A client with a history of hypertension has a urine analysis ordered. Which finding would warrant additional assessment?
Negative for glucose
Negative for white blood cells
Positive for protein
Positive for creatinine
The Correct Answer is C
Choice A reason: Negative glucose in urine is normal, as the kidneys reabsorb glucose unless blood levels exceed 180 mg/dL (e.g., in diabetes). In hypertension, this finding does not indicate renal damage or require further assessment, as it aligns with normal renal function and glucose handling.
Choice B reason: Negative white blood cells in urine suggest no urinary tract infection or inflammation, a normal finding. In hypertensive patients, this does not signal kidney damage or other complications, so no additional assessment is needed, as it indicates an absence of acute inflammatory processes.
Choice C reason: Proteinuria (positive protein) indicates potential renal damage, common in hypertension due to glomerular injury from elevated pressure. It suggests impaired filtration, allowing proteins like albumin to leak into urine. This finding warrants further assessment, such as quantifying protein levels or evaluating kidney function, making it the correct choice.
Choice D reason: Creatinine in urine is normal, as it is a waste product excreted by the kidneys. While serum creatinine assesses renal function, urinary creatinine presence is expected and does not indicate pathology in hypertension, so it does not require additional assessment in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Avoiding pain medication may increase discomfort, reducing mobility and increasing complications like atelectasis. Opioids can cause constipation, but this is managed with stool softeners, not avoidance. This statement is inaccurate, as pain control is essential for recovery and does not directly support wound healing.
Choice B reason: Excessive rest increases risks like venous thromboembolism or pneumonia, especially in obese patients. Early ambulation promotes circulation and wound healing without straining incisions if done cautiously. This statement is inaccurate, as limiting movement excessively hinders recovery and increases postoperative complications.
Choice C reason: Returning to normal activity too soon risks incision dehiscence or infection, particularly in obese patients with higher wound complication rates. Gradual activity increase under medical guidance is needed. This statement is inaccurate, as premature activity resumption can compromise healing and safety post-surgery.
Choice D reason: Adequate nutrition, especially high-protein intake, supports collagen synthesis and tissue repair, critical for wound healing. Obesity increases metabolic demand, and protein prevents malnutrition, enhancing immune response and incision strength. This statement is accurate, as nutrition is a priority to optimize postoperative recovery and prevent complications.
Correct Answer is D
Explanation
Choice A reason: Colorectal cancer may cause bleeding or pain but typically presents with mass lesions or obstruction, not a continuous pattern of mucosal lesions on X-ray. Its symptoms are less likely to remit and exacerbate cyclically, unlike inflammatory bowel diseases, making it less likely than ulcerative colitis.
Choice B reason: Crohn’s disease causes patchy, transmural bowel lesions, not continuous large bowel involvement. Its skip lesions and potential for small bowel involvement distinguish it from the continuous mucosal inflammation seen in ulcerative colitis, making this an inaccurate diagnosis for the described X-ray findings.
Choice C reason: Diverticulitis involves inflamed diverticula, typically causing localized pain and fever, not continuous large bowel lesions or bloody diarrhea with remissions. X-ray may show diverticula, but not diffuse mucosal involvement. This condition is less likely than ulcerative colitis given the described symptom pattern.
Choice D reason: Ulcerative colitis causes continuous mucosal inflammation in the large bowel, leading to bloody diarrhea, abdominal pain, and periods of exacerbation and remission. X-ray showing continuous lesions aligns with its diffuse colitis pattern, making this the most accurate diagnosis for the client’s symptoms and findings.
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