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MED-SURG > RENAL AND URINARY > Flashcards

RENAL AND URINARY Flashcards

1
Q

Situation 1: Reviewing the BASICS: 1. Men have more water in their body 1/1 as compared to women for the reason that:

a. men have more fat tissue
b. women have more muscles
c. women have more fat tissue
d. men have wider body surface area

A

c. women have more fat tissue

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2
Q
  1. The most abundant cations; Intracellular: ________ while Extracellular: ________

a. Na and Cl
b. Cl and PO4
c. PO4 and Mg
d. K and Na

A

d. K and Na

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3
Q

3.The distribution of water from a lesser area of solute concentration to a higher area of solute concentration:

a. Active transport
b. Diffusion
c. Filtration
d. Osmosis

A

d. Osmosis

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4
Q
  1. A cell exposed to a solution with more solvent than solutes will:

a. Shrink
b. Swell
c. Dehydrate
d. Maintain its shape

A

b. Swell

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5
Q

Which among the following mechanisms has an end result of increasing fluid volume?

a. Inactivity of baroreceptors
b. Stimulation of osmoreceptors
c. Inhibition of thirst mechanism
d. Activation of Atrial Natriuretic Peptide Release

A

b. Stimulation of osmoreceptors

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6
Q
  1. Normal Urine Specific Gravity:

a. 200-800 mOsm/kg
b. 1.010-1.025
c. 10-120 mg/dL
d. 0.7-1.4 mg/dL

A

b. 1.010-1.025

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7
Q

A client’s blood chemistry revealed Na level of 150 mEq/dL to prevent cellular dehydration what kind of solution will you anticipate the care provider to order:

a. Expanders
b. Isotonic solution
c. Hypotonic solution
d. Hypertonic solution

A

c. Hypotonic solution

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8
Q

A client is suffering from fluid volume excess. His nurse expects the following signs to be seen in him; SELECT ALL THAT APPLY:

  1. Increased BP
  2. Increased CVP
  3. Increased serum sodium
  4. Tachycardia; bounding pulse
  5. Altered mental status r/t cerebral edema
A
  1. Increased BP
  2. Increased CVP
  3. Tachycardia; bounding pulse
  4. Altered mental status r/t cerebral edema
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9
Q

One of the possible cause of the above condition is:

a. Burns
b. GI suctioning
c. Heart failure
d. Diabetes Insipidus

A

c. Heart failure

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10
Q

Situation 2: A client suspected to have heart failure presented to the 1/1 emergency room with complaints of chest tightness and difficulty of breathing. Upon assessment, the nurse noted a blood pressure of 130/80 and pitting of the skin over the shins of about 6 mm.

Question 10. The nurse grades the edema as:

a. 1+
b. 2+
c. 3+
d. 4+

A

c. 3+

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11
Q
  1. The nurse may anticipate that eventually the client may develop which 1/1 sodium imbalance:

a. Both
b. Hypernatremia
c. Hyponatremia

A

c. Hyponatremia

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12
Q

Situation 3: A body builder, was immediately admitted because of a back injury right after his workout and underwent routine tests including CBC, blood chemistry and urinalysis. There was a delay in the workup of the specimens but eventually were carried out.

Question 12. His blood chemistry result revealed an slight increase in serum potassium level of 6 mEq/L but he doesn’t manifest any of its signs and symptoms.
What could have caused this condition?

a. Quick hemolysis of aged transfused blood
b. Client have sweated too much from the workout
c. Possible hemolysis from the delay of the blood studies
d. Blood was taken from the arm with IV infusion with K+

A

c. Possible hemolysis from the delay of the blood studies

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13
Q
  1. What would the nurse suggests as the best action for the above condition?

a. Retest
b. Administer Kayexalate
c. Increased oral fluid intake
d. Start oral supplementation of K+

A

a. Retest

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14
Q
  1. Another client under the nurse’s care has a potassium level of 6.2 1/1 mEq/L. The nurse anticipates that the doctor will order what possible treatment?

a. Osmotic diuretics
b. Insulin and glucose
c. Sodium bicarbonate
d. Potassium supplement

A

b. Insulin and glucose

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15
Q

Situation 4: A client who just had surgery of the thyroid gland suddenly experienced tingling and spasms of the extremities. His blood test revealed a total calcium level of 7 mg/dL and a potassium level of 3.5mEq/L.

Question 15. The nurse may suspect:

a. Hypercalcemia
b. Hypocalcemia
c. Hyperkalemia
d. Hypokalemia

A

b. Hypocalcemia

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16
Q
  1. Which other findings my support the nurse’s suspicion: SELECT ALL THAT APPLY:
  2. Edema
  3. Muscular spasms
  4. Dysrhythmia
  5. Hyper-reactive deep tendon reflex
  6. Twitching of the face when the cheeks are tapped
A
  1. Muscular spasms
  2. Dysrhythmia
  3. Hyper-reactive deep tendon reflex
  4. Twitching of the face when the cheeks are tapped
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17
Q
  1. The nurse notes positive Trousseau sign if there is:

a. Respiratory arrest due to laryngospasm
b. Hypotension and ventricular dysrhythmias
c. Spasm of the carpals when an inflated BP cuff is applied
d. Contraction of the facial muscles following a tap on the facial nerve

A

c. Spasm of the carpals when an inflated BP cuff is applied

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18
Q

Situation 5: A nurse is assigned to the medical ward and received a 1/1 number of adult patients.

Question 18. A patient is placed on arterial blood gas (ABG) analysis, the trained nurse performs which clearance assessment before extraction:

a. Allen’s test
b. O2 Saturation
c. BP and pulse rate
d. Clotting time and bleeding time
e. Partial thromboplastin time and prothrombin time

A

a. Allen’s test

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19
Q
  1. The nurse is reviewing a 40-year-old client’s arterial blood gas (ABG) result and it revealed the following values: pH of 7.36, PaCO2 of 32mmHg, HCO3 of 17 mEq/dL and PaO2 of 94 mmHg.

The nurse interpreted this as:
a. Partially compensated mix alkalosis
b. Uncompensated metabolic alkalosis
c. Uncompensated respiratory alkalosis
d. Fully compensated metabolic acidosis
e. Fully compensated respiratory acidosis

A

d. Fully compensated metabolic acidosis

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20
Q
  1. The cause of the above condition is possibly?

a. Diarrhea
b. Vomiting
c. Severe anxiety
d. Gastric suctioning

A

a. Diarrhea

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21
Q
  1. The managements for the above condition are the following; EXCEPT:

a. Start PNSS infusion
b. Oral fluid replacement
c. Eliminating sources of Chloride
d. Administration of sodium bicarbonate

A

a. Start PNSS infusion

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22
Q
  1. The nurse receives the ABG values of a 35-year-old patient who has a1/1 chief complaint of shortness of breath and orthopnea.

The result showed the following: pH of 7.30, PaCO2 of 50 mmHg, HCO3 of 26 mEq/dL and PaO2 of 97 mmHg.

The nurse knows that this is:

a. Partially compensated mix alkalosis
b. Uncompensated metabolic alkalosis
c. Uncompensated respiratory acidosis
d. Fully compensated metabolic acidosis
e. Fully compensated respiratory acidosis

A

c. Uncompensated respiratory acidosis

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23
Q
  1. What could be the possible cause of the patient’s ABG result (client from question 22):

a. Anxiety
b. Diarrhea
c. Gastric fistula
d. Pulmonary edema

A

d. Pulmonary edema

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24
Q

24.The possible management for the above condition are the following; SELECT ALL THAT APPLY:

  1. Semi-fowler’s position
  2. Supplemental oxygen per PCP’s orders
  3. Administer Bronchodilator per PCP’s order
  4. Adequate hydration to moisten mucous membrane
A
  1. Semi-fowler’s position
  2. Supplemental oxygen per PCP’s orders
  3. Administer Bronchodilator per PCP’s order
  4. Adequate hydration to moisten mucous membrane
25
Q
  1. A pH of 7.30 mmHg and partial pressure CO2 of 40 mmHg and HCO3 of 17 mEq/dL are the results of a young adult’s ABG analysis. He also has increased ketones during care and is known to have uncontrolled high glucose level for years.
    The nurse interpreted this as:

a. Compensated Respiratory acidosis
b. Uncompensated Respiratory acidosis
c. Compensated Metabolic acidosis
d. Uncompensated Metabolic acidosis

A

d. Uncompensated Metabolic acidosis

26
Q
  1. The client’s condition (from question 25) is possibly caused by:

a. Vomiting
b. Gastric suction
c. Diabetes Mellitus
d. Antacid overdose

A

c. Diabetes Mellitus

27
Q
  1. The nurse may anticipate the primary care provider to order which management for the above condition?

a. IV insulin
b. Fluid replacement
c. Narcotic antagonist
d. Administration of sodium bicarbonate

A

a. IV insulin

28
Q
  1. A tachypneic client’s ABG result showed an abnormal increase in pH 1/1 level and abnormal decrease of partial pressure CO2, the best nursing action for this is:

a. Refer to the doctor right away
b. Ask the client to breathe slowly in a bag
c. Encourage the client to do breathing exercises
d. Adjust room temperature to keep the client cool

A

b. Ask the client to breathe slowly in a bag

29
Q
  1. What are the possible cause/s of the above condition?
  2. Asthma
  3. Anxiety
  4. Chest trauma
  5. Chronic obstructive pulmonary disease
A
  1. Anxiety
30
Q

Situation 6: A nurse in the Kidney Center encountered the following 1/1 clients. Question 30. A fatty mass that holds the kidney in place and acts as a cushion against trauma:

a. Renal cortex
b. Outer renal fascia
c. Inner renal capsule
d. Middle adipose capsule

A

d. Middle adipose capsule

31
Q
  1. A routine urinalysis is ordered for Tina for her employment checkup. If 1/1 a delay for the specimen to be tested would occur, what action should
    the nurse take?

a. Take no special action
b. Refrigerate the specimen
c. Store on “dirty” side of utility room
d. Discard and collect a new specimen later

A

b. Refrigerate the specimen

32
Q
  1. Tina’s urinalysis revealed a pH of 6.0, clear, light yellow, aromatic with 1/1 2 per hpf WBC. The nurse knows that this mean a/an:

a. normal result
b. artifact result
c. abnormal result
d. unremarkable result

A

a. normal result

33
Q
  1. Tina had her follow up checkup and complained of a radiating pain on 0/1 her abdomen that is colicky in nature. The nurse explains to her that most likely she has a problem in her:

a. Bladder
b. Kidneys
c. Ureter
d. Urethra

A

c. Ureter

34
Q
  1. A nurse is interviewing a patient diagnosed with Urinary Tract Infection (UTI). She expects to see which signs and symptoms in his history of present illness. SELECT ALL THAT APPLY
  2. Pyuria
  3. Dysuria
  4. Fever, chills
  5. Loss of appetite
  6. Pain: Flank, one or both sides
A
  1. Pyuria
  2. Dysuria
  3. Fever, chills
  4. Loss of appetite
  5. Pain: Flank, one or both sides
35
Q
  1. A client with UTI is given the prescription to take phenazopyridine hydrochloride (Pyridium). The nurse recall that this is indicated for:

a. Pyuria
b. Oliguria
c. Hyperthermia
d. Discomforts on costo-vertebral angle

A

d. Discomforts on costo-vertebral angle

36
Q
  1. A day status post radical nephrectomy, a client had episodes of urination with urine amounting only to 15 ml/hour.
    The nurse best response to this is to:

a. Continue monitoring
b. Increased IV fluids flow rate
c. Report immediately to the physician
d. Review medications and monitor effects

A

c. Report immediately to the physician

37
Q
  1. What information in a client’s history would support her diagnosis of acute post streptococcal glomerulonephritis (APSGN)?

a. Salty diet
b. History of pharyngitis
c. History of dehydration form sever diarrhea
d. Uncle from mother side with cystic kidney disease

A

b. History of pharyngitis

38
Q
  1. A patient diagnosed with Nephrotic Syndrome, was assigned to a 1/1 nurse who is about to do her initial rounds. Before her rounds she recalls that the most common manifestation of this disorder are;
    SELECT ALL THAT APPLY
  2. Massive edema
  3. Hyperlipidemia
  4. Massive Proteinuria
  5. Severe Hypertension
A
  1. Massive edema
  2. Hyperlipidemia
  3. Massive Proteinuria
39
Q
  1. A patient develops anasarca. The nurse includes the following in her care; EXCEPT:

a. Turn frequently
b. No IM injection
c. Do not use adhesives
d. Use egg crate mattress
e. Apply supportive elastic bandage

A

e. Apply supportive elastic bandage

40
Q
  1. In the Emergency Department the nurse received a patient from a 1/1 vehicular accident. The nurse noticed that he has a massive hematoma
    on the right flank and is showing signs of shock which are: SELECT ALL THAT APPLY
  2. Hypotension
  3. Tachycardia
  4. Tachypnea
  5. Decreased level of consciousness
  6. Cool pale skin
A
  1. Hypotension
  2. Tachycardia
  3. Tachypnea
  4. Decreased level of consciousness
  5. Cool pale skin
41
Q
  1. A patient diagnosed with Chronic Renal Failure manifested anemia, 1/1 edema, pulmonary congestion and GFR of 15-20%. The nurse knows that this means he is in what stage of CRF:

a. Stage I
b. Stage II
c. Stage III
d. Stage IV

A

c. Stage III

42
Q
  1. The patient’s (from question 42) serum potassium is elevated and the nurse administer sodium polysterene sulfonate (Kayexalate).
    This drug acts by:

a. Releasing hydrogen ions for sodium ions.
b. Increasing calcium absorption in the colon.
c. Exchanging sodium for potassium in the colon.
d. Increasing potassium excretion from the colon through binding.

A

d. Increasing potassium excretion from the colon through binding.

43
Q
  1. If the client’s serum potassium continues to rise, a nurse should anticipate to prepare for which of the following emergency situations?

a. Hemorrhage
b. Cardiac arrest
c. Pulmonary edema
d. Circulatory collapse

A

b. Cardiac arrest

44
Q
  1. A patient was placed on hemodialysis therapy. The nurse considers the following care prior to his hemodialysis; EXCEPT:

a. Have client to void
b. Auscultate for bruit
c. Taking BP on the fistula site
d. Assess vital signs before and every 30 minutes during procedure

A

c. Taking BP on the fistula site

45
Q
  1. Which of the following abnormal blood values cannot directly be improve by dialysis treatment?

a. Hyperkalemia
b. Hypernatremia
c. Decreased hemoglobin
d. Elevated serum creatinine

A

c. Decreased hemoglobin

46
Q

47.The nurse started a patient’s first hemodialysis treatment. During the procedure the patient develops headache, confusion and nausea. These findings indicate which of the following potential complications?

a. Peritonitis
b. Air embolism
c. Hyperkalemia
d. Disequilibrium syndrome

A

d. Disequilibrium syndrome

47
Q
  1. A patient is placed on renal replacement therapy and he found a compatible, living relative as a donor. The nurse recalls that the
    requirement for living donors are the following, EXCEPT:

a. Emotional well being is determined
b. Should have been cleared from communicable diseases
c. Must have excellent health with a functioning kidney
d. Should have been screened for ABO, tissue specific antigen, histocompatibility

A

c. Must have excellent health with a functioning kidney

48
Q
  1. To ensure adequate nutritional intake the most appropriate diet plan for a patient with CRF is:

a. Low protein, low potassium
b. High carbohydrate, high protein
c. Low protein, low potassium, low sodium
d. High calcium, high potassium, high protein

A

c. Low protein, low potassium, low sodium

49
Q

Situation 7 (for questions 50-52): A 60-year-old patient, is experiencing gross hematuria, decreased caliber of urine stream and urgency which he came to the clinic for check up. He is suspected to have bladder cancer.

Question 50. Which of the symptoms below is the most common clinical finding associated with bladder cancer?

a. Dysuria
b. Urinary retention
c. Suprapubic pain
d. Painless hematuria

A

d. Painless hematuria

50
Q
  1. The patient (from question 50) underwent cystoscopy to confirm initial findings. Which of the following symptoms would indicate that he has developed a complication after the procedure?

a. Chills
b. Dizziness
c. Bladder spasms
d. Pink-tinged urine

A

a. Chills

51
Q
  1. A urinary diversion was made after confirming bladder cancer and 0/1 the patient tells you, “This can be very embarrassing for me and my family, especially for a very influential person like me.” An appropriate diagnosis for this is:

a. Anxiety related to urinary diversion care.
b. Low-esteem related to feelings of role change.
c. Deficient knowledge about the care of urinary diversion.
d. Disturbed body image related to creation of a urinary diversion

A

b. Low-esteem related to feelings of role change.

52
Q

Situation 8 (for questions 53 to 57): A female patient is admitted with a 1/1 diagnosis of renal calculi. She is experiencing severe sharp flank pain and complains of nausea and vomiting. She is also flushed and with warm
skin and a temperature of 38.5 o C. Question 53.

Which of the following would be a priority goal for this patient?

a. Alleviation of pain
b. Relief from nausea and vomiting
c. Maintenance of fluid and electrolyte
d. Prevention of urinary tract complications

A

a. Alleviation of pain

53
Q
  1. She is scheduled to have kidney, ureter, bladder (KUB) radiograph. Which of the following will be ordered to prepare her for the procedure?

a. An enema will be done prior to examination.
b. A sedative will be administered before the procedure.
c. No special preparation is required for this ordered procedure.
d. Food and fluids will be withheld 8 hours prior to the procedure.

A

c. No special preparation is required for this ordered procedure.

54
Q
  1. The radiograph result conveyed vague findings and the patient is 1/1 scheduled for intravenous pyelogram (IVP) to confirm diagnosis.
    Which of the following responsibilities would be most important for you to observe prior to the procedure?

a. Checking the client’s history for iodine allergy.
b. Encouraging client to increase fluid intake on the day of the test.
c. Checking client’s last voiding and bowel movement prior to the test.
d. Educating the client for possible bladder spasms during the procedure

A

a. Checking the client’s history for iodine allergy.

55
Q
  1. The nurse anticipates which measure to include in her plan of care after an IVP procedure:

a. Maintaining flat on bed order.
b. Administering of pain reliever.
c. Assessing for signs of hematuria.
d. Encouraging client to increase fluid intake.

A

d. Encouraging client to increase fluid intake.

56
Q
  1. The patient undergo surgery which revealed a stone composed of 1/1 calcium, an acid-ash diet was ordered. Choosing which of the following food items at home would indicate that the patient understands the necessary diet changes?

a. Milk, apples, tomatoes and corn.
b. Grapes, poultry, fish, and cranberry
c. Tea, chocolate, spinach and wheat.
d. Liver, brains, kidney, venison, and meat soups

A

b. Grapes, poultry, fish, and cranberry

57
Q

Situation 9: A client is scheduled for his first peritoneal dialysis.
Question58. You explained to him that during peritoneal dialysis the solution has
to be warmed. The primary reason for this is to?

a. Add extra warmth and avoid chills
b. Force electrolytes back to the cells
c. Promote abdominal muscle relaxation.
d. Encourage vasodilation for better removal of serum urea

A

d. Encourage vasodilation for better removal of serum urea

58
Q
  1. During the early outflow phase the nurse observes that the flow of dialysate stops, her best response should be:

a. Have the client walk.
b. Have the client sit on a chair.
c. Turn the client from side to side.
d. Reposition the peritoneal catheter.

A

c. Turn the client from side to side.

59
Q
  1. When asked what best indicates peritoneal infection in peritoneal dialysis, you know that the patient fully understood the health teaching if he would answer:

a. Swelling of legs.
b. Cloudy dialysate flow.
c. Redness at the catheter site.
d. Poor drainage during inflow and outflow.

A

b. Cloudy dialysate flow.

MED-SURG (4 decks)

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