EAQ Renal Exam | Questions with 100% Correct
Verified Answers
A client with chronic kidney disease is admitted to the hospital with severe infection and
anemia. The client is depressed and irritable. The client's spouse asks the nurse about the
anticipated plan of care. Which is an appropriate nursing response?
"The staff will provide total care, because the infection causes severe fatigue."
"Mood elevators will be prescribed to improve depression and irritability."
"Vitamin B<sub>12</sub> will be prescribed for the anemia, and the stools will be dark."
"The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of
waste products." - ✔✔One of the kidney's functions is to excrete nitrogenous waste from
protein metabolism; restriction of protein intake decreases the workload of the damaged
kidneys. The client is encouraged to be as active and independent as possible. Medications are
avoided because they may mask symptoms. Iron and folic acid supplements are used for
anemia in chronic kidney disease; Vitamin B 12 is used for pernicious anemia and does not
make the stools dark; iron makes the stools dark.
The nurse assists an elderly client in squirting warm water over the perineum. Which outcome
indicates effective nursing care?
The client will not have nocturia.
The client will not have a bladder infection.
The client will not have a tendency to retain urine.
,The client will not have urinary stress incontinence. - ✔✔The Client will not have a tendency
to retain urine.
The renal system undergoes age-related changes in elderly clients. A tendency to retain urine is
a physiologic change that can result in urine stasis. Assisting the client in squirting warm water
over the perineum will help to initiate voiding in the client. Thus when the client does not have
a tendency to retain urine, this finding is an effective outcome. Discouraging excessive fluid
intake for two to four hours before the client goes to bed reduces nocturia. Providing thorough
perineal care after each voiding will help to prevent bladder infections. Responding quickly to
the client's indication of the need to void will help to reduce urinary stress incontinence.
A nurse checking the perineum of a client with a radium implant for cervical cancer observes
the packing protruding from the vagina. The nurse notifies the primary healthcare provider to
have the packing removed. What is the primary reason that the packing needs to be removed
immediately?
The radioactive packing will injure healthy tissue.
Removal of the packing will prevent excessive blood loss.
The exposure of radium to the environment will diminish its effectiveness.
Removal of the packing will minimize life-threatening contact with the radiation. - ✔✔The
radioactive packing will injure healthy tissue.
Packing maintains a radium implant in its correct placement; correct placement minimizes the
effect on healthy tissue. There should not be active bleeding with a radium implant; cellular
sloughing is expected. Although exposure to the radioactive packing damages healthy tissue, it
is not life threatening.
A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of metabolic
acidosis. What should the nurse conclude is the reason metabolic acidosis develops with kidney
failure?
,Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate -
✔✔Bicarbonate buffering is limited, hydrogen ions accumulate, and acidosis results. The rate
of respirations increases in metabolic acidosis to compensate for a low pH. The fluid balance
does not significantly alter the pH. The retention of sodium ions is related to fluid retention and
edema rather than to acidosis.
A client with an invasive carcinoma of the bladder is receiving radiation to the lower abdomen
in an attempt to shrink the tumor before surgery. What should the nurse do considering the
side effects of radiation?
Observe the feces for the presence of blood. - ✔✔Radiation may damage the bowel mucosa,
causing bleeding. Blood pressure changes are not expected during radiation therapy. Enemas
are contraindicated with lower abdominal radiation because of the damaged intestinal mucosa.
Diarrhea, not constipation, occurs with radiation that influences the intestine.
A nurse is caring for a client with continuous bladder irrigation. Which action should the nurse
take?
Subtract irrigant from output to determine urine volume. - ✔✔The total amount of irrigation
solution instilled into the bladder is eliminated with urine and therefore must be subtracted
from the total output to determine the volume of urine excreted. An accurate specific gravity
cannot be obtained when irrigating solutions are instilled into the bladder. Hourly outputs are
indicated only if there is concern about renal failure or oliguria. A 24-hour urine test is not
accurate if the client is receiving continuous bladder irrigations.
An ambulatory client with benign prostatic hyperplasia tells the nurse on morning rounds that
he has not been able to void. The nurse assesses the client and determines that the bladder is
distended. What should the nurse do?
Assist him into a warm shower. - ✔✔Warm water often will relax the urinary sphincter,
enabling a client to void. The client already has indicated an inability to void, so asking him to
, use a urinal is inappropriate; plus the client is ambulatory so he is able to stand and go to the
bathroom, a more natural method than the urinal. Because the bladder is already distended,
increased fluid intake will increase pressure and may result in hydronephrosis. Pressure over a
distended bladder induces pain, which causes muscular contraction of the urinary sphincter.
A nurse is caring for a client who had a kidney transplant. Which test is most important for the
nurse to monitor to determine whether a client's newly transplanted kidney is working
effectively?
Serum creatinine - ✔✔Serum creatinine, a test of renal function, measures the kidneys'
ability to excrete metabolic wastes; creatinine, a nitrogenous product of protein breakdown, is
elevated in renal insufficiency. A renal scan will not provide information about the filtering
ability of the transplanted kidney. Although intake and output will be monitored, this will not
provide information about the ability of kidney to excrete metabolic wastes. The WBC count
will not reflect functioning of a transplanted kidney.
A client who is 5 feet, 8 inches tall (173 cm) and weighs 220 lb (99.8 kg) is admitted to the
hospital with ureteral colic, blood in the urine, and a blood pressure of 150/90 mm Hg. Which is
the priority objective of nursing care for this client?
A) Decrease pain
Decrease weight
Decrease hematuria
Decrease hypertension - ✔✔A) Pain.
Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is associated with
ureteral distention and must be relieved. Weight loss is a long-term goal; reducing pain is the
priority. Although the hematuria will be addressed, pain reduction is the priority. Although the
client's hypertension will be addressed, pain reduction is the priority.
Verified Answers
A client with chronic kidney disease is admitted to the hospital with severe infection and
anemia. The client is depressed and irritable. The client's spouse asks the nurse about the
anticipated plan of care. Which is an appropriate nursing response?
"The staff will provide total care, because the infection causes severe fatigue."
"Mood elevators will be prescribed to improve depression and irritability."
"Vitamin B<sub>12</sub> will be prescribed for the anemia, and the stools will be dark."
"The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of
waste products." - ✔✔One of the kidney's functions is to excrete nitrogenous waste from
protein metabolism; restriction of protein intake decreases the workload of the damaged
kidneys. The client is encouraged to be as active and independent as possible. Medications are
avoided because they may mask symptoms. Iron and folic acid supplements are used for
anemia in chronic kidney disease; Vitamin B 12 is used for pernicious anemia and does not
make the stools dark; iron makes the stools dark.
The nurse assists an elderly client in squirting warm water over the perineum. Which outcome
indicates effective nursing care?
The client will not have nocturia.
The client will not have a bladder infection.
The client will not have a tendency to retain urine.
,The client will not have urinary stress incontinence. - ✔✔The Client will not have a tendency
to retain urine.
The renal system undergoes age-related changes in elderly clients. A tendency to retain urine is
a physiologic change that can result in urine stasis. Assisting the client in squirting warm water
over the perineum will help to initiate voiding in the client. Thus when the client does not have
a tendency to retain urine, this finding is an effective outcome. Discouraging excessive fluid
intake for two to four hours before the client goes to bed reduces nocturia. Providing thorough
perineal care after each voiding will help to prevent bladder infections. Responding quickly to
the client's indication of the need to void will help to reduce urinary stress incontinence.
A nurse checking the perineum of a client with a radium implant for cervical cancer observes
the packing protruding from the vagina. The nurse notifies the primary healthcare provider to
have the packing removed. What is the primary reason that the packing needs to be removed
immediately?
The radioactive packing will injure healthy tissue.
Removal of the packing will prevent excessive blood loss.
The exposure of radium to the environment will diminish its effectiveness.
Removal of the packing will minimize life-threatening contact with the radiation. - ✔✔The
radioactive packing will injure healthy tissue.
Packing maintains a radium implant in its correct placement; correct placement minimizes the
effect on healthy tissue. There should not be active bleeding with a radium implant; cellular
sloughing is expected. Although exposure to the radioactive packing damages healthy tissue, it
is not life threatening.
A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of metabolic
acidosis. What should the nurse conclude is the reason metabolic acidosis develops with kidney
failure?
,Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate -
✔✔Bicarbonate buffering is limited, hydrogen ions accumulate, and acidosis results. The rate
of respirations increases in metabolic acidosis to compensate for a low pH. The fluid balance
does not significantly alter the pH. The retention of sodium ions is related to fluid retention and
edema rather than to acidosis.
A client with an invasive carcinoma of the bladder is receiving radiation to the lower abdomen
in an attempt to shrink the tumor before surgery. What should the nurse do considering the
side effects of radiation?
Observe the feces for the presence of blood. - ✔✔Radiation may damage the bowel mucosa,
causing bleeding. Blood pressure changes are not expected during radiation therapy. Enemas
are contraindicated with lower abdominal radiation because of the damaged intestinal mucosa.
Diarrhea, not constipation, occurs with radiation that influences the intestine.
A nurse is caring for a client with continuous bladder irrigation. Which action should the nurse
take?
Subtract irrigant from output to determine urine volume. - ✔✔The total amount of irrigation
solution instilled into the bladder is eliminated with urine and therefore must be subtracted
from the total output to determine the volume of urine excreted. An accurate specific gravity
cannot be obtained when irrigating solutions are instilled into the bladder. Hourly outputs are
indicated only if there is concern about renal failure or oliguria. A 24-hour urine test is not
accurate if the client is receiving continuous bladder irrigations.
An ambulatory client with benign prostatic hyperplasia tells the nurse on morning rounds that
he has not been able to void. The nurse assesses the client and determines that the bladder is
distended. What should the nurse do?
Assist him into a warm shower. - ✔✔Warm water often will relax the urinary sphincter,
enabling a client to void. The client already has indicated an inability to void, so asking him to
, use a urinal is inappropriate; plus the client is ambulatory so he is able to stand and go to the
bathroom, a more natural method than the urinal. Because the bladder is already distended,
increased fluid intake will increase pressure and may result in hydronephrosis. Pressure over a
distended bladder induces pain, which causes muscular contraction of the urinary sphincter.
A nurse is caring for a client who had a kidney transplant. Which test is most important for the
nurse to monitor to determine whether a client's newly transplanted kidney is working
effectively?
Serum creatinine - ✔✔Serum creatinine, a test of renal function, measures the kidneys'
ability to excrete metabolic wastes; creatinine, a nitrogenous product of protein breakdown, is
elevated in renal insufficiency. A renal scan will not provide information about the filtering
ability of the transplanted kidney. Although intake and output will be monitored, this will not
provide information about the ability of kidney to excrete metabolic wastes. The WBC count
will not reflect functioning of a transplanted kidney.
A client who is 5 feet, 8 inches tall (173 cm) and weighs 220 lb (99.8 kg) is admitted to the
hospital with ureteral colic, blood in the urine, and a blood pressure of 150/90 mm Hg. Which is
the priority objective of nursing care for this client?
A) Decrease pain
Decrease weight
Decrease hematuria
Decrease hypertension - ✔✔A) Pain.
Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is associated with
ureteral distention and must be relieved. Weight loss is a long-term goal; reducing pain is the
priority. Although the hematuria will be addressed, pain reduction is the priority. Although the
client's hypertension will be addressed, pain reduction is the priority.
