?

Accepted Answer

The pH range of urine is 4.6 to 8.0,with an average of 6.0.Diet has the greatest influence on urine pH.A vegetarian diet results in more alkaline urine.B.Lactose does not influence urine pH.C.A high-protein diet results in more acidic urine.D.Acetaminophen use does not influence urine pH.

Question 16

The nurse is reviewing the results of a patient's urinalysis.Which components should the nurse identify as being abnormal in urine? (Select all that apply.)

Accepted Answer

Persistent proteinuria is seen with renal disease from damage to the glomerulus.Intermittent protein in the urine can result from strenuous exercise,dehydration,or fever.Protein in the urine is a significant sign of renal problems.Blood in the urine may be caused by infection,stones,cancer,renal disease,or trauma.A.B.D.E.These components are considered normal within urine.

Question 17

The nurse is instructing a patient on the use of Kegel exercises.How many times a day should the nurse recommend that these exercises be performed?

Accepted Answer

The patient should be advised to perform these exercises 30 to 80 times per day.A.B.D.The exercises need to be done more than 30 times a day however not as much as 85 to 100 times a day.

Question 18

A patient recovering from radiological studies of the renal system has a nursing diagnosis of Impaired Urinary Elimination.Which outcome indicates that the nursing interventions have been effective?

Accepted Answer

An expected outcome would be for the patient to maintain a urine output greater than 30 mL per hour in the post-procedure period.B.Cloudy urine could indicate an infection.C.Only 10 mL of red urine could indicate renal failure.D.Urine output should be at least 30 mL/hr.

Question 19

The nurse is caring for a patient with an indwelling catheter.What should the nurse include in this patient's routine care? (Select all that apply.)

Accepted Answer

Routine care should include encourage fluid intake,maintain a closed system,secure the catheter to the patient's leg,and remove the catheter as soon as possible.F.Aseptic technique should be used when emptying the drainage bag.D.The catheter should not routinely be clamped.

Question 20

The nurse is making a visit to the home of a patient with functional incontinence.Which observation indicates that teaching about the disorder has been effective?

Accepted Answer

If clothing is inhibiting timely voiding for the patient with functional incontinence,the patient should be instructed to wear clothing with Velcro fasteners or sweat pants.B.Coffee is a bladder irrigant and could precipitate voiding.C.Elevating the legs is not an action appropriate for functional incontinence.D.Restricting fluids after 6 pm is not an appropriate action for functional incontinence.

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