Question 1

The nurse on the medical unit is admitting an older adult patient whose primary symptoms include fatigue,pruritus,and pain in the right flank area.When conducting this patient's assessment,which technique is the most appropriate?

Accepted Answer

Blunt percussion over the costovertebral angles and flanks is the most appropriate technique to assess for kidney pain or tenderness, which could be related to the patient's symptoms of flank pain.

Question 2

A patient is admitted to the emergency department and diagnosed with urinary calculi after experiencing symptoms for one week.When planning care for this patient,which nursing diagnosis is the most appropriate?

Accepted Answer

C

Question 3

The nurse is triaging a patient who presents to the urgent care clinic with symptoms of severe flank pain with spasms,nausea,vomiting,and oliguria.The patient states that the pain was initially intermittent and radiated from the lower back to the lower quadrants of the abdomen.Which action by the nurse is the most appropriate?

Accepted Answer

B

Question 4

The nurse is preparing to discharge a patient who underwent lithotripsy in the treatment of a kidney stone.What should the nurse teach the patient to prevent further complications of urinary calculi after discharge?

Accepted Answer

Monitoring for signs and symptoms of a urinary tract infection (UTI) is important after lithotripsy, as the procedure can increase the risk of infection.

Question 5

The nurse is assessing an adult patient in a urology clinic.The patient reports that she has been having "accidents" and expresses frustration about this normal part of aging.Which response by the nurse is the most appropriate?

Accepted Answer

The most appropriate response by the nurse is to ask the patient to explain more about the symptoms and the experience. This will help the nurse to understand the full extent of the patient's concerns and develop an appropriate plan to manage the issue. Responses B, C, and D may not be appropriate and could potentially cause the patient more anxiety or distress.

Question 6

The nurse is caring for a patient with a history of kidney stones.The stones have been analyzed and are all composed of calcium phosphate.Based on this data,which foods should the nurse teach the patient to avoid?

Accepted Answer

Calcium phosphate stones can form when there is an excess of calcium in the diet. Foods like milk and ice cream are high in calcium and should be limited to prevent the formation of these types of kidney stones.

Question 7

The nurse is caring for a patient with a history of chronic urinary tract infections.The nurse is planning care for this patient based on the priority nursing diagnosis of urinary retention related to scarring.Based on this data,which prescription does the nurse anticipate from the health-care provider?

Accepted Answer

Urinary retention related to scarring indicates that the patient may have difficulty emptying their bladder completely, which can lead to complications such as urinary tract infections. Intermittent straight catheterization is a common treatment for urinary retention as it allows for the complete emptying of the bladder and reduces the risk of infection. Antibiotic therapy may be prescribed if an infection is present but it does not address the issue of urinary retention. An anticholinergic medication may be prescribed for overactive bladder but it is not appropriate for urinary retention. Removal of bladder stones may be necessary if they are contributing to the urinary retention, but it is not the first-line treatment.

Question 8

The nurse providing care to a patient whose medication therapy for the treatment of renal calculi has failed.Based on this data,which treatment option does the nurse anticipate for this patient?

Accepted Answer

Lithotripsy is a common non-invasive procedure used to break down kidney stones when medication therapy fails.

Question 9

The nurse is caring for a patient who will be discharged with an indwelling catheter.The nurse has provided education to the patient and family about catheter care once the patient is discharged.Which patient or family action indicates a correct understanding of the information presented?

Accepted Answer

Taking a shower instead of a tub bath helps prevent infection by avoiding submerging the catheter site in water.

Question 10

The nurse is attempting to place a urinary catheter for an older adult female patient.The nurse is unable to visualize the patient's urinary meatus.Which alternate position for catheterization may be appropriate for this patient?

Accepted Answer

Lifting up the buttock in side-lying position may provide better visualization and accessibility to the urinary meatus in older adult females. This position may also be more comfortable and less invasive than other options.

Question 11

The nurse provides education for a patient who is experiencing urinary incontinence.Which statement by the patient indicates the need for further education?

Accepted Answer

Incontinence is not a normal part of aging and the patient needs further education on this. The other statements are correct and indicate a good understanding of the causes of incontinence.

Question 12

A patient admitted to the hospital with a diagnosis of gout has also been diagnosed with uric acid renal calculi.When planning meals for this patient,which diet will the nurse anticipate?

Accepted Answer

A low-purine diet can help decrease the production of uric acid and prevent uric acid renal calculus formation. This diet includes limiting or avoiding high-purine foods such as organ meats, shellfish, and certain vegetables. A low-sodium diet may also be beneficial for managing gout, but it is not the most appropriate choice for preventing uric acid renal calculi. A diet high or low in calcium is not directly related to gout or uric acid renal calculi.

Question 13

The nurse is providing care to a patient with a spinal cord injury.Which type of incontinence should the nurse include in this patient's plan of care?

Accepted Answer

Patients with spinal cord injuries often have impaired bladder control, leading to overflow incontinence. Urge incontinence occurs due to an overactive bladder, which is not typically seen in spinal cord injury patients. Stress incontinence occurs due to pressure on the bladder during activities such as coughing or exercise, which is also not typically seen in spinal cord injury patients. Functional incontinence may occur in patients who have physical or cognitive limitations that prevent them from reaching the bathroom in time, but it is not specific to spinal cord injury patients.

Question 14

A patient with urinary calculi is admitted to the hospital.When planning care for this patient,which goal is most appropriate?

Accepted Answer

The most appropriate goal for a patient with urinary calculi is pain management as the patient may experience pain during the passage of the stones. Losing weight, ambulation, and showering independently may be important goals for overall health, but they are not directly related to the treatment of urinary calculi.

Question 15

The nurse is caring for a patient with a urinary catheter.Which nursing diagnosis is a priority for this patient?

Accepted Answer

The risk for infection is a priority nursing diagnosis for a patient with a urinary catheter. The catheter provides a direct pathway for bacteria to enter the bladder and cause infection. It is essential to monitor the patient for signs and symptoms of infection and take appropriate measures to prevent infection.

Question 16

The nurse is working in a urology clinic and is providing care for a patient with urinary stress incontinence.The nurse has chosen the diagnosis of Stress Urinary Incontinence related to sphincter incompetence.Which is the desired outcome for a patient with this diagnosis?

Accepted Answer

The desired outcome for a patient with stress urinary incontinence related to sphincter incompetence is for the patient to improve their pelvic floor muscle strength through exercises such as Kegels. Therefore, choice D is the best option as it focuses on the patient performing four to five squeezes (Kegel exercises) for 10-15 seconds, which will strengthen the pelvic floor muscles and potentially improve the patient's urinary incontinence. Choices A, B, and C do not specifically address the issue of sphincter incompetence or the need for pelvic floor muscle strengthening.

Question 17

The nurse educator is speaking with a group of students about renal disorders.Which statement is appropriate for the educator to include regarding renal stones?

Accepted Answer

Young- or middle-age adult men are at an increased risk for renal stones. This is because men tend to form stones more readily than women due to differences in bladder and ureteral anatomy, as well as hormonal differences.

Question 18

A nurse is providing care to a group of patients on a urology unit.Which patient does the nurse identify as being at the greatest risk for developing urinary stones?

Accepted Answer

Patients with quadriplegia have a higher risk of developing urinary stones due to decreased mobility and bladder dysfunction, which can result in incomplete bladder emptying, stasis of urine, and increased alkalinity of urine. These factors can lead to the formation of stones in the urinary tract. The other patient conditions listed do not necessarily increase the risk of urinary stones development.

Question 19

The nurse is reviewing discharge instructions for a patient diagnosed with urinary incontinence resulting from a urinary tract infection.Which statement made by the patient indicates the need for further education?

Accepted Answer

Holding urine can actually increase the risk of a urinary tract infection. The patient needs further education on appropriate voiding habits and should be encouraged to use the bathroom regularly and not hold urine for extended periods of time.

Question 20

The nurse is providing care to a patient who is experiencing urine leakage when coughing or laughing.Which type of incontinence should the nurse include in this patient's plan of care?

Accepted Answer

Stress incontinence is characterized by involuntary loss of urine during activities such as coughing, sneezing, or laughing, which increase intra-abdominal pressure and put stress on the bladder. Urge incontinence is characterized by a sudden urge to urinate followed by an involuntary loss of urine, while overflow incontinence is characterized by continuous dribbling of urine due to a bladder that is always full. Functional incontinence occurs when a patient has a physical or cognitive impairment that makes it difficult for them to reach the bathroom in time.

Quiz 63: Coordinating Care for Patients With Urinary Disorders