Chapter 30 Urinary Elimination


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Chapter 30  Urinary Elimination



Complete Chapter Questions And Answers

Sample Questions


Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. What is the most significant change in kidney function that occurs with aging?
Decreased glomerular filtration rate

Proliferation of micro blood vessels to renal cortex 3)
Formation of urate crystals
Increased renal mass

ANS: 1
Glomerular filtration rate is the amount of filtrate formed by the kidneys in 1 minute. Renal blood flow progressively decreases with aging primarily because of reduced blood supply through the micro blood vessels of the kidney. A decrease in glomerular filtration is the most important functional deficit caused by aging. Urate crystals are somewhat common in the newborn period. They might indicate that the infant is dehydrated. In older people, they result from too much uric acid in the blood, although this is not related to aging. Renal mass (weight) decreases over time, starting around age 30 to 40.

PTS: 1 DIF: Difficult REF: p. 1013
KEY: Nursing process: N/A | Client need: PHSI | Cognitive level: Recall

____ 2. While performing a physical assessment, the student nurse tells her instructor that she cannot palpate her patient’s bladder. Which statement by the instructor is best? “You should:
Try to palpate it again; it takes practice but you will locate it.”
Palpate the patient’s bladder only when it is distended by urine.”
Document this abnormal finding on the patient’s chart.”
Immediately notify the nurse assigned to the care of your patient.”

ANS: 2
The bladder is not palpable unless it is distended by urine. It is not difficult to palpate the bladder when distended. The nurse should document her finding, but it is not an abnormal finding. It is not necessary to notify the nurse assigned to the patient.

Treas/Wilkinson 30-2 Basic Nursing

PTS: 1 DIF: Easy REF: p. 1014
KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 3. dehydration? 1)

Which urine specific gravity would be expected in a patient admitted with

ANS: 4
Normal urine specific gravity ranges from 1.010 to 1.025. Specific gravity less than 1.010 indicates fluid volume excess, such as when the patient has fluid overload (too much IV fluid) or when the kidneys fail to concentrate urine. Specific gravity greater than 1.025 is a sign of deficient fluid volume that occurs, for example, as a result of blood loss or dehydration.

PTS: 1 DIF: Moderate REF: p. 1015
KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 4. Which medication class will the primary care provider most likely prescribe to increase urine output in the patient admitted with congestive heart failure? 1)
Thiazide diuretic
Loop diuretic
MAO inhibitor

ANS: 2

A loop diuretic [e.g., Furosemide (Lasix)] increases urine elimination. It works by limiting the reabsorption of water in the renal tubules and is used to reduce congestion in the cardiopulmonary circulation. A thiazide diuretic is used to treat high blood pressure by reducing the amount of sodium and water in the blood vessels. An MAO inhibitor

Treas/Wilkinson 30-3 Basic Nursing
[e.g., phenelzine (Nardil)] is an antidepressant that is used after other medications have proven unsuccessful in lifting symptoms of serious depression. Anticholinergics [e.g., ipratropium (Atrovent)] relax smooth muscle in the airways. Also known as antispasmodics, they reduce airway constriction experienced by those with asthma, for example.

is a cholesterol-lowering drug. Although high cholesterol is a leading factor for heart disease, the medication is used to reduce cholesterol in the blood—not to promote diuresis to reduce the demand on the heart and backflow into the lungs.

PTS: 1 DIF: Moderate REF: p. 1016; not stated directly in the text and requires critical thinking
KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Application

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