ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 65 : Assessment of the Renal/Urinary System Questions
Question 1 of 5
A nurse assesses clients on the medical-surgical unit. Which clients are at risk for kidney problems? (Select all that apply.)
Correct Answer: B,C,D
Rationale: Many medications and supplements can affect kidney function. Synthetic creatine supplements, metformin, and high-dose or long-term NSAIDs increase the risk of kidney dysfunction due to their nephrotoxic potential or impact on renal perfusion. Prenatal vitamins and albuterol nebulizers do not pose significant risks to kidney function.
Question 2 of 5
A nurse plans care for an older adult client. Which interventions should the nurse include in this clients plan of care to promote kidney health? (Select all that apply.)
Correct Answer: A,B,E,F
Rationale: Adequate fluid intake prevents dehydration, which can stress the kidneys. Leaving the bathroom light on aids safe ambulation for older adults, reducing fall risk. Thorough perineal care prevents infections, and assessing for urinary retention and UTIs ensures early detection of issues. Delegating bladder training to UAP is inappropriate, as it requires nursing judgment, and scheduled toileting every 6 hours may not address individual needs.
Question 3 of 5
A nurse reviews the urinalysis of a client and notes the presence of glucose. Which action should the nurse take?
Correct Answer: D
Rationale: Glucose normally is not found in the urine. The normal renal threshold for glucose is about 200 mg/dL, which means that a person whose blood glucose is less than 200 mg/dL will not have glucose in the urine. A positive finding for glucose on urinalysis indicates high blood sugar. The most appropriate action would be to perform a capillary artery glucose assessment. The client needs further evaluation for this abnormal result; therefore, documenting and continuing to monitor is not appropriate. Requesting a 24-hour urine test or reviewing the client's dietary selections will not allow the nurse to make a clinical decision related to this abnormality.
Question 4 of 5
A nurse assesses a client with renal insufficiency and a low red blood cell count. The client asks, Is my anemia related to the renal insufficiency? How should the nurse respond?
Correct Answer: C
Rationale: Erythropoietin is produced in the kidney and is released in response to decreased oxygen tension in the renal blood supply. Erythropoietin stimulates red blood cell production in the bone marrow. Anemia and renal insufficiency are not manifestations of vitamin D deficiency. The kidneys do not play a role in the transportation of red blood cells or any other cells in the blood.
Question 5 of 5
A nurse contacts the health care provider after reviewing a clients laboratory results and noting a blood urea nitrogen (BUN) 10 mg/dL and a creatinine 1.0 mg/dL. For which action should the nurse recommend a prescription?
Correct Answer: A
Rationale: Normal BUN is 10"?20 mg/dL, and normal creatinine is 0.6"?1.2 mg/dL (males) or 0.5"?1.1 mg/dL (females). The values provided are within normal limits, so no immediate intervention like hemodialysis or urine culture is necessary. However, given the context, a 24-hour urine test could provide additional data on kidney function, making it the most appropriate recommendation.