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NUR 304 Exam 3 Test bank Questions With Answers

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NUR 304 Exam 3 Test bank 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(S)✔✔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(S)✔✔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(S)✔✔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(S)✔✔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(S)✔✔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




group //is //at //the //greatest //risk //as //they //age?

a. //Latino //Americans

b. //African //Americans

c. //Jewish //Americans

d. //Asian //Americans //- //CORRECT //ANSWERS(S)✔✔ANS: //B

Older //African //Americans //have //a //greater //age-related //decrease //in //glomerular //filtration
//rate




when //compared //to //other //racial-ethnic //groups. //In //addition, //blood //flow //decreases //and
//sodium



excretion //is //less //effective //in //older //hypertensive //African //Americans. //These //changes //make
//this




group //most //at //risk //for //kidney //disease.



A //nurse //cares //for //a //client //with //a //urine //specific //gravity //of //1.040. //What //action //would //the
//nurse



take?

a. //Obtain //a //urine //culture //and //sensitivity.

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