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CHAPTER 18: KIDNEY CLINICAL ASSESSMENT AND DIAGNOSTIC PROCEDURES

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Urden: Priorities in Critical Care Nursing, 8th Edition MULTIPLE CHOICE 1. A patient was admitted with acute kidney injury. Which urinalysis value reflects a decreased ability of the kidneys to concentrate urine? a. pH of 5.0 b. Specific gravity of 1.000 c. No casts d. Urine sodium of 140 mEq/24 hr ANS: B Specific gravity measures the density or weight of urine compared with that of distilled water. The normal urinary specific gravity is 1.005 to 1.025. For comparison, the specific gravity of distilled water is 1.000. Because urine is composed of many solutes and substances suspended in water, the specific gravity should always be higher than that of water. PTS: 1 DIF: Cognitive Level: Analyzing OBJ: Nursing Process Step: Assessment TOP: Kidney Clinical Assessment and Diagnostic Procedures MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 2. A patient is admitted in acute kidney injury. The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites. The nurse suspects the main cause of ascites is what condition? a. Hypervolemia b. Dehydration c. Volume overload d. Liver damage ANS: C Individuals with acute kidney injury may have ascites caused by volume overload, which forces fluid into the abdomen because of increased capillary hydrostatic pressures. However, ascites may or may not represent fluid volume excess. PTS: 1 DIF: Cognitive Level: Applying OBJ: Nursing Process Step: Assessment TOP: Kidney Clinical Assessment and Diagnostic Procedures MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. A patient is admitted in acute heart failure secondary to renal insufficiency. The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites. Which diagnostic tests would provide the best information about the internal kidney structures, such as the parenchyma, calyces, pelvis, ureters, and bladder? a. Kidney–ureter–bladder (KUB) b. Intravenous pyelography (IVP) c. Renal ultrasonography (ECHO) d. Renal angiography

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C HAPTER 18: K IDNEY C LINICAL A SSESSMENT
AND D IAGNOSTIC P ROCEDURES
Urden: Priorities in Critical Care Nursing, 8th Edition




MULTIPLE CHOICE


1. A patient was admitted with acute kidney injury. Which urinalysis value
reflects a decreased abilit y of the kidneys to concentrate urine?
a. pH of 5.0
b. Specific gravit y of 1.000
c. No casts
d. Urine sodium of 1 40 mEq/24 hr



ANS: B



Specific gravit y measures the densit y or weight of urine compared with
that of distilled water. The normal urinary specific gravit y is 1.005 to
1.025. For comparison, the specific gravity of distilled water is 1.000.
Because urine is composed of many solutes and substances suspended
in water, the specific gravit y should always be higher than that of
water.



PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Assessment TOP: Kidney Clinical
Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential

, 2. A patient is admitted in acute kidney injury. The patient reports that
over the past few weeks, his urine output has decreased, and he has
developed peripheral edema and ascites . The nurse suspects the main
cause of ascites is what condition?
a. Hypervolemia
b. Dehydration
c. Volume overload
d. Liver damage



ANS: C



Individuals with acute kidney injury may have ascites caused by
volume overload, which forces fluid into the abdomen because o f
increased capillary hydrostatic pressures. However, ascites may or may
not represent fluid volume excess.



PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Assessment TOP: Kidney Clinical Assessment
and Diagnostic Procedures MSC: NC LEX: Physiological
Integrit y: Physiological Adaptation



3. A patient is admitted in acute heart failure secondary to renal
insufficiency. The patient reports that over the past few weeks, his urine
output has decreased, and he has developed peripheral edema and
ascites. Which diagnostic tests would provide the best information about
the internal kidney structures, such as the parenchyma, cal yces, pelvis,
ureters, and bladder?
a. Kidney–ureter–bladder (KUB)
b. Intravenous pyelography (IVP)
c. Renal ultrasonography (ECH O)
d. Renal angiography
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