C HAPTER 25: K IDNEY C LINICAL
A SSESSMENT AND D IAGNOSTIC
P ROCEDURES
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. A patient was admitted with acute kidney failure. Which urinalysis value
reflects a decreased abilit y of the kidneys to concentrate urine?
a. pH of 5.0
b. Specific gravit y of 1.000
c. No casts
d. Urine sodium of 140 mEq/24 h
ANS: B
Specific gravit y measures the densit y or weight of urine compared with
that of distilled water. The normal urinary specific gravit y is 1.005 to
1.025. For comparison, the specific gravity of distilled water is 1.000.
Because urine is composed of many solutes and substances suspended
in water, the specific gravit y should always be higher than that of
water.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
627 OBJ: Nursing Process Step: Assessment TOP: Renal
MSC: NC LEX: Physiologic Integrit y
, 2. A patient is admitted in acute heart failure secondary to renal
insufficiency. The patient reports that over the past few weeks, his urine
output has decreased, and he has developed peripheral edema and ascites.
The nurse suspects the main cause of ascites is what condition?
a. Hypervolemia
b. Dehydration
c. Volume overload
d. Liver damage
ANS: C
Individuals with kidney failure may have ascites caused by volume
overload, which forces fluid into the abdomen because of increased
capillary hydrostatic pressures. However, ascites may or may not
represent fluid volume excess. Severe ascites in persons with
compromised liver function may result from decreased plasma proteins.
The ascites occurs because the increased vascular pressure associated
with liver dysfunction forces fluid and plasma protei ns from the
vascular space into the interstitial space and abdominal cavity.
Although the individual may exhibit marked edema, the intravascular
space is volume depleted, and the patient is hypovolemic.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
623 OBJ: Nursing Process Step: Assessment TOP: Renal
MSC: NC LEX: Physiologic Integrit y
3. A patient is admitted in acute heart failure secondary to renal
insufficiency. The patient reports that over the past few weeks, his urine
output has decreased, an d he has developed peripheral edema and ascites.
A SSESSMENT AND D IAGNOSTIC
P ROCEDURES
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. A patient was admitted with acute kidney failure. Which urinalysis value
reflects a decreased abilit y of the kidneys to concentrate urine?
a. pH of 5.0
b. Specific gravit y of 1.000
c. No casts
d. Urine sodium of 140 mEq/24 h
ANS: B
Specific gravit y measures the densit y or weight of urine compared with
that of distilled water. The normal urinary specific gravit y is 1.005 to
1.025. For comparison, the specific gravity of distilled water is 1.000.
Because urine is composed of many solutes and substances suspended
in water, the specific gravit y should always be higher than that of
water.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
627 OBJ: Nursing Process Step: Assessment TOP: Renal
MSC: NC LEX: Physiologic Integrit y
, 2. A patient is admitted in acute heart failure secondary to renal
insufficiency. The patient reports that over the past few weeks, his urine
output has decreased, and he has developed peripheral edema and ascites.
The nurse suspects the main cause of ascites is what condition?
a. Hypervolemia
b. Dehydration
c. Volume overload
d. Liver damage
ANS: C
Individuals with kidney failure may have ascites caused by volume
overload, which forces fluid into the abdomen because of increased
capillary hydrostatic pressures. However, ascites may or may not
represent fluid volume excess. Severe ascites in persons with
compromised liver function may result from decreased plasma proteins.
The ascites occurs because the increased vascular pressure associated
with liver dysfunction forces fluid and plasma protei ns from the
vascular space into the interstitial space and abdominal cavity.
Although the individual may exhibit marked edema, the intravascular
space is volume depleted, and the patient is hypovolemic.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
623 OBJ: Nursing Process Step: Assessment TOP: Renal
MSC: NC LEX: Physiologic Integrit y
3. A patient is admitted in acute heart failure secondary to renal
insufficiency. The patient reports that over the past few weeks, his urine
output has decreased, an d he has developed peripheral edema and ascites.
