Deck 49: Care of the Patient with a Urinary Disorder

Question 1

The patient is on postoperative day 1 after having undergone a TURP procedure. He has continuous bladder irrigation (CBI). Actual urine output during continuous bladder irrigation is calculated by:

A) measuring and recording all fluid output in the drainage bag.
B) measuring the total output and deducting the total of the irrigating and intravenous solutions.
C) adding the total of the intravenous and irrigating solutions and then deducting the amount of output.
D) measuring total output and deducting the amount of irrigating solution used.

Answer 1

measuring total output and deducting the amount of irrigating solution used.

Question 2

The patient is scheduled for a transurethral resection of the prostate. During preoperative teaching, what should the nurse emphasize about what the patient can expect after the procedure?

A) Red drainage from the catheter
B) Limited intake of fluids
C) A sodium-restricted diet
D) Incisional drainage

Answer 2

Red drainage from the catheter

Question 3

The nurse is aware that as a person ages there is a loss of the __________mechanism of the kidney due to a decrease in blood supply to the kidneys and loss of nephrons.

A) filtering
B) reabsorption
C) sterile water.
D) concentrating

Answer 3

filtering

Question 4

The nurse notes the amount and color of the urine the patient with urolithiasis has voided. While using Standard Precautions, what should be the nurse's next action?

A) Discard the urine
B) Add the urine to a 24-hour collector
C) Send the urine to the laboratory
D) Strain the urine

Question 5

What is the hormone from the posterior pituitary gland that influences the amount of water that is eliminated with the urine?

A) Pitocin
B) Renin hormone
C) Antidiuretic hormone (ADH)
D) ACTH

Question 6

A male patient, age 71, has benign prostatic hypertrophy. He is recovering from a trans-urethral prostatic resection. The physician orders removal of the indwelling catheter 2 days after the TURP procedure. What might the patient experience after the catheter is removed?

A) Burning on urination
B) Passing of blood clots in the urine
C) Dribbling of urine
D) Coffee-colored urine

Question 7

What should the nurse instruct the patient to do before obtaining the urine specimen for a urine culture?

A) Collect the urine for a 24-hour period
B) Obtain a clean-catch specimen
C) Bring in an early morning specimen
D) Limit fluid intake to concentrate the urine

Question 8

A patient who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP) complains of "spasm-like" pain over his lower abdomen. What should the initial intervention be by the nurse?

A) Inform the nurse in charge
B) Decrease the continuous bladder irrigation flow
C) Administer the prescribed analgesic
D) Check the catheter and drainage system for obstruction

Question 9

A patient, age 69, is admitted to the hospital with gross hematuria and history of a 20-lb weight loss during the last 3 months. The physician suspects renal cancer. In obtaining a nursing history from this patient, the nurse recognizes which of the following as a significant risk factor for renal cancer?

A) High caffeine intake
B) Cigarette smoking
C) Use of artificial sweeteners
D) Chronic cystitis

Question 10

What portion of the nephron is involved with filtration?

A) Glomerulus of the Bowman capsule
B) Henle loop
C) Proximal convoluted tubule
D) Distal convoluted tubule

Question 11

As the body breaks down protein, nitrogen wastes are broken down into urea, ammonia, and:

A) nitrogen.
B) uric acid.
C) nitrates.
D) creatinine.

Question 12

The patient with nephrosis complains about the need for bed rest. How would the nurse explain the benefit of bed rest?

A) The recumbent position may initiate diuresis.
B) It preserves the skin integrity.
C) It lowers the level of albuminuria.
D) It saves stress on joints.

Question 13

A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with an ileal conduit. What is an important aspect in nursing interventions of the patient with an ileal conduit?

A) Instructing the patient to void when the urge is felt.
B) Maintaining skin integrity.
C) Limiting oral intake to 1000 mL/day
D) Limiting acid-ash foods.

Question 14

Because the kidneys are located in proximity to the vertebrae and are protected by the ribs, their location in documentation is referred to as:

A) retroperitoneal.
B) diaphragm-vertebral.
C) costovertebral.
D) urachal-peritoneal.

Question 15

The nurse assessing a patient who is taking furosemide (Lasix) finds an irregular pulse. This is likely a sign of:

A) hypomagnesemia.
B) hypernatremia.
C) hypokalemia.
D) hypercalcemia.

Question 16

When the home health patient is started on dialysis, the home health nurse refers the patient to a community support group that assists with the adjustments necessary to living with dialysis. Which group offers this service?

A) National Kidney Foundation
B) American Association of Kidney Patients
C) American Red Cross
D) Veterans Administration

Question 17

A home health patient with end-stage renal disease (ESRD) has a nursing diagnosis of powerlessness related to life-altering disease. Which nursing intervention would be most helpful?

A) Ensure restricted protein intake to prevent nitrogenous product accumulation.
B) Include the patient in making the plan of care.
C) Counsel patient about end-of-life provisions.
D) Write out a detailed schedule of physician's appointments.

Question 18

It is 2 days after a 42-year-old male patient's urinary diversion surgery. He continues to be critical of the hospital and the nursing care, even though the staff has spent time explaining the care to him. What is the most likely explanation for his behavior?

A) He is angry about hospital policy.
B) He is feeling neglected by the nursing staff.
C) He is in denial of the effects of the surgery.
D) He is reacting to the loss of self-esteem and altered body image.

Question 19

What should the nurse encourage, barring any other contraindication, when teaching a patient how to decrease the chance of further problems with urolithiasis?

A) Increase his fluid intake
B) Increase intake of dairy products
C) Restrict his protein intake
D) Take one baby aspirin daily

Question 20

As the nurse and the dietitian review a female patient's diet plan with her, she shouts that with her diabetes and now the kidney failure, there is just nothing she can eat. She says she might as well eat what she wants, because there is nothing she can do to help herself. Based on the patient's response, which nursing diagnosis does the nurse identify?

A) Noncompliance, risk for, related to feelings of anger
B) Imbalanced nutrition less than body requirements, related to knowledge deficit
C) Anticipatory grieving, related to actual and perceived losses
D) Ineffective coping, related to sense of powerlessness

Question 21

Exercises to increase muscle tone of the pelvic floor are known as ____________ exercises.

Question 22

A patient with cystitis is receiving phenazopyridine (Pyridium) for pain and is voiding a bright red-orange urine. What should the nurse do?

A) Report this immediately
B) Explain to the patient that this is normal
C) Increase fluid intake
D) Collect a specimen

Question 23

The nurse reassures the patient recovering from acute glomerulonephritis that after all other signs and symptoms of the disease subside, it is normal to have some residual (select all that apply):

A) proteinuria
B) oliguria
C) hematuria
D) anasarca
E) oliguria

Question 24

A patient, age 78, has been admitted to the hospital with dehydration and electrolyte imbalance. She is confused and incontinent of urine on admission. Which nursing intervention does the nurse include in developing a plan of care?

A) Restrict fluids after the evening meal
B) Insert an indwelling catheter
C) Assist the patient to the bathroom every 2 hours
D) Apply absorbent incontinence pads

Question 25

The home health nurse suggests the use of complementary and alternative therapies to prevent and/or treat urinary tract infections (UTIs). Which of the following is an example of such therapies?

A) Grape juice
B) Caffeine
C) Tea
D) Cranberry juice

Question 26

_____________ is a term for severe generalized edema.

Question 27

The nurse is reviewing the urinalysis report on an assigned patient. The nurse recognizes which findings to be normal? (Select all that apply.)

A) Turbidity clear
B) pH 6.0
C) Glucose negative
D) Red blood cells, 15 to 20
E) White blood cells

Question 28

An intravenous pyelogram confirms the presence of a 4-mm renal calculus in the proximal left ureter of a newly admitted patient. Physician orders include meperidine (Demerol) 100 mg IM q4h PRN, strain all urine, and encourage fluids to 4000 mL/day. What should be the nurse's highest priority when planning care for this patient?

A) Pain related to irritation of a stone
B) Anxiety related to unclear outcome of condition
C) Ineffective health maintenance related to lack of knowledge about prevention of stones
D) Risk for injury related to disorientation

Question 29

Which foods should the home health nurse counsel hypokalemic patients to include in their diet?

A) Bananas, oranges, cantaloupe
B) Carrots, summer squash, green beans
C) Apples, pineapple, watermelon
D) Winter squash, cauliflower, lettuce

Question 30

Why are pediatric patients, especially girls, susceptible to urinary tract infections?

A) Genetically females have a weaker immune system
B) Females have a short and proximal urethra in relation to the vagina
C) Girls are more sexually active than males
D) Girls have a weakened musculature and sphincter tone

Question 31

Which action can reduce the risk of skin impairment secondary to urinary incontinence?

A) Decreasing fluid intake
B) Catheterization of the elderly patient
C) Limiting the use of medication (diuretics, etc.)
D) Frequent toileting and meticulous skin care

Question 32

What should the nurse counsel the young man with chronic prostatitis to avoid?

A) Cessation of intercourse
B) Warm baths
C) Stool softeners
D) Continuing antibiotics when symptoms abate

Question 33

What should the patient be encouraged to eat during the active phase of acute renal failure?

A) A diet high in sodium
B) A diet high in potassium
C) A diet high in fats
D) A diet high in fluid sources

Question 34

A patient is receiving chlorothiazide (Diuril), a thiazide diuretic for hypertension. What nursing action is most important for prevention of complications?

A) Measure output
B) Increase fluid intake
C) Assess for hypokalemia
D) Assess for hypernatremia

Question 35

Which of the following are signs of fluid overload in the patient with nephrosis? (Select all that apply.)

A) Increase in pulse rate
B) Increase in daily weight
C) Clear lung sounds
D) Edema
E) Labored respirations

Question 36

The patient, age 43, has cancer of the urinary bladder. He has received a cystectomy with an ileal conduit. Which characteristics would be considered normal for his urine?

A) Hematuria
B) Clear amber with mucus shreds
C) Dark bile-colored
D) Dark amber

Question 37

To help a patient control incontinence, what should the nurse recommend the patient avoid?

A) Spicy foods
B) Citrus fruits
C) Organ meats
D) Shellfish

Question 38

The patient has end-stage renal disease (ESRD) and is admitted to the hospital with a blood urea nitrogen (BUN) level of 48 mg/dL. An excessive elevation of BUN could result from:

A) dehydration.
B) disorientation.
C) edema.
D) catabolism.

Question 39

A patient has nephrotic syndrome. Which statement made by the patient indicates understanding of the necessary diet modifications?

A) "I will need to increase protein and decrease sodium intake."
B) "I will need to drink more milk to get my calcium."
C) "Carbohydrate restriction will be difficult."
D) "Potassium restriction won't be hard since I don't like fruit."

Question 40

Why are urinary tract infections (UTI) common in older adults? (Select all that apply.)

A) Older adults have weakened musculature in the bladder and urethra.
B) Older adults have urinary stasis.
C) Older adults have increased bladder capacity.
D) Older adults have diminished neurologic sensation.
E) The effects of medications such as diuretics that many older adults take.

Question 41

Put the sequence of blood flow in order of flow through the nephron. (Separate letters by a comma and space as follows: A, B, C, D)

A) Reabsorption in loop of Henle
B) Efferent arteriole
C) Filtration in the glomerulus
D) Reabsorption in proximal convoluted tubule
E) Afferent arteriole
F) Secretion in the distal convoluted tubule

Question 42

Acute glomerulonephritis is commonly a result of a preexisting infection of _____________.

Question 43

_________ is a prostatic pain without evidence of infection or inflammation.

Question 44

In the nephrotic syndrome, the glomeruli are damaged by inflammation and allow small _______ to pass through into the urine.

Question 45

The prostatectomy technique, which involves an incision through the abdomen and the bladder, is a ____________prostatectomy.