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Chapter 30 Alterations of Renal and Urinary Tract Function
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- Galen College Of Nursing
Chapter 30 Alterations of Renal and Urinary Tract Function
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Chapter 30: Alterations of Renal and Urinary Tract FunctionMULTIPLE CHOICE
1. A patient is diagnosed with urinary tract obstruction. While planning care, the nurse realizes
that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate
caused by:
a. decreased renal blood flow.
b. decreased peritubular capillary pressure.
c. dilation of the renal pelvis and calyces proximal to a blockage.
d. stimulation of antidiuretic hormone.
ANS: C
Hydronephrosis occurs due to dilation of the renal pelvis and calyces proximal to a
blockage. Hydronephrosis is not the result of a decrease in renal blood flow, or peritubular
capillary pressure, or stimulation of the antidiuretic hormone.
REF: p. 747
2. A patient has a severe kidney obstruction leading to removal of the affected kidney. Which
of the following would the nurse expect to occur?
a. Atrophy of the remaining kidney
b. Compensatory hypertrophy of the remaining kidney
c. Dysplasia in the remaining kidney
d. Renal failure
ANS: B
The remaining kidney would hypertrophy to compensate for the increased workload of the
loss of the affected kidney. Compensation for such a situation would not include atrophy or a
change in cell structure of the remaining kidney. Renal failure would be avoided.
REF: p. 748
3. A 55-year-old presents reporting urinary retention. Tests reveal a lower urinary
tract obstruction. Which of the following is of most concern to the nurse?
a. Vesicoureteral reflux and pyelonephritis
b. Formation of renal calculi
c. Glomerulonephritis
d. Increased bladder compliance
ANS: B
Urine stasis occurs with urinary tract obstruction and can lead to the formation of renal
calculi. Reflux and pyelonephritis would not lead to calculi as much as stasis would. Neither
glomerulonephritis nor increased bladder compliance causes the stasis that would lead to
calculus formation.
REF: p. 748
4. What is the most common type of renal stone composed of?
, a. Struvite
b. Cystine
c. Calcium
d. Uric acid
ANS: C
The most common stone types are calcium oxalate or phosphate (70-80%). Struvite
(magnesium-ammonium-phosphate) occurs 15% of the time. Cystine stoes are rare (less than
1%). Uric acid stones occur 7% of the time.
REF: p. 748
5. While planning care for a patient with renal calculi, the nurse remembers the most important
factor in renal calculus formation is:
a. urine pH.
b. body temperature.
c. gender.
d. serum mineral concentrations.
ANS: A
The most important factor in renal calculus formation is urine pH, not gender, although
calculi form more often in men. Neither body temperature nor serum mineral concentrations
are as important as urine pH.
REF: p. 749
6. A patient is diagnosed with renal calculus that is causing a urinary obstruction. Which
symptoms would be most likNely RexpIerieGncedB?.C M
a. Anuria
U S N T
b. Hematuria O
c. Pyuria
d. Flank pain
ANS: D
Significant flank pain is the most common manifestation. Neither anuria nor pyuria is a
common manifestation. Hematuria does occur, but it is not the most common
manifestation.
REF: p. 749
7. When a patient’s CT scan reveals a lesion above the pontine micturition center, which
condition would the nurse expect?
a. Dyssynergia
b. Detrusor hyperreflexia
c. Detrusor areflexia
d. Detrusor sphincter dyssynergia
ANS: B
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