Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
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Chapter 68: Assessment of the Renal/Urinary System
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | The problem involves the right kidney. |
| b. | The problem involves the left kidney. |
| c. | Both kidneys are in the normal position. |
| d. | The client is at increased risk for kidney impairment. |
ANS: C
Normally, the left kidney is situated more deeply, and often it cannot be palpated. This is a normal finding.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 1476
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | Inform the health care provider. |
| b. | Ask the client about his or her protein intake. |
| c. | Obtain the client’s weight. |
| d. | Document the finding in the chart. |
ANS: A
Protein is normally reabsorbed and does not show up, except in very small amounts, in the urine. Protein greater than 0.8 mg/dL is abnormal and could indicate stress, infection, recent strenuous exercise, or glomerular problems. This finding should be reported. The other actions would not give information about the origin of the protein.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Laboratory Values) MSC: Integrated Process: Nursing Process (Implementation)
| a. | Document the finding and call the health care provider. |
| b. | Collect and send another urinalysis sample to the laboratory. |
| c. | Review the client’s recent dietary selections. |
| d. | Perform a finger stick blood glucose on the client. |
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 finger stick blood glucose. If facility policy does not allow that action, calling the provider would be best. The client needs further evaluation for this abnormal result.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Laboratory Values) MSC: Integrated Process: Nursing Process (Assessment)
| a. | Alzheimer’s disease |
| b. | Hypertension |
| c. | Diabetes mellitus |
| d. | Diabetes insipidus |
ANS: B
Renin is secreted when special cells in the distal convoluted tubule (DCT), called the macula densa, sense changes in blood volume and pressure. When the macula densa cells sense that blood volume is low, blood pressure is low, 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.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 1471
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
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Original price was: $30.00.$20.00Current price is: $20.00.