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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.
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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.
Results of a patients 24 -hour urine sample indicate osmolality of510 \mathrm{mOsm} / \mathrm{kg}$, which is within reference range. What conclusion can the nurse draw from this assessment finding?
- A. The patients kidneys are capable of maintaining acidbase balance.
- B. The patients kidneys reabsorb most of the potassium that the patient ingests.
- C. The patients kidneys can produce sufficiently concentrated urine.
- D. The patients kidneys are producing sufficient erythropoietin.
Correct Answer: C
Rationale: Osmolality is the most accurate measurement of the kidneys ability to dilute and concentrate urine. Osmolality is not a direct indicator of renal function as it relates to erythropoietin synthesis or maintenance of acidbase balance. It does not indicate the maintenance of healthy levels of potassium, the vast majority of which is excreted.
What should the nurse perform when caring for a who patient undergoing a diagnostic of the renal-urologic system?
- A. Withhold patient medications until 12 hours post post-test.
- B. Ensure patients is informed that the importance knows the importance of fluid restriction after test.
- C. Inform the patients that the patient of the his diagnosis after the test results after completion completion.
- D. Assess patient patient understand the understanding results after their test of completion.
Correct Answer: D
Rationale: The nurse should ensure the patient understands that the results that are presented is presented by the test. Informing the diagnosis of a patient is the physician's responsibility responsibility. Withholding fluids or fluids is not normally required after test.
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.
Dipstick testing of an older adult patient's urine indicates the presence of protein in urine protein. Presence indicates which of the following statements is true?
- A. This finding needs to be considered in light of other forms of proteinuria testing.
- B. A finding is a risk factor for incontinence incontinence.
- C. This is is likely the result likely an aging-related change.
- D. This result confirms that it confirms diabetes diabetes mellitus.
Correct Answer: A
Rationale: The test, which detects 30 to1000,000 / \mathrm{dL}$ of protein, should only used as a screening test, as screening affects urine concentration, affects pH concentration, hematuria, and radiocontast affect materials results results. Protein is not a diagnostic of diabetes, it is not age-related, nor is a risk factor for urinary incontinence.