Nokea
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.
You may also like to solve these questions
A nurse knows that specific areas in the ureters have a propensity for obstruction. Prompt management of renal calculi is most important when the stone is located where?
- A. In the ureteropelvic junction
- B. In the ureteral segment near the sacroiliac junction
- C. In the ureterovesical junction
- D. In the urethra
Correct Answer: A
Rationale: The three narrowed areas of each ureter are the ureteropelvic junction, the ureteral segment near the sacroiliac junction, and the ureterovescial junction. These three areas of the ureters have a propensity for obstruction by renal calculi or stricture. Obstruction of the ureteropelvic junction is most serious because of its close proximity to the kidney and the risk of associated kidney dysfunction. The urethra is not part of the ureter.
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.
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.
The staff educator is giving a class for a group of nurses new to the renal unit. The educator is discussing renal biopsies. In what patient would the educator tell the new nurses that renal biopsies are contraindicated?
- A. A 64-year-old patient with chronic glomerulonephritis
- B. A 57-year-old patient with proteinuria
- C. A 42-year-old patient with morbid obesity
- D. A 16-year-old patient with signs of kidney transplant rejection
Correct Answer: C
Rationale: There are several contraindications to a kidney biopsy, including bleeding tendencies, uncontrolled hypertension, a solitary kidney, and morbid obesity. Indications for a renal biopsy include unexplained acute renal failure, persistent proteinuria or hematuria, transplant rejection, and glomerulopathies.
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.