A nurse notes a high specific gravity in a client's urine sample. Which interpretation is most appropriate?
The client has renal failure.
The urine is dilute due to hydration.
The client has well-controlled diabetes.
The urine is highly concentrated.
The Correct Answer is D
Rationale:
A. The client has renal failure is incorrect. In renal failure, the kidneys often lose the ability to concentrate urine, which usually results in low or fixed specific gravity, not high. A high specific gravity is not a direct indicator of renal failure.
B. The urine is dilute due to hydration is incorrect. Dilute urine corresponds to low specific gravity, which occurs when a client is well-hydrated or when the kidneys are excreting large volumes of water. High specific gravity indicates the opposite.
C. The client has well-controlled diabetes is incorrect. While diabetes mellitus can cause glucosuria in uncontrolled cases, which may slightly increase urine specific gravity, well-controlled diabetes does not typically produce a high specific gravity.
D. The urine is highly concentrated is correct. A high urine specific gravity reflects a high solute concentration relative to water, indicating concentrated urine. This can result from dehydration, reduced fluid intake, excessive loss of water (e.g., vomiting, diarrhea, sweating), or conditions that promote water reabsorption such as elevated antidiuretic hormone (ADH) activity. Measuring specific gravity is a useful indicator of the kidney’s concentrating ability and the client’s hydration status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Proteinuria is the hallmark finding in nephrotic syndrome. This condition results from increased permeability of the glomerular basement membrane, allowing large amounts of protein, primarily albumin, to leak into the urine. The loss of protein in urine leads to foamy or frothy urine, which is often one of the first noticeable signs. Proteinuria also contributes to hypoalbuminemia, resulting in decreased plasma oncotic pressure, fluid shifting into interstitial spaces, and subsequent edema, commonly seen in the face, periorbital area, and lower extremities.
B. Nephrotic syndrome typically causes hyperlipidemia, not a decrease. The liver compensates for low plasma oncotic pressure by increasing lipoprotein synthesis, leading to elevated cholesterol and triglyceride levels in the blood.
C. On the contrary, nephrotic syndrome causes hypoalbuminemia due to excessive urinary loss of albumin. Low serum albumin contributes directly to the development of edema.
D. Urine output is often normal or may even be reduced in nephrotic syndrome. The condition is characterized by protein loss, not an increase in volume output. Fluid retention is more common due to hypoalbuminemia and sodium retention.
Correct Answer is A
Explanation
Rationale:
A. Raised, solid lesion less than 1 cm in diameter is correct. A papule is a small, elevated, solid lesion of the skin that is typically less than 1 centimeter in diameter. Papules can result from a variety of dermatologic conditions, including inflammatory responses, infections, or benign growths, and they are distinct from vesicles or pustules because they do not contain fluid or pus.
B. Non-inflammatory lesion with darkened color due to oxidation is incorrect. This description corresponds to a comedo, such as a blackhead, which is a type of acne lesion formed by oxidized sebum in clogged hair follicles. While comedones are common in acne, they are not considered papules because they are not solid raised lesions caused by cellular proliferation or inflammation.
C. Inflamed bump on the skin that can be tender to the touch is incorrect. While some papules may become inflamed and tender, the defining characteristic of a papule is its size and solid, raised nature, not necessarily inflammation. Inflammatory bumps that are tender and red may be better classified as pustules or nodules depending on their content and size.
D. Large, firm lesion containing purulent material is incorrect. This description defines a pustule or abscess, which contains pus composed of white blood cells, bacteria, and cellular debris. Papules do not contain fluid or pus, making this option inconsistent with the definition of a papule.
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