and Answers (Nursing Concepts and Clinical Applications) || Nurs
352 Exam 2 Latest version!!!
A patient has urinary calculi. While planning care, the nurse considers
which most important factor in the formation of renal calculi?
A. Urine pH
B. Urine sodium levels
C. Serum lactate levels
D. Temperature of the urine - Answer-A. Urine pH
Rationale
The temperature and pH of the urine influence the risk of precipitation
and calculus formation, and pH is most important. Urine sodium
levels and serum lactate levels do not have a major influence on
formation of renal calculi.
Which are causes of chronic kidney disease? Select all that apply.
A. Infection
B. Hypertension
C. Diabetes mellitus
D. Chronic pyelonephritis
E. Toxic injury to kidney cells
F. Acute bladder neck obstruction - Answer-B. Hypertension
C. Diabetes mellitus
D. Chronic pyelonephritis
Systemic diseases, such as hypertension and diabetes mellitus, or
intrinsic kidney diseases, such as chronic pyelonephritis, are causes of
chronic kidney disease. Infection, acute bladder neck obstruction, and
toxic injury to kidney cells are more likely associated with acute
kidney injury than with chronic kidney disease.
pg. 1
,An individual has a lower urinary tract obstruction. Which findings
will typically be observed upon assessment? Select all that apply.
A. Nocturia
B. Flank pain
C. Urinary urgency
D. Intermittent urinary stream
E. Increased voiding frequency - Answer-A. Nocturia
C. Urinary urgency
D. Intermittent urinary stream
E. Increased voiding frequency
An individual recently underwent a release of a unilateral complete
ureteral obstruction, resulting in post obstructive diuresis. Which
clinical manifestation is to be expected?
A. Edema
B. Weight gain
C. Increased urine output
D. Increased blood pressure - Answer-C. Increased urine output
Diuresis is an increase in urine output. Relief of bilateral, partial
urinary tract obstruction or complete obstruction of one kidney is
usually followed by a brief period of diuresis (commonly called post
obstructive diuresis). Increased blood pressure, edema, and weight
gain are indications of increased fluid volume, not decreased volume.
An individual with a kidney obstruction developed compensatory
hypertrophy and hyperfunction. Which physiologic process occurred?
A. Relief of obstruction followed by a brief period of diuresis
pg. 2
,B. Increase in glomerular and tubular size to increase filtration of the
unaffected kidney
C. Sympathetic nervous system responses to compensate for fluid
volume depletion
D. Release of somatomedin to break down renal calculi in the affected
kidney - Answer-B. Increase in glomerular and tubular size to
increase filtration of the unaffected kidney
Rationale
The body is able to partially counteract the negative consequences of
unilateral obstruction by processes called compensatory hypertrophy
and hyperfunction. These processes cause the unobstructed kidney to
increase the size of individual glomeruli and tubules but not the total
number of functioning nephrons. Relief of obstruction followed by a
brief period of diuresis is commonly called post obstructive diuresis,
not compensatory hypertrophy and hyperfunction. Sympathetic
nervous system responses can compensate for fluid volume depletion
by release of hormones and neurotransmitters, but such release does
not cause compensatory hypertrophy and hyperfunction.
Somatomedins cause the obligatory growth that occurs in
compensatory hypertrophy, not the breakdown of renal calculi.
Which information is correct regarding physiologic mechanisms that
protect against urinary tract infections? Select all that apply.
A. Prostatitis
B. Acidic urine
C. Hypercalcemia
D. Tamm-Horsfall protein
E. Uroepithelial secretions - Answer-B. Acidic urine
D. Tamm-Horsfall protein
E. Uroepithelial secretions
pg. 3
, Several factors normally combine to protect against urinary tract
infections. Most bacteria are washed out of the urethra during
micturition. The low pH (acidic urine) and high osmolality of urea,
the presence of Tamm-Horsfall protein, and secretions from the
uroepithelium provide a bactericidal effect. Inflammation of the
prostate (prostatitis) causes urinary stasis and increases the risk of
urinary tract infection, whereas hypercalcemia promotes renal calculi
and urinary stasis.
Which laboratory result would indicate a 25-year-old woman
experiencing urinary frequency, urgency, and dysuria has interstitial
cystitis?
A. Urinalysis demonstrating an acidic pH
B. Urinalysis demonstrating cloudy urine
C. Urine culture demonstrating no bacteria
D. Urine culture demonstrating Escherichia coli - Answer-C. Urine
culture demonstrating no bacteria
Interstitial cystitis occurs most commonly in women ages 20 to 30
years who have symptoms of cystitis, such as frequency, urgency,
dysuria, and nocturia, but with negative urine cultures and no other
known cause. Urine pH is supposed to be acidic, and cloudy urine is
associated with a urinary tract infection. Interstitial cystitis would
have a negative urine culture, not a culture with E. coli, which would
indicate a urinary tract infection.
Which should be considered about the calcium level in an individual
in chronic renal failure?
A. Calcium will be abnormally high due to acidosis.
B. Calcium will be abnormally low in the blood serum.
C. Calcium will be abnormally high in the blood serum.
pg. 4