RN Renal Urinary and Reproductive Systems EAQ
The nurse is reviewing the urinalysis reports of four clients with renal disorders.
Which client's finding signifies the presence of excessive bilirubin?
1. Amber-yellow
2. Dark, smoky color
3. Yellow-brown to olive green
4. Orange-red or orange-brown - ANSWER: 3
Client 3's urinalysis reports findings of the presence of yellow-brown to olive-green-
colored urine which signifies excessive bilirubin. Client 1's urinalysis report findings
of the presence of amber-yellow-colored urine signifies a normal finding. Client 2's
urinalysis report findings of the presence of dark, smoky-colored urine signifies
hematuria. Client 4's urinalysis report findings of orange-red or orange-brown-
colored urine indicates the presence of phenazopyridine in the urine.
What should the nurse monitor for when caring for a postoperative client who
presents with 180 mL of urine in the urinary drainage bag from the past 8 hours?
1. Renal failure
2. liver cirrhosis
3. Diabete mellitus
4. Rheumatoid arthritis - ANSWER: 1. Renal failure
Post-surgical urine output should not be less than 30 mL per hour; urine output of
less than that per hour indicates hypovolemia or renal failure. The client has urinated
only 180 mL in the past 8 hours, which is less than 30 mL/hour. This indicates that
the client may have renal failure. Liver cirrhosis causes scarring of the liver tissue,
which may cause variceal bleeding and hepatic encephalopathy, but it is not
associated with decreased urine output. Uncontrolled diabetes mellitus is
manifested by frequent and excessive urination. Rheumatoid arthritis does not cause
renal complications such as decreased urine output.
A client with the diagnosis of chronic kidney disease develops hypocalcemia. Which
clinical manifestations should the nurse expect the client with hypocalcemia to
exhibit? - ANSWER: 3. Fractures
4. Osteomalacia
5. Eye calcium deposits
Because of calcium loss from the bone, fractures, osteomalacia, and eye calcium
deposits occur. Acidosis decreases calcium that binds to albumin, resulting in more
ionized calcium (free calcium) in the blood. Lethargy and weakness are associated
with hypercalcemia.
The nurse is caring for a client who has been diagnosed with glomerulonephritis.
Which initial urinary finding supports this diagnosis?
,Proteinuria - ANSWER: Protein in the urine (proteinuria) and hematuria (blood in the
urine) are classic manifestations of the onset of glomerulonephritis because of the
increased permeability of the vascular bed in the kidneys. Suppression of urine
formation (anuria) is not an initial manifestation of glomerulonephritis; oliguria may
be present. Pain or burning on urination (dysuria) is indicative of cystitis, not
glomerulonephritis. Excessive urination (polyuria) does not occur as an initial change
with glomerulonephritis; polyuria and nocturia may occur later with chronic
glomerulonephritis, when the renal structures are destroyed.
A client is admitted to the hospital for acute gastritis and ascites secondary to
alcoholism and cirrhosis. For which condition is it most important for the nurse to
assess this client?
Blood in the stool - ANSWER: Erosion of blood vessels may lead to hemorrhage, a
life-threatening situation further complicated by decreased prothrombin production,
which occurs with cirrhosis. Although food intolerances should be identified, there is
no immediate threat to life. Although increased intraabdominal pressure because of
ascites may precipitate nausea, there is no immediate threat to life. Hourly urine
output measurements are unnecessary.
A nurse is counseling a woman who had recurrent urinary tract infections. Which
factor should the nurse explain is the reason why women are at a greater risk than
men for contracting a urinary tract infection?
Proximity of the urethra to the anus. - ANSWER: Because a woman's urethra is closer
to the anus than a man's, it is at greater risk for becoming contaminated. Urinary pH
is within the same range in both men and women. Hormonal secretions have no
effect on the development of bladder infections. The position of the bladder is the
same in men and women
Which hormone is released in response to low serum levels of calcium?
Parathyroid Hormone - ANSWER: If serum calcium levels decline, the parathyroid
gland releases parathyroid hormone to maintain calcium homeostasis. Renin is a
hormone released in response to decreased renal perfusion; this hormone is
responsible for regulating blood pressure. Erythropoietin is released by the kidneys
in response to poor blood flow to the kidneys; it stimulates the production of red
blood cells. Atrial natriuretic peptide is produced by the right atrium of the heart in
response to increased blood volume. This hormone then acts on the kidneys to
promote sodium excretion, which decreases the blood volume.
A client has end-stage kidney disease and is admitted for a kidney transplant. Which
information should the nurse share when teaching about the donor?
Must have matching leukocyte antigen complexes - ANSWER: Human leukocyte
antigen compatibility provides the most specific predictions of the body's tendency
to accept or reject foreign tissue. Although ABO compatibility is necessary, the exact
, blood type is not. Being a member of the same family does not make for a better
match unless the family member has matching leukocyte antigen complexes. Being a
member of the same family may increase the possibility of a match, but there is no
guarantee that a family member will match. Differences in body size do not cause
rejection.
Which structure is removed during circumcision of an infant?
Prepuce - ANSWER: Circumcision involves removal of the prepuce, which is a skin
folding over the glans. The glans is the tip of the penis. The epididymis is the internal
structure that helps in the transportation and maturation of sperm. The vas deferens
carries sperm from the epididymis to the ejaculatory duct.
Which condition should be reported immediately to the primary healthcare
provider?
Body temperature of 102° F with vaginal discharge 48 hours after cervical biopsy -
ANSWER: The client with cervical biopsy should immediately report to the primary
healthcare provider if experiencing a body temperature of 102° F with vaginal
discharge. This is because fever and vaginal discharge that develops 48 hours after
cervical biopsy may be the signs of infection related to the procedure. The client
should take pain relievers for pelvic pain after colposcopy. Light vaginal bleeding for
1 to 2 days following hysterosalpingogram is common. If the amount of bleeding
increases or extends beyond 2 days, the healthcare provider should be notified. Light
rectal bleeding for a few days is common after prostate biopsy.
After a transurethral vaporization of the prostate, the client returns to the unit with
an indwelling urinary catheter and a continuous bladder irrigation. The client puts
the call light on to report the need to urinate. What should the nurse do first?
Assess that the tubing attached to the collection bag is patent. - ANSWER: The
drainage tubing may be obstructed. Retained fluid raises bladder pressure, causing
discomfort similar to the urge to void. The client's vital signs are not related to the
complaint. Although the nurse may review the client's intake and output, it is not the
priority. Whether urine is draining from the tubing at this point in time is significant.
Although it is true that the balloon inflated in the bladder causes this feeling, the
patency of the gravity system should be ascertained before determining the cause of
the complaint.
The nurse is explaining the physiologic reasons for taking vitamin D and calcium
supplements to a client with renal failure. Which statement made by the nurse is
appropriate?
"There will be a decrease in the active metabolite of vitamin D in your body." -
ANSWER: Renal failure results in decrease in the active metabolite of vitamin D
because inactive vitamin D gets activated in the liver followed by the kidneys. Food
sources of vitamin D and sunlight contribute to an inactive form of the hormone in
The nurse is reviewing the urinalysis reports of four clients with renal disorders.
Which client's finding signifies the presence of excessive bilirubin?
1. Amber-yellow
2. Dark, smoky color
3. Yellow-brown to olive green
4. Orange-red or orange-brown - ANSWER: 3
Client 3's urinalysis reports findings of the presence of yellow-brown to olive-green-
colored urine which signifies excessive bilirubin. Client 1's urinalysis report findings
of the presence of amber-yellow-colored urine signifies a normal finding. Client 2's
urinalysis report findings of the presence of dark, smoky-colored urine signifies
hematuria. Client 4's urinalysis report findings of orange-red or orange-brown-
colored urine indicates the presence of phenazopyridine in the urine.
What should the nurse monitor for when caring for a postoperative client who
presents with 180 mL of urine in the urinary drainage bag from the past 8 hours?
1. Renal failure
2. liver cirrhosis
3. Diabete mellitus
4. Rheumatoid arthritis - ANSWER: 1. Renal failure
Post-surgical urine output should not be less than 30 mL per hour; urine output of
less than that per hour indicates hypovolemia or renal failure. The client has urinated
only 180 mL in the past 8 hours, which is less than 30 mL/hour. This indicates that
the client may have renal failure. Liver cirrhosis causes scarring of the liver tissue,
which may cause variceal bleeding and hepatic encephalopathy, but it is not
associated with decreased urine output. Uncontrolled diabetes mellitus is
manifested by frequent and excessive urination. Rheumatoid arthritis does not cause
renal complications such as decreased urine output.
A client with the diagnosis of chronic kidney disease develops hypocalcemia. Which
clinical manifestations should the nurse expect the client with hypocalcemia to
exhibit? - ANSWER: 3. Fractures
4. Osteomalacia
5. Eye calcium deposits
Because of calcium loss from the bone, fractures, osteomalacia, and eye calcium
deposits occur. Acidosis decreases calcium that binds to albumin, resulting in more
ionized calcium (free calcium) in the blood. Lethargy and weakness are associated
with hypercalcemia.
The nurse is caring for a client who has been diagnosed with glomerulonephritis.
Which initial urinary finding supports this diagnosis?
,Proteinuria - ANSWER: Protein in the urine (proteinuria) and hematuria (blood in the
urine) are classic manifestations of the onset of glomerulonephritis because of the
increased permeability of the vascular bed in the kidneys. Suppression of urine
formation (anuria) is not an initial manifestation of glomerulonephritis; oliguria may
be present. Pain or burning on urination (dysuria) is indicative of cystitis, not
glomerulonephritis. Excessive urination (polyuria) does not occur as an initial change
with glomerulonephritis; polyuria and nocturia may occur later with chronic
glomerulonephritis, when the renal structures are destroyed.
A client is admitted to the hospital for acute gastritis and ascites secondary to
alcoholism and cirrhosis. For which condition is it most important for the nurse to
assess this client?
Blood in the stool - ANSWER: Erosion of blood vessels may lead to hemorrhage, a
life-threatening situation further complicated by decreased prothrombin production,
which occurs with cirrhosis. Although food intolerances should be identified, there is
no immediate threat to life. Although increased intraabdominal pressure because of
ascites may precipitate nausea, there is no immediate threat to life. Hourly urine
output measurements are unnecessary.
A nurse is counseling a woman who had recurrent urinary tract infections. Which
factor should the nurse explain is the reason why women are at a greater risk than
men for contracting a urinary tract infection?
Proximity of the urethra to the anus. - ANSWER: Because a woman's urethra is closer
to the anus than a man's, it is at greater risk for becoming contaminated. Urinary pH
is within the same range in both men and women. Hormonal secretions have no
effect on the development of bladder infections. The position of the bladder is the
same in men and women
Which hormone is released in response to low serum levels of calcium?
Parathyroid Hormone - ANSWER: If serum calcium levels decline, the parathyroid
gland releases parathyroid hormone to maintain calcium homeostasis. Renin is a
hormone released in response to decreased renal perfusion; this hormone is
responsible for regulating blood pressure. Erythropoietin is released by the kidneys
in response to poor blood flow to the kidneys; it stimulates the production of red
blood cells. Atrial natriuretic peptide is produced by the right atrium of the heart in
response to increased blood volume. This hormone then acts on the kidneys to
promote sodium excretion, which decreases the blood volume.
A client has end-stage kidney disease and is admitted for a kidney transplant. Which
information should the nurse share when teaching about the donor?
Must have matching leukocyte antigen complexes - ANSWER: Human leukocyte
antigen compatibility provides the most specific predictions of the body's tendency
to accept or reject foreign tissue. Although ABO compatibility is necessary, the exact
, blood type is not. Being a member of the same family does not make for a better
match unless the family member has matching leukocyte antigen complexes. Being a
member of the same family may increase the possibility of a match, but there is no
guarantee that a family member will match. Differences in body size do not cause
rejection.
Which structure is removed during circumcision of an infant?
Prepuce - ANSWER: Circumcision involves removal of the prepuce, which is a skin
folding over the glans. The glans is the tip of the penis. The epididymis is the internal
structure that helps in the transportation and maturation of sperm. The vas deferens
carries sperm from the epididymis to the ejaculatory duct.
Which condition should be reported immediately to the primary healthcare
provider?
Body temperature of 102° F with vaginal discharge 48 hours after cervical biopsy -
ANSWER: The client with cervical biopsy should immediately report to the primary
healthcare provider if experiencing a body temperature of 102° F with vaginal
discharge. This is because fever and vaginal discharge that develops 48 hours after
cervical biopsy may be the signs of infection related to the procedure. The client
should take pain relievers for pelvic pain after colposcopy. Light vaginal bleeding for
1 to 2 days following hysterosalpingogram is common. If the amount of bleeding
increases or extends beyond 2 days, the healthcare provider should be notified. Light
rectal bleeding for a few days is common after prostate biopsy.
After a transurethral vaporization of the prostate, the client returns to the unit with
an indwelling urinary catheter and a continuous bladder irrigation. The client puts
the call light on to report the need to urinate. What should the nurse do first?
Assess that the tubing attached to the collection bag is patent. - ANSWER: The
drainage tubing may be obstructed. Retained fluid raises bladder pressure, causing
discomfort similar to the urge to void. The client's vital signs are not related to the
complaint. Although the nurse may review the client's intake and output, it is not the
priority. Whether urine is draining from the tubing at this point in time is significant.
Although it is true that the balloon inflated in the bladder causes this feeling, the
patency of the gravity system should be ascertained before determining the cause of
the complaint.
The nurse is explaining the physiologic reasons for taking vitamin D and calcium
supplements to a client with renal failure. Which statement made by the nurse is
appropriate?
"There will be a decrease in the active metabolite of vitamin D in your body." -
ANSWER: Renal failure results in decrease in the active metabolite of vitamin D
because inactive vitamin D gets activated in the liver followed by the kidneys. Food
sources of vitamin D and sunlight contribute to an inactive form of the hormone in
