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The nurse has received morning lab work on a client with chronic renal disease. Which finding indicates renal disease?
- A. Urine pH of 6.5
- B. Urine nitrate: negative
- C. Protein level of 400 mg/dL
- D. Specific gravity: 1.0.2
Correct Answer: C
Rationale: The nurse must analyze components of a urinalysis to determine abnormal results. Protein at a level of 400 mg/dL is high and indicates renal disease. The other results are normal.
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During the physical examination of a client, the nurse monitors for signs that may indicate a urinary tract disorder. Which of the following would suggest that the client may have a urinary tract disorder?
- A. Light-headedness
- B. Malaise
- C. Periorbital edema
- D. Flank pain
Correct Answer: C
Rationale: Periorbital edema, among other signs, such as edema of the extremities, cardiac failure, and mental changes may indicate a urinary tract disorder. Light-headedness and flank pain may suggest urinary bleeding. Malaise is a sign of systemic infection. Flank pain and malaise could occur after a biopsy, and if they occur, the physician is to be notified immediately.
The nurse is caring for a client who has a history of urine reflux. To assess the client for this urinary complication, which nursing action is best?
- A. Ask the client if voiding sufficient quantities has been a problem.
- B. Monitor the client's intake and output for inconsistency.
- C. Have the client void into a collection device.
- D. Palpate the client's bladder for distension.
Correct Answer: D
Rationale: Normally, urine flows in one direction because of peristaltic action and because the ureters enter the bladder at an oblique angle. The reflux of urine (urine that flows backward) can occur secondary to a distended bladder. By palpating for bladder distension, the nurse is able to determine that reflux urine traveled back to the bladder instead of traveling from the bladder down the urethra. All of the other options provide data that can be helpful, but actually feeling for the distension is best. Using a bladder scanner would also provide an amount of urine in the bladder.
The nurse is caring for a client about to undergo urologic testing. Which nursing action is best to comfort the client?
- A. Reassure the client the nurses are here to help and all will be fine.
- B. Allow for client's family to be present during testing.
- C. Provide for privacy and allow verbalization of concerns.
- D. Allow the client to determine the care to be provided.
Correct Answer: C
Rationale: Clients undergoing diagnostic testing are often anxious and worried. Clients having urologic testing may also feel embarrassed. Telling the client that all will be well dismisses the client's concerns. Provide privacy, reassurance, and information and maintain professional and empathic attitude. Allowing families to be present during testing and the client to determine care is not appropriate and may be distracting to the client.
The nurse is caring for a client who is admitted to the nursing unit for a biopsy of the urinary tract tissue. When planning nursing care for the postoperative period, which nursing intervention documents the prescribed activity level?
- A. Maintain the client on bedrest
- B. Assist the client for bathroom privileges
- C. Ambulate the client in the hall
- D. Activity as tolerated
Correct Answer: A
Rationale: Following a urinary tract biopsy, the client is typically maintained on bedrest to minimize the risk of bleeding, given the high vascularity of the renal system. Assisting with bathroom privileges, ambulating in the hall, or allowing activity as tolerated may increase the risk of complications such as bleeding and are not typically prescribed immediately post-procedure.
A client has a full bladder. Which sound would the nurse expect to hear on percussion?
- A. Tympany
- B. Dullness
- C. Resonance
- D. Flatness
Correct Answer: B
Rationale: Dullness on percussion indicates a full bladder; tympany indicates an empty bladder. Resonance is heard over areas that are part air and part solid, such as the lungs. Flatness is heard over very dense tissue, such as the bone or muscle.