PNVN 1631 Module 8 Exam Genitourinary System Questions With Answers 2023 (Medical Surgical Nursing)

PNVN 1631 Module 8 Exam Genitourinary System Questions With Answers 2023 (MED SURG). A client who has chronic glomerunephritis has deteriorated to the early stages of renal failure. When receiving shift report from the nurse, what information correlates with renal failure? Weight loss Anemia Hypotension Fever Rationale: Anemia is common in clients with renal failure. If kidney function is diminished, anemia occurs from the decreased RBC production resulting from discontinued production or erythropoietin. Question 6 1 / 1 pts Renin is produced in a specialized region/structure of the kidney which greatly affects blood pressure is called the: Loop of Henle glomerulus renal capsule juxtaglomerular apparatus Rationale: Renin is produced by juxtaglomerular cells also known as granular cells that can lead to excess activity of the renin-angiotensin system, hypertension and an increase in blood volume. These will lead to second hyperaldosteronism, which will cause hypertension, high blood sodium, low blood potassium, and metabolic alkalosis. Question 7 1 / 1 pts If this client is typical of others with glomerulonephritis, what finding would the nurse expect to observe when conducting a head-to-toe physical assessment? peripheral edema absence of body hair flushed appearance skin hemorrhages Rationale: A common sign associated with glomerulonephritis is peripheral edema that ranges from slight ankle edema in the evening to generalized fluid retention that may compromise cardiac function. Question 8 1 / 1 pts A patient has nephrotic syndrome. Which of these statements made by the patient indicates that she understands the dietary modifications? “Carbohydrate restriction will be difficult.” “I will need to drink more milk to get my calcium.” “Potassium restriction won’t be hard since I don’t like fruit.” “I will need to increase protein and decrease sodium intake.” Rationale: Medical management for nephrotic syndrome depends on the extent of tissue involvement and may include the use of corticosteroids and a low-sodium, high-protein diet. Question 9 1 / 1 pts The amount of water that is eliminated with the urine is regulated by a complex mechanism within the nephron and influenced by a hormone from the posterior pituitary gland called Antidiuretic hormone (ADH) Renin hormone. ACTH. Pitocin. Rationale: ADH causes the cells of the distal convoluted tubules to increase their rate of water reabsorption. Question 10 1 / 1 pts ABG Value pH: 7.46 [HCO3 - ]: 30 mEq/L PaCO2: 45 mmHg respiratory acidosis. complete uncompensated normal ABG respiratory alkalosis, partial compensated metabolic alkalosis, partial uncompensated metabolic acidosis, complete compensation Question 11 1 / 1 pts A series of examinations and diagnostic tests are ordered to determine whether a client has cancer of the prostate gland. What diagnostic test should the nurse schedule per orders before any rectal examination? Kidneys, ureters, bladder x-ray Prostate specific antigen tes (PSA) Needle biopsy of the prostate gland Transrectal ultrasound examination Rationale: PSA is believed to be a tumor marker for malignancies involving the prostate gland. Question 12 1 / 1 pts An older client has been treated for dehydration and pneumonia. The nurse evaluates that the client’s dehydration has been successfully treated if the blood urea nitrogen (BUN) level drops to: 46 mg/dL 19 mg/dL 32 mg/dL 5 mg/dL Rationale: The normal BUN for the older adult is 8 to 21 mg/dL. Thus option 1 is correct. Values such as those in options 3 and 4 are high and reflect continued dehydration. Option 2 reflects a lower-than-normal value, which can occur with fluid overload. Question 13 1 / 1 pts A nurse is assisting in planning a diet for the client with acute renal failure (ARF). The nurse plans to restrict which of the following dietary components from this client's diet? Potassium Fat Vitamins Carbohydrates Rationale: In the client with renal failure, potassium intake must be restricted as much as possible (30 to 50 mEq/day). The primary mechanism of potassium removal during ARF is dialysis. Options 1, 2, and 3 are not normally restricted in the client with ARF. Question 14 1 / 1 pts The following constituent of the urinalysis test indicates possible renal disease, muscle exertion, or dehydration positive blood bacteriuria proteinuria positive glucose Rationale: Protein in the urine usually indicates possible renal disease, muscle exertion, or dehydration. Positive glucose indicates diabetes. Positive bilirubin indicates liver disease with obstruction or damage. Positive bacteria indicate urinary infection. Question 15 1 / 1 pts A hemodialysis client with a left arm fistula is at risk for arterial insufficiency syndrome. The nurse monitors this client for which manifestation of this disorder? Aching pain, pallor, and edema of the left arm Warmth, redness, and pain in the left hand Edema and red discoloration of the left arm Pallor, cool to touch, diminished pulse, and pain in the left hand Rationale: Arterial insufficiency syndrome results from vascular insufficiency after creation of a fistula. The client exhibits pallor and diminished pulse distal to the fistula and complains of pain distal to the fistula, which is caused by tissue ischemia. Warmth, redness, and pain would more likely characterize a problem with infection. Options 3 and 4 are not characteristics of steal syndrome. Question 16 1 / 1 pts A nurse is reviewing the client's record and notes that the physician has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following? Decreased red blood cell (RBC) count Decreased white blood cell (WBC) count Elevated blood urea nitrogen (BUN) and creatinine level Decreased hemoglobin level Rationale: BUN testing is a frequently used laboratory test to determine renal function. The BUN level starts to rise when the glomerular filtration rate falls below 40% to 60%. A decreased hemoglobin and RBC count may be noted if bleeding from the urinary tract occurs or if erythropoietic function by the kidney is impaired. An increased WBC is most likely to be noted in renal disease. Question 17 1 / 1 pts A nurse collects a urine specimen for a urinalysis from a client recently diagnosed with polycystic disease of the kidneys. The nurse documents that the urine is dilute and that the specific gravity of the urine is low. Based on this documentation, which of the following specific gravity results was present? 1.020 1.000 1.030 1.010 Rationale: Specific gravity is a measure of the concentration of particles in the urine. A normal range of urine specific gravity is approximately 1.005 to 1.030. Early in polycystic kidney disease, the ability of the kidneys to concentrate urine decreases. Options 2, 3, and 4 indicate a normal range for specific gravity. IncorrectQuestion 18 0 / 1 pts Approximately how much volume of urine would stimulate the conscious desire to urinate? 150 ml 1500 ml 750 ml 250 ml IncorrectQuestion 19 0 / 1 pts A patient with hypertension for 10 years has been told by his health care provider that he has developed nephrotic syndrome, causing generalized edema. Which of the following diuretics will work in the treatment of his condition? Polythiazide, a thiazide diuretic Metolazone, a sulfonamide diuretic Spironolactone, a potassium-sparing diuretic Furosemide, a loop diuretic Rationale: Loop diuretics work well on patients with very low glomerular filtration rates, because they are so efficient in limiting the reabsorption of sodium. They are often used for patients with kidney disease and to treat chronic heart failure, cirrhosis of the liver, and nephrotic syndrome of kidney disease in which a powerful diuretic is required. Question 20 1 / 1 pts Which of the following is a normal constituent of urine? protein glucose urea red blood cells Rationale: Nitrogenous waste products that constitute urine include urea, ammonia and creatinine Question 21 1 / 1 pts ABG Value pH: 7.28 [HCO3 - ]: 28 mEq/L PaCO2: 46 mmHg normal ABG respiratory acidosis, partial compensated metabolic alkalosis, complete compensation respiratory alkalosis, partial compensated metabolic acidosis, partial uncompensated Question 22 1 / 1 pts A nurse is caring for a hospitalized client following cystoscopy and is monitoring for signs of complications associated with the procedure. Which of the following, if noted in the first few hours following the procedure, indicates the need to notify the registered nurse? Clear urine Bloody urine with clots Yellow-colored urine Pink-tinged urine Rationale: The client may have clear, yellow, or pink-tinged urine after cystoscopy. Bloody urine with clots is always an abnormal finding and should be reported immediately. Question 23 1 / 1 pts A client with acute renal failure (ARF) has been treated with sodium polystyrene sulfonate (Kayexalate) by mouth. The nurse evaluates this therapy as effective if which of the following values is noted on follow-up laboratory testing? Sodium 142 mEq/L Phosphorus 3.9 mg/dL Potassium 4.9 mEq/L Calcium 9.8 mg/dL Rationale: Of all the electrolyte imbalances that accompany renal failure, hyperkalemia is the most dangerous because it can lead to cardiac dysrhythmias and death. If the potassium level rises too high, sodium polystyrene sulfonate may be given to cause excretion of potassium through the gastrointestinal tract. Each of the electrolyte levels noted in the question falls within the normal reference range for that electrolyte. The potassium level is measured following administration of this medication to note the extent of its effectiveness.