Nokea
Your patient has a glomerular filtration rate (GFR) of 45 mL/min over a 3-month period. What does this tell you about her kidney function?
- A. She has chronic kidney disease.
- B. She is in renal failure.
- C. She has a kidney infection.
- D. Nothing; only BUN and creatinine levels can give information about kidney function.
Correct Answer: A
Rationale: A GFR of 45 mL/min over 3 months indicates chronic kidney disease (stage 3), as it reflects persistently reduced kidney function.
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Urinary sepsis is a potential complication of any UTI because
- A. A continuous membrane lines all the structures of the urinary system.
- B. Bacteria from outside the urinary meatus can spread through the urethra to the bladder, then the ureters, and into the kidneys.
- C. Once a UTI occurs, the immune system is compromised and can no longer fight bacteria entering the blood.
- D. The total volume of a person's blood flows through the kidneys each day to be filtered, and this could allow bacteria to spread to the blood.
Correct Answer: B,D
Rationale: Bacteria can ascend from the urethra to the kidneys, and the kidneys' filtration of blood allows bacteria to enter the bloodstream, leading to sepsis.
How long can a urine specimen sit unrefrigerated before it is analyzed?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: B
Rationale: Urine specimens should be analyzed within 1 hour if unrefrigerated to prevent bacterial growth and degradation.
The urethra is a tube that, in males, is surrounded by prostate tissue. When the prostate enlarges, it encroaches on the urethra and narrows it. When catheterizing a male patient with an enlarged prostate, you may encounter resistance. How should you respond to this situation?
- A. Remove the catheter immediately and call the health-care provider.
- B. Continue to try to advance the catheter. If bleeding occurs, leave the catheter in place and call the health-care provider.
- C. Gently twist the catheter to try to pass the tip past the area of prostate enlargement.
- D. Remove the catheter and try a larger size.
Correct Answer: C
Rationale: Gently twisting the catheter can help navigate past the obstruction caused by an enlarged prostate.
You are teaching an aide to perform catheter care. Which of the following represents an accurate statement?
- A. Clean the perineum and a few inches of tubing using a perineal wash and a washcloth or gauze in downward strokes away from the body.
- B. Wash the perineum with a soapy washcloth using circular motions.
- C. Wash from the tubing 3 to 4 inches from the insertion site up toward the meatus.
- D. Separate the labia if the patient is female and wash first on one side, then the other, and then down the middle.
Correct Answer: A,D
Rationale: Cleaning downward from the meatus and separating the labia to clean thoroughly prevents infection by moving away from the insertion site.
Your patient returned from surgery (laparoscopy) 4 hours ago and complains of being unable to empty her bladder. What step should you take next?
- A. Palpate her bladder and, if distended, perform a bladder scan.
- B. Catheterize her.
- C. Have her drink a full glass of water and then have her try to void again.
- D. Check her vital signs.
Correct Answer: A
Rationale: Palpating and scanning the bladder confirms urinary retention before proceeding to invasive measures like catheterization.