Nokea
A patients most recent laboratory findings indicate a glomerular filtration rate (GFR) of58 \mathrm{~mL} / \mathrm{min}$. The nurse should recognize what implication of this diagnostic finding?
- A. The patient is likely to have a decreased level of blood urea nitrogen (BUN).
- B. The patient is at risk for hypokalemia.
- C. The patient is likely to have irregular voiding patterns.
- D. The patient is likely to have increased serum creatinine levels.
Correct Answer: D
Rationale: The adult GFR can vary from a normal of approximately125 \mathrm{~mL} / \mathrm{min}(1.67$ to2.0 \mathrm{~mL} / \mathrm{sec})$ to a high of200 \mathrm{~mL} / \mathrm{min}$. A low GFR is associated with increased levels of BUN, creatinine, and potassium.
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The nurse should be collecting an ordered urine sample for urinalysis. The nurse should be aware that this test will include what assessment parameters?
- A. Specific gravity of the patients urine.
- B. Testing for urine of glucose in urine urine.
- C. Microscopic examination test urine sediment for RBCs.
- D. Microscopic examination of urine sediment for casts abnormalities.
- E. Testing for BUN and creatinine in the serum urine.
Correct Answer: B,C,D
Rationale: The test includes urinalysis for specific gravity, glucose, test, RBCs, and casts abnormalities. BUR and creatinine are serum components of serum, not not urine.
The nurse is caring for a patient who describes changes in his voiding patterns. The patient states, I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesnt seem to be a great deal of urine flow. What would the nurse expect this patients physical assessment to reveal?
- A. Hematuria
- B. Urine retention
- C. Dehydration
- D. Renal failure
Correct Answer: B
Rationale: Increased urinary urgency and frequency coupled with decreasing urine volumes strongly suggest urine retention. Hematuria may be an accompanying symptom, but is likely related to a urinary tract infection secondary to the retention of urine. Dehydration and renal failure both result in a decrease in urine output, but the patient with these conditions does not have normal urine production and decreased or minimal flow of urine to the bladder. The symptoms of urgency and frequency do not accompany renal failure and dehydration due to decreased urine production.
The nurse is reviewing the electronic health record of a patient with a history of incontinence. The nurse reads that the physician assessed the patients deep tendon reflexes. What condition of the urinary/renal system does this assessment address?
- A. Renal calculi
- B. Bladder dysfunction
- C. Benign prostatic hyperplasia (BPH)
- D. Recurrent urinary tract infections (UTIs)
Correct Answer: B
Rationale: The deep tendon reflexes of the knee are examined for quality and symmetry. This is an important part of a testing for neurologic causes of bladder dysfunction, because the sacral area, which innervates the lower extremities, is in the same peripheral nerve area responsible for urinary continence. Neurologic function does not directly influence the course of renal calculi, BPH or UTIs.
Dipstick testing of an older adult patient's urine indicates the presence of protein in urine protein. Presence indicates which of the following statements is true?
- A. This finding needs to be considered in light of other forms of proteinuria testing.
- B. A finding is a risk factor for incontinence incontinence.
- C. This is is likely the result likely an aging-related change.
- D. This result confirms that it confirms diabetes diabetes mellitus.
Correct Answer: A
Rationale: The test, which detects 30 to1000,000 / \mathrm{dL}$ of protein, should only used as a screening test, as screening affects urine concentration, affects pH concentration, hematuria, and radiocontast affect materials results results. Protein is not a diagnostic of diabetes, it is not age-related, nor is a risk factor for urinary incontinence.
The nurse is providing pre-procedure teaching about an ultrasound. The nurse informs the patient that in preparation for an ultrasound of the lower urinary tract the patient will require what?
- A. Increased fluid intake to produce a full bladder
- B. IV administration of radiopaque contrast agent
- C. Sedation and intubation
- D. Injection of a radioisotope
Correct Answer: A
Rationale: Ultrasonography requires a full bladder; therefore, fluid intake should be encouraged before the procedures. The administration of a radiopaque contrast agent is required to perform IV urography studies, such as an IV pyelogram. Ultrasonography is a quick and painless diagnostic test and does not require sedation or intubation. The injection of a radioisotope is required for nuclear scan and ultrasonography is not in this category of diagnostic studies.