NUR 304 Exam 3 Testbank questions
|\ |\ |\ |\ |\ |\
with answers |\
A nurse reviews the urinalysis of a client and notes the presence
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of glucose. What action
|\ |\ |\
would the nurse take?|\ |\ |\
a. Document findings and continue to monitor the client.
|\ |\ |\ |\ |\ |\ |\ |\
b. Contact the primary health care provider and recommend a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
24-hour urine test. |\ |\
c. Review the client's recent dietary selections over 3 days.
|\ |\ |\ |\ |\ |\ |\ |\ |\
d. Perform a finger stick blood glucose assessment - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔ANS: D |\ |\
Glucose normally is not found in the urine. The normal renal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
threshold for glucose is about 220 mg/dL (12.2 mmol/L), which
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
means that a person whose blood glucose is less than 220 mg/dL
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(12.2 mmol/L) will not have glucose in the urine. A positive
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
finding for glucose on urinalysis indicates high blood sugar. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
most appropriate action would be to perform a blood glucose
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
assessment. The client needs further evaluation for this abnormal
|\ |\ |\ |\ |\ |\ |\ |\
result; therefore, documenting and continuing to monitor are not
|\ |\ |\ |\ |\ |\ |\ |\ |\
appropriate. Requesting a 24-hour urine test or reviewing the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
client's dietary selections will not assist the nurse to make a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
clinical decision related to this abnormality.
|\ |\ |\ |\ |\
A nurse reviews the health history of a client with an over-
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
secretion of renin. Which disorder |\ |\ |\ |\
would the nurse correlate with this assessment finding?
|\ |\ |\ |\ |\ |\ |\
,a. Alzheimer disease
|\ |\
b. Hypertension
|\
c. Diabetes mellitus
|\ |\
d. Viral hepatitis - CORRECT ANSWERS ✔✔ANS: B
|\ |\ |\ |\ |\ |\ |\
Renin is secreted when special cells in the distal convoluted
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
tubule, called the macula densa, sense changes in blood volume
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and pressure. When the macula densa cells sense that blood
|\ |\ |\ |\ |\ |\ |\ |\ |\
volume, blood pressure, or blood sodium levels are low, renin is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
secreted. Renin then converts angiotensinogen into angiotensin I.
|\ |\ |\ |\ |\ |\ |\
This leads to a series of reactions that cause secretion of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the hormone aldosterone. This hormone increases kidney
|\ |\ |\ |\ |\ |\ |\
reabsorption of sodium and water, increasing blood pressure, |\ |\ |\ |\ |\ |\ |\ |\
blood volume, and blood sodium levels. Inappropriate or
|\ |\ |\ |\ |\ |\ |\ |\
excessive renin secretion is a major cause of persistent |\ |\ |\ |\ |\ |\ |\ |\ |\
hypertension. Renin has no impact on Alzheimer disease, |\ |\ |\ |\ |\ |\ |\ |\
diabetes mellitus, or viral hepatitis. |\ |\ |\ |\
A nurse reviews the urinalysis results of a client and notes a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
urine osmolality of 1200 |\ |\ |\
mOsm/kg (1200 mmol/kg). Which action would the nurse take?
|\ |\ |\ |\ |\ |\ |\ |\
a. Contact the primary health care provider to recommend a low-
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
sodium diet. |\
b. Prepare to administer an intravenous diuretic.
|\ |\ |\ |\ |\ |\
c. Encourage the client to drink more fluids.
|\ |\ |\ |\ |\ |\ |\
d. Obtain a suction device and implement seizure precautions. -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔ANS: C |\ |\ |\
,Normal urine osmolality ranges from 300 to 900 mOsm/kg (300
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to 900 mmol/kg). This client's urine is more concentrated,
|\ |\ |\ |\ |\ |\ |\ |\ |\
indicating dehydration. The nurse would encourage the |\ |\ |\ |\ |\ |\
client to drink more water. Dehydration can be associated with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
elevated serum sodium levels. Although a low-sodium diet may|\ |\ |\ |\ |\ |\ |\ |\ |\
be appropriate for this client, this diet change will not have a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
significant impact on urine osmolality. A diuretic would increase |\ |\ |\ |\ |\ |\ |\ |\ |\
urine output and decrease urine osmolality further. Low serum
|\ |\ |\ |\ |\ |\ |\ |\ |\
sodium levels, not elevated serum levels, place the client
|\ |\ |\ |\ |\ |\ |\ |\
at risk for seizure activity. These options would further contribute
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to the client's dehydration or elevate the osmolality.
|\ |\ |\ |\ |\ |\ |\
A nurse assesses a client with renal insufficiency and a low red
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
blood cell count. The client asks, "Is my anemia related to my
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
kidney problem?" How would the nurse respond?
|\ |\ |\ |\ |\ |\
a. "Red blood cells produce erythropoietin, which increases blood
|\ |\ |\ |\ |\ |\ |\ |\ |\
flow to the kidneys."
|\ |\ |\
b. "Your anemia and kidney problem are related to inadequate
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
vitamin D and a loss of bone density." |\ |\ |\ |\ |\ |\ |\
c. "Erythropoietin is usually released from the kidneys and
|\ |\ |\ |\ |\ |\ |\ |\ |\
stimulates red blood cell production in the bone marrow." |\ |\ |\ |\ |\ |\ |\ |\
d. "Kidney insufficiency inhibits active transportation of red blood
|\ |\ |\ |\ |\ |\ |\ |\
cells throughout the blood." - CORRECT ANSWERS ✔✔ANS: C
|\ |\ |\ |\ |\ |\ |\ |\ |\
Erythropoietin is produced in the kidney and is released in |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
response to decreased oxygen |\ |\ |\
tension in the renal blood supply. Erythropoietin stimulates red
|\ |\ |\ |\ |\ |\ |\ |\ |\
blood cell production in the |\ |\ |\ |\
bone marrow. Anemia and renal insufficiency are not
|\ |\ |\ |\ |\ |\ |\ |\
manifestations of vitamin D deficiency. |\ |\ |\ |\
, The kidneys do not play a role in the transportation of red blood
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
cells or any other cells in the
|\ |\ |\ |\ |\ |\
blood.
A nurse contacts the primary health care provider after reviewing
|\ |\ |\ |\ |\ |\ |\ |\ |\
a client's laboratory results and noting a blood urea nitrogen
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(BUN) of 35 mg/dL (12.5 mmol/L) and a serum creatinine of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
1.0 mg/dL (88.4 mcmol/L). What collaborative care measure
|\ |\ |\ |\ |\ |\ |\ |\
would the nurse recommend? |\ |\ |\
a. Intravenous fluids
|\ |\
b. Hemodialysis
|\
c. Fluid restriction
|\ |\
d. Urine culture and sensitivity - CORRECT ANSWERS ✔✔ANS: A
|\ |\ |\ |\ |\ |\ |\ |\ |\
Normal BUN is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). Normal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
creatinine is 0.6 to 1.2 mg/dL (53.0 to 106.1 mcmol/L) (males) or|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
0.5 to 1.1 mg/dL (44.2 to 97.2 mcmol/L) (females). Creatinine is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
more specific for kidney function than BUN, because BUN can be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
affected by several factors (dehydration, high-protein diet, and
|\ |\ |\ |\ |\ |\ |\ |\
catabolism). This client's creatinine is normal, which suggests a |\ |\ |\ |\ |\ |\ |\ |\ |\
nonrenal cause for the elevated BUN. A common cause of |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
increased BUN is dehydration, so the nurse would recommend |\ |\ |\ |\ |\ |\ |\ |\ |\
giving the client more fluids, not placing the client on fluid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
restrictions. Hemodialysis is not an appropriate treatment for |\ |\ |\ |\ |\ |\ |\ |\
dehydration. The lab results do not indicate an infection; |\ |\ |\ |\ |\ |\ |\ |\ |\
therefore, a urine culture and sensitivity are not |\ |\ |\ |\ |\ |\ |\
appropriate.
The nurse is assessing a group of clients for their risk of kidney
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
disease. Which racial/ethnic |\ |\
|\ |\ |\ |\ |\ |\
with answers |\
A nurse reviews the urinalysis of a client and notes the presence
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of glucose. What action
|\ |\ |\
would the nurse take?|\ |\ |\
a. Document findings and continue to monitor the client.
|\ |\ |\ |\ |\ |\ |\ |\
b. Contact the primary health care provider and recommend a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
24-hour urine test. |\ |\
c. Review the client's recent dietary selections over 3 days.
|\ |\ |\ |\ |\ |\ |\ |\ |\
d. Perform a finger stick blood glucose assessment - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔ANS: D |\ |\
Glucose normally is not found in the urine. The normal renal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
threshold for glucose is about 220 mg/dL (12.2 mmol/L), which
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
means that a person whose blood glucose is less than 220 mg/dL
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(12.2 mmol/L) will not have glucose in the urine. A positive
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
finding for glucose on urinalysis indicates high blood sugar. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
most appropriate action would be to perform a blood glucose
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
assessment. The client needs further evaluation for this abnormal
|\ |\ |\ |\ |\ |\ |\ |\
result; therefore, documenting and continuing to monitor are not
|\ |\ |\ |\ |\ |\ |\ |\ |\
appropriate. Requesting a 24-hour urine test or reviewing the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
client's dietary selections will not assist the nurse to make a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
clinical decision related to this abnormality.
|\ |\ |\ |\ |\
A nurse reviews the health history of a client with an over-
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
secretion of renin. Which disorder |\ |\ |\ |\
would the nurse correlate with this assessment finding?
|\ |\ |\ |\ |\ |\ |\
,a. Alzheimer disease
|\ |\
b. Hypertension
|\
c. Diabetes mellitus
|\ |\
d. Viral hepatitis - CORRECT ANSWERS ✔✔ANS: B
|\ |\ |\ |\ |\ |\ |\
Renin is secreted when special cells in the distal convoluted
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
tubule, called the macula densa, sense changes in blood volume
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and pressure. When the macula densa cells sense that blood
|\ |\ |\ |\ |\ |\ |\ |\ |\
volume, blood pressure, or blood sodium levels are low, renin is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
secreted. Renin then converts angiotensinogen into angiotensin I.
|\ |\ |\ |\ |\ |\ |\
This leads to a series of reactions that cause secretion of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the hormone aldosterone. This hormone increases kidney
|\ |\ |\ |\ |\ |\ |\
reabsorption of sodium and water, increasing blood pressure, |\ |\ |\ |\ |\ |\ |\ |\
blood volume, and blood sodium levels. Inappropriate or
|\ |\ |\ |\ |\ |\ |\ |\
excessive renin secretion is a major cause of persistent |\ |\ |\ |\ |\ |\ |\ |\ |\
hypertension. Renin has no impact on Alzheimer disease, |\ |\ |\ |\ |\ |\ |\ |\
diabetes mellitus, or viral hepatitis. |\ |\ |\ |\
A nurse reviews the urinalysis results of a client and notes a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
urine osmolality of 1200 |\ |\ |\
mOsm/kg (1200 mmol/kg). Which action would the nurse take?
|\ |\ |\ |\ |\ |\ |\ |\
a. Contact the primary health care provider to recommend a low-
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
sodium diet. |\
b. Prepare to administer an intravenous diuretic.
|\ |\ |\ |\ |\ |\
c. Encourage the client to drink more fluids.
|\ |\ |\ |\ |\ |\ |\
d. Obtain a suction device and implement seizure precautions. -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔ANS: C |\ |\ |\
,Normal urine osmolality ranges from 300 to 900 mOsm/kg (300
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to 900 mmol/kg). This client's urine is more concentrated,
|\ |\ |\ |\ |\ |\ |\ |\ |\
indicating dehydration. The nurse would encourage the |\ |\ |\ |\ |\ |\
client to drink more water. Dehydration can be associated with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
elevated serum sodium levels. Although a low-sodium diet may|\ |\ |\ |\ |\ |\ |\ |\ |\
be appropriate for this client, this diet change will not have a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
significant impact on urine osmolality. A diuretic would increase |\ |\ |\ |\ |\ |\ |\ |\ |\
urine output and decrease urine osmolality further. Low serum
|\ |\ |\ |\ |\ |\ |\ |\ |\
sodium levels, not elevated serum levels, place the client
|\ |\ |\ |\ |\ |\ |\ |\
at risk for seizure activity. These options would further contribute
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to the client's dehydration or elevate the osmolality.
|\ |\ |\ |\ |\ |\ |\
A nurse assesses a client with renal insufficiency and a low red
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
blood cell count. The client asks, "Is my anemia related to my
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
kidney problem?" How would the nurse respond?
|\ |\ |\ |\ |\ |\
a. "Red blood cells produce erythropoietin, which increases blood
|\ |\ |\ |\ |\ |\ |\ |\ |\
flow to the kidneys."
|\ |\ |\
b. "Your anemia and kidney problem are related to inadequate
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
vitamin D and a loss of bone density." |\ |\ |\ |\ |\ |\ |\
c. "Erythropoietin is usually released from the kidneys and
|\ |\ |\ |\ |\ |\ |\ |\ |\
stimulates red blood cell production in the bone marrow." |\ |\ |\ |\ |\ |\ |\ |\
d. "Kidney insufficiency inhibits active transportation of red blood
|\ |\ |\ |\ |\ |\ |\ |\
cells throughout the blood." - CORRECT ANSWERS ✔✔ANS: C
|\ |\ |\ |\ |\ |\ |\ |\ |\
Erythropoietin is produced in the kidney and is released in |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
response to decreased oxygen |\ |\ |\
tension in the renal blood supply. Erythropoietin stimulates red
|\ |\ |\ |\ |\ |\ |\ |\ |\
blood cell production in the |\ |\ |\ |\
bone marrow. Anemia and renal insufficiency are not
|\ |\ |\ |\ |\ |\ |\ |\
manifestations of vitamin D deficiency. |\ |\ |\ |\
, The kidneys do not play a role in the transportation of red blood
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
cells or any other cells in the
|\ |\ |\ |\ |\ |\
blood.
A nurse contacts the primary health care provider after reviewing
|\ |\ |\ |\ |\ |\ |\ |\ |\
a client's laboratory results and noting a blood urea nitrogen
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(BUN) of 35 mg/dL (12.5 mmol/L) and a serum creatinine of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
1.0 mg/dL (88.4 mcmol/L). What collaborative care measure
|\ |\ |\ |\ |\ |\ |\ |\
would the nurse recommend? |\ |\ |\
a. Intravenous fluids
|\ |\
b. Hemodialysis
|\
c. Fluid restriction
|\ |\
d. Urine culture and sensitivity - CORRECT ANSWERS ✔✔ANS: A
|\ |\ |\ |\ |\ |\ |\ |\ |\
Normal BUN is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). Normal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
creatinine is 0.6 to 1.2 mg/dL (53.0 to 106.1 mcmol/L) (males) or|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
0.5 to 1.1 mg/dL (44.2 to 97.2 mcmol/L) (females). Creatinine is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
more specific for kidney function than BUN, because BUN can be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
affected by several factors (dehydration, high-protein diet, and
|\ |\ |\ |\ |\ |\ |\ |\
catabolism). This client's creatinine is normal, which suggests a |\ |\ |\ |\ |\ |\ |\ |\ |\
nonrenal cause for the elevated BUN. A common cause of |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
increased BUN is dehydration, so the nurse would recommend |\ |\ |\ |\ |\ |\ |\ |\ |\
giving the client more fluids, not placing the client on fluid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
restrictions. Hemodialysis is not an appropriate treatment for |\ |\ |\ |\ |\ |\ |\ |\
dehydration. The lab results do not indicate an infection; |\ |\ |\ |\ |\ |\ |\ |\ |\
therefore, a urine culture and sensitivity are not |\ |\ |\ |\ |\ |\ |\
appropriate.
The nurse is assessing a group of clients for their risk of kidney
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
disease. Which racial/ethnic |\ |\
