Deck 27: Nursing Care of Patients with Urinary Tract Disorders

Question 1

A patient is discharged after transurethral resection of a superficial bladder tumor. Which of the following would be included in the discharge instructions? Select all that apply.

A)avoid constipation, continue stool softener
B)increase fluid intake
C)bedrest
D)calling physician if painless hematuria occurs
E)making a follow-up appointment in one year

Answer 1

avoid constipation, continue stool softener
increase fluid intake
calling physician if painless hematuria occurs

Question 2

A female patient is admitted with multiple medical problems and incontinence, regardless of the position or situation. The type of incontinence that this patient is more likely to be experiencing is which of the following?

A)total
B)urge
C)stress
D)overflow

Answer 2

total

Question 3

A male patient is admitted for removal of a bladder papilloma. Which of the following should the nurse assess in this patient?

A)history of cigarette smoking
B)daily fluid intake
C)pedal pulses
D)appetite level

Answer 3

history of cigarette smoking

Question 4

A patient is diagnosed with chronic pyelonephritis. The nurse realizes that this patient is prone to developing which of the following?

A)chronic renal failure
B)cystitis
C)acute renal failure
D)renal calculi

Question 5

A patient who is recovering from spinal surgery had "an accident" while attempting to reach the bathroom to void. The type of incontinence this patient most likely experienced is which of the following?

A)functional
B)urge
C)stress
D)total

Question 6

A female patient is admitted with an overdistended bladder. Which of the following diagnostic tests can be done to confirm the diagnosis of urine retention?

A)bladder scan
B)renal scan
C)intravenous pyelography (IVP)
D)MRI

Question 7

A middle-aged male patient comes into the clinic for "frequency" and voiding "small amounts of urine at a time." The nurse realizes that this patient might be experiencing symptoms of which of the following?

A)benign prostatic hypertrophy (BPH)
B)cystitis
C)renal calculi
D)bladder cancer

Question 8

A male patient with a urinary stoma says, "I looked at it while you were out of the room. It's not so bad." The nurse realizes that this patient is demonstrating which of the following?

A)coping
B)denial
C)grief
D)anger

Question 9

A male patient has a history of calcium calculi. Which of the following medications can be prescribed to help this patient?

A)furosemide (Lasix)
B)penicillin (Pentids)
C)allopurinol (Alloprim)
D)NSAIDs

Question 10

A patient asks the nurse for ways to prevent recurrent urinary tract infections. Which of the following is an appropriate nursing response?

A)"Avoid douching."
B)"Clean the perineal area from back to front."
C)"Use feminine hygiene sprays."
D)"Wear clean nylon underpants."

Question 11

A patient with an indwelling urinary catheter is demonstrating signs of asymptomatic bacteriuria. Which of the following would be the best course of action for this patient?

A)Remove the catheter and begin antibiotic therapy.
B)Begin intravenous antibiotic therapy.
C)Begin oral antibiotic therapy for three days.
D)Remove the catheter and monitor for continued signs of bacteriuria.

Question 12

Which of the following methods of bladder emptying would be preferred for an elderly patient who is prone to developing urinary tract infections (UTIs)?

A)intermittent catheterization
B)indwelling urinary catheterizations
C)Credé maneuver
D)timed intervals for taking patient to bathroom to void

Question 13

A male patient comes into the emergency department with symptoms of renal colic. The nurse realizes that this patient most likely has a calculi that is obstructing which of the following?

A)ureter
B)bladder
C)renal pelvis
D)urethra

Question 14

A patient had a renal stent removed. Which of the following should be included in the care of this patient?

A)Monitor urine output.
B)Encourage ambulation.
C)Ensure an adequate protein intake.
D)Monitor blood pressure.

Question 15

A patient is scheduled for a lithotripsy for renal calculi. The purpose of a bowel preparation prior to this procedure is to do which of the following?

A)Ensure maximum visualization of the kidney and the stones.
B)Ensure that there is no evidence of constipation prior to the procedure.
C)Increase comfort.
D)Reduce postoperative pain.

Question 16

An 80-year-old female patient says to the nurse, "I can't hold my water very well so I don't leave the house much." Which of the following is an appropriate nursing response?

A)"This is not something you have to live with.Talk with your doctor about this problem."
B)"I understand."
C)"I guess it's hard getting older."
D)"Do you get enjoyment out of watching television?"

Question 17

A married female patient has a history of repeated urinary tract infections (UTIs). Which of the following should the nurse include while assessing this patient?

A)preferred method of birth control
B)employment status
C)height and weight
D)activity status

Question 18

A male patient needs to increase the acidity of his urine. Which foods should this patient increase in his diet?

A)cranberries, grapes, and tomatoes
B)sardines and herring
C)green vegetables and oranges
D)beans, chocolate, and dairy products

Question 19

An elderly patient with diabetes is diagnosed with a flaccid bladder. Which of the following should be included in the care of this patient?

A)Instruct the patient about the Credé method of bladder emptying.
B)Maintain alkaline urine.
C)Instruct the patient about the use of anticholinergic medications.
D)Remind the patient to restrict fluids.

Question 20

While being catheterized for urinary retention, the patient becomes diaphoretic and pale. Which of the following can be done to help this patient?

A)Clamp the catheter after draining 500 mL of urine.
B)No action is needed, as this situation is transient.
C)Remove the urinary catheter.
D)Provide the patient with fluids.

Question 21

A patient with an indwelling urinary catheter is demonstrating signs of asymptomatic bacteriuria. Which of the following would be the best course of action for this patient?

A)Remove the catheter and begin antibiotic therapy.
B)Begin oral antibiotic therapy for three days.
C)Begin intravenous antibiotic therapy.
D)Remove the catheter and monitor for continued signs of bacteriuria.

Question 22

The nurse observes no change in urine output and a distended bladder in a patient with an indwelling urinary catheter and drainage system. The immediate nursing intervention is to do which of the following?

A)Assess the catheter tubing for kinks and position so drainage is maintained by gravity.
B)Notify the physician.
C)Flush the catheter with sterile saline using a large syringe.
D)Change the catheter.

Question 23

A patient is participating in bladder retraining activities. Of the following, select the toileting activities that can reduce episodes of incontinence. Select all that apply.

A)scheduled toileting
B)habit training
C)intermittent straight catheterization
D)external catheter placement at bedtime
E)use of adult incontinence protection devices

Question 24

The nurse recognizes this patient (see above) is demonstrating which complication of urinary calculi? 11ea992e_0a3c_4a1f_9f38_b902035f0b28

A)hydronephrosis
B)infection
C)renal colic
D)ureteral tumor

Question 25

Place the following steps in correct order when caring for a urinary stoma. Click and drag the options below to move them up or down.

A)Cleanse skin around stoma with soap and water, rinse, pat or air dry.
B)Assess stoma, noting color and moisture.
C)Remove old pouch; use warm water to loosen seal.
D)Use stoma guide to determine size of bag opening and/or protective ring.Trim as needed.
E)Apply bag with opening no more than 1-2 mm wider than outside of stoma.
F)Apply skin barrier; allow skin to dry, then connect bag to urine-collection device.

Question 26

Which of the following statements by a patient with uric acid stones indicates that teaching was effective about prevention of lithiasis?

A)"I should avoid organ meats and sardines in my diet."
B)"I will increase purine-rich foods in my diet."
C)"I know to avoid eating vitamin D-enriched foods."
D)"I will have to make my urine more acidic by eating cheese, cranberries, grapes, and tomatoes."

Question 27

The nurse is to collect a urine culture specimen from a catheterized patient. Which of the following statements describes the correct technique?

A)With a sterile syringe, the nurse aspirates several mL of urine from the sampling port after swabbing it with alcohol.A small volume of urine is emptied from the urine collection bag into a sterile specimen cup.
B)The nurse disconnects the catheter from the drainage tubing and allows 1-3 mL of urine to drain into a sterile specimen container.
C)With a sterile syringe and needle, the nurse aspirates 50 mL of urine from the catheter above where it is connected to the drainage tubing.
D)A small volume of urine is emptied from the urine collection bag into a sterile specimen cup.

Question 28

The nurse reviews the data presented (see above) and recognizes these symptoms as being compatible with a diagnosis of which of the following? 11ea992e_0a3b_fbfc_9f38_e71d045ee989

A)pyelonephritis
B)nephrolithiasis
C)hydronephrosis
D)cystitis

Question 29

A patient is discharged after photocoagulation for a bladder papilloma. Instructions for this patient including making an appointment for follow-up

A)in three months.
B)in one year.
C)in three years.
D)if symptoms return.

Question 30

A patient with a urinary diversion device has the nursing diagnosis of Risk for Impaired Skin Integrity. Which of the following interventions will the nurse use with this patient?

A)Empty the bag reservoir every two hours.
B)Change urine collection device every other day.
C)Teach self-catheterization technique.
D)Monitor for foul-smelling urine.

Question 31

A patient with struvite-type kidney stones may be managed by what two interventions?

A)surgical intervention; antibiotic therapy
B)limiting foods high in calcium; taking thiazide diuretics
C)a sodium restricted diet; taking penicillamine
D)a low-purine diet; taking potassium citrate

Question 32

A patient diagnosed with a symptomatic urinary tract infection (UTI), is prescribed phenazopyridine (Pyridium). The patient should be instructed that urine will

A)become orange or red.
B)have a green tint.
C)turn brown in color.
D)become clearer and pale yellow.

Question 33

Which of the following statements by a female patient indicates that teaching was effective about ways to prevent urinary tract infection (UTI)?

A)"I should drink 8 to 10 glasses of fluids per day."
B)"I should limit intake of water so I won't need to urinate so often."
C)"I should only wear nylon underpants."
D)"I should void every six hours while I am awake."

Question 34

During the health history interview of a patient diagnosed with postoperative urinary retention, the nurse asks if the patient is taking what medication to stimulate micturition?

A)bethanechol (Urecholine)
B)tolterodine (Detrol)
C)propantheline bromide (Pro-Banthine)
D)nitrofurantoin (Macrobid)

Question 35

Place an "X" over the area of the body where the nurse would percuss for costovertebral tenderness.

Question 36

The nurse, completing discharge teaching for a patient diagnosed with pyelonephritis, is asked "What is pyelonephritis?" The nurse's best response would be which of the following?

A)"Pyelonephritis is an infection of the kidney."
B)"It is an inflammation of the bladder."
C)"Pyelonephritis is an infection of the lower urinary tract."
D)"It is a blockage in the tube from your kidney to your bladder."

Question 37

Which of the following contributes to the increased incidence of urinary tract infections (UTIs) among older adult females?

A)loss of tissue elasticity
B)enhanced immune response
C)decreased risk of urinary stasis
D)decreased and less protective prostatic secretions

Question 38

A patient is being instructed on how to perform Kegel exercises. Which of the following should be included in these instructions? Select all that apply. Select all that apply.

A)While voiding, stop the flow of urine and hold for a few minutes.
B)Tighten the muscles around the anus to resist defecation.
C)Take a deep breath and hold while performing the exercise.
D)These should be performed at least once per day.
E)These should be performed for at least several months.