Nokea
A nurse knows that specific areas in the ureters have a propensity for obstruction. Prompt management of renal calculi is most important when the stone is located where?
- A. In the ureteropelvic junction
- B. In the ureteral segment near the sacroiliac junction
- C. In the ureterovesical junction
- D. In the urethra
Correct Answer: A
Rationale: The three narrowed areas of each ureter are the ureteropelvic junction, the ureteral segment near the sacroiliac junction, and the ureterovescial junction. These three areas of the ureters have a propensity for obstruction by renal calculi or stricture. Obstruction of the ureteropelvic junction is most serious because of its close proximity to the kidney and the risk of associated kidney dysfunction. The urethra is not part of the ureter.
You may also like to solve these questions
The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse interprets the presence of which substances in the urine as most suggestive of pathology?
- A. Potassium and sodium
- B. Bicarbonate and urea
- C. Glucose and protein
- D. Creatinine and chloride
Correct Answer: C
Rationale: The various substances normally filtered by the glomerulus, reabsorbed by the tubules, and excreted in the urine include sodium, chloride, bicarbonate, potassium, glucose, urea, creatinine, and uric acid. Within the tubule, some of these substances are selectively reabsorbed into the blood. Glucose is completely reabsorbed in the tubule and normally does not appear in the urine. However, glucose is found in the urine if the amount of glucose in the blood and glomerular filtrate exceeds the amount that the tubules are able to reabsorb. Protein molecules are also generally not found in the urine because amino acids are also filtered at the level of the glomerulus and reabsorbed so that it is not excreted in the urine.
The nurse is caring for a patient who had a brush biopsy 12 hours ago. The presence of what assessment finding should prompt the nurse to notify the physician?
- A. Scant hematuria
- B. Renal colic
- C. Temperature100.2 \mathrm{~F}$ orally
- D. Infiltration of the patients intravenous catheter
Correct Answer: C
Rationale: Hematuria and renal colic are common and expected findings after the performance of a renal brush biopsy. The physician should be notified of the patients body temperature, which likely indicates the onset of an infectious process. IV infiltration does not warrant notification of the primary care physician.
A kidney biopsy has been scheduled for a patient with a history of acute renal failure. The patient asks the nurse why this test has been scheduled. What is the nurses best response?
- A. A biopsy is routinely ordered for all patients with renal disorders.
- B. A biopsy is generally ordered following abnormalx$-ray findings of the renal pelvis.
- C. A biopsy is often ordered for patients before they have a kidney transplant.
- D. A biopsy is sometimes necessary for diagnosing and evaluating the extent of kidney disease.
Correct Answer: D
Rationale: Biopsy of the kidney is used in diagnosing and evaluating the extent of kidney disease. Indications for biopsy include unexplained acute renal failure, persistent proteinuria or hematuria, transplant rejection, and glomerulopathies.
A patient with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value?
- A. Hematocrit
- B. Hemoglobin
- C. Erythrocyte sedimentation rate (ESR)
- D. Serum creatinine
Correct Answer: B
Rationale: Although historically hematocrit has been the blood test of choice when assessing a patient for anemia, use of the hemoglobin level rather than hematocrit is currently recommended, because that measurement is a better assessment of the oxygen transport ability of the blood. ESR and creatinine levels are not indicative of oxygen transport ability.
The nurse is caring for a patient with a nursing diagnosis of deficient fluid volume. The nurses assessment reveals a BP of98 / 52 \mathrm{~mm} \mathrm{Hg}$. The nurse should recognize that the patients kidneys will compensate by secreting what substance?
- A. Antidiuretic hormone (ADH)
- B. Aldosterone
- C. Renin
- D. Angiotensin
Correct Answer: C
Rationale: When the vasa recta detect a decrease in BP, specialized juxtaglomerular cells near the afferent arteriole, distal tubule, and efferent arteriole secrete the hormone renin. Renin converts angiotensinogen to angiotensin I, which is then converted to angiotensin II. The vasoconstriction causes the BP to increase. The adrenal cortex secretes aldosterone in response to stimulation by the pituitary gland, which in turn is in response to poor perfusion or increasing serum osmolality. The result is an increase in BP.