Deck 65: Assessment of the Renal/Urinary System

Question 1

A nurse obtains a sterile urine specimen from a client's Foley catheter.After applying a clamp to the drainage tubing distal to the injection port,which action should the nurse take next?

A) Clamp another section of the tube to create a fixed sample section for retrieval.
B) Insert a syringe into the injection port and aspirate the quantity of urine required.
C) Clean the injection port cap of the drainage tubing with povidone-iodine solution.
D) Withdraw 10 mL of urine and discard it; then withdraw a fresh sample of urine.

Answer 1

Clean the injection port cap of the drainage tubing with povidone-iodine solution.

Question 2

A nurse reviews the allergy list of a client who is scheduled for an intravenous urography.Which client allergy should alert the nurse to urgently contact the health care provider?

A) Seafood
B) Penicillin
C) Bee stings
D) Red food dye

Answer 2

Seafood

Question 3

A nurse reviews a client's laboratory results.Which results from the client's urinalysis should the nurse identify as normal? (Select all that apply.)

A) pH: 6
B) Specific gravity: 1.015
C) Protein: 1.2 mg/dL
D) Glucose: negative
E) Nitrate: small

Answer 3

pH: 6
Specific gravity: 1.015
Glucose: negative

Question 4

A nurse assesses clients on the medical-surgical unit.Which clients are at risk for kidney problems? (Select all that apply.)

A) A 24-year-old pregnant woman prescribed prenatal vitamins
B) A 32-year-old bodybuilder taking synthetic creatine supplements
C) A 56-year-old who is taking metformin for diabetes mellitus
D) A 68-year-old taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic back pain
E) A 75-year-old with chronic obstructive pulmonary disease (COPD) who is prescribed an albuterol nebulizer

Question 5

A nurse cares for a client who has elevated levels of antidiuretic hormone (ADH).Which disorder should the nurse identify as a trigger for the release of this hormone?

A) Pneumonia
B) Dehydration
C) Renal failure
D) Edema

Question 6

A nurse teaches a client who is recovering from a urography.Which instruction should the nurse include in this client's discharge teaching?

A) "Avoid direct contact with your urine for 24 hours until the radioisotope clears."
B) "You may have some dribbling of urine for several weeks after this procedure."
C) "Be sure to drink at least 3 liters of fluids today to help eliminate the dye faster."
D) "Your skin may become slightly yellow from the dye used in this procedure."

Question 7

A nurse cares for a client who is recovering from a closed percutaneous kidney biopsy.The client states,"My pain has suddenly increased from a 3 to a 10 on a scale of 0 to 10." Which action should the nurse take first?

A) Reposition the client on the operative side.
B) Administer the prescribed opioid analgesic.
C) Assess the pulse rate and blood pressure.
D) Examine the color of the client's urine.

Question 8

A nurse reviews the health history of a client with an oversecretion of renin.Which disorder should the nurse correlate with this assessment finding?

A) Alzheimer's disease
B) Hypertension
C) Diabetes mellitus
D) Viral hepatitis

Question 9

A nurse reviews a female client's laboratory results.Which results from the client's urinalysis should the nurse recognize as abnormal?

A) pH 5.6
B) Ketone bodies present
C) Specific gravity of 1.020
D) Clear and yellow color

Question 10

A nurse cares for a client with diabetes mellitus who is prescribed metformin (Glucophage)and is scheduled for an intravenous urography.Which action should the nurse take first?

A) Contact the provider and recommend discontinuing the metformin.
B) Keep the client NPO for at least 6 hours prior to the examination.
C) Check the client's capillary artery blood glucose and administer prescribed insulin.
D) Administer intravenous fluids to dilute and increase the excretion of dye.

Question 11

A nurse assesses a client with renal insufficiency and a low red blood cell count.The client asks,"Is my anemia related to the renal insufficiency?" How should the nurse respond?

A) "Red blood cells produce erythropoietin, which increases blood flow to the kidneys."
B) "Your anemia and renal insufficiency are related to inadequate vitamin D and a loss of bone density."
C) "Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow."
D) "Kidney insufficiency inhibits active transportation of red blood cells throughout the blood."

Question 12

After delegating to an unlicensed assistive personnel (UAP)the task of completing a bladder scan examination for a client,the nurse evaluates the UAP's performance.Which action by the UAP indicates the nurse must provide additional instructions when delegating this task?

A) Selecting the female icon for all female clients and male icon for all male clients
B) Telling the client, "This test measures the amount of urine in your bladder."
C) Applying ultrasound gel to the scanning head and removing it when finished
D) Taking at least two readings using the aiming icon to place the scanning head

Question 13

A nurse contacts the health care provider after reviewing a client's laboratory results and noting a blood urea nitrogen (BUN)of 35 mg/dL and a creatinine of 1.0 mg/dL.For which action should the nurse recommend a prescription?

A) Intravenous fluids
B) Hemodialysis
C) Fluid restriction
D) Urine culture and sensitivity

Question 14

A nurse reviews the urinalysis of a client and notes the presence of glucose.Which action should the nurse take?

A) Document findings and continue to monitor the client.
B) Contact the provider and recommend a 24-hour urine test.
C) Review the client's recent dietary selections.
D) Perform a capillary artery glucose assessment.

Question 15

A nurse cares for a client with a urine specific gravity of 1.040.Which action should the nurse take?

A) Obtain a urine culture and sensitivity.
B) Place the client on restricted fluids.
C) Assess the client's creatinine level.
D) Increase the client's fluid intake.

Question 16

A nurse cares for a client who is having trouble voiding.The client states,"I cannot urinate in public places." How should the nurse respond?

A) "I will turn on the faucet in the bathroom to help stimulate your urination."
B) "I can recommend a prescription for a diuretic to improve your urine output."
C) "I'll move you to a room with a private bathroom to increase your comfort."
D) "I will close the curtain to provide you with as much privacy as possible."

Question 17

A nurse reviews the urinalysis results of a client and notes a urine osmolality of 1200 mOsm/L.Which action should the nurse take?

A) Contact the provider and recommend a low-sodium diet.
B) Prepare to administer an intravenous diuretic.
C) Obtain a suction device and implement seizure precautions.
D) Encourage the client to drink more fluids.

Question 18

A nurse cares for a client with an increased blood urea nitrogen (BUN)/creatinine ratio.Which action should the nurse take first?

A) Assess the client's dietary habits.
B) Inquire about the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
C) Hold the client's metformin (Glucophage).
D) Contact the health care provider immediately.

Question 19

A nurse cares for a client with a urine specific gravity of 1.018.Which action should the nurse take?

A) Evaluate the client's intake and output for the past 24 hours.
B) Document the finding in the chart and continue to monitor.
C) Obtain a specimen for a urine culture and sensitivity.
D) Encourage the client to drink more fluids, especially water.

Question 20

A nurse reviews laboratory results for a client who was admitted for a myocardial infarction and cardiogenic shock 2 days ago.Which laboratory test result should the nurse expect to find?

A) Blood urea nitrogen (BUN) of 52 mg/dL
B) Creatinine of 2.3 mg/dL
C) BUN of 10 mg/dL
D) BUN/creatinine ratio of 8:1

Question 21

A nurse plans care for an older adult client.Which interventions should the nurse include in this client's plan of care to promote kidney health? (Select all that apply.)

A) Ensure adequate fluid intake.
B) Leave the bathroom light on at night.
C) Encourage use of the toilet every 6 hours.
D) Delegate bladder training instructions to the unlicensed assistive personnel (UAP).
E) Provide thorough perineal care after each voiding.
F) Assess for urinary retention and urinary tract infection.

Question 22

A nurse assesses a client recovering from a cystoscopy.Which assessment findings should alert the nurse to urgently contact the health care provider? (Select all that apply.)

A) Decrease in urine output
B) Tolerating oral fluids
C) Prescription for metformin
D) Blood clots present in the urine
E) Burning sensation when urinating

Question 23

A nurse prepares a client for a percutaneous kidney biopsy.Which actions should the nurse take prior to this procedure? (Select all that apply.)

A) Keep the client NPO for 4 to 6 hours.
B) Obtain coagulation study results.
C) Maintain strict bedrest in a supine position.
D) Assess for blood in the client's urine.
E) Administer antihypertensive medications.