Chapter 53: Assessment of Kidney and Urinary Function - Nurselytic

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Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)

Chapter 53 : Assessment of Kidney and Urinary Function Questions

Question 1 of 5

Results of a patients 24 -hour urine sample indicate osmolality of510 \mathrm{mOsm} / \mathrm{kg}$, which is within reference range. What conclusion can the nurse draw from this assessment finding?

Correct Answer: C

Rationale: Osmolality is the most accurate measurement of the kidneys ability to dilute and concentrate urine. Osmolality is not a direct indicator of renal function as it relates to erythropoietin synthesis or maintenance of acidbase balance. It does not indicate the maintenance of healthy levels of potassium, the vast majority of which is excreted.

Question 2 of 5

A patient is scheduled for diagnostic testing to address prolonged signs and symptoms of genitourinary dysfunction. What signs and symptoms are particularly suggestive of urinary tract disease? Select all that apply.

Correct Answer: B,C,D

Rationale: Dysfunction of the kidney can produce a complex array of symptoms throughout the body. Pain, changes in voiding, and gastrointestinal symptoms are particularly suggestive of urinary tract disease. Jaundice and petechiae are not associated with genitourinary health problems.

Question 3 of 5

A patient asks the nurse why kidney problems can cause gastrointestinal disturbances. What relationship should the nurse describe?

Correct Answer: A

Rationale: The proximity of the right kidney to the colon, duodenum, head of the pancreas, common bile duct, liver, and gallbladder may cause GI disturbances. The proximity of the left kidney to the colon (splenic flexure), stomach, pancreas, and spleen may also result in intestinal symptoms. Digestive enzymes do not affect renal function and the left kidney is not connected to the common bile duct.

Question 4 of 5

A patient with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value?

Correct Answer: B

Rationale: Although historically hematocrit has been the blood test of choice when assessing a patient for anemia, use of the hemoglobin level rather than hematocrit is currently recommended, because that measurement is a better assessment of the oxygen transport ability of the blood. ESR and creatinine levels are not indicative of oxygen transport ability.

Question 5 of 5

The nurse is reviewing the electronic health record of a patient with a history of incontinence. The nurse reads that the physician assessed the patients deep tendon reflexes. What condition of the urinary/renal system does this assessment address?

Correct Answer: B

Rationale: The deep tendon reflexes of the knee are examined for quality and symmetry. This is an important part of a testing for neurologic causes of bladder dysfunction, because the sacral area, which innervates the lower extremities, is in the same peripheral nerve area responsible for urinary continence. Neurologic function does not directly influence the course of renal calculi, BPH or UTIs.

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