Nokea
A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify what as part of the upper urinary tract?
- A. Bladder
- B. Urethra
- C. Ureters
- D. Pelvic floor muscles
Correct Answer: C
Rationale: The upper urinary tract is composed of the kidneys, renal pelvis, and ureters. The lower urinary tract consists of the bladder, urethra, and pelvic floor muscles.
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The nurse is teaching a client about a urologic diagnostic procedure. Which teaching philosophy provides the best manner to present the information to the client?
- A. Stand beside the client and direct all information in the client's direction.
- B. Begin with the information most difficult to understand.
- C. Include humorous pictures to lighten the mood.
- D. Move from general details of the procedure to specifics.
Correct Answer: D
Rationale: Move from the general aspects such as purpose of the procedure to specifics including how the client will assist in the procedure. Doing so provides a foundation of knowledge and proceeds to more specific information. The client is more willing to participate when knowing the rationale. Standing beside the client, particularly if the client is in bed or seated, is a position of power. Humorous pictures do not convey the importance of the procedure or client participation.
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness?
- A. The upper abdominal quadrants on the left and right side
- B. The costovertebral angle
- C. Above the symphysis pubis
- D. Around the umbilicus
Correct Answer: B
Rationale: The nurse is correct to assess the kidneys for tenderness at the costovertebral angle. The other options are incorrect.
The nurse has received morning lab work on a client with chronic renal disease. Which finding indicates renal disease?
- A. Urine pH of 6.5
- B. Urine nitrate: negative
- C. Protein level of 400 mg/dL
- D. Specific gravity: 1.0.2
Correct Answer: C
Rationale: The nurse must analyze components of a urinalysis to determine abnormal results. Protein at a level of 400 mg/dL is high and indicates renal disease. The other results are normal.
The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period?
- A. Encourage voiding following the procedure.
- B. Assess renal blood work.
- C. Assess cognitive status
- D. Complete a pulse assessment of the legs and feet.
Correct Answer: D
Rationale: A renal angiography provides details about the arterial blood supply to the kidney. A catheter is passed up the femoral artery into the aorta in the area of the renal artery. After the procedure, a pressure dressing remains in place for several hours. It is essential that the nurse palpate pulses in the legs and feet at least every 1 to 2 hours for signs of arterial occlusion. Reviewing lab work is completed in the preoperative period. Voiding assessment and cognitive status provide additional data in the post-procedural period. Assessing cognitive status is completed due to the sedative that is administered in the preprocedural period.
The nurse is assisting the physician in completing a cystoscopy. In which position would the nurse place the client when preparing for the procedure?
- A. On the client's back with knees to the side
- B. On the client's back with feet in the stirrups
- C. On the client's right side with a pillow behind the back
- D. On the client's left side with a pillow behind the back
Correct Answer: B
Rationale: The client who is undergoing a cystoscopy will be positioned on the back with the feet in stirrups. The client is also to have an empty bladder and may be sedated for the procedure.