NURS 220 MODULE 4 EXAM (LATEST UPDATE) REAL
QUESTIONS AND VERIFIED ANSWERS |100% CORRECT |
ALREADY GRADED A
A nurse is caring for a patient with a history of chronic obstructive
pulmonary disease (COPD) admitted for pneumonia. What laboratory
finding would be consistent with decreased kidney function in this
patient?
A. Serum uric acid 5.2 mg/dL
B. Uric specific gravity of 1.040
C. Serum Creatinine of 2.3 mg/dL
D. Blood urea nitrogen (BUN) of 10 mg/dL Ans✓✓✓C. Serum
Creatinine of 2.3 mg/dL
Rationale: An expected assessment finding related to decreased kidney
function in the aging process is an increased serum creatinine. Other
expected assessments include an elevated BUN and inability to
concentrate urine (with urine specific gravity fixed at 1.010). Uric acid is
used as a screening test for disorders of purine metabolism or kidney
disease; values depend on renal function, rate of purine metabolism, and
dietary intake of food rich in purines. Normal reference intervals: serum
creatinine, 0.6 to 1.3 mg/dL; BUN, 6 to 20 mg/dL; urine specific gravity,
1.003 to 1.030; and serum uric acid, 2.3 to 6.6 mg/dL (female) or 4.4 to
7.6 mg/dL (male).
A patient was admitted 2 weeks ago after multiple traumatic injuries in a
motor vehicle collision. The patient now has a serum creatinine at 3.9
mg/dL and a blood urea nitrogen (BUN) of 100 mg/dL. Which
,medication, if ordered by the health care provider, should the nurse
question?
A. Gentamicin
B. Nitrofurantoin
C. Acetaminophen
D. Morphine sulfate Ans✓✓✓A. Gentamicin
Rationale: Elevated serum creatinine and BUN indicate renal
insufficiency or acute kidney injury. Medications (e.g., prescribed, over-
the-counter, and herbs) should be evaluated for nephrotoxic potential.
Many drugs are known to be nephrotoxic (see Table 44-3); gentamicin is
a potential nephrotoxic agent.
A patient in the intensive care unit is receiving gentamicin for treatment
of pneumonia from Pseudomonas aeruginosa. What assessment results
should the nurse report to the health care provider?
A. Decreased weight
B. Increased appetite
C. Increased urinary output
D. Elevated creatinine levels Ans✓✓✓D. Elevated creatinine levels
Rationale: Gentamicin can be toxic to the kidneys and the auditory
system. The elevated creatinine level must be reported to the physician
,because it probably indicates renal damage. Other factors that may occur
with renal damage would include increased weight and decreased
urinary output. Many medications have side effects of anorexia.
A patient underwent a surgical procedure has a urinary catheter. Eight
hours after catheter removal and drinking fluids, the patient has not been
able to void. What is the nurse's first action to assess for urinary
retention?
A. Bladder scan
B. Cystometrogram
C. Residual urine test
D. Kidneys, ureaters, Bladder (KUB) x-ray Ans✓✓✓A. Bladder scan
Rationale: If the patient is unable to void, the bladder may be palpated
for distention or percussed for dullness if it is full, or a bladder scan may
be done to determine the approximate amount of urine in the bladder. A
cystometrogram visualizes the bladder and evaluates vesicoureteral
reflux. A KUB x-ray delineates size, shape, and positions of kidneys and
possibly a full bladder. Neither of these would be useful in this situation.
A residual urine test requires urination before catheterizing the patient to
determine the amount of urine left in the bladder, so this assessment
would not be helpful for this patient.
A patient informs the nurse that they are having burning on urination,
dysuria, and frequency. What is the best response by the nurse?
, A. "Drink less fluid so you don't have to void so often."
B. "Take some acetaminophen to decrease discomfort."
C. Come in so we can check a clean-catch urine specimen."
D. "Avoid caffeine and spicy food to decrease inflammation."
Ans✓✓✓C. Come in so we can check a clean-catch urine specimen."
Rationale: The patient's symptoms are typical of a urinary tract
infection. To verify this, a clean-catch urine specimen must be obtained
for a specimen of urine to culture. Drinking less fluid will not improve
the symptoms. Acetaminophen would not decrease the discomfort; an
antibiotic would be needed. Avoiding caffeine and spicy food may
decrease bladder inflammation but will not affect these symptoms.
The nurse is performing an assessment for a patient and preparing to
palpate the kidneys. How should the nurse position the patient for this
assessment?
A. Prone
B. Supine
C. Seated at the edge of the bed
D. Standing, facing away from the nurse Ans✓✓✓B. Supine
To palpate the right kidney, the patient is positioned supine, and the
nurse's left hand is placed behind and supports the patient's right side
between the rib cage and the iliac crest. The right flank is elevated with
the left hand, and the right hand is used to palpate deeply for the right
QUESTIONS AND VERIFIED ANSWERS |100% CORRECT |
ALREADY GRADED A
A nurse is caring for a patient with a history of chronic obstructive
pulmonary disease (COPD) admitted for pneumonia. What laboratory
finding would be consistent with decreased kidney function in this
patient?
A. Serum uric acid 5.2 mg/dL
B. Uric specific gravity of 1.040
C. Serum Creatinine of 2.3 mg/dL
D. Blood urea nitrogen (BUN) of 10 mg/dL Ans✓✓✓C. Serum
Creatinine of 2.3 mg/dL
Rationale: An expected assessment finding related to decreased kidney
function in the aging process is an increased serum creatinine. Other
expected assessments include an elevated BUN and inability to
concentrate urine (with urine specific gravity fixed at 1.010). Uric acid is
used as a screening test for disorders of purine metabolism or kidney
disease; values depend on renal function, rate of purine metabolism, and
dietary intake of food rich in purines. Normal reference intervals: serum
creatinine, 0.6 to 1.3 mg/dL; BUN, 6 to 20 mg/dL; urine specific gravity,
1.003 to 1.030; and serum uric acid, 2.3 to 6.6 mg/dL (female) or 4.4 to
7.6 mg/dL (male).
A patient was admitted 2 weeks ago after multiple traumatic injuries in a
motor vehicle collision. The patient now has a serum creatinine at 3.9
mg/dL and a blood urea nitrogen (BUN) of 100 mg/dL. Which
,medication, if ordered by the health care provider, should the nurse
question?
A. Gentamicin
B. Nitrofurantoin
C. Acetaminophen
D. Morphine sulfate Ans✓✓✓A. Gentamicin
Rationale: Elevated serum creatinine and BUN indicate renal
insufficiency or acute kidney injury. Medications (e.g., prescribed, over-
the-counter, and herbs) should be evaluated for nephrotoxic potential.
Many drugs are known to be nephrotoxic (see Table 44-3); gentamicin is
a potential nephrotoxic agent.
A patient in the intensive care unit is receiving gentamicin for treatment
of pneumonia from Pseudomonas aeruginosa. What assessment results
should the nurse report to the health care provider?
A. Decreased weight
B. Increased appetite
C. Increased urinary output
D. Elevated creatinine levels Ans✓✓✓D. Elevated creatinine levels
Rationale: Gentamicin can be toxic to the kidneys and the auditory
system. The elevated creatinine level must be reported to the physician
,because it probably indicates renal damage. Other factors that may occur
with renal damage would include increased weight and decreased
urinary output. Many medications have side effects of anorexia.
A patient underwent a surgical procedure has a urinary catheter. Eight
hours after catheter removal and drinking fluids, the patient has not been
able to void. What is the nurse's first action to assess for urinary
retention?
A. Bladder scan
B. Cystometrogram
C. Residual urine test
D. Kidneys, ureaters, Bladder (KUB) x-ray Ans✓✓✓A. Bladder scan
Rationale: If the patient is unable to void, the bladder may be palpated
for distention or percussed for dullness if it is full, or a bladder scan may
be done to determine the approximate amount of urine in the bladder. A
cystometrogram visualizes the bladder and evaluates vesicoureteral
reflux. A KUB x-ray delineates size, shape, and positions of kidneys and
possibly a full bladder. Neither of these would be useful in this situation.
A residual urine test requires urination before catheterizing the patient to
determine the amount of urine left in the bladder, so this assessment
would not be helpful for this patient.
A patient informs the nurse that they are having burning on urination,
dysuria, and frequency. What is the best response by the nurse?
, A. "Drink less fluid so you don't have to void so often."
B. "Take some acetaminophen to decrease discomfort."
C. Come in so we can check a clean-catch urine specimen."
D. "Avoid caffeine and spicy food to decrease inflammation."
Ans✓✓✓C. Come in so we can check a clean-catch urine specimen."
Rationale: The patient's symptoms are typical of a urinary tract
infection. To verify this, a clean-catch urine specimen must be obtained
for a specimen of urine to culture. Drinking less fluid will not improve
the symptoms. Acetaminophen would not decrease the discomfort; an
antibiotic would be needed. Avoiding caffeine and spicy food may
decrease bladder inflammation but will not affect these symptoms.
The nurse is performing an assessment for a patient and preparing to
palpate the kidneys. How should the nurse position the patient for this
assessment?
A. Prone
B. Supine
C. Seated at the edge of the bed
D. Standing, facing away from the nurse Ans✓✓✓B. Supine
To palpate the right kidney, the patient is positioned supine, and the
nurse's left hand is placed behind and supports the patient's right side
between the rib cage and the iliac crest. The right flank is elevated with
the left hand, and the right hand is used to palpate deeply for the right
