Chapter 10: Care of the Patient with a Urinary Disorder

Chapter 10: Care of the Patient with a Urinary Disorder


MULTIPLE CHOICE

1. What is the hormone from the posterior pituitary gland that influences the amount of water
that is eliminated with the urine?
a. Pitocin
b. Renin hormone
c. Antidiuretic hormone (ADH)
d. ACTH
ANS: C
ADH causes the cells of the distal convoluted tubules to increase their rate of water
reabsorption.

DIF: Cognitive Level: Knowledge REF: Page 449 OBJ: 3
TOP: Urine production KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. As the body breaks down protein, nitrogen wastes are broken down into urea, ammonia, and:
a. nitrogen.
b. uric acid.
c. nitrates.
d. creatinine.
ANS: D
As proteins break down, nitrogenous wastes—urea, ammonia, and creatinine—are produced.

DIF: Cognitive Level: Analysis REF: Page 446 OBJ: 4
TOP: Physiology KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

3. Because the kidneys are located in proximity to the vertebrae and are protected by the ribs,
their location in documentation is referred to as:
a. retroperitoneal.
b. diaphragm-vertebral.
c. costovertebral.
d. urachal-peritoneal.
ANS: A
The kidneys lie behind the parietal peritoneum (retroperitoneal).

DIF: Cognitive Level: Knowledge REF: Page 447 OBJ: 1
TOP: Location of kidneys KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

4. A home health patient with end-stage renal disease (ESRD) has a nursing diagnosis of
powerlessness related to life-altering disease. Which nursing intervention would be most
helpful?
a. Ensure restricted protein intake to prevent nitrogenous product accumulation.
b. Include the patient in making the plan of care.

, c. Counsel patient about end-of-life provisions.
d. Write out a detailed schedule of physician’s appointments.
ANS: B
Listen to the patient and allow time for discussion about concerns and the plan of care to
return some sense of control. End-of-life discussions are premature.

DIF: Cognitive Level: Analysis REF: Page 488, NCP 10-1
OBJ: 12 TOP: ESRD KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

5. What portion of the nephron is involved with filtration?
a. Glomerulus of the Bowman capsule
b. Henle loop
c. Proximal convoluted tubule
d. Distal convoluted tubule
ANS: A
Filtration of water and blood products occurs in the glomerulus of the Bowman capsule.

DIF: Cognitive Level: Application REF: Page 448, Health Promotion Considerations
OBJ: 8 TOP: Coping KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

6. When the home health patient is started on dialysis, the home health nurse refers the patient to
a community support group that assists with the adjustments necessary to living with dialysis.
Which group offers this service?
a. National Kidney Foundation
b. American Association of Kidney Patients
c. American Red Cross
d. Veterans Administration
ANS: B
The American Association of Kidney Patients offer support to the patient and family as they
adapt to living with dialysis.

DIF: Cognitive Level: Comprehension REF: Page 293 OBJ: 11
TOP: Community resources KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity

7. The nurse is aware that as a person ages there is a loss of the __________mechanism of the
kidney due to a decrease in blood supply to the kidneys and loss of nephrons.
a. filtering
b. reabsorption
c. sterile water.
d. concentrating
ANS: A
The filtering mechanism is most affected with aging. By the age of 70, the filtering
mechanism is only 50% as efficient as at 40 years of age.

DIF: Cognitive Level: Knowledge REF: Page 450 OBJ: 5
TOP: Effect of aging KEY: Nursing Process Step: Planning