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 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 2 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 3 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.
Question 4 of 5
A nurse cares for a client with a urine specific gravity of 1.030. Which action should the nurse take?
Correct Answer: C
Rationale: Normal specific gravity for urine is 1.005"?1.030. A high specific gravity (1.030) can indicate dehydration, decreased kidney blood flow, or the presence of antidiuretic hormone. The most appropriate action is to increase the client's fluid intake to address potential dehydration. A urine culture is not indicated unless infection is suspected, and restricting fluids or administering ADH would worsen dehydration.
Question 5 of 5
A nurse reviews laboratory results for a client who was admitted for a myocardial infarction and cardiogenic shock. Which laboratory result indicates the client may have acute kidney injury?
Correct Answer: B
Rationale: Normal creatinine levels are 0.6"?1.2 mg/dL (males) or 0.5"?1.1 mg/dL (females). A creatinine level of 2.3 mg/dL is elevated, indicating possible acute kidney injury, especially in the context of cardiogenic shock, which can reduce renal perfusion. A BUN of 52 mg/dL is also elevated but less specific, as BUN can be affected by non-renal factors.