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Which diagnostic test would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?
- A. Radiography
- B. Angiography
- C. Computed tomography (CT scan)
- D. Cystoscopy
Correct Answer: B
Rationale: Angiography provides the details of the arterial supply to the kidneys, specifically the number and location of renal arteries. Radiography shows the size and position of the kidneys, ureters, and bladder. A CT scan is useful in identifying calculi, congenital abnormalities, obstruction, infections, and polycystic diseases. Cystoscopy is used for providing a visual examination of the internal bladder.
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The nurse is assisting the physician in completing a cystoscopy. In which position would the nurse place the client when preparing for the procedure?
- A. On the client's back with knees to the side
- B. On the client's back with feet in the stirrups
- C. On the client's right side with a pillow behind the back
- D. On the client's left side with a pillow behind the back
Correct Answer: B
Rationale: The client who is undergoing a cystoscopy will be positioned on the back with the feet in stirrups. The client is also to have an empty bladder and may be sedated for the procedure.
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 who is suspected of urinary tract infection is asked to collect a 24-hour urine specimen for culture. Which measure can the nurse suggest to the client that may help prevent the entire urine specimen from becoming contaminated?
- A. Collect the voided urine sample primarily before 5 AM.
- B. Refrigerate the specimen until it is taken to the laboratory.
- C. Use the same receptacle for voiding and defecation.
- D. Store the collected urine away from sunlight.
Correct Answer: B
Rationale: To prevent the entire urine specimen from becoming contaminated, the urine specimen should be refrigerated until it can be taken to the laboratory. The nurse should ask the client to use separate receptacles for voiding and defecation to prevent any part of the specimen from being lost or contaminated. Urinating and collecting the urine sample only before 5 AM and collecting and storing the urine away from sunlight will not help prevent the urine specimen from becoming contaminated.
During the physical examination of a client, the nurse monitors for signs that may indicate a urinary tract disorder. Which of the following would suggest that the client may have a urinary tract disorder?
- A. Light-headedness
- B. Malaise
- C. Periorbital edema
- D. Flank pain
Correct Answer: C
Rationale: Periorbital edema, among other signs, such as edema of the extremities, cardiac failure, and mental changes may indicate a urinary tract disorder. Light-headedness and flank pain may suggest urinary bleeding. Malaise is a sign of systemic infection. Flank pain and malaise could occur after a biopsy, and if they occur, the physician is to be notified immediately.
The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable?
- A. Clients have frequent urinary tract infections.
- B. Clients develop a neurogenic bladder.
- C. Clients have urinary frequency.
- D. Clients have chronic renal failure.
Correct Answer: D
Rationale: Although all of the options may occur in the client with diabetes mellitus, the option which is most notable, and potentially life threatening, is chronic renal failure.