Chapter 10 Care of the Patient with a Urinary Disorder

Chapter 10  Care of the Patient with a Urinary Disorder

MULTIPLE CHOICE

1. The amount of water that is eliminated with the urine is regulated by a complex mechanism within the nephron and influenced by a hormone from the posterior pituitary gland called

1. pitocin.
2. rennin hormone.
3. antidiuretic hormone.
4. ACTH.

ANS: C
ADH causes the cells of the distal convoluted tubules to increase their rate of water reabsorption.

DIF: Cognitive Level: Knowledge REF: Page 438 OBJ: 4 TOP: Urine production KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. As the body breaks down protein, nitrogen wastes are broken down into urea, ammonia, and

1. nitrogen.
2. uric acid.
3. nitrates.
4. creatinine.

ANS: D
As proteins break down, nitrogenous wastes—urea, ammonia, and creatinine—are produced.

DIF: Cognitive Level: Analysis REF: Page 434 OBJ: 4 TOP: Physiology KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

3. Because the kidneys are located in proximity to the vertebrae and are protected by the ribs, their location in documentation is referred to as
a. retroperitoneal.
b. diaphragm-vertebral.

c. costovertebral.
d. urachal-peritoneal.

ANS: A
The kidneys lie behind the parietal peritoneum (retroperitoneal).

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 10-2

DIF: Cognitive Level: Knowledge TOP: Location of kidneys
Assessment
MSC: NCLEX: Physiological Integrity

REF: Page 434 OBJ: 1 KEY: Nursing Process Step:

4. A patient with chronic renal failure (CRF) has a nursing diagnosis of Disturbed sensory perceptions related to central nervous system changes induced by uremic toxins. Which nursing intervention is appropriate for this problem?

1. Ensure restricted protein intake to prevent nitrogenous product accumulation.
2. Provide an opportunity for the patient to discuss concerns about his condition.
3. Convey a caring attitude and foster the nurse-patient relationship.
4. Discourage eating fruits and vegetables as sources of high potassium in the diet.

ANS: C
Listen to the patient. Restricted protein intake will benefit acute renal failure but may not help CRF.

DIF: Cognitive Level: Analysis REF: Page 472, Health Promotion box OBJ: 7 TOP: Chronic renal failure (CRF)
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

5. Chronic renal failure (CRF) affects both patients and their families because of the financial predicament and facing the death of a loved one. Which would be an appropriate nursing intervention to address these concerns?

1. Encourage open discussion with social services.
2. Allow family privacy to resolve their issues.
3. Refer the family to a support group.
4. Have the physician speak to the family.

ANS: A
Encourage verbalization of financial concerns and long term care options with representative from social services. Support groups are not designed to assist with financial concerns.

DIF: Cognitive Level: Application REF: Page 472, Health Promotion box OBJ: 12 TOP: Coping KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

6. A nursing intervention to assist the patient with chronic renal failure (CRF) in learning about available community resources would be a consultation with

1. a chaplain.
2. social services.
3. the physician’s office.
4. administrative services.

ANS: B
Patient teaching—inform the patient of community resources.

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 10-3

DIF: Cognitive Level: Application REF: Page 472, Box 10-4 OBJ: 12 TOP: Community resources

KEY: Nursing Process Step: Planning MSC:

NCLEX: Psychosocial Integrity