Nursing Interventions
The nursing instructor is talking with students about the renal system. What would the instructor tell the students about the renal system, especially how it helps maintain calcium levels in the body by regulating the activation of what?
A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D
D) Vitamin D
Rationale: Pg. 881
The renal system has 4 major functions. What are they?
1.Maintaining the volume and composition of body fluids within normal ranges
2. Regulating vitamin D activation, which helps maintain and regulate calcium levels
3. Regulating blood pressure through the renin–angiotensin–aldosterone system
4. Regulating red blood cell production through the production and secretion of erythropoietin
The patient has just been diagnosed with acute renal failure. The patient asks the nurse what part of his or her kidneys is involved. What would the nurse reply?
A) Glomerulus
B) Renal pelves
C) Nephron
D) Renal capsule
C) Nephron
The functional unit of the kidneys is called the nephron. Pg. 882
The nurse admits a patient with a high potassium level. The nurse recognizes this activates the body’s sodium-potassium exchange leading to which physical symptom?
A) Dehydration
B) Water retention
C) Fatigue
D) Dizziness
B) Water retention
If potassium levels are very high, the retention of sodium in exchange for potassium also leads to retention of water and a dilution of blood volume, which decreases potassium concentration. pg. 884
WATER FOLLOWS SOLUTES
A patient who has just been told that he or she needs to go on dialysis asks the nurse what the normal output of urine is per day. What would be the nurse’s best response?
A) 2,000 mL
B) 3,000 mL
C) 4,000 mL
D) 5,000 mL
A) 2,000 mL
Approximately 1% or 2,000 mL of fluid is excreted each day in the form of urine. Pg. 883
Glomerular filtration
The instructor explains about when a person has chronic renal failure; how it leads to a decrease in the production of red blood cells and so the person becomes anemic. This anemia is usually caused by a loss of what?
A) Erythropoietin
B) Hydrogen ions
C) Renin
D) Urea
A) Erythropoietin
When nephrons are lost, as in renal failure, the juxtaglomerular cells that produce erythropoietin are also lost leading to a decrease in red blood cell production and anemia. pg. 886
The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse recalls that several substances are filtered from the blood by the glomerulus and these substances are then excreted in the urine. The nurse identifies the presence of which substances in the urine as abnormal findings?
A) Potassium and sodium
B) Bicarbonate and urea
C) Blood cells and protein
D) Creatinine and chloride
C) Blood cells and protein
Glucose scarring or swelling of or damage to the semipermeable membrane leads to the escape of larger plasma components such as blood cells or protein into the filtrate. A clinical sign of renal damage is the presence of blood cells or protein in the urine. pg. 883
The anatomy class is learning about the countercurrent mechanism in the medullary nephrons. What would the students learn about this mechanism and what it acts to do?
A) Promote sodium excretion
B) Concentrate or dilute the urine
C) Block the effects of aldosterone
D) Stimulate antidiuretic hormone (ADH) release
B) Concentrate or dilute the urine
Rationale: The countercurrent mechanism in the medullary nephrons acts to concentrate or dilute urine. Pg. 884
Occurs in the loop of henle
The students are discussing the electrolytes in the body. What should the students know has the greatest influence on potassium loss from the body?
A) Aldosterone
B) Antidiuretic hormone
C) Renin
D) Carbonic anhydrase
A) Aldosterone
The fine-tuning of potassium levels occurs in the distal convoluted tubule, where aldosterone activates sodium-potassium exchange, leading to a loss of potassium. pg. 885
A patient who has signs and symptoms of kidney failure has experienced what percentage of loss of the nephrons in the kidneys?
A) 10%
B) 25%
C) 50%
D) 75%
D. 75%
It is estimated that only about 25% of the total number of nephrons are necessary to maintain healthy renal function. That means that the renal system is well protected from failure with a large backup system. pg. 882
The physiology instructor explains that the nephrons are fragile and require a constant supply of blood and oxygen. What compensatory mechanisms work to maintain this supply?
A) The reninangiotensin system, causing vasoconstriction
B) Baroreceptor monitoring of the renal artery
C) Increased sweating when total water volume becomes too great
D) Antidiuretic hormone (ADH) release in response to increased blood volume or decreased osmolarity
A) The reninangiotensin system, causing vasoconstriction (RAAS)
Compensatory process that leads to increased blood pressure and blood volume to ensure perfusion of the kidneys; important in the continual regulation of blood pressure pg. 881 and 886
The students are studying the male reproductive system. The instructor tells the students that in the male, the urethra leaves the urinary bladder and passes through what?
A) Vas deferens
B) Renal calyx
C) Prostate gland
D) Renal cortex
C) Prostate gland
pg. 886
A 78-year-old male patient presents at the clinic complaining of urinary problems. The patient tells the nurse that he experiences frequency, urgency, and has problems initiating and maintaining a urinary stream. Based on the patient’s age, what would the nurse suspect?
A) Enlarged prostate
B) Decreased bladder function
C) Increased kidney fucntion
D) Partially obstructed ureter
A) Enlarged prostate
The kidneys regulate calcium levels within a very tight range by the activity of the parathyroid hormone (PTH) and calcitonin. Where does the fine-tuning of the calcium level occur?
A) Bowman’s capsule
B) The proximal convoluted tubule
C) The distal convoluted tubule
D) The loop of Henle
C) The distal convoluted tubule
pg. 885
32. A student is giving a presentation about the function of antidiuretic hormone and reports that it is released in response to what stimuli? (Select all that apply.)
A) Falling blood volume
B) Parasympathetic stimulation
C) Rising sodium levels
D) Rising calcium levels
E) Rising parathyroid hormone levels
A) Falling blood volume
C) Rising sodium levels
Antidiuretic hormone (ADH) is released in response to falling blood volume, sympathetic stimulation, or rising sodium levels. pg. 884