Question 1

A 65-year-old female comes into the clinic to be seen for urinary incontinence. What may this symptom indicate?

Accepted Answer

Urinary incontinence can indicate a variety of underlying issues such as weak pelvic muscles, urinary tract infections, neurological disorders, hormonal changes, and more. It is important to evaluate the individual to determine the cause and develop a treatment plan.

Question 2

A person with renal failure is demonstrating signs of an altered blood pH. Which of the following kidney functions aids in the maintenance of normal blood pH?

Accepted Answer

Tubular secretion is the kidney function that aids in maintaining normal blood pH. This is because the kidneys secrete hydrogen ions (H+) and reabsorb bicarbonate ions (HCO3-) in the renal tubules, thereby regulating blood pH balance. In renal failure, this function may be compromised, leading to an altered blood pH.

Question 3

An older adult female is demonstrating signs of bladder dysfunction. Which of the following are characteristics of age-related bladder changes? Select all that apply.

Accepted Answer

Age-related bladder changes can lead to decreased bladder capacity and decreased muscle tone, which can result in large amounts of residual urine and an increase in nocturia. Decreased blood flow and an increased risk of glycosuria are less commonly associated with bladder dysfunction in older adults.

Question 4

A person is admitted with possible renal calculi. Which diagnostic test might this person undergo?

Accepted Answer

Intravenous pyelogram is the most appropriate diagnostic test for the possible identification of renal calculi. It is a radiographic test that uses injected dye to assess the function of the urinary system, and is especially useful in locating urinary tract obstruction and detecting renal calculi.

Question 5

A person is admitted with an infection of the ureters. The nurse realises that this infection could not include which of the following structures of the kidney?

Accepted Answer

The ureters are tubes that carry urine from the kidneys to the bladder, and do not involve the internal structures of the kidneys. Therefore, the infection of the ureters would not include the pelvis or any of the internal structures of the kidney such as nephrons, medulla, or renal columns.

Question 6

A person is unable to provide a urine specimen for culture. Which of the following can be done to obtain this sterile specimen?

Accepted Answer

Catheterization is the most reliable way to obtain a sterile urine specimen when the person is unable to provide one on their own. It involves inserting a sterile tube (catheter) through the urethra into the bladder to collect the urine sample. Other options, such as waiting or drinking water, may not guarantee a sterile specimen. Waiting too long may result in bacterial growth in the urinary tract, while drinking water may dilute the urine and make it more difficult to detect any bacteria present. Instructing the person to obtain the specimen the next morning also poses the same risks as waiting. Therefore, catheterization is the safest and most effective option.

Question 7

A person is voiding large amounts of highly diluted urine. The nurse realises the dilution or concentration of urine is determined by which of the following?

Accepted Answer

The action of aldosterone plays a critical role in determining the concentration of urine. Aldosterone is a hormone produced by the adrenal glands that regulates the reabsorption of sodium and water in the kidneys, which directly affects the concentration of urine. When aldosterone levels are high, more sodium and water are reabsorbed, leading to more concentrated urine. Conversely, when aldosterone levels are low, less sodium and water are reabsorbed, leading to more dilute urine.

Question 8

During the assessment of a person with multiple injuries, the nurse notices a large haematoma located at the left costovertebral angle. Which additional body system should this nurse assess?

Accepted Answer

A haematoma located at the left costovertebral angle may indicate an injury to the kidney or renal system, thus the nurse should assess the renal system for any signs of damage or impairment.

Question 9

Upon a routine urinalysis, a person is found to have +3 ketones in the urine. Which of the following should be done following this finding?

Accepted Answer

+3 ketones in the urine can indicate diabetic ketoacidosis, which is a complication of diabetes mellitus. Therefore, it is important to suggest testing for diabetes mellitus.

Question 10

A person is participating in rehabilitation for bladder retraining. Which of the following bladder layers houses the detrusor muscle?

Accepted Answer

The muscle layer houses the detrusor muscle, which is responsible for bladder contractions. The fibrous outer layer provides structural support, the inner epithelial mucosa lines the bladder, and the connective tissue mucosa connects the epithelial lining to the muscle layer.

Question 11

A person experienced a temporary reduction of oxygen. The nurse realises that this drop in oxygen level will have which impact on the person's renal functioning?

Accepted Answer

A drop in oxygen levels is often associated with hypoxia, resulting in increased erythropoietin secretion, which stimulates the production of red blood cells in the bone marrow. This has no direct impact on sodium, urine production, or calcium and phosphate reabsorption.

Question 12

The nurse is studying the process of net filtration pressure within the kidney. Which of the following forces create net filtration pressure?

Accepted Answer

The net filtration pressure within the kidney is created by the difference between hydrostatic pressure and osmotic pressure. The hydrostatic pressure is created by the pressure of blood within the glomerular capillaries, while the osmotic pressure is created by the concentration of solutes in the blood. The permeability of the filtration membrane and the surface area for filtration are important factors in the filtration process, but do not directly create net filtration pressure. Glomerular filtration rate is a measure of the amount of filtrate produced by the kidneys per unit of time, and is also not a direct factor in creating net filtration pressure.

Question 13

The nurse is collecting a sample of a person's urine for composite analysis. Which of the following is the largest component of urine, by weight?

Accepted Answer

Urea is the largest component of urine by weight, making up about 50% of the total weight of urine. Glucose, sodium, and magnesium are also present in urine, but in smaller amounts.

Question 14

The nurse is able to percuss a dull tone over a person's bladder. What is this finding suggestive of?

Accepted Answer

Percussion of a dull tone over the bladder suggests urinary retention, which is a condition where the bladder is unable to completely empty itself. This can be caused by several factors such as prostate enlargement, urethral obstruction, neurogenic bladder or medication side effects.

Question 15

The nurse is preparing to catheterise a person after the person has just independently voided. What is the purpose of this catheterisation? To:

Accepted Answer

The purpose of catheterisation after a person has just voided is to evaluate for residual urine, which can help detect urinary retention or incomplete bladder emptying.

Question 16

During the assessment of a person's renal system, the nurse is unable to palpate the kidneys. What is this finding indicative of?

Accepted Answer

The inability to palpate the kidneys during a renal assessment is typically a normal finding. The kidneys are often difficult to palpate due to their location deep within the abdomen and their relatively small size. Inability to palpate the kidneys does not necessarily indicate any specific kidney disease or condition.

Question 17

During the assessment of a person's urinary system, the nurse learns that the person has painful urination. How should this finding be documented? As:

Accepted Answer

Dysuria refers to painful or difficult urination, which is the description given in the scenario. Pyuria refers to the presence of pus in the urine, polyuria refers to excessive urine production, and anuria refers to the absence of urine production.

Question 18

After stating the need to 'go to the bathroom', a person voids 450 ml of urine. What is this person's urine output considered to be?

Accepted Answer

The person's urine output of 450 ml is within the normal range of 400-600 ml for a single voiding. Therefore, the best choice is B, normal.

Question 19

While auscultating a person's renal arteries, the nurse hears a 'whooshing' sound. What might this finding be indicative of?

Accepted Answer

The 'whooshing' sound heard while auscultating the renal arteries is known as a renal artery bruit and is indicative of renal artery stenosis, which is a narrowing of the renal artery. The narrowed artery disrupts blood flow to the kidney and can result in high blood pressure, kidney damage, or even kidney failure. Renal artery vasodilation would not cause a 'whooshing' sound, while acute and end-stage renal failure would have different clinical manifestations.

Question 20

A person is experiencing a sudden decrease in systemic blood pressure. Which of the following will occur within the kidney to help control this blood pressure drop?

Accepted Answer

When systemic blood pressure drops, juxtaglomerular cells within the kidney release the enzyme renin. Renin activates the renin-angiotensin-aldosterone system (RAAS), which helps to increase blood pressure by constricting blood vessels and retaining sodium and water within the body. The other options are not correct. A decrease in blood pressure would actually decrease the GFR, renal arteries would constrict to redirect blood to other organs, and an increase in osmotic pressure would have no effect on systemic blood pressure.

Quiz 25: A Person-Centred Approach to Assessing the Renal System