Nokea
The nurse caring for a patient with suspected renal dysfunction calculates that the patients weight has increased by 5 pounds in the past 24 hours. The nurse estimates that the patient has retained approximately how much fluid?
- A. $1,300 \mathrm{~mL}$ of fluid in 24 hours
- B. $2,300 \mathrm{~mL}$ of fluid in 24 hours
- C. $3,100 \mathrm{~mL}$ of fluid in 24 hours
- D. $5,000 \mathrm{~mL}$ of fluid in 24 hours
Correct Answer: B
Rationale: An increase in body weight commonly accompanies edema. To calculate the approximate weight gain from fluid retention, remember that1 \mathrm{~kg}$ of weight gain equals approximately1,000 \mathrm{~mL}$ of fluid. Five lbs=2.27 \mathrm{~kg}=2,270 \mathrm{~mL}$.
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The nurse is caring for a patient scheduled for renal angiography following a motor vehicle accident. What patient preparation should the nurse most likely provide before this test?
- A. Administration of IV potassium chloride
- B. Administration of a laxative
- C. Administration of Gastrografin
- D. Administration of a 24-hour urine test
Correct Answer: B
Rationale: Before the procedure, a laxative may be prescribed to evacuate the colon so that unobstructedx$-rays can be obtained. A 24-hour urine test is not necessary prior to the procedure. Gastrografin and potassium chloride are not administered prior to renal angiography.
The nurse is performing a focused genitourinary and renal assessment of a patient. Where should the nurse assess for pain at the costovertebral angle?
- A. At the umbilicus and the right lower quadrant of the abdomen
- B. At the suprapubic region and the umbilicus
- C. At the lower border of the 12th rib and the spine
- D. At the 7th rib and the xyphoid process
Correct Answer: C
Rationale: The costovertebral angle is the angle formed by the lower border of the 12th rib and the spine. Renal dysfunction may produce tenderness over the costovertebral angle.
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 asks the nurse why kidney problems can cause gastrointestinal disturbances. What relationship should the nurse describe?
- A. The right kidneys proximity to the pancreas, liver, and gallbladder
- B. The indirect impact of digestive enzymes on renal function
- C. That the peritoneum encapsulates the GI system and the kidneys
- D. The left kidneys connection to the common bile duct
Correct Answer: A
Rationale: The proximity of the right kidney to the colon, duodenum, head of the pancreas, common bile duct, liver, and gallbladder may cause GI disturbances. The proximity of the left kidney to the colon (splenic flexure), stomach, pancreas, and spleen may also result in intestinal symptoms. Digestive enzymes do not affect renal function and the left kidney is not connected to the common bile duct.
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.