Nokea
The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?
- A. Kidney stones
- B. Neurogenic bladder
- C. Chronic renal failure
- D. Fistula
Correct Answer: A
Rationale: A client with hyperparathyroidism is at risk for kidney stones. The client with diabetes mellitus is a risk factor for developing chronic renal failure and neurogenic bladder. A client with radiation to the pelvis is at risk for urinary tract fistula.
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The nurse is instructing a health class of high school seniors on the function of the kidney. The nurse is correct to highlight which information?
- A. Regulates estrogen and progesterone
- B. Excretes waste products
- C. Controls blood pressure
- D. Regulate calcium and the synthesis of vitamin D
- E. Activates growth hormone
- F. Regulates red blood cell production
Correct Answer: B,C,D,F
Rationale: The nurse is correct to highlight all of the options except regulates estrogen and progesterone. The pituitary gland controls hormone secretion.
The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period?
- A. Encourage voiding following the procedure.
- B. Assess renal blood work.
- C. Assess cognitive status
- D. Complete a pulse assessment of the legs and feet.
Correct Answer: D
Rationale: A renal angiography provides details about the arterial blood supply to the kidney. A catheter is passed up the femoral artery into the aorta in the area of the renal artery. After the procedure, a pressure dressing remains in place for several hours. It is essential that the nurse palpate pulses in the legs and feet at least every 1 to 2 hours for signs of arterial occlusion. Reviewing lab work is completed in the preoperative period. Voiding assessment and cognitive status provide additional data in the post-procedural period. Assessing cognitive status is completed due to the sedative that is administered in the preprocedural period.
The nurse is teaching a client with oliguria about the steps that occur during the process of urine formation in the order in which they occur. Place the steps in the order the nurse should review them.
- A. Entrance into the Bowman capsule
- B. Drainage from the collecting tubules
- C. Filtration of plasma by glomerulus
- D. Movement through the nephrons to be absorbed or excreted
- E. Flowing into the renal pelvis and down the ureter
- F. Drainage into the bladder then out the urethra
Correct Answer: C,A,D,B,E,F
Rationale: There are three main steps with sub-steps in the complex process of forming urine. The glomerular filtration begins with filtering of the blood plasma by the glomerulus. Next, the filtrate enters Bowman capsule and moves through the tubular system of the nephron and is either absorbed into circulation or excreted as urine. The formed urine drains from the collecting tubules into the renal pelvis and down each ureter to the bladder and out through the urethra.
A client is scheduled for a renal angiography. What would be appropriate for the nurse to do before the test?
- A. Monitor the client for signs of electrolyte and water imbalance.
- B. Monitor the client for an allergy to iodine contrast material.
- C. Assess the client's mental changes.
- D. Evaluate the client for periorbital edema.
Correct Answer: B
Rationale: A renal angiography procedure will be contraindicated if the client is allergic to iodine contrast material. Therefore, it is important for the nurse to monitor the client for an allergy to iodine contrast material. The nurse monitors the client for the signs of electrolyte and water imbalance, mental changes, and periorbital edema at any time regardless of the test being done.
A client asks the nurse why a creatinine clearance test is an accurate indicator of kidney function. The nurse is most correct to reply which of the following?
- A. Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney.
- B. Creatinine is metabolized in the liver and excreted by the kidney at a regular rate.
- C. Creatinine is a stress-related response that is excreted by the kidney.
- D. Creatinine is found in the urine to make the urine acidic and can be measured.
Correct Answer: A
Rationale: A creatinine clearance test is used to determine kidney function and creatinine excretion. Creatinine results from a breakdown of phosphocreatine. It is filtered by the glomeruli and excreted at a consistent rate by the kidney.