Nokea
One of your patients is awaiting laboratory results for kidney function. The patient has recently recovered from a streptococcal throat infection. The patient has most likely developed symptoms of:
- A. Pyelonephritis.
- B. Nephrolithiasis.
- C. Chronic renal failure.
- D. Glomerulonephritis.
Correct Answer: D
Rationale: The correct answer is D: Glomerulonephritis. Streptococcal infection can lead to poststreptococcal glomerulonephritis (PSGN), an immune-mediated inflammation of the glomeruli in the kidneys. This results in hematuria, proteinuria, hypertension, and edema. Pyelonephritis (choice A) is a bacterial infection of the kidneys, not related to streptococcal infection. Nephrolithiasis (choice B) is the formation of kidney stones, which is not directly linked to streptococcal infection. Chronic renal failure (choice C) is a long-term decline in kidney function, not typically caused by streptococcal infection.
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The nurse has implemented a bladder retraining
- A. Risk for deficient fluid volume related to urinary program for an older adult patient. The nurse places the diversion patient on a timed voiding schedule and performs an
- B. Risk for autonomic dysreflexia related to disruption of ultrasonic bladder scan after each voi
- C. The nurse notes the sacral plexus that the patient typically has approximately 50 mL of urine remaining in her bladder after voiding. What would
Correct Answer: A
Rationale: The correct answer is A because bladder retraining aims to improve urinary control and prevent incontinence in older adults. Implementing a timed voiding schedule helps the patient regain control over their bladder function and reduces the risk of urinary issues. Option B is incorrect as autonomic dysreflexia is not typically associated with bladder retraining. Option C is incorrect as it describes a normal bladder residual volume, which does not directly relate to bladder retraining. Option D is incomplete.
The right atrium myocytes secrete atrial natriuretic peptide (ANP) when there is increased plasma volume. What actions does ANP take to produce a large volume of dilute urine?
- A. Inhibits renin
- B. Increases ADH
- C. Inhibits angiotensin II action
- D. Decreases sodium excretion
Correct Answer: A
Rationale: The correct answer is A: Inhibits renin. ANP inhibits renin release, which leads to decreased aldosterone secretion. This results in decreased reabsorption of sodium and water in the kidneys, promoting excretion of sodium and water, ultimately producing a large volume of dilute urine.
Summary:
B: Increases ADH - ANP actually opposes the action of ADH, which promotes water reabsorption in the kidneys.
C: Inhibits angiotensin II action - ANP does inhibit the action of angiotensin II, but this does not directly lead to the production of dilute urine.
D: Decreases sodium excretion - ANP actually increases sodium excretion by inhibiting renin and aldosterone, leading to decreased reabsorption of sodium.
A 62-year-old man states that his physician told him that he has an “inguinal hernia.†He asks the nurse to explain what a hernia is. The nurse should:
- A. Tell him not to worry and that most men his age develop hernias.
- B. Explain that a hernia is often the result of prenatal growth abnormalities.
- C. Refer him to his physician for additional consultation because the physician made the initial diagnosis.
- D. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
Correct Answer: D
Rationale: Step 1: Define hernia as a condition where an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue.
Step 2: Emphasize the relevance to the patient's situation.
Step 3: Clarify that an inguinal hernia specifically involves the intestines protruding through the inguinal canal in the groin area.
Step 4: Explain that surgery may be needed to repair the hernia.
Step 5: Stress the importance of seeking medical attention for proper evaluation and treatment.
Summary:
A: Incorrect - Dismissing the patient's concerns is not appropriate.
B: Incorrect - Hernias are not typically related to prenatal growth abnormalities.
C: Incorrect - The nurse can provide basic information about hernias without needing the physician to explain further.
Which test is required for a diagnosis of pyelonephritis?
- A. Renal biopsy
- B. Blood culture
- C. Intravenous pyelogram (IVP)
- D. Urine for culture and sensitivity
Correct Answer: D
Rationale: The correct answer is D, Urine for culture and sensitivity. This test is required for a diagnosis of pyelonephritis as it helps identify the specific bacteria causing the infection and determines the most effective antibiotic treatment. Renal biopsy (A) is not typically required for diagnosing pyelonephritis. Blood culture (B) may be helpful in severe cases but is not specific for pyelonephritis. Intravenous pyelogram (IVP) (C) is a radiological test used to visualize the urinary tract but does not confirm the diagnosis of pyelonephritis.
Which laboratory result is of most concern for a patient with cystitis?
- A. Serum WBC 9000/mm?
- B. Urinalysis with 1-2 WBCs present
- C. Urine bacteria 100,000 colonies/mL
- D. Serum hematocrit 36%
Correct Answer: C
Rationale: The correct answer is C because a urine bacteria count of 100,000 colonies/mL indicates a significant bacterial infection, which is concerning for cystitis. This result suggests an active infection in the urinary tract, requiring prompt treatment.
A: Serum WBC of 9000/mm³ is within the normal range and may not necessarily indicate an active infection.
B: Urinalysis with 1-2 WBCs present is also within the normal range and may not be indicative of an acute infection.
D: Serum hematocrit of 36% is a measure of the proportion of red blood cells in the blood and is not directly related to cystitis.