Test Bank for ATI Renal and Urinary Exam
2024
(All chapters covered)
(Complete Guide)
(Graded A+)
A nurse reviews the urinalysis of a client and notes the presence of glucose. Which
action should the nurse take?
a. Document findings and continue to monitor the client.
b. Contact the provider and recommend a 24-hour urine test.
c. Review the clients recent dietary selections.
d. Perform a capillary artery glucose assessment. - ANS: D
Glucose normally is not found in the urine. The normal renal threshold for glucose is
about 220 mg/dL, which means that a person whose blood glucose is less than 220
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 clients 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 oversecretion of renin. Which
disorder should the nurse correlate with this assessment finding?
a. Alzheimers disease
b. Hypertension
c. Diabetes mellitus
d. Viral hepatitis - 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 Alzheimers disease, diabetes mellitus,
or viral hepatitis.
A nurse reviews the urinalysis results of a client and notes a urine osmolality of 1200
mOsm/L. Which action should the nurse take?
a. Contact the provider and recommend a low-sodium diet.
,b. Prepare to administer an intravenous diuretic.
c. Obtain a suction device and implement seizure precautions.
d. Encourage the client to drink more fluids. - ANS: D
Normal urine osmolality ranges from 300 to 900 mOsm/L. This clients urine is more
concentrated, indicating dehydration. The nurse should 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
clients 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 the renal insufficiency? How should the nurse
respond?
a. Red blood cells produce erythropoietin, which increases blood flow to the kidneys.
b. Your anemia and renal insufficiency 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. - 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 health care provider after reviewing a clients laboratory results and
noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For
which action should the nurse recommend a prescription?
a. Intravenous fluids
b. Hemodialysis
c. Fluid restriction
d. Urine culture and sensitivity - ANS: A
, Normal BUN is 10 to 20 mg/dL. Normal creatinine is 0.6 to 1.2 mg/dL (males) or 0.5 to
1.1 mg/dL (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 clients creatinine is normal, which suggests a non-renal cause for the elevated
BUN. A common cause of increased BUN is dehydration, so the nurse should anticipate
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 is not appropriate.
A nurse cares for a client with an increased blood urea nitrogen (BUN)/creatinine ratio.
Which action should the nurse take first?
a. Assess the clients dietary habits.
b. Inquire about the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
c. Hold the clients metformin (Glucophage).
d. Contact the health care provider immediately. - ANS: A
An elevated BUN/creatinine ratio is often indicative of dehydration, urinary obstruction,
catabolism, or a high- protein diet. The nurse should inquire about the clients dietary
habits. Kidney damage related to NSAID use most likely would manifest with elevations
in both BUN and creatinine, but no change in the ratio. The nurse should obtain more
assessment data before holding any medications or contacting the provider.
A nurse cares for a client with a urine specific gravity of 1.040. Which action should the
nurse take?
a. Obtain a urine culture and sensitivity.
b. Place the client on restricted fluids.
c. Assess the clients creatinine level.
d. Increase the clients fluid intake. - 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 the
presence of antidiuretic hormone. Increasing the clients 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 laboratory results for a client who was admitted for a myocardial
infarction and cardiogenic shock 2 days ago. Which laboratory test result should the
nurse expect to find?
a. Blood urea nitrogen (BUN) of 52 mg/dL
2024
(All chapters covered)
(Complete Guide)
(Graded A+)
A nurse reviews the urinalysis of a client and notes the presence of glucose. Which
action should the nurse take?
a. Document findings and continue to monitor the client.
b. Contact the provider and recommend a 24-hour urine test.
c. Review the clients recent dietary selections.
d. Perform a capillary artery glucose assessment. - ANS: D
Glucose normally is not found in the urine. The normal renal threshold for glucose is
about 220 mg/dL, which means that a person whose blood glucose is less than 220
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 clients 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 oversecretion of renin. Which
disorder should the nurse correlate with this assessment finding?
a. Alzheimers disease
b. Hypertension
c. Diabetes mellitus
d. Viral hepatitis - 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 Alzheimers disease, diabetes mellitus,
or viral hepatitis.
A nurse reviews the urinalysis results of a client and notes a urine osmolality of 1200
mOsm/L. Which action should the nurse take?
a. Contact the provider and recommend a low-sodium diet.
,b. Prepare to administer an intravenous diuretic.
c. Obtain a suction device and implement seizure precautions.
d. Encourage the client to drink more fluids. - ANS: D
Normal urine osmolality ranges from 300 to 900 mOsm/L. This clients urine is more
concentrated, indicating dehydration. The nurse should 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
clients 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 the renal insufficiency? How should the nurse
respond?
a. Red blood cells produce erythropoietin, which increases blood flow to the kidneys.
b. Your anemia and renal insufficiency 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. - 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 health care provider after reviewing a clients laboratory results and
noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For
which action should the nurse recommend a prescription?
a. Intravenous fluids
b. Hemodialysis
c. Fluid restriction
d. Urine culture and sensitivity - ANS: A
, Normal BUN is 10 to 20 mg/dL. Normal creatinine is 0.6 to 1.2 mg/dL (males) or 0.5 to
1.1 mg/dL (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 clients creatinine is normal, which suggests a non-renal cause for the elevated
BUN. A common cause of increased BUN is dehydration, so the nurse should anticipate
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 is not appropriate.
A nurse cares for a client with an increased blood urea nitrogen (BUN)/creatinine ratio.
Which action should the nurse take first?
a. Assess the clients dietary habits.
b. Inquire about the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
c. Hold the clients metformin (Glucophage).
d. Contact the health care provider immediately. - ANS: A
An elevated BUN/creatinine ratio is often indicative of dehydration, urinary obstruction,
catabolism, or a high- protein diet. The nurse should inquire about the clients dietary
habits. Kidney damage related to NSAID use most likely would manifest with elevations
in both BUN and creatinine, but no change in the ratio. The nurse should obtain more
assessment data before holding any medications or contacting the provider.
A nurse cares for a client with a urine specific gravity of 1.040. Which action should the
nurse take?
a. Obtain a urine culture and sensitivity.
b. Place the client on restricted fluids.
c. Assess the clients creatinine level.
d. Increase the clients fluid intake. - 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 the
presence of antidiuretic hormone. Increasing the clients 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 laboratory results for a client who was admitted for a myocardial
infarction and cardiogenic shock 2 days ago. Which laboratory test result should the
nurse expect to find?
a. Blood urea nitrogen (BUN) of 52 mg/dL
