Deck 25: Kidney Clinical Assessment and Diagnostic Procedures

Question 1

A patient was admitted with heart failure.The nurse is assessing the patient for peripheral edema.The nurse presses two fingers over the tibial area,and it takes 1 minute before the indention disappears.What would the nurse note in the medical record?

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

Answer 1

+3 pitting edema

Question 2

A patient is admitted with renal failure.The patient's weight upon admission was 176 lb,and the next day it 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

Answer 2

3600 mL

Question 3

A patient has been on complete bed rest for 3 days.The practitioner has left orders to get the patient out of bed for meals.The patient complains of feeling dizzy and faint while sitting at the bedside.The nurse suspects that the patient is experiencing what problem?

A) Orthostatic hypertension
B) Orthostatic hypotension
C) Hypervolemia
D) Electrolyte imbalance

Answer 3

Orthostatic hypotension

Question 4

A patient was admitted with multiple trauma who has been volume resuscitated.The nurse suspects the patient is fluid overloaded.Which assessment findings would confirm the nurse's suspicion?

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) Presence of a third heart sound

Question 5

A patient is admitted in acute 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.The nurse suspects the main cause of ascites is what condition?

A) Hypervolemia
B) Dehydration
C) Volume overload
D) Liver damage

Question 6

Percussion of kidneys is usually done to assess what parameter?

A) Size and shape of the kidneys
B) Presence of pain in the renal area
C) Presence of a fluid wave
D) Patient's overall fluid status

Question 7

What causes the presence of myoglobin in urine?

A) Bleeding
B) Traumatic damage to the skeletal muscle
C) Asthmatic attack
D) Rhabdomyolysis
E) Cocaine abuse

Question 8

A patient has been admitted with acute kidney injury.The nurse knows the most important consideration for evaluating the patient's fluid status is what parameter?

A) Daily weights
B) Urine and serum osmolality
C) Intake and output
D) Hemoglobin and hematocrit levels

Question 9

When calculating the anion gap,what is the predominant cation?

A) Sodium
B) Potassium
C) Chloride
D) Bicarbonate

Question 10

A patient was admitted with acute heart failure a few days ago.Today the patient's urine 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 11

A patient has been admitted in acute heart failure.Which parameter would indicate to the nurse that the patient is fluid overloaded?

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 12

A patient was admitted with acute heart failure who has been receiving diuretic therapy.The nurse suspects the patient is hypovolemic.What auscultatory parameter would confirm the nurse's suspicion?

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

Question 13

Which findings 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 14

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

A) Ketones
B) Glucagon
C) Antidiuretic hormone
D) Potassium

Question 15

A patient was admitted with acute kidney failure.Which urinalysis value 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 h

Question 16

Loss of albumin from the vascular space may result in which condition?

A) Peripheral edema
B) Extra heart sounds
C) Hypertension
D) Hyponatremia

Question 17

A patient is admitted in acute 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.Which diagnostic tests would provide 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 18

In a patient with a distended abdomen,differentiating ascites from solid bowel contents is accomplished by performing what assessment?

A) Auscultation of bowel sounds
B) Palpation of the liver margin
C) Measuring abdominal girth
D) Eliciting a fluid wave

Question 19

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

A) Glycosuria
B) Proteinuria
C) Myoglobin
D) Uremia

Question 20

A patient is admitted in acute 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 which laboratory results?

A) Blood urea nitrogen (BUN)
B) Creatinine
C) Glucose
D) Hemoglobin and hematocrit
E) Protein