Question 1

Erythropoietin is a hormone produced by the kidney.What will a deficiency of erythropoietin in a patient in chronic renal failure result in?

Accepted Answer

A)   Diminished immunologic function with fewer white blood cells
B)   Elevated lipid levels in the bloodstream, contributing to accelerated atherosclerosis
C)   Anemia as a result of the diminished number of red blood cells being produced
D)   Hypertension as a result of the increased, concentrated blood volume C

Question 2

What laboratory value change should indicate to a nurse that a patient with renal failure has entered the oliguric stage?

Accepted Answer

A)   Blood urea nitrogen (BUN) level rises.
B)   Serum calcium increases.
C)   Blood volume decreases.
D)   Urine osmolality increases. A

Question 3

What should nursing care focus on when caring for a patient with a ureteral catheter in place after the removal of a kidney stone?

Accepted Answer

A)   Irrigating the catheter regularly
B)   Assessing for patency
C)   Including ureteral output with the bladder output
D)   Early ambulation B

Question 4

A nurse is performing frequent catheterizations for residual urine.What causes the greatest concern for the nurse?

Accepted Answer

A)   Introduction of pathogens into the bladder
B)   Frequent genital exposure of the patient
C)   Presence of the indwelling catheter
D)   Causing urethral erosion

Question 5

Which urine test provides the most accurate measurement of renal function?

Accepted Answer

A)   BUN
B)   Phosphates
C)   Specific gravity
D)   Creatinine

Question 6

A nurse is assessing a patient with renal impairment.Which facial characteristic is a sign of fluid retention?

Accepted Answer

A)   Broken blood vessels around the nose
B)   Periorbital edema
C)   Rash on cheeks and neck
D)   Facial twitching

Question 7

A nurse reads the serum calcium laboratory report of a patient as 4.2 mEq/L.Which symptoms should the nurse anticipate that the patient might exhibit? (Select all that apply.)

Accepted Answer

A)   Irritability
B)   Tingling sensations in limbs
C)   Tetany
D)   Nausea
E)   Visual disturbances

Question 8

A nurse is planning the care for an older adult patient.Which age-related changes in kidney function should the nurse consider when providing care to this patient? (Select all that apply.)

Accepted Answer

A)   Thinning of nephron membranes
B)   Sclerosis of renal blood vessels
C)   Decreasing glomerular filtrations
D)   Decreasing ability to concentrate or dilute urine
E)   Decreasing erythropoietin

Question 9

A nurse is caring for a patient with a Foley catheter.What actions should the nurse implement to decrease this patient's risk for infection? (Select all that apply.)

Accepted Answer

A)   Keep the bag below the level of the bed.
B)   Provide perineal care twice a day.
C)   Flush the tubing as needed.
D)   Use Standard Precautions when handling urine and tubing.
E)   Keep the drainage system open.

Question 10

A nurse is caring for a patient after urinary diversion surgery.What postoperative nursing assessment is the priority?

Accepted Answer

A)   Level of fluid intake
B)   Position on the left side
C)   Keep the bed flat
D)   Bowel sounds

Question 11

What is true about the urine osmolality when the kidney is adequately functioning?

Accepted Answer

A)   Equal to the osmolality of the serum
B)   Approximately half of the serum
C)   In a ratio of 10:1 with the serum
D)   Equal to the excretion of urea

Question 12

A patient has a nephrostomy tube that has been inserted because of an obstruction in the ureter.What special precautions in the care of the nephrostomy tube should the nurse implement?

Accepted Answer

A)   Clamping every 2 hours to allow expansion of the kidney pelvis
B)   Instilling no more than 50 mL of sterile water if sterile irrigations are ordered
C)   Being certain the tube is connected, not kinked, or not clamped to ensure that it continually drains
D)   Leaving the nephrostomy site open to air

Question 13

Which statement by a patient on dialysis, taking gentamicin (Garamycin), should cause the nurse the most concern?

Accepted Answer

A)   "I have a horrible headache."
B)   "Speak up! I can't hear you."
C)   "I've had diarrhea once or twice today."
D)   "I'm thirsty.I can't get enough water."

Exam 41: Urologic System Introduction