Assessment of the Renal, Urinary System (Concepts for Interprofessional Collaborative Care College Test

Assessment of the Renal, Urinary System (Concepts for Interprofessional Collaborative Care College Test
MULTIPLE CHOICE
1. A nurse reviews the urinalysis of a client and notes the presence of glucose. Which action should the nurse
take?
a. Document findings and continue to monitor the client.
b. Contact the provider and recommend a 24-hour urine test.
c. Review the clients recent dietary selections.
d. Perform a capillary artery glucose assessment.
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 capillary artery glucose assessment. The client needs further evaluation for this abnormal result; therefore,
documenting and continuing to monitor is not appropriate. Requesting a 24-hour urine test or reviewing the
clients dietary selections will not assist the nurse to make a clinical decision related to this abnormality.
2. A nurse reviews the health history of a client with an oversecretion of renin. Which disorder should the
nurse correlate with this assessment finding?
a. Alzheimers disease
b. Hypertension
c. Diabetes mellitus
d. Viral hepatitis
ANS: B
Renin is secreted when special cells in the distal convoluted tubule, called the macula densa, sense changes in
blood volume and pressure. When the macula densa cells sense that blood volume, blood pressure, 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. Renin has no impact on
Alzheimers disease, diabetes mellitus, or viral hepatitis.
3. A nurse reviews the urinalysis results of a client and notes a urine osmolality of 1200 mOsm/L. Which
action should the nurse take?
a. Contact the provider and recommend a low-sodium diet.
b. Prepare to administer an intravenous diuretic.
c. Obtain a suction device and implement seizure precautions.
d. Encourage the client to drink more fluids.
ANS: D
Normal urine osmolality ranges from 300 to 900 mOsm/L. This clients urine is more concentrated, indicating
dehydration. The nurse should encourage the client to drink more water. Dehydration can be associated with
elevated serum sodium levels. Although a low-sodium diet may be appropriate for this client, this diet change
will not have a significant impact on urine osmolality. A diuretic would increase urine output and decrease
urine osmolality further. 

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