Test 2 Ch 50

Question 1

Which hormone from the posterior pituitary gland influences the amount of water that is eliminated with the urine?

a. Pitocin
b. Renin hormone
c. Antidiuretic hormone (ADH)
d. ACTH

Answer 1

c. Antidiuretic hormone (ADH)

Question 2

As the body breaks down protein, nitrogen wastes are broken down into urea, ammonia, and which other product?
a. nitrogen.
b. uric acid.
c. nitrates.
d. creatinine.

Answer 2

d. creatinine

Question 3

Because the kidneys are located in proximity to the vertebrae and are protected by the ribs, their location is referred to by which term?
a. retroperitoneal.
b. diaphragm-vertebral.
c. costovertebral.
d. urachal-peritoneal.

Answer 3

a. retroperitoneal.

Question 4

A home health patient with end-stage renal disease (ESRD) verbalizes feeling helplessness related to this life-altering disease. Which nursing intervention would be most helpful?
a. Ensure restricted protein intake to prevent nitrogenous product accumulation.
b. Include the patient in making the plan of care.
c. Counsel patient about end-of-life provisions.
d. Write out a detailed schedule of health care provider’s appointments.

Answer 4

b. Include the patient in making the plan of care.

Question 5

Which portion of the nephron is involved with filtration?
a. Glomerulus of the Bowman capsule
b. Henle loop
c. Proximal convoluted tubule
d. Distal convoluted tubule

Answer 5

a. Glomerulus of the Bowman capsule

Question 6

When the patient receiving home health services is started on dialysis, the home health nurse refers the patient to a community support group that assists with the adjustments necessary to living with dialysis. Which group offers this service?
a. National Kidney Foundation
b. American Association of Kidney Patients
c. American Red Cross
d. Veterans Administration

Answer 6

b. American Association of Kidney Patients

Question 7

The nurse is aware that as a person ages there is a loss of which mechanism of the kidney due to a decrease in blood supply to the kidneys and loss of nephrons?.
a. filtering
b. reabsorption
c. sterile water
d. concentrating

Answer 7

a. filtering

Question 8

A patient who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP) complains of “spasm-like” pain over his lower abdomen. Which step will be the initial intervention by the nurse?
a. Inform the nurse in charge.
b. Decrease the continuous bladder irrigation flow.
c. Administer the prescribed analgesic.
d. Check the catheter and drainage system for obstruction.

Answer 8

d. Check the catheter and drainage system for obstruction.

Question 9

A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with an ileal conduit. Which aspect is an important nursing intervention of the patient with an ileal conduit?
a. Instructing the patient to report mucus from the stoma
b. Maintaining skin integrity
c. Limiting oral intake to 1000 mL/day
d. Limiting acid-ash foods

Answer 9

b. Maintaining skin integrity

Question 10

It is 2 days after a 42-year-old male patient’s urinary diversion surgery. He continues to be critical of the hospital and the nursing care, even though the staff has spent time explaining the care to him. Which explanation is most likely for his behavior?
a. He is angry about hospital policy.
b. He is feeling neglected by the nursing staff.
c. He is in denial of the effects of the surgery.
d. He is reacting to the loss of self-esteem and altered body image.

Answer 10

d. He is reacting to the loss of self-esteem and altered body image.

Question 11

Which aspect of self care wil lthe nurse encourage, barring any other contraindication, when teaching a patient how to decrease the chance of further problems with urolithiasis?
a. Increase his fluid intake.
b. Increase intake of dairy products.
c. Restrict his protein intake.
d. Take one baby aspirin daily.

Answer 11

a. Increase his fluid intake.

Question 12

The nurse notes the amount and color of the urine the patient with urolithiasis has voided. While using Standard Precautions, which action will be the nurse’s next action?
a. Discard the urine.
b. Add the urine to a 24-hour collector.
c. Send the urine to the laboratory.
d. Strain the urine.

Answer 12

d. Strain the urine.

Question 13

The nurse assessing a patient who is taking furosemide finds an irregular pulse. This is likely a sign of which disorder?
a. hypomagnesemia.
b. hypernatremia.
c. hypokalemia.
d. hypercalcemia.

Answer 13

c. hypokalemia.

Question 14

The patient with nephrosis questions the need for bed rest. How would the nurse explain the benefit of bed rest?
a. The recumbent position may initiate diuresis.
b. It preserves the skin integrity.
c. It lowers the level of albuminuria.
d. It saves stress on joints.

Answer 14

a. The recumbent position may initiate diuresis.

Question 15

In which way will the nurse instruct the patient to do before obtaining the urine specimen for a urine culture?
a. Collect the urine for a 24-hour period.
b. Obtain a clean-catch specimen.
c. Bring in an early morning specimen.
d. Limit fluid intake to concentrate the urine.

Answer 15

b. Obtain a clean-catch specimen.

Question 16

The patient is scheduled for a transurethral resection of the prostate. During preoperative teaching, which aspect will the nurse emphasize about what the patient can expect after the procedure?
a. Red drainage from the catheter
b. Limited intake of fluids
c. A sodium-restricted diet
d. Incisional drainage

Answer 16

a. Red drainage from the catheter

Question 17

A male patient, age 71, is recovering from a trans-urethral prostatic resection (TURP). The health care provider requests removal of the indwelling catheter 2 days after the TURP procedure. Which occurrence might the patient experience after the catheter is removed?
a. Burning on urination
b. Passing of blood clots in the urine
c. Dribbling of urine
d. Coffee-colored urine

Answer 17

c. Dribbling of urine

Question 18

A patient, age 69, is admitted to the hospital with gross hematuria and history of a 20-lb weight loss during the last 3 months. The health care provider suspects renal cancer. When assisting with data collection from this patient, the nurse recognizes which risk factor as significant for renal cancer?
a. High caffeine intake
b. Cigarette smoking
c. Use of artificial sweeteners
d. Chronic cystitis

Answer 18

b. Cigarette smoking

Question 19

As the nurse and the dietitian review a female patient’s diet plan with her, she shouts that with her diabetes and now the kidney failure, there is just nothing she can eat. She says she might as well eat what she wants, because there is nothing she can do to help herself. Based on the patient’s response, which patient problem does the nurse identify?
a. The patient will not likely follow a prescribed diet due to anger.
b. The patient does not understand the diet, and will likely have poor nutrition.
c. The patient is in the grieving process, due to the probability she will die soon.
d. The patient is feeling unable to cope, and feels helpless over having diabetes and
kidney failure.

Answer 19

d. The patient is feeling unable to cope, and feels helpless over having diabetes and
kidney failure.

Question 20

The patient is on postoperative day 1 after having undergone a Transurethral resection of the prostate (TURP) procedure. He has continuous bladder irrigation (CBI). Actual urine output during continuous bladder irrigation in which manner?
a. measuring and recording all fluid output in the drainage bag.
b. measuring the total output and deducting the total of the irrigating and intravenous solutions.
c. adding the total of the intravenous and irrigating solutions and then deducting the amount of output.
d. measuring total output and deducting the amount of irrigating solution used.

Answer 20

d. measuring total output and deducting the amount of irrigating solution used.

Question 21

A patient has nephrotic syndrome. Which statement made by the patient indicates understanding of the necessary diet modifications?
a. “I will need to increase protein and decrease sodium intake.”
b. “I will need to drink more milk to get my calcium.”
c. “Carbohydrate restriction will be difficult.”
d. “Potassium restriction won’t be hard since I don’t like fruit.”

Answer 21

a. “I will need to increase protein and decrease sodium intake.”

Question 22

Which type of diet will the patient be encouraged to eat during the active phase of acute renal failure?
a. A diet high in sodium
b. A diet high in potassium
c. A diet high in carbohydrates
d. A diet high in fluid sources

Answer 22

c. A diet high in carbohydrates

Question 23

The patient has end-stage renal disease (ESRD) and is admitted to the hospital with a blood urea nitrogen (BUN) level of 48 mg/dL. An excessive elevation of BUN could cause which problem?
a. dehydration.
b. disorientation.
c. edema.
d. catabolism.

Answer 23

b. disorientation.

Question 24

An intravenous pyelogram confirms the presence of a large renal calculus in the proximal left ureter of a newly admitted patient. The patient is not a candidate for conservative measures, so surgical correction is recommended. In addition to observing the patient for hemorrhage, which aspect of care will be the nurse’s postsurgical interventions included for this patient?
a. Encouraging fluid intake
b. Addressing anxiety related to unclear outcome of condition
c. Monitoring the patient for signs of prostatic hypertrophy
d. Recommending appropriate oral analgesics to the health care provider

Answer 24

a. Encouraging fluid intake

Question 25

A patient is receiving chlorothiazide a thiazide diuretic for hypertension. Which nursing action is important for prevention of complications?
a. Measure output.
b. Increase fluid intake.
c. Assess for hypokalemia.
d. Assess for hypernatremia.

Answer 25

c. Assess for hypokalemia.

Question 26

A patient with cystitis is receiving phenazopyridine for pain and is voiding a bright red-orange urine. Which action will the nurse take?
a. Report this immediately.
b. Explain to the patient that this is normal.
c. Increase fluid intake.
d. Collect a specimen.

Answer 26

b. Explain to the patient that this is normal.

Question 27

The patient, age 43, has cancer of the urinary bladder The patient has received a cystectomy with an ileal conduit. Which characteristics would be considered normal for the patient’s urine?
a. Hematuria
b. Clear amber with mucus
c. Dark bile-colored
d. Dark amber

Answer 27

b. Clear amber with mucus

Question 28

A patient, age 78, has been admitted to the hospital with dehydration and electrolyte imbalance. The patient is confused and incontinent of urine on admission. Which nursing intervention does the nurse expect to see in the plan of care?
a. Restrict fluids after the evening meal.
b. Insert an indwelling catheter.
c. Assist the patient to the bathroom every 6 hours.
d. Apply absorbent incontinence pads.

Answer 28

d. Apply absorbent incontinence pads.

Question 29

The home health nurse suggests the use of complementary and alternative therapies to prevent and/or treat urinary tract infections (UTIs). Which liquid is an example of such therapies?
a. Grape juice
b. Caffeine
c. Tea
d. Cranberry juice

Answer 29

d. Cranberry juice

Question 30

Which action can reduce the risk of skin impairment secondary to urinary incontinence?
a. Decreasing fluid intake
b. Catheterization of the older adult patient
c. Limiting the use of medication (diuretics, etc.)
d. Frequent toileting and meticulous skin care

Answer 30

d. Frequent toileting and meticulous skin care

Question 31

Why are pediatric patients, especially girls, susceptible to urinary tract infections?
a. Genetically females have a weaker immune system.
b. Females have a short and proximal urethra in relation to the vagina.
c. Girls are more sexually active than males.
d. Girls have a weakened musculature and sphincter tone.

Answer 31

b. Females have a short and proximal urethra in relation to the vagina.

Question 32

Which foods will the home health nurse counsel patients with hypokalemia to include in their diet?
a. Bananas, oranges, cantaloupe
b. Carrots, summer squash, green beans
c. Apples, pineapple, watermelon
d. Winter squash, cauliflower, lettuce

Answer 32

a. Bananas, oranges, cantaloupe

Question 33

To help a patient control incontinence, which food item will the nurse recommend the patient avoid?
a. Spicy foods
b. Citrus fruits
c. Organ meats
d. Shellfish

Answer 33

a. Spicy foods

Question 34

The nurse will counsel the young man with chronic prostatitis to avoid which action?
a. Cessation of intercourse
b. Taking warm baths
c. Using stool softeners
d. Continuing antibiotics when symptoms abate

Answer 34

a. Cessation of intercourse

Question 35

Which step is the second step of blood flow in order of flow through the nephron?
a. Reabsorption in loop of Henle
b. Efferent arteriole
c. Filtration in the glomerulus
d. Reabsorption in proximal convoluted tubule
e. Afferent arteriole
f. Secretion in the distal convoluted tubule

Answer 35

c. Filtration in the glomerulus

Question 36

multiple response

The nurse reassures the patient recovering from acute glomerulonephritis that after all other signs and symptoms of the disease subside, which change in the urine is normal? (Select all that apply.)
a. proteinuria.
b. oliguria. c. hematuria. d. anasarca. e. oliguria.

Answer 36

A, C

Question 37

multiple response

Why is a urinary disorder common in older adults? (Select all that apply.)
a. Older adults have weakened musculature in the bladder and urethra.
b. Older adults have urinary stasis.
c. Older adults have increased bladder capacity.
d. Older adults have diminished neurologic sensation.
e. The effects of medications such as diuretics that many older adults take

Answer 37

A, B, D, E

Question 38

Which sign is indicative of fluid overload in the patient with chronic glomerulonephritis ? (Select all that apply.)
a. Increase in blood pressure
b. Increase in daily weight
c. Clear lung sounds
d. Edema
e. Labored respirations

Answer 38

A, B, D, E

Question 39

The nurse is reviewing the urinalysis report on an assigned patient. The nurse recognizes which finding to be normal? (Select all that apply.)
a. Turbidity clear
b. pH 6.0
c. Glucose negative
d. Red blood cells, 15 to 20
e. White blood cells

Answer 39

A, C