NUR 304 Exam 3 Testbank Questions And Answers Well Illustrated 2024.
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NUR 304 Exam 3 Testbank Questions And Answers Well Illustrated 2024.
A nurse reviews the urinalysis of a client and notes the presence of glucose. What action
would the nurse take?
a. Document findings and continue to monitor the client.
b. Contact the primary health care provider and...
NUR 304 Exam 3 Testbank Questions And
Answers Well Illustrated 2024.
A nurse reviews the urinalysis of a client and notes the presence of glucose. What
action
would the nurse take?
a. Document findings and continue to monitor the client.
b. Contact the primary health care provider and recommend a 24-hour urine test.
c. Review the client's recent dietary selections over 3 days.
d. Perform a finger stick blood glucose assessment - correct answer. ANS: D
Glucose normally is not found in the urine. The normal renal threshold for glucose is
about 220 mg/dL (12.2 mmol/L), which means that a person whose blood glucose is
less than 220 mg/dL (12.2 mmol/L) 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 blood glucose assessment. The client needs further evaluation for this
abnormal result; therefore, documenting and continuing to monitor are not appropriate.
Requesting a 24-hour urine test or reviewing the client's dietary selections will not assist
the nurse to make a
clinical decision related to this abnormality.
A nurse reviews the health history of a client with an over-secretion of renin. Which
disorder
would the nurse correlate with this assessment finding?
a. Alzheimer disease
b. Hypertension
c. Diabetes mellitus
d. Viral hepatitis - correct answer. ANS: B
Renin is secreted when special cells in the distal convoluted tubule, called the macula
densa, sense changes in blood volume and pressure. When the macula densa cells
sense that blood
volume, blood pressure, or blood sodium levels are low, renin is secreted. Renin then
converts angiotensinogen into angiotensin I. This leads to a series of reactions that
cause secretion of
the hormone aldosterone. This hormone increases kidney reabsorption of sodium and
water, increasing blood pressure, blood volume, and blood sodium levels. Inappropriate
or excessive renin secretion is a major cause of persistent hypertension. Renin has no
impact on Alzheimer disease, diabetes mellitus, or viral hepatitis.
A nurse reviews the urinalysis results of a client and notes a urine osmolality of 1200
mOsm/kg (1200 mmol/kg). Which action would the nurse take?
,a. Contact the primary health care provider to recommend a low-sodium diet.
b. Prepare to administer an intravenous diuretic.
c. Encourage the client to drink more fluids.
d. Obtain a suction device and implement seizure precautions. - correct answer.
ANS: C
Normal urine osmolality ranges from 300 to 900 mOsm/kg (300 to 900 mmol/kg). This
client's urine is more concentrated, indicating dehydration. The nurse would encourage
the
client to drink more water. Dehydration can be associated with elevated serum sodium
levels. Although a low-sodium diet may be appropriate for this client, this diet change
will not have a
significant impact on urine osmolality. A diuretic would increase urine output and
decrease urine osmolality further. Low serum sodium levels, not elevated serum levels,
place the client
at risk for seizure activity. These options would further contribute to the client's
dehydration or elevate the osmolality.
A nurse assesses a client with renal insufficiency and a low red blood cell count. The
client asks, "Is my anemia related to my kidney problem?" How would the nurse
respond?
a. "Red blood cells produce erythropoietin, which increases blood flow to the kidneys."
b. "Your anemia and kidney problem are related to inadequate vitamin D and a loss of
bone density."
c. "Erythropoietin is usually released from the kidneys and stimulates red blood cell
production in the bone marrow."
d. "Kidney insufficiency inhibits active transportation of red blood cells throughout the
blood." - correct answer. ANS: C
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.
A nurse contacts the primary health care provider after reviewing a client's laboratory
results and noting a blood urea nitrogen (BUN) of 35 mg/dL (12.5 mmol/L) and a serum
creatinine of
1.0 mg/dL (88.4 mcmol/L). What collaborative care measure would the nurse
recommend?
a. Intravenous fluids
b. Hemodialysis
c. Fluid restriction
d. Urine culture and sensitivity - correct answer. ANS: A
,Normal BUN is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). Normal creatinine is 0.6 to 1.2
mg/dL (53.0 to 106.1 mcmol/L) (males) or 0.5 to 1.1 mg/dL (44.2 to 97.2 mcmol/L)
(females). Creatinine is more specific for kidney function than BUN, because BUN can
be affected by several factors (dehydration, high-protein diet, and catabolism). This
client's creatinine is normal, which suggests a nonrenal cause for the elevated BUN. A
common cause of increased BUN is dehydration, so the nurse would recommend giving
the client more fluids, not placing the client on fluid restrictions. Hemodialysis is not an
appropriate treatment for dehydration. The lab results do not indicate an infection;
therefore, a urine culture and sensitivity are not
appropriate.
The nurse is assessing a group of clients for their risk of kidney disease. Which
racial/ethnic
group is at the greatest risk as they age?
a. Latino Americans
b. African Americans
c. Jewish Americans
d. Asian Americans - correct answer. ANS: B
Older African Americans have a greater age-related decrease in glomerular filtration
rate
when compared to other racial-ethnic groups. In addition, blood flow decreases and
sodium
excretion is less effective in older hypertensive African Americans. These changes
make this
group most at risk for kidney disease.
A nurse cares for a client with a urine specific gravity of 1.040. What action would the
nurse
take?
a. Obtain a urine culture and sensitivity.
b. Place the client on restricted fluids.
c. Assess the client's creatinine level.
d. Increase the client's fluid intake. - correct answer. ANS: D
Normal specific gravity for urine is 1.005 to 1.030. A high specific gravity can occur with
dehydration, decreased kidney blood flow (often because of dehydration), and presence
of
antidiuretic hormone. Increasing the client's fluid intake would be a beneficial
intervention.
Assessing the creatinine or obtaining a urine culture would not provide data necessary
for the
nurse to make a clinical decision.
A nurse reviews a client's laboratory results. Which results from the client's urinalysis
would the nurse recognize as abnormal?
a. pH of 5.6
b. Ketone bodies present
, c. Specific gravity of 1.020
d. Clear and yellow color - correct answer. ANS: B
Ketone bodies are by-products of incomplete metabolism of fatty acids. Normally, no
ketones are present in urine. Ketone bodies are produced when fat sources are used
instead of glucose to provide cellular energy. A pH between 4.6 and 8, specific gravity
between 1.005 and 1.030, and clear yellow urine are normal findings in a urinalysis.
A nurse cares for a client who is recovering from a closed percutaneous kidney biopsy.
The client states, "My pain has suddenly increased from a 3 to a 10 on a scale of 0-10."
Which
action would the nurse take first?
a. Reposition the client on the operative side.
b. Administer the prescribed opioid analgesic.
c. Assess the client's pulse rate and blood pressure.
d. Examine the color of the client's urine. - correct answer. ANS: C
An increase in the intensity of pain after a percutaneous kidney biopsy is a symptom of
possible internal hemorrhage. A change in vital signs (elevated pulse and decreased
blood pressure) can indicate that hemorrhage is occurring.
The nurse delegates completing a bladder scan to assistive personnel (AP). Which
action by
the AP indicates that the nurse must provide additional instructions when delegating this
task?
a. Selecting the female icon for all female patients and male icon for all male patients
b. Telling the client, "This test measures the amount of urine in your bladder."
c. Applying ultrasound gel to the scanning head and removing it when finished
d. Taking at least two readings using the aiming icon to place the scanning head -
correct answer. ANS: A
The AP should use the female icon for women who have not had a hysterectomy. This
allows
the scanner to subtract the volume of the uterus from readings. If a woman has had a
hysterectomy, the AP should choose the male icon. The AP should explain the
procedure to
the client, apply gel to the scanning head and clean it after use, and take at least two
readings.
A nurse reviews a client's laboratory results. Which results from the client's urinalysis
would
the nurse identify as normal? (Select all that apply.)
a. pH: 6
b. Specific gravity: 1.015
c. Protein: 1.2 mg/dL
d. Glucose: negative
e. Nitrate: small
f. Leukocyte esterase: positive - correct answer. ANS: A, B, D
The pH, specific gravity, and glucose are all within normal ranges. The other values are
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