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A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?
- A. Nephron
- B. Renal pelvis
- C. Parenchyma
- D. Glomerulus
Correct Answer: B
Rationale: The renal pelvis empties into the ureter which carries urine to the bladder for storage. The nephron consists of the glomerulus, afferent arteriole, efferent arteriole, Bowman's capsule, distal and proximal convoluted tubules, the loop of Henle, and collecting tubule. The nephron is located in the cortex and carries out the functions of the kidney. The parenchyma is made up of the cortex and medulla.
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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 is caring for a client who has a history of urine reflux. To assess the client for this urinary complication, which nursing action is best?
- A. Ask the client if voiding sufficient quantities has been a problem.
- B. Monitor the client's intake and output for inconsistency.
- C. Have the client void into a collection device.
- D. Palpate the client's bladder for distension.
Correct Answer: D
Rationale: Normally, urine flows in one direction because of peristaltic action and because the ureters enter the bladder at an oblique angle. The reflux of urine (urine that flows backward) can occur secondary to a distended bladder. By palpating for bladder distension, the nurse is able to determine that reflux urine traveled back to the bladder instead of traveling from the bladder down the urethra. All of the other options provide data that can be helpful, but actually feeling for the distension is best. Using a bladder scanner would also provide an amount of urine in the bladder.
The nurse is caring for a client who is admitted to the nursing unit for a biopsy of the urinary tract tissue. When planning nursing care for the postoperative period, which nursing intervention documents the prescribed activity level?
- A. Maintain the client on bedrest
- B. Assist the client for bathroom privileges
- C. Ambulate the client in the hall
- D. Activity as tolerated
Correct Answer: A
Rationale: Following a urinary tract biopsy, the client is typically maintained on bedrest to minimize the risk of bleeding, given the high vascularity of the renal system. Assisting with bathroom privileges, ambulating in the hall, or allowing activity as tolerated may increase the risk of complications such as bleeding and are not typically prescribed immediately post-procedure.