NURS 223 - MS Q3, Study Guide
An appropriate nursing intervention for the client following a nuclear scan of the kidney
is to:
a) Encourage high fluid intake.
b) Apply moist heat to the flank area.
c) Strain all urine for 48 hours.
d) Monitor for hematuria. - answera) Encourage high fluid intake.
A nuclear scan of the kidney involves the IV administration of a radioisotope. Fluid
intake is encouraged to flush the urinary tract to promote excretion of the isotope.
Monitoring for hematuria, applying heat, and straining urine do not address the potential
renal complications associated with the radioisotope.
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse
initiate the procedure?
a) With the first specimen voided after 8:00 am
b) At 8:00 am, with or without a specimen
c) 6 hours after the urine is discarded
d) After discarding the 8:00 am specimen - answerd) After discarding the 8:00 am
specimen
A 24-hour collection of urine is the primary test of renal clearance used to evaluate how
well the kidney performs this important excretory function. The client is initially
instructed to void and discard the urine. The collection bottle is marked with the time the
client voided. Thereafter, all the urine is collected for the entire 24 hours. The last urine
is voided at the same time the test originally began.
Retention of which electrolyte is the most life-threatening effect of renal failure?
a) Calcium
b) Phosphorous
c) Sodium
d) Potassium - answerd) Potassium
Retention of potassium is the most life-threatening effect of renal failure.
A client has undergone diagnostic testing that involved the insertion of a lighted tube
with a telescopic lens. The nurse identifies this test as which of the following?
a) Renal angiography
,b) Excretory urogram
c) Cystoscopy
d) Intravenous pyelography - answerc) Cystoscopy
Cystoscopy is the visual examination of the inside of the bladder using an instrument
called a cystoscope, a lighted tube with a telescopic lens. Renal angiography involves
the passage of a catheter up the femoral artery into the aorta to the level of the renal
vessels. Intravenous pyelography or excretory urography is a radiologic study that
involves the use of a contrast medium to evaluate the kidneys' ability to excrete it.
The nurse is providing instructions to the client prior to an intravenous pyelogram.
Which statement by the client indicates teaching was effective?
a) "I should remove all jewelry before the test."
b) "I should let the staff know if I feel claustrophobic."
c) "I will feel a warm sensation as the dye is injected."
d) "I will need to drink all of the dye as quickly as possible." - answerc) "I will feel a
warm sensation as the dye is injected."
A contrast agent is injected into the client for an intravenous pyelogram. The client may
experience a feeling of warmth, flushing of the face, or taste a seafood flavor as the
contrast infuses. Jewelry does not need to be removed before the procedure.
Claustrophobia is not expected.
The wall of the bladder has four layers. Which of the following layers contains a
membrane that prevents reabsorption of urine stored in the bladder?
a) Detrusor
b) Connective tissue
c) Adventitia
d) Mucosal - answerd) Mucosal
Beneath the detrusor is a submucosal layer of loose connective tissue that serves as an
interface between the detrusor and the innermost layer, a mucosal lining. This inner
layer contains specialized transitional cell epithelium, a membrane that is impermeable
to water and prevents reabsorption of urine stored in the bladder.
A client in a short-procedure unit is recovering from renal angiography in which a
femoral puncture site was used. When providing postprocedure care, the nurse should:
a) keep the client's knee on the affected side bent for 6 hours.
b) remove the dressing on the puncture site after vital signs stabilize.
c) apply pressure to the puncture site for 30 minutes.
d) check the client's pedal pulses frequently. - answerd) check the client's pedal pulses
frequently.
, After renal angiography involving a femoral puncture site, the nurse should check the
client's pedal pulses frequently to detect reduced circulation to the feet caused by
vascular injury. The nurse also should monitor vital signs for evidence of internal
hemorrhage and should observe the puncture site frequently for fresh bleeding. The
client should be kept on bed rest for several hours so the puncture site can seal
completely. Keeping the client's knee bent is unnecessary. By the time the client returns
to the short-procedure unit, manual pressure over the puncture site is no longer needed
because a pressure dressing is in place. The nurse should leave this dressing in place
for several hours — and only remove it if instructed to do so.
When the bladder contains 350 mL or more of urine, this is referred to as which of the
following?
a) Functional capacity
b) Renal clearance
c) Specific gravity
d) Anuria - answera) Functional capacity
A marked sense of fullness and discomfort, with a strong desire to void, usually occurs
when the bladder contains 350 mL or more of urine, referred to as the "functional
capacity." Anuria is a total urine output of less than 50 mL in 24 hours. Specific gravity
reflects the weight of particles dissolved in the urine. Renal clearance refers to the
ability of the kidneys to clear solutes from the plasma.
A patient is having a problem with retention of urine in the bladder. Which of the
following diagnostic tests measures the amount of residual urine in the bladder?
a) IV urography
b) Nuclear scan
c) Cystography
d) Bladder ultrasonography - answerd) Bladder ultrasonography
A bladder ultrasonography is a noninvasive method of measuring urine volume in the
bladder; automatic calculations display the urine volume. A nuclear scan provides
information about kidney perfusion and function. It is used to evaluate acute and chronic
renal failure. Cystography aids in evaluating vesicourethral reflux and in assessing
bladder injury. IV urography provides an approximate estimate of renal function and
may be used as the initial assessment of many urologic problems.
To obtain information about the chief complaint and medical history of an older male
patient, the nurse asks the patient about his medication history. What is the importance
of obtaining a medication history?
a) It may indicate multiple medications administered by the patient.
b) It may indicate drugs that should not be prescribed to the patient.
c) It may reflect the patient's childhood and family illnesses.
An appropriate nursing intervention for the client following a nuclear scan of the kidney
is to:
a) Encourage high fluid intake.
b) Apply moist heat to the flank area.
c) Strain all urine for 48 hours.
d) Monitor for hematuria. - answera) Encourage high fluid intake.
A nuclear scan of the kidney involves the IV administration of a radioisotope. Fluid
intake is encouraged to flush the urinary tract to promote excretion of the isotope.
Monitoring for hematuria, applying heat, and straining urine do not address the potential
renal complications associated with the radioisotope.
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse
initiate the procedure?
a) With the first specimen voided after 8:00 am
b) At 8:00 am, with or without a specimen
c) 6 hours after the urine is discarded
d) After discarding the 8:00 am specimen - answerd) After discarding the 8:00 am
specimen
A 24-hour collection of urine is the primary test of renal clearance used to evaluate how
well the kidney performs this important excretory function. The client is initially
instructed to void and discard the urine. The collection bottle is marked with the time the
client voided. Thereafter, all the urine is collected for the entire 24 hours. The last urine
is voided at the same time the test originally began.
Retention of which electrolyte is the most life-threatening effect of renal failure?
a) Calcium
b) Phosphorous
c) Sodium
d) Potassium - answerd) Potassium
Retention of potassium is the most life-threatening effect of renal failure.
A client has undergone diagnostic testing that involved the insertion of a lighted tube
with a telescopic lens. The nurse identifies this test as which of the following?
a) Renal angiography
,b) Excretory urogram
c) Cystoscopy
d) Intravenous pyelography - answerc) Cystoscopy
Cystoscopy is the visual examination of the inside of the bladder using an instrument
called a cystoscope, a lighted tube with a telescopic lens. Renal angiography involves
the passage of a catheter up the femoral artery into the aorta to the level of the renal
vessels. Intravenous pyelography or excretory urography is a radiologic study that
involves the use of a contrast medium to evaluate the kidneys' ability to excrete it.
The nurse is providing instructions to the client prior to an intravenous pyelogram.
Which statement by the client indicates teaching was effective?
a) "I should remove all jewelry before the test."
b) "I should let the staff know if I feel claustrophobic."
c) "I will feel a warm sensation as the dye is injected."
d) "I will need to drink all of the dye as quickly as possible." - answerc) "I will feel a
warm sensation as the dye is injected."
A contrast agent is injected into the client for an intravenous pyelogram. The client may
experience a feeling of warmth, flushing of the face, or taste a seafood flavor as the
contrast infuses. Jewelry does not need to be removed before the procedure.
Claustrophobia is not expected.
The wall of the bladder has four layers. Which of the following layers contains a
membrane that prevents reabsorption of urine stored in the bladder?
a) Detrusor
b) Connective tissue
c) Adventitia
d) Mucosal - answerd) Mucosal
Beneath the detrusor is a submucosal layer of loose connective tissue that serves as an
interface between the detrusor and the innermost layer, a mucosal lining. This inner
layer contains specialized transitional cell epithelium, a membrane that is impermeable
to water and prevents reabsorption of urine stored in the bladder.
A client in a short-procedure unit is recovering from renal angiography in which a
femoral puncture site was used. When providing postprocedure care, the nurse should:
a) keep the client's knee on the affected side bent for 6 hours.
b) remove the dressing on the puncture site after vital signs stabilize.
c) apply pressure to the puncture site for 30 minutes.
d) check the client's pedal pulses frequently. - answerd) check the client's pedal pulses
frequently.
, After renal angiography involving a femoral puncture site, the nurse should check the
client's pedal pulses frequently to detect reduced circulation to the feet caused by
vascular injury. The nurse also should monitor vital signs for evidence of internal
hemorrhage and should observe the puncture site frequently for fresh bleeding. The
client should be kept on bed rest for several hours so the puncture site can seal
completely. Keeping the client's knee bent is unnecessary. By the time the client returns
to the short-procedure unit, manual pressure over the puncture site is no longer needed
because a pressure dressing is in place. The nurse should leave this dressing in place
for several hours — and only remove it if instructed to do so.
When the bladder contains 350 mL or more of urine, this is referred to as which of the
following?
a) Functional capacity
b) Renal clearance
c) Specific gravity
d) Anuria - answera) Functional capacity
A marked sense of fullness and discomfort, with a strong desire to void, usually occurs
when the bladder contains 350 mL or more of urine, referred to as the "functional
capacity." Anuria is a total urine output of less than 50 mL in 24 hours. Specific gravity
reflects the weight of particles dissolved in the urine. Renal clearance refers to the
ability of the kidneys to clear solutes from the plasma.
A patient is having a problem with retention of urine in the bladder. Which of the
following diagnostic tests measures the amount of residual urine in the bladder?
a) IV urography
b) Nuclear scan
c) Cystography
d) Bladder ultrasonography - answerd) Bladder ultrasonography
A bladder ultrasonography is a noninvasive method of measuring urine volume in the
bladder; automatic calculations display the urine volume. A nuclear scan provides
information about kidney perfusion and function. It is used to evaluate acute and chronic
renal failure. Cystography aids in evaluating vesicourethral reflux and in assessing
bladder injury. IV urography provides an approximate estimate of renal function and
may be used as the initial assessment of many urologic problems.
To obtain information about the chief complaint and medical history of an older male
patient, the nurse asks the patient about his medication history. What is the importance
of obtaining a medication history?
a) It may indicate multiple medications administered by the patient.
b) It may indicate drugs that should not be prescribed to the patient.
c) It may reflect the patient's childhood and family illnesses.
