Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

130--Test 6 Laura's deck > Iggy Ch 68 SG - assessment of the Renal/urinary System > Flashcards

Iggy Ch 68 SG - assessment of the Renal/urinary System Flashcards

1
Q

_______________: also known as vasopressin

A

antidiuretic hormone (ADH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

______________: series of specialized capillary loops.

A

glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

___________________: Acts on distal tubule and collecting duct to increase sodium and water excretion

A

prostaglandin E2 (PGE2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

__________: needed to absorb calcium in the intestinal tract and to regulate calcium balance.

A

Vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

__________:small hormone that dilates the afferent arteriole and increases capillary membrane permeability to some solutes.

A

bradykinin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A patient has sustained a minor kidney injury. Which structure must remain functional in order for urine to be removed from the blood?

a. Medulla
b. Nephron
c. Caylx
d. Capsule

A

b.

Nephron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blood flows in to the ______and through these specialized capillaries, water and small particles are filtered from the blood to make urine.

A

glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Renin is a hormone that helps regulate which functions? (select all that apply)

a. blood flow
b. production of platelets
c. glomerular filtration rate (GFR)
d. Heart rate
e. Blood pressure

A

A,C,E

a. blood flow
c. glomerular filtration rate (GFR)
e. blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What substance increases kidney reabsorption of sodium and water?

a. bradykinins
b. aldosterone
c. antidiuretic hormone
d. renin

A

b. aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

___________________:is a hormone produced by the kidney parenchyma that stimulates the one marrow to make red blood cells.

A

erytropoietin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which hormone is released from the posterior pituitary and makes the distal convoluted tubule and the collecting duct permeable to water to maximize reabsorption and produce a concentrated urine?

a. aldosterone
b. vasopressin
c. bradykinins
d. natriuetic

A

b. vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Based on knowledge of the normal function of the kidney, which large particles are not found in the urine because they are too large to filter through the glomerular capillary walls? (select all that apply)

a. Blood cells
b. albumin
c. other proteins
d. electrolytes
e. water

A

A,B & C

a. Blood cells
b. albumin
c. other proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the average urine output of a healthy adult for a 24-hour period?

a. 500 mL to 1000 mL per day
b. 1500 mL to 2000 mL per day
c. 3000 mL to 5000 mL per day
d. 5000 mL to 7000 mL per day

A

B.

b. 1500 mL to 2000 mL per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Kidney function, in particular the GFR, is compromised when the systolic blood pressure drops below what reading?

a. 50 mm Hg
b. 70 mm Hg
c. 80 mm Hg
d. 100 mm Hg

A

B

b. 70 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Damage to which renal structure or tissue can change the actual production of urine?

a. Kidney parenchyma
b. . Convoluted tubules
c. Calyces
d. Ureters

A

B

b.. Convoluted tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A patient has been immobilized for several days after a motor vehicle accident. The nurse encourages ambulation to stimulate the movement of urine through the ureter by what phenomenon?

a. peristalsis
b. gravity
c. pelvic pressure
d. backflow

A

a. peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which renal change associated with aging does the nurse expect an older adult patient to report?

a. Nocturnal polyuria
b. Micturition
c. Hermaturia
d. Dysuria

A

a. Nocturnal polyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

An older adult male patient has a history of an enlarged prostate. the patient is lost likely to report which symptom associated with this condition.

a. inability to sense the urge to void.
b. difficulty starting the urine stream
c. excreating large amounts of very dilute urine.
d. frequent leakage of small amounts of urine.

A

b. difficulty starting the urine stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Impairment in the thirst mechanism associated with aging makes an older adult patient more vulnerable to which disorder?

a. hypovolemia
b. hypocalcemia
c. hypokalemia
d. hyponatremia

A

a. hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

the nurse is talking to a group of older women about changes in the urinary system related to aging. what symptom is likely to be the common concern for this group?

a. incontinence
b. hematuria
c. retention
d. dysuria

A

a. incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

the most important roles of the kidneys are to maintain body fluid ______ and ________, and to filter _______ products for elimination

A

Volume
composition’
Waste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The kidneys help to regulate blood pressure and __________ balance.

A

Acid-base

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The kidneys have a rich blood supply and receive _____% to _________% of the total cardiac output.

A

20% to 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal GFR averages _____ mL/min

A

125 mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

GFR is controlled by blood _____ and blood ________.

A

pressure

flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

___________ increases tubular permeability to water, allowing water to leave the tube ad be reabsorbed into the capillaries

A

(ADH) antidiuretic hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where sodium goes, ________follows.

A

water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

During water reabsorption. the membrane of the distal convoluted tubule is more permerable to water due to the influence of ___________.

A

(ADH) antidiuretic hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The primary function of the proxmal convoluted tubule is _________ of water and electrolytes.

A

reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The nurse is taking a history on a 55-year-old patient who denies any serious chronic health problems. Which sudden-onset sign/symptom suggests possible kidney disease in this patient?

a. weakness
b. hypertension
c. confusion
d. dysrhythmia

A

b. hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which patient narrative describes the symptom of dysuria?

a. “I have to pee all the time.”
b. “I have to wait before the pee starts.”
c. “It burns when I pee.”
d. “It feels like I’m going to pee in my pants.”

A

c. “It burns when I pee.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

The nurse and nutritionist are evaluating the diet and nutritional therapies for a patient with kidney problems. Blood urea nitrogen (BUN) levels for this patient are being tracked because of the direct relationship to the intake and metabolism of which substance?

a. lipids
b. carbohydrates
c. protein
d. fluids

A

c. protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The nurse is taking a history on a patient with a change in urinary patterns. In addition to the medical and surgical history, what does the nurse ask the patient about to complete the assessment? (select all that apply)

a. occupational exposure to toxins
b. use of illicit substances, such as cocaine
c. financial resources for payment of treatments
d. religious beliefs about urination
e. potential exposure to sexually transmitted disease.

A

a. occupational exposure to toxins
b. use of illicit substances, such as cocaine
e. potential exposure to sexually transmitted disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

The nurse is determining whether a patient has a history of hypertension because of the potential of hypertension because of the potential for kidney problems. which question is best to elicit this information?

a. “do you have high blood pressure?”
b. “do you take any blood pressure medications?”
c. Have you ever been told that your blood pressure was high?”
d. “when was the last time you had your blood pressure checked?”

A

c. Have you ever been told that your blood pressure was high?”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

A patient appears very uncomfortable with the nurse’s questions about urinary infections and patterns. What is the best technique for the nurse to use to elicit relevant information and decrease the patient’s discomfort?

a. defer the questions until a later time.
b. direct the questions toward a family member.
c. use anatomic or medical terminology.
d. Use the patient’s own terminology.

A

d. Use the patient’s own terminology.

36
Q

The nurse is taking a nutritional history on a patient. The patient states, “ I really don’t drink as much water as I should.” What is the nurse’s best response?

a. “ we should probably all drink more water than we do.”
b. “It’s an easy thing to forget; just try to remember to drink more.”
c. “what would encourage you to drink the recommended 3 liters per days?”
d. “I’d like you to read this brochure about kidney health and fluids.”

A

c. “what would encourage you to drink the recommended 3 liters per days?”

37
Q

When patients have problems with the kidneys or urinary tract, what is the most common symptom that prompts them to seek medical attention?

a. change in the frequency or mount of urination.
b. pain in flank or abdomen or pain when urinating.
c. Noticing a change in the color or odor of the urine.
d. Exposure to nephrotoxic substance

A

b. pain in flank or abdomen or pain when urinating.

38
Q

Which ethnic group has the highest risk for end-stage kidney disease secondary to diabetes mellitus and hypertension?

a. Caucasian americans
b. African americans
c. Asian americans
d. native americans

A

b. African Americans

39
Q

which over the counter product used by a patient does the nurse explore further for potential impact on kidney function?

a. peroxide containing mouthwash
b. milk of magnesia laxative
c. Vitamin c
d. NSAIDs

A

d. NSAIDs

40
Q

The nurse is performing an assessment on the renal system. what is the first step in the assessment process?

a. percuss the lower abdomen; continue toward umbilicus.
b. Observe the flank region for asymmetry or discoloration.
c. Listen for bruit over each renal artery.
d. lightly palpate the abdomen in all quadrants.

A

b. Observe the flank region for asymmetry or discoloration.

41
Q

the nurse is auscultating the renal artery and hears bruit. What does this finding indicate?

a. Acute kidney injury
b. Renal artery stenosis
c. Renal artery aneurysm
d. Renal tumor

A

b. Renal artery stenosis

42
Q

A patient has anorexia, nausea, and vomiting, muscle cramping, and prutitus. how does the nurse interpret these findings?

a. Oliguria
b. Azotemia
c. Anuria
d. Uremia

A

d. Uremia

43
Q

A pt is diagnosed with renal artery stenosis. which sound does the nurse expect to hear by auscultation when a bruit is present in the renal artery?

a. Quite, pulsating sound
b. swishing sound.
c. Faint wheezing
d. No sound at all.

A

b. swishing sound.

44
Q

Which volume of urine does the nurse expect to find documented for a pt who is oliguric?

a. Between 100 and 400 mL in 24 hours
b. Greater that 2000 mL in 24 hours
c. Less than 100 mL in 24 hours
d. greater than 400 mL during the night.

A

a. Between 100 and 400 mL in 24 hours

45
Q

the nurse is assessing a pt for bladder distension. what technique does the nurse use?

a. Gently palpate for the outline of the bladder, percuss the lower abd, continue toward the umbilicus until dull sounds are no longer produced.
b. Gently palpate for the outline of the bladder, auscultate for sounds in the lower abdomen.
c. place one hand under the back and palpate with the other hand over the bladder, percuss the lower abd until tympanic sounds are no longer heard.
d. Use the hand to depress the bladder as the pt takes a deep breath, then percuss

A

a. Gently palpate for the outline of the bladder, percuss the lower abd, continue toward the umbilicus until dull sounds are no longer produced.

46
Q

A pt report flank pain or tenderness. What technique does the nurse use to assess for costovertebral tenderness?

a. percuss the non-tender flank and assess for rebound.
b. thump the CVA area with the flat surface of the hand.
c. Thump the CVA area with a clenched fist.
d. Place one hand flat over the CVA area, thump with the other fist.

A

d. Place one hand flat over the CVA area, thump with the other fist.

47
Q

the nurse is preparing to assess a female pt’s urethra prior to the insertion of a Foley Catheter. In addition to sterile gloves, which equipment does the nurse obtain to perform the initial assessment?

a. Glass slide
b. Good light source
c. speculum
d. cotton swab

A

b. Good light source

48
Q

A female pt who has been running 3 to 4 times per week for the past 2 weeks is being seen for a routine physical. Urinalysis results reveal a protein level of >0.8 mg/dL and a white blood cell count of 4 per high powered field. what might be the cause of these findings?

a. UTI
b. hepatic or biliary disease
c. kidney infection
d. strenuous exercise

A

d. strenuous exercise

49
Q

Keytones in the urine may indicate which occurrence or process? (select all that apply)

a. incomplete metabolism of fatty acids
b. increased glomerular membrane permeability
c. kidney disease
d. Body’s use of fat instead of glucose for cellular energy.
e. UTI

A

a. incomplete metabolism of fatty acids

d. Body’s use of fat instead of glucose for cellular energy.

50
Q

_________: less than 7 acidic, greater than 7 alkaline

A

pH

51
Q

_______: only identified by microscopic examination for protein.

A

Microalbuminuria

52
Q

_____: structure found around cell. bacteria, protein , and clumps.

A

Cast

53
Q

_____: urine is normally sterile; these multiply and grow.

A

bacteria

54
Q

_____: urochrome pigment

A

Color

55
Q

_____:1.005 to 1.030

A

specific gravity

56
Q

_____: not normally in the urine

A

protein

57
Q

______: cells, casts, crystals, and bacteria

A

sediment

58
Q

_____: various salts.

A

crystals

59
Q

______: epithelial cells, RBC, WBC, tubular cells

A

cells

60
Q

_____: not seen in the urine until blood sugar above 220 mg/dL

A

glucose

61
Q

_______: cloudiness or haziness

A

turbidity

62
Q

_____: faint ammonia

A

odor

63
Q

the nurse is caring for a pt with dehydration. which laboratory test results does the nurse anticipate to see for this pt?

a. BUN and creatinine ratio stay the same.
b. Bun rises faster that the creatinine level.
c. creatinine rises faster that BUN.
d. Bun and creatinine have a direct relationship.

A

b. Bun rises faster that the creatinine level.

64
Q

What does the BUN test measure?

a. Kidney excretion of urea nitrogen
b. GFR
c. creatinine clearance
d. urine output

A

a. Kidney excretion of urea nitrogen

65
Q

Which pt is most likely to have a decreased calcium level?

a. pt w/ nephritis.
b. pt w/ cystitis
c. pt w/ a Foley catheter
d. pt w/ urinary retention

A

a. pt w/ nephritis.

66
Q

the nurse performs a dipstick urine stest for a pt being evaluated for kidney problems. Glucose present in the urine. how does the nurse interpret this result?

a. Blood glucose level is greater that 220 mg/dL
b. the kidneys are failing to filter any glucose.
c. the pt is at risk for hypoglycemia
d. the renal threshold has not been exceeded.

A

a. Blood glucose level is greater that 220 mg/dL

67
Q

In addition to kidney disease, which pt condition causes the BUN to rise above the normal range?

a. anemia
b. Asthma
c. Infection
d. malnutrition

A

c. infection

68
Q

the community health nurse is taking to a group of African American adults about renal health.the nurse encourages the participants to have which type of yearly examination to screen for kidney problems?

a. kidney ultrasound
b. serum creatinine and blood urea nitrogen.
c. urinalysis and microalbuminuria
d. 24 hours urine collection

A

c. urinalysis and microalbuminuria

69
Q

Which test in the best indicator of kidney function?

a. Urine osmolarity
b. serum creatinine
c. Urine pH
d. Color of urine

A

b. serum creatinine

70
Q

In relation to kidney problems, what does an increase in the ratio of BUN to serum creatinine indicate?

a. Highly suggestive of kidney dysfunction
b. definitive for kidney dysfunction
c. Suggest nonkidney factors causing an elevation in BUN.
d. suggest nonkidney factors causing an elevation in serum creatinine

A

c. Suggest nonkidney factors causing an elevation in BUN.

71
Q

Which urine characteristic listed on a urinalysis report arouses the nurse’s suspicion of a problem in the urinary tract?

a. Cloudiness
b. straw color
c. ammonia odor
d. one cast per high powered field

A

a. Cloudiness

72
Q

A patient has urinalysis ordered. when is the best time for the nurse to collect the specimen?

a. in the evening
b. after a meal
c. in the morning
d. after a fluid bolus

A

c. in the morning

73
Q

During the day, the nursing student is measuring urine output and observing for urine characteristics in a patient. Which abnormal finding in the urine is the most urgent finding that must be reported to the supervising nurse?

a. specific gravity is decreased
b. output is decreased
c. pH is decreased
d. color has changed.

A

b. output is decreased

74
Q

a 24 hour urine specimen is required from a patient. Which strategy is best to ensure that all the urine is collected for the full 24 hour period?

a. instruct the unlicensed assistive personnel (UAP) to collect all the urine.
b. put a bedpan or commode next to the bed as a reminder.
c. Place a sign in the bathroom reminding the patient to save the urine.
d. verbally remind the patient about the test.

A

c. Place a sign in the bathroom reminding the patient to save the urine.

75
Q

place the steps of using a bedside bladder scanner in the correct order using the numbers 1 through 8.

a. Select the male or female icon on the bladder scanner.
b. Aim the scan head towards the expected location of the bladder.
c. Place the probe midline about 1.5 inches (4cm) above the pubic bone.
d. Explain the purpose and what sensations to expect.
e. listen for the sound of a beep and a volume display.
f. place the ultrasound probe with gel right above the symphysis pubis.
g. press and release the scan button
h. repeat for best accuracy.

A 
1 = d
2 = a
3 = f
4 = c
5 = b
6 = g
7 = e
8 = h
76
Q

A patient is scheduled for an IV urography. Which medications is discontinued at the time of the procedure and for at least 48 hours until kidney function has been re-evaluated.

a. Glucophage (metformin)
b. diphenhydramine (benadryl)
c. prednisone (deltasone)
d. acetycysteine (mucomyst)

A

a. Glucophage (metformin)

77
Q

Several patients are scheduled for testing to diagnose potential kidney problems. Which test requires a patient to have a urinary catheter inserted before the test?

a. IV urography
b. Computed tomography
c. cystography
d. kidney scan

A

c. cystography

78
Q

A patient has had an IV urography. What is included in the postprocedural care for this patient?

a. bowel cleansing with laxatives
b. IV or oral fluid hydration
c. administration of captopril (capoten)
d. Insertion of a urinary catheter

A

b. IV or oral fluid hydration

79
Q

Which diagnostic test incorporates contrast dye, but does not place a patient at risk for nephrotoxicity?

a. IV urography
b. renal angiography
c. voiding cystourethrogram
d. Computed tomography

A

c. voiding cystourethrogram

80
Q

The nurse is reviewing the results of a pt’s ultrasound of the kidney. the report reveals an enlarged kidney which suggest which possible problem?

a. polycystic kidney
b. kidney infection
c. renal carcinoma
d. chronic kidney disease

A

a.polycystic kidney

81
Q

A pt returns to the unit after a kidney scan. which instruction about the pt’s urine does the nurse give to the UAP caring for the pt?

a. it is radioactive, so it should be handled w/ special biohazard precautions.
b. it does not place anyone at risk because of the small amount of radioactive material.
c. its radioactivity is dangerous only to those who are pregnant.
d. It is potentially dangerous if allowed to sit for prolonged periods in the commode.

A

b. it does not place anyone at risk because of the small amount of radioactive material.

82
Q

The nurse is alerted by the radiology dept that a pt had a “captopril renal scan” What does the nurse monitor for when the pt returns from the procedure.

a. cardiac dysrhythmias
b. urine discoloration
c. signs of dehydration
d. orthostatic hypotension

A

d. orthostatic hypotension

83
Q

the nurse is teaching a pt scheduled for an ultrasonography. What preprocedural instruction does the nurse give the pt?

a. Void just before the test begins
b. dink a lot of water.
c. stop routine medications
d. complete a bowel preparation

A

b. dink a lot of water.

84
Q

a pt had a cystoscopy. after the procedure, what does the nurse expect to see in this pt?

a. pink-tinged urine
b. bloody urine
c. very dilute urine
d. decreased urine output

A

a. pink-tinged urine

85
Q

a pt is scheduled for retograde urethrography. Postprocedural care is similar to postprocedural care given for which test?

a. ultrasonography
b. computed tomography
c. IV urography
d. cystoscopy

A

c. IV urography

86
Q

a pt has undergone a kidney biopsy. what does the nurse monitor for in the pt related to this procedure?

a. nephrotoxicity
b. hemorrhage
c. urinary retention
d. hypertension

A

b. hemorrhage

87
Q

a ot has undergone a kidney biopsy. In the immediate pstprocedural period, the nurse notifies the health care provider about which findings? (select all that apply)

a. Hematuria
b. localized pain at the site
c. “tamponade effect”
d. Decreasing urine output
e. flank pain
f. decreasing blood pressure

A

a,d,e,f

a. Hematuria
d. Decreasing urine output
e. flank pain
f. decreasing blood pressure

130--Test 6 Laura's deck (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions