Nokea
Diagnostic testing of an adult patient reveals renal glycosuria. The nurse should recognize the need for the patient to be assessed for what health problem?
- A. Diabetes insipidus
- B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- C. Diabetes mellitus
- D. Renal carcinoma
Correct Answer: C
Rationale: Renal glycosuria can occur on its own as a benign condition. It also occurs in poorly controlled diabetes, the most common condition that causes the blood glucose level to exceed the kidneys reabsorption capacity. Glycosuria is not associated with SIADH, diabetes insipidus, or renal carcinoma.
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A patient is scheduled for a diagnostic MRI of the lower urinary system. What pre-procedure education should the nurse include?
- A. The need to be NPO for 12 hours prior to the test
- B. Relaxation techniques to apply during the test
- C. The need for conscious sedation prior to the test
- D. The need to limit fluid intake to 1 liter in the 24 hours before the test
Correct Answer: B
Rationale: Patient preparation should include teaching relaxation techniques because the patient needs to remain still during an MRI. The patient does not normally need to be NPO or fluid-restricted before the test and conscious sedation is not usually implemented.
A patient with recurrent urinary tract infections has just undergone a cystoscopy and complains of slight hematuria during the first void after the procedure. What is the nurses most appropriate action?
- A. Administer a STAT dose of vitamin\mathrm{K}$, as ordered.
- B. Reassure the patient that this is not unexpected and then monitor the patient for further bleeding.
- C. Promptly inform the physician of this assessment finding.
- D. Position the patient supine and insert a Foley catheter, as ordered.
Correct Answer: B
Rationale: Some burning on voiding, blood-tinged urine, and urinary frequency from trauma to the mucous membranes can be expected after cystoscopy. The nurse should explain this to the patient and ensure that the bleeding resolves. No clear need exists to report this finding and it does not warrant insertion of a Foley catheter or vitamin\mathrm{K}$ administration.
A patient with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acidbase balance?
- A. Sequestering free hydrogen ions in the nephrons
- B. Returning bicarbonate to the bodys circulation
- C. Returning acid to the bodys circulation
- D. Excreting bicarbonate in the urine
Correct Answer: B
Rationale: The kidney performs two major functions to assist in acidbase balance. The first is to reabsorb and return to the bodys circulation any bicarbonate from the urinary filtrate; the second is to excrete acid in the urine. Retaining bicarbonate will counteract an acidotic state. The nephrons do not sequester free hydrogen ions.
The nurse is caring for a patient who has a fluid volume deficit. When evaluating this patients urinalysis results, what should the nurse anticipate?
- A. A fluctuating urine specific gravity
- B. A fixed urine specific gravity
- C. A decreased urine specific gravity
- D. An increased urine specific gravity
Correct Answer: D
Rationale: Urine specific gravity depends largely on hydration status. A decrease in fluid intake will lead to an increase in the urine specific gravity. With high fluid intake, specific gravity decreases. In patients with kidney disease, urine specific gravity does not vary with fluid intake, and the patients urine is said to have a fixed specific gravity.
A geriatric nurse is performing an assessment of body systems on an 85-year-old patient. The nurse should be aware of what age-related change affecting the renal or urinary system?
- A. Increased ability to concentrate urine
- B. Increased bladder capacity
- C. Urinary incontinence
- D. Decreased glomerular filtration rate
Correct Answer: D
Rationale: Many age-related changes in the renal and urinary systems should be taken into consideration when taking a health history of the older adult. One change includes a decreased glomerular surface area resulting in a decreased glomerular filtration rate. Other changes include the decreased ability to concentrate urine and a decreased bladder capacity. It also should be understood that urinary incontinence is not a normal age-related change, but is common in older adults, especially in women because of the loss of pelvic muscle tone.