Question 1

The nurse caring for a patient after cystoscopy plans that the patient&#10;A)learns to request narcotics for pain.&#10;B)understands to expect blood-tinged urine.&#10;C)restricts activity to bed rest for 4 to 6 hours.&#10;D)remains NPO for 8 hours to prevent vomiting.

Accepted Answer

Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common,but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required after cystoscopy.

Question 2

A patient gives the admitting nurse health information before a scheduled intravenous pyelogram (IVP). Which item requires the nurse to intervene before the procedure?&#10;A)The patient has not had food or drink for 8 hours.&#10;B)The patient lists allergies to shellfish and penicillin.&#10;C)The patient complains of costovertebral angle (CVA) tenderness.&#10;D)The patient used a bisacodyl (Dulcolax) tablet the previous night.

Accepted Answer

Iodine-based contrast dye is used during IVP and for many CT scans. The nurse will need to notify the health care provider before the procedures so that the patient can receive medications such as antihistamines or corticosteroids before the procedures are started. The other information is also important to note and document but does not have immediate implications for the patient's care during the procedures.

Question 3

A patient who has elevated blood urea nitrogen (BUN)and serum creatinine levels is scheduled for a renal arteriogram. Which bowel preparation order would the nurse question for this patient?&#10;A)Fleet enema&#10;B)Tap-water enema&#10;C)Senna/docusate (Senokot-S)&#10;D)Bisacodyl (Dulcolax) tablets

Accepted Answer

High-phosphate enemas,such as Fleet enemas,should be avoided in patients with elevated BUN and creatinine because phosphate cannot be excreted by patients with renal failure. The other medications for bowel evacuation are more appropriate.

Question 4

A female patient with a suspected urinary tract infection (UTI)is to provide a clean-catch urine specimen for culture and sensitivity testing. To obtain the specimen,the nurse will&#10;A)have the patient empty the bladder completely; then obtain the next urine specimen that the patient is able to void.&#10;B)teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.&#10;C)insert a short sterile &#34;mini&#34; catheter attached to a collecting container into the urethra and bladder to obtain the specimen.&#10;D)clean the area around the meatus with a povidone-iodine (Betadine) swab and then have the patient void into a sterile container.

Accepted Answer

This answer describes the technique for obtaining a clean-catch specimen. The answer beginning,"insert a short,small,'mini' catheter attached to a collecting container" describes a technique that would result in a sterile specimen,but a health care provider's order for a catheterized specimen would be required. Using Betadine before obtaining the specimen is not necessary and might result in suppressing the growth of some bacteria. The technique described in the answer beginning "have the patient empty the bladder completely" would not result in a sterile specimen.

Question 5

A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a creatinine clearance test. Which item will the nurse need to obtain?&#10;A)Urinary catheter&#10;B)Sterile specimen cup&#10;C)Cleansing towelettes&#10;D)Large urine container

Accepted Answer

Because creatinine clearance testing involves a 24-hour urine specimen,the nurse should obtain a large container for the urine collection. Catheterization,cleaning of the perineum with antiseptic towelettes,and a sterile specimen cup are not needed for this test.

Question 6

What glomerular filtration rate (GFR)would the nurse estimate for a 30-yr-old patient with a creatinine clearance result of 60 mL/min?&#10;A)60 mL/min&#10;B)90 mL/min&#10;C)120 mL/min&#10;D)180 mL/min

Accepted Answer

The creatinine clearance approximates the GFR. The other responses are not accurate.

Question 7

How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?&#10;A)Palpate along both sides of the lumbar vertebral column.&#10;B)Strike a flat hand covering the costovertebral angle (CVA).&#10;C)Push fingers upward into the two lowest intercostal spaces.&#10;D)Percuss between the iliac crest and ribs at the midaxillary line.

Accepted Answer

Checking for flank pain is best performed by percussion of the CVA and asking about pain. The other techniques would not assess for flank pain.

Question 8

A male patient in the clinic provides a urine sample that is red-orange in color. Which action should the nurse take?&#10;A)Notify the patient's health care provider.&#10;B)Teach correct midstream urine collection.&#10;C)Ask the patient about current medications.&#10;D)Question the patient about urinary tract infection (UTI) risk factors.

Accepted Answer

A red-orange color in the urine is normal with some over-the-counter (OTC)medications such as phenazopyridine . The color would not be expected with urinary tract infection,is not a sign that poor technique was used in obtaining the specimen,and does not need to be communicated to the health care provider until further assessment is done.

Question 9

A female patient being admitted with pneumonia has a history of neurogenic bladder as a result of a spinal cord injury. Which action will the nurse plan to take first?&#10;A)Ask about the usual urinary pattern and any measures used for bladder control.&#10;B)Assist the patient to the toilet at scheduled times to help ensure bladder emptying.&#10;C)Check the patient for urinary incontinence every 2 hours to maintain skin integrity.&#10;D)Use intermittent catheterization on a regular schedule to avoid the risk of infection.

Accepted Answer

Before planning any interventions,the nurse should complete the assessment and determine the patient's normal bladder pattern and the usual measures used by the patient at home. All the other responses may be appropriate,but until the assessment is complete,an individualized plan for the patient cannot be developed.

Question 10

When a patient's urine dipstick test indicates a small amount of protein,the nurse's next action should be to&#10;A)send a urine specimen to the laboratory to test for ketones.&#10;B)obtain a clean-catch urine for culture and sensitivity testing.&#10;C)inquire about which medications the patient is currently taking.&#10;D)ask the patient about any family history of chronic renal failure.

Accepted Answer

Normally the urinalysis will show zero to trace amounts of protein,but some medications may give false-positive readings. The other actions by the nurse may be appropriate,but checking for medications that may affect the dipstick accuracy should be done first.

Question 11

Which medication taken at home by a patient with decreased renal function will be of most concern to the nurse?&#10;A)ibuprofen (Motrin)&#10;B)warfarin (Coumadin)&#10;C)folic acid (vitamin B9)&#10;D)penicillin (Bicillin C-R)

Accepted Answer

The answer of Which medication taken at home by a...

Question 12

A young adult who is employed as a hairdresser and has a 15 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for

A)renal failure.
B)kidney stones.
C)pyelonephritis.
D)bladder cancer.

Accepted Answer

The answer of A young adult who is employed as...

Question 13

A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate?&#10;A)&#34;Your doctor will place a catheter into an artery in your groin and inject a dye to visualize the blood supply to the kidneys.&#34;&#10;B)&#34;Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney.&#34;&#10;C)&#34;Your doctor will insert a lighted tube in the bladder through your urethra, inspect the bladder, and instill dye that will outline your bladder on x-ray.&#34;&#10;D)&#34;Your doctor will inject a radioactive solution into a vein in your arm, then the distribution of the isotope in your kidneys and bladder will be visible.&#34;

Accepted Answer

The answer of A patient passing bloody urine is scheduled...

Question 14

Which information from a patient's urinalysis requires that the nurse notify the health care provider?&#10;A)pH 6.2&#10;B)Trace protein&#10;C)WBC 20 to 26/hpf&#10;D)Specific gravity 1.021

Accepted Answer

The answer of Which information from a patient's urinalysis requires...

Question 15

A 79-yr-old patient has been admitted with benign prostatic hyperplasia. What is most appropriate to include in the nursing plan of care?&#10;A)Limit fluid intake to no more than 1000 mL/day.&#10;B)Leave a light on in the bathroom during the night.&#10;C)Ask the patient to use a urinal so that urine can be measured.&#10;D)Pad the patient's bed to accommodate overflow incontinence.

Accepted Answer

The answer of A 79-yr-old patient has been admitted with...

Question 16

Which nursing action is essential for a patient immediately after a renal biopsy?&#10;A)Insert a urinary catheter and test urine for microscopic hematuria.&#10;B)Apply a pressure dressing and keep the patient on the affected side.&#10;C)Check blood glucose to assess for hyperglycemia or hypoglycemia.&#10;D)Monitor blood urea nitrogen (BUN) and creatinine to assess renal function.

Accepted Answer

The answer of Which nursing action is essential for a...

Question 17

The nurse assessing the urinary system of a 45-yr-old patient would use palpation to&#10;A)determine kidney function.&#10;B)identify renal artery bruits.&#10;C)check for ureteral peristalsis.&#10;D)assess for bladder distention.

Accepted Answer

The answer of The nurse assessing the urinary system of...

Question 18

The nurse completing a physical assessment for a newly admitted patient is unable to feel either kidney on palpation. Which action should the nurse take?&#10;A)Obtain a urine specimen to check for hematuria.&#10;B)Document the information on the assessment form.&#10;C)Ask the patient about any history of recent sore throat.&#10;D)Ask the health care provider about scheduling a renal ultrasound.

Accepted Answer

The answer of The nurse completing a physical assessment for...

Question 19

To assess whether there is any improvement in a patient's dysuria,which question will the nurse ask?&#10;A)&#34;Do you have to urinate at night?&#34;&#10;B)&#34;Do you have blood in your urine?&#34;&#10;C)&#34;Do you have to urinate frequently?&#34;&#10;D)&#34;Do you have pain when you urinate?&#34;

Accepted Answer

The answer of To assess whether there is any improvement...

Question 20

The nurse is caring for a hospitalized patient with a decreased glomerular filtration rate who is scheduled for an intravenous pyelogram (IVP). Which action will be included in the plan of care?&#10;A)Monitor the urine output after the procedure.&#10;B)Assist with monitored anesthesia care (MAC).&#10;C)Give oral contrast solution before the procedure.&#10;D)Insert a large size urinary catheter before the IVP.

Accepted Answer

The answer of The nurse is caring for a hospitalized...

Question 21

When assessing a patient with a urinary tract infection,indicate on the accompanying figure where the nurse will percuss to assess for possible pyelonephritis.  &#10;A)1&#10;B)2&#10;C)3&#10;D)4

Accepted Answer

The answer of When assessing a patient with a urinary...

Question 22

Which statement by a patient who had a cystoscopy the previous day should be reported immediately to the health care provider?&#10;A)&#34;My urine looks pink.&#34;&#10;B)&#34;My IV site is bruised.&#34;&#10;C)&#34;My sleep was restless.&#34;&#10;D)&#34;My temperature is 101.&#34;

Accepted Answer

The answer of Which statement by a patient who had...

Question 23

When working in the urology/nephrology clinic,which patient could the nurse delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?&#10;A)Patient who is scheduled for a renal biopsy after a recent kidney transplant&#10;B)Patient who will need monitoring for several hours after a renal arteriogram&#10;C)Patient who requires teaching about possible post-cystoscopy complications&#10;D)Patient who will have catheterization to check for residual urine after voiding

Accepted Answer

The answer of When working in the urology/nephrology clinic,which patient...

Deck 44: Assessment of Urinary System