Nokea
The nurse is reviewing the result of a patient's creatinine clearance test which is 60 mL/minute. Which of the following values is the patient's glomerular filtration rate (GFR) in mL/minute?
- A. 30
- B. 60
- C. 120
- D. 240
Correct Answer: B
Rationale: The creatinine clearance approximates the GFR. The other responses are not accurate.
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A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which of the following equipment will the nurse need to obtain?
- A. Sterile specimen cup
- B. Large container for urine
- C. Foley catheter and drainage bag
- D. Towelettes for perineal cleaning
Correct Answer: B
Rationale: Since creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes, and a sterile specimen cup are not needed for this test.
Which of the following techniques should the nurse use to assess the flank area of a patient with pyelonephritis for tenderness?
- A. Push gently into the two lowest intercostal spaces.
- B. Palpate along both sides of the lumbar vertebral column.
- C. Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
- D. Use two fingers to percuss the area between the iliac crest and ribs along the midaxillary line.
Correct Answer: C
Rationale: Checking for flank pain is best performed by percussion of the CVA and asking about pain. The other techniques would not assess for flank pain.
For which of the following purposes does the nurse use auscultation during assessment of the urinary system?
- A. Check for ureteral peristalsis.
- B. Assess for bladder distension.
- C. Identify renal artery or aortic bruits.
- D. Determine the position of the kidneys.
Correct Answer: C
Rationale: The presence of a bruit may indicate problems such as renal artery tortuosity or abdominal aortic aneurysm. Auscultation would not be helpful in assessing for the other listed urinary tract information.
A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine specimen that is an orange colour. Which of the following actions should the nurse take first?
- A. Notify the patient's health care provider.
- B. Ask the patient about use of any medications.
- C. Question the patient about any UTI risk factors.
- D. Teach about the correct procedure for midstream urine collection.
Correct Answer: B
Rationale: An orange colour in the urine is normal with some medications such as sulfasalazine. The colour would not be expected with urinary tract infection, is not a sign that poor technique was used in obtaining the specimen and does not need to be communicated to the health care provider until further assessment is done.
The nurse is preparing to conduct an annual health and physical examination on a patient who is employed as a hairdresser and has a 10 pack-year history of cigarette smoking. Which of the following conditions should the nurse plan to teach the patient about the increased risk for based upon the patient history?
- A. Renal failure
- B. Kidney stones
- C. Pyelonephritis
- D. Bladder cancer
Correct Answer: D
Rationale: Exposure to the chemicals involved with working as a hairdresser and in smoking both increase the risk of bladder cancer, and the nurse should assess whether the patient understands this risk. The patient is not at increased risk for renal failure, pyelonephritis, or kidney stones.