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The nurse is caring for a patient who had a brush biopsy 12 hours ago. The presence of what assessment finding should prompt the nurse to notify the physician?
- A. Scant hematuria
- B. Renal colic
- C. Temperature100.2 \mathrm{~F}$ orally
- D. Infiltration of the patients intravenous catheter
Correct Answer: C
Rationale: Hematuria and renal colic are common and expected findings after the performance of a renal brush biopsy. The physician should be notified of the patients body temperature, which likely indicates the onset of an infectious process. IV infiltration does not warrant notification of the primary care physician.
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The nurse is caring for a patient who is going to have an open renal biopsy. What would be an important nursing action in preparing this patient for the procedure?
- A. Discuss the patients diagnosis with the family.
- B. Bathe the patient before the procedure with antiseptic skin wash.
- C. Administer antivirals before sending the patient for the procedure.
- D. Keep the patient NPO prior to the procedure.
Correct Answer: D
Rationale: Preparation for an open biopsy is similar to that for any major abdominal surgery. When preparing the patient for an open biopsy you would keep the patient NPO. You may discuss the diagnosis with the family, but that is not a preparation for the procedure. A pre-procedure wash is not normally ordered and antivirals are not administered in anticipation of a biopsy.
The nurse is reviewing the electronic health record of a patient with a history of incontinence. The nurse reads that the physician assessed the patients deep tendon reflexes. What condition of the urinary/renal system does this assessment address?
- A. Renal calculi
- B. Bladder dysfunction
- C. Benign prostatic hyperplasia (BPH)
- D. Recurrent urinary tract infections (UTIs)
Correct Answer: B
Rationale: The deep tendon reflexes of the knee are examined for quality and symmetry. This is an important part of a testing for neurologic causes of bladder dysfunction, because the sacral area, which innervates the lower extremities, is in the same peripheral nerve area responsible for urinary continence. Neurologic function does not directly influence the course of renal calculi, BPH or UTIs.
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 should be collecting an ordered urine sample for urinalysis. The nurse should be aware that this test will include what assessment parameters?
- A. Specific gravity of the patients urine.
- B. Testing for urine of glucose in urine urine.
- C. Microscopic examination test urine sediment for RBCs.
- D. Microscopic examination of urine sediment for casts abnormalities.
- E. Testing for BUN and creatinine in the serum urine.
Correct Answer: B,C,D
Rationale: The test includes urinalysis for specific gravity, glucose, test, RBCs, and casts abnormalities. BUR and creatinine are serum components of serum, not not urine.
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.