Deck 63: Coordinating Care for Patients With Urinary Disorders

Question 1

In preparing an educational program about urolithiasis, the nurse explains which person is at greatest risk for this disorder?
1)25-year-old African American female who works as a librarian in Maine
2)28-year-old Caucasian male who works as a lifeguard at a beach in Florida
3)32-year-old Caucasian female who works as a physical education teacher in California
4)35-year-old African American male who works as an architect in Texas

Answer 1

2

Question 2

The nurse includes which information in an educational presentation to staff about the development of urolithiasis?
1)Incidence is greater in African Americans.
2)Incidence is greater in men.
3)Incidence is greatest in the winter months.
4)Incidence is greater in the northern United States.

Answer 2

2

Question 3

In the patient who develops complications related to a 5-cm calculi in the renal pelvis, the nurse prepares the patient for which emergent procedure?
1)Extracorporeal shock-wave lithotripsy
2)Ureteroscopy
3)Ureteral stent
4)Percutaneous nephrolithotomy

Answer 3

4

Question 4

The nurse is teaching a class about the risks of bladder cancer. Which statement by one of the participants indicates that the teaching was effective?
1)"I will decrease my alcohol consumption."
2)"I will follow a high-protein diet."
3)"I will stop smoking."
4)"I will increase my physical activity."

Question 5

In reviewing teaching with a patient being treated with antibiotics and Pyridium for a urinary tract infection (UTI), which patient statement indicates the need for further teaching?
1)"I will urinate after sexual activity."
2)"I will increase my intake of fluids."
3)"I will report any vomiting that persists after I start the medications."
4)"I will report if my urine is orange or red in color."

Question 6

The patient with damage to which level of the spinal cord is at greatest risk of urinary incontinence?
1)L1-L2
2)L3-L5
3)L5-S1
4)S2-S4

Question 7

In providing care to a patient with a spinal cord injury, the nurse correlates that this disorder makes the patient at greatest risk for which type of incontinence?
1)Urge
2)Stress
3)Overflow
4)Functional

Question 8

In assessing pain in the patient with a urinary tract infection, which clinical manifestation does the nurse correlate to progression of the infection to pyelonephritis?
1)Dysuria
2)Flank pain
3)Hematuria
4)Urinary frequency

Question 9

The nurse recognizes which finding as the earliest clinical manifestation of bladder cancer?
1)Dysuria
2)Painless hematuria
3)Dull back pain
4)Cloudy urine

Question 10

The nurse provides care for the patient diagnosed with a kidney stone that has not passed. What statement is most important to include in the teaching for this patient?
1)"You need to take the prescribed morphine sulfate for your pain."
2)"You must strain all urine to confirm whether or not the stone has passed."
3)"A low-sodium diet will help to decrease your risk of kidney stones in the future."
4)"Terazosin (Hytrin) helps relax the lower ureter and increases the likelihood for the stone to pass."

Question 11

In providing care to a patient who is experiencing urine leakage when coughing or laughing, the nurse includes management of which type of incontinence in the plan of care?
1)Urge
2)Stress
3)Overflow
4)Functional

Question 12

In providing care to a patient diagnosed with urinary stress incontinence, the nurse identifies which outcome that correlates to effective management?
1)The patient will stop the flow of urine when voiding.
2)The patient will improve incontinence within one month.
3)The patient will empty the bladder every time voiding.
4)The patient will perform four to five squeezes (Kegel exercises) for 10 to 15 seconds.

Question 13

In preparing a patient for evaluation of urinary incontinence, the nurse monitors the results of which diagnostic study to get the most accurate information on the patient's bladder filling and storage function?
1)Cystometrogram
2)Intravenous urogram (pyelogram)
3)Uroflowmetry
4)KUB (kidney, ureters, bladder) x-ray

Question 14

Which statement by the patient about the medications prescribed for the treatment of urinary incontinence indicates the need for further teaching?
1)"Topical estrogen helps restore moisture and flexibility of the urethra."
2)"Imipramine (Tofranil) is used to treat depression caused by this condition."
3)"Anticholinergic medications relax and control bladder muscle contractions."
4)"Alpha-adrenergic agonists are prescribed to treat urinary retention that can cause incontinence."

Question 15

In administering an alpha-adrenergic blockers to a patient diagnosed with urolithiasis, the nurse correlates the primary rationale for this medication to which mechanism of action?
1)Decrease nausea and vomiting
2)Decrease pain
3)Dilate lower ureter
4)Promote contraction of the ureter

Question 16

Which statement by the patient being discharged after hospitalization for urolithiasis indicates the need for further teaching."
1)"I should increase sodium in my diet to increase urine output."
2)"If my urine is amber, I need to drink more fluid."
3)"My urine output should be at least 2 liters per day to flush out the stones."
4)"I am not supposed to drink coffee or tea."

Question 17

The nurse monitors the patient with multiple sclerosis for which type of incontinence?
1)Functional
2)Overflow
3)Reflex
4)Stress

Question 18

The nurse monitors the patient diagnosed with upper ureteral calculi with which clinical manifestation?
1)Lower abdominal pain
2)Radiating flank pain
3)Groin pain
4)Genital pain

Question 19

The nurse provides education for a patient who is experiencing urinary incontinence. Which statement by the patient indicates the need for further education?
1)"Relaxation of pelvic muscles may be a factor in incontinence."
2)"Reduced urethral resistance can be a cause of incontinence."
3)"Incontinence is normal with aging."
4)"A disturbance of my bladder is a factor in the development of incontinence."

Question 20

The nurse correlates which physiological factor to the decreased risk of urinary tract infection in men compared with women?
1)Increased urine flow
2)Ureter length
3)Prostate enlargement
4)Urethral length

Question 21

The nurse correlates which data in a female patient's history to an increased risk of urinary tract infection (UTI)? Select all that apply.
1)25 years old
2)Drinks 2 L of water a day 3.28 weeks pregnant
4)History of back strain
5)History of renal calculi

Question 22

Which statement by the patient who had an ileal conduit for treatment of bladder cancer indicates that teaching was effective?
1)"I will not have to wear an external pouch."
2)"I will need to use a catheter to empty the urine."
3)"I will have to decrease my fluid intake."
4)"I will wear a drainage bag to collect the urine."

Question 23

In preparing to care for a female patient after an anterior exenteration for treatment of bladder cancer, the nurse understands that which structures were removed during this procedure? Select all that apply.
1)Anterior vaginal wall
2)Bladder
3)Ovaries
4)Ureters
5)Rectum

Question 24

The nurse is providing care to a patient who is diagnosed with bladder cancer and receiving bacille Calmette-Guérin therapy. Which is the priority teaching point for this patient?
1)Straining all urine to assess for calculi
2)Flushing the toilet immediately after urination
3)Pouring 2 cups of bleach in the toilet and flushing 20 minutes later
4)Notifying the healthcare provider if the patient does not void every 2 hours

Question 25

In preparing an educational presentation for nursing staff regarding care of patient with renal calculi, the nurse explains that percutaneous nephrolithotomy is the treatment of choice for which types of stone? Select all that apply.
1)Distal ureteral stones
2)Stones in the renal pelvis
3)Staghorn calculi
4)Mid-ureteral stones
5)Stones greater than 2 cm

Question 26

Which statement by the patient who will have a neobladder with continent catheterizable stoma for the treatment of bladder cancer indicates the need for further teaching?
1)"I will have an external pouch."
2)"I will need to use a catheter to empty the urine."
3)"There may be some leakage of urine from the stoma."
4)"I do not have to wear a drainage bag."

Question 27

The nurse monitors for which clinical manifestations in the patient diagnosed with stress incontinence? Select all that apply.
1)Dysuria
2)Urine leakage while coughing
3)Urine leakage while laughing
4)Skin irritation in the perineal area
5)Hematuria

Question 28

In developing a teaching plan for a patient about treatment for bladder cancer, which data does the nurse include in the plan?
1)Radiation therapy is not indicated after laser ablation of bladder cancer.
2)Radical cystectomy, combined with neoadjuvant chemotherapy, is considered to be the definitive treatment for bladder cancer.
3)Chemotherapy is not effective for bladder cancer.
4)The entire bladder has to be removed to treat bladder cancer.

Question 29

The nurse prepares the patient with suspected bladder cancer for which diagnostic test that is needed for the definitive diagnosis?
1)Culture and sensitivity
2)Urine cytology
3)Intravenous urography
4)Cystoscopy with biopsy

Question 30

The nurse is providing training for the clinical staff of a skilled care facility and includes information about which risk factors for functional incontinence? Select all that apply.
1)Limited mobility
2)Impaired vision
3)Lack of access to facilities
4)Dementia
5)Depression