Deck 39: Urinary System

Question 1

To assess a client who is experiencing symptoms of overflow incontinence,the nurse will focus on which area?

A)amount of caffeinated beverages consumed daily
B)use of diuretics
C)evidence of edema
D)presence of diabetes

Answer 1

presence of diabetes

Question 2

Which of the following laboratory results would the nurse expect for the client who has chronic glomerulonephritis?

A)decreased serum creatinine
B)normal blood urea nitrogen (BUN)
C)normal complete blood count (CBC)
D)proteinuria

Answer 2

proteinuria

Question 3

A client who has an allergy to sulfa drugs is given a prescription for Amoxil to treat a urinary tract infection.Which of these actions should the nurse take?

A)Tell the client to take the medication as ordered.
B)Consult with the health care provider about administering an antihistamine drug 30 minutes prior to each dose of the antimicrobial.
C)Tell the client to hold the prescription,and inform the health care provider of the allergy.
D)Ask the pharmacist to verify use of this medicine.

Answer 3

Tell the client to take the medication as ordered.

Question 4

A client who has multiple sclerosis develops total urinary incontinence.What initial treatment should the nurse tell the client to expect?

A)anticholinergic medications
B)indwelling catheter to a collection bag
C)intermittent self-catheterization of the urinary bladder
D)surgery to create a permanent ileal conduit

Question 5

A client has developed a nosocomial cystitis.Which of these organisms MOST commonly causes cystitis?

A)Candida albicans
B)Clostridium
C)Escherichia coli
D)Streptococcus aureus

Question 6

Which of these statements should the nurse include for clients who have frequent urinary tract infections,to prevent recurrence?

A)"Clean the perineum back to front."
B)"Wear incontinence control products to prevent accidents."
C)"Douche regularly with pleasantly scented products."
D)"Void more frequently,especially after sexual intercourse."

Question 7

A client who had tonsillitis several weeks ago now complains of severe flank pain on the left side,headache,malaise,hematuria,and facial edema.The client describes urine appearing to be "smoky." The nurse should suspect the client has developed which of these conditions?

A)acute glomerulonephritis
B)bladder tumor
C)chronic renal failure
D)urolithiasis

Question 8

In addition to strict monitoring of intake and output,nursing interventions for the hospitalized client with acute glomerulonephritis would include which of the following?

A)Monitor intake of carbohydrates.
B)Incorporate a turning schedule that includes range-of-motion exercises.
C)Allow fluids to be consumed only with meals.
D)Encourage family and friends to visit whenever possible.

Question 9

A client with urinary retention may be treated by all of the following methods.Which method is preferred when the client is in acute distress?

A)antispasmodics
B)surgery
C)urinary analgesics
D)urinary catheterization

Question 10

A client who has cystitis complains of extreme dysuria,and Pyridium has been prescribed.Which of these aspects should the nurse include in client teaching?

A)"Drink at least 3 liters of water and 3 liters of cranberry juice per day."
B)"Reduce the amount of whole grains and meats in your diet."
C)"Expect your urine to appear more concentrated."
D)"This medicine turns your urine red-orange and can stain clothes and toilets."

Question 11

Which of these aspects should a nurse include when teaching a client who has nocturnal enuresis?

A)limiting fluid intake after 6:00 P.M.
B)attaching an external condom
C)reducing fluid intake volume each day
D)attempting to void every 2 hours when awake

Question 12

The client with urge incontinence is BEST treated by which approach?

A)Encouraging a fluid intake of 3,000 mL/day.
B)Restricting fluid intake to 1,000 mL/day.
C)Strengthening the perineal muscles with Kegel exercises.
D)Taking anticholinergic medications as ordered.

Question 13

What is the goal of surgery to treat stress urinary incontinence?

A)to close the urethra enough to prevent urine from leaking out
B)to inject collagen into the tissues surrounding the urethra
C)to perform the Kegel procedure
D)to restore and reconstruct the support of the pelvic floor muscles

Question 14

What is the MOST common cause of urge incontinence?

A)an irritated bladder due to infection or very concentrated urine
B)excessive intake of fluids
C)loss of perineal muscle tone due to trauma or aging
D)use of alpha-antagonist medications

Question 15

Which of these normal changes occurring in the urinary system with aging may contribute to an older adult female client developing cystitis?

A)decreased bladder capacity
B)weakening of bladder and perineal muscles resulting in the inability to empty the bladder
C)development of stress incontinence
D)decreased renal function

Question 16

A 60-year-old female client states that whenever she coughs,sneezes,or laughs there is leakage of urine.The nurse explains to the client that the incontinence this client experiencing is:

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

Question 17

Discharge teaching for a client who has been treated for pyelonephritis would include which statement?

A)"Report any sudden weight loss of 2 pounds per week."
B)"Get plenty of rest,even when you are feeling better."
C)"Avoid crowds where you may become reinfected."
D)"Practice perineal hygiene by cleansing from back to front."

Question 18

A client who has an enlarged prostate gland tells the nurse he feels like his bladder is not completely empty after voiding,and his health care provider requests a check for residual urine.Which of these nursing actions is correct?

A)Catheterize him immediately after he voids,and record the amount obtained.
B)Have him measure his voidings in sequentially numbered containers and record the amount and time of each voiding.
C)Insert a retention catheter,and connect it to a bedside collection unit.
D)Keep an accurate intake and output (I&O),and subtract and record the difference between the intake and the output for each 8-hour shift.

Question 19

Nursing management of a client who has acute glomerulonephritis would include which aspect?

A)monitoring skin condition and integrity
B)weighing client weekly
C)taking apical pulse daily
D)assisting client to ambulate and complete activities of daily living (ADLs)

Question 20

A client is to be treated for suspected cystitis.Which of these orders should the nurse implement first?

A)Administer urinary antimicrobial medication.
B)Administer urinary tract analgesics.
C)Obtain a urine specimen for culture and sensitivity (C&S).
D)Start an IV fluid at 100 mL/h.

Question 21

What is the major cause of intrarenal acute renal failure (ARF)?

A)acute tubular necrosis
B)glomerulonephritis
C)renal tumors
D)urolithiasis

Question 22

Which nursing intervention is indicated for a client who had intravesical chemotherapy today?

A)Ambulate in the hall each hour.
B)Change positions every 15 minutes for several hours.
C)Observe strict bed rest for 24 hours.
D)Turn and reposition every 2 to 3 hours.

Question 23

Which of these observations would a nurse expect in a client who is in the recovery phase of acute tubular necrosis (ATN)?

A)a short period of rapid improvement,followed by rapid decline in the client's condition
B)return of normal urine output
C)elevated creatinine and blood urea nitrogen (BUN)levels
D)rapid increase in volume of urinary output

Question 24

What are the only early warning signs of bladder cancer?

A)dysuria and urgency
B)gradual-onset oliguria and proteinuria
C)increased urinary frequency and painless,intermittent hematuria
D)sudden onset anuria after cystitis

Question 25

A client who has a renal mass on the right side is scheduled for a right radical nephrectomy.Immediate postoperative nursing care would include all of the following.Which action is MOST important?

A)assessing neurological status and lung sounds
B)monitoring IV fluid infusions
C)observing the dressing frequently for bleeding
D)planning several periods of uninterrupted rest each day

Question 26

Following treatment for renal calculi that were primarily calcium in composition,which of these dietary modifications would assist a client in preventing recurrence?

A)Avoid anchovies,sardines,and organ meats.
B)Eat foods such as broccoli,asparagus,chocolate,tea,and spinach.
C)Avoid cereals,cranberries,plums,eggs,and meats.
D)Eat foods high in calcium such as milk,broccoli,and cheese.

Question 27

Leading causes of chronic renal failure include diabetes mellitus,hypertension,and:

A)urolithiasis
B)congestive heart failure
C)hepatotoxic drugs
D)glomerulonephritis

Question 28

When weighing a client with acute renal failure,the nurse recognizes that 1 pound of weight gain is equivalent to how many milliliters of retained fluid?

A)250
B)500
C)750
D)1,000

Question 29

A client who has urolithiasis asks the nurse what causes this condition to develop.Which of the following factors will the nurse explain predisposes the development of calculi?

A)thyroid disorders
B)recurrent urinary tract infections (UTIs)
C)increased physical activity
D)eating a high-protein diet

Question 30

Which statement should the nurse include when teaching a client who has end-stage renal disease about hemodialysis?

A)"Dialysis filters wastes,excess electrolytes,and water from your blood."
B)"It is advised that you fast for at least 12 hours prior to the treatment.'"
C)"Be sure and take any prescribed medications before each treatment."
D)"Each treatment is usually done three times a week and takes several hours to complete."

Question 31

What is a major goal in the medical management of a client who has polycystic kidney disease?

A)management of hematuria
B)prevention of urinary retention
C)relief of bladder spasms
D)preservation of kidney function

Question 32

Which sign signals the onset of end-stage renal disease (ESRD)in a client who has chronic renal failure?

A)polyuria
B)nocturia
C)severe fluid and electrolyte imbalances
D)blood urea nitrogen (BUN)of at least 20 mg/dL

Question 33

The medical treatment for prerenal acute renal failure (ARF)related to fluid volume deficit is focused on:

A)administering IV fluids,albumin,plasma,or blood
B)increasing the effective arterial blood volume (EABV)by dobutamine or Inocor
C)removing the obstruction
D)restoring perfusion to the kidney quickly

Question 34

Extracorporeal shock wave lithotripsy (ESWL)is administered to a client to treat urolithiasis.Which of these aspects should the client anticipate following this treatment?

A)IV fluids for 72 hours
B)remaining NPO for 12 hours
C)normal skin appearance
D)bloody urine for 1 to 2 days

Question 35

With the progression of chronic renal disease,fluid restrictions are necessary.Which fluid intake schedule would be MOST appropriate for each 24-hour period?

A)250 cc days;200 cc evenings;350 cc nights
B)300 cc days;250 cc evenings;250 cc nights
C)400 cc days;200 cc evenings;200 cc nights
D)500 cc days;200 cc evenings;100 cc nights

Question 36

A nurse observes that a client's ileal conduit stoma is dark bluish in the immediate postoperative period.Which of these actions should the nurse take?

A)Chart the observation.
B)Have the client assume a semi-Fowler's position.
C)Remove the pouch,and make the pouch opening larger.
D)Notify the health care provider immediately.

Question 37

What is the focus of medical treatment for clients who have postrenal acute renal failure (ARF)?

A)administering IV fluids,albumin,plasma,or blood
B)increasing the effective arterial blood volume (EABV)with dobutamine or Inocor
C)removing the obstruction
D)restoring perfusion to the kidney quickly

Question 38

Which of the following signs and symptoms may indicate that the condition of a client who has chronic glomerulonephritis is deteriorating?

A)anasarca
B)ataxia
C)polyuria
D)uremic frost

Question 39

Which of these procedures is performed before hemodialysis is initiated for a new client who has chronic renal failure?

A)The client must be weighed before and after each session.
B)The client is prepared to be placed in protective isolation during the treatment.
C)The hemodialysis access site is restrained to prevent dislodging.
D)Blood pressure and blood draws are taken on the extremity where the hemodialysis access site is located.

Question 40

Which of these medications is considered to be nephrotoxic?

A)ciprofloxacin (Cipro)
B)ibuprofen (Advil)
C)sulfisoxazole (Gantrisin)
D)furosemide (Lasix)

Question 41

Which of these signs may indicate development of infection in a postoperative kidney transplant client who is on immunosuppressive therapy?

A)cloudy urine
B)development of rales
C)fever of 103 degrees Fahrenheit or higher
D)severe,excruciating pain in the wound site

Question 42

A nurse is palpating the hemodialysis access site and does not feel a "thrill." Which of these steps should the nurse take next?

A)Administer a heparin flush to the cannula.
B)Place an absorbent dressing over the site.
C)Check the site with a Doppler stethoscope to confirm finding.
D)Notify the health care provider.

Question 43

The nurse explains to the client that several causes of incontinence are reversible.Which of the following should be included? (Select all that apply. )

A)restricted mobility
B)polyuria
C)infections
D)delirium
E)nocturia

Question 44

The client with chronic renal failure is scheduled for hemodialysis this morning and is due to receive a once-daily medication.Nursing intervention would include administering the medication:

A)just prior to dialysis
B)during dialysis
C)on return from dialysis
D)the day after dialysis

Question 45

When teaching a client about peritoneal dialysis,the nurse should stress:

A)eating a meal before each session
B)having family members or friends available for assistance
C)staying in bed for the duration of the procedure
D)strict aseptic care of the catheter site

Question 46

What appearance should the returned dialysate from a client's manual peritoneal dialysis session have?

A)clear and white
B)clear and light yellow
C)cloudy and white
D)cloudy and dark yellow

Question 47

The nurse should monitor a postoperative kidney transplant client for which sign of organ rejection?

A)polyuria
B)generalized edema
C)flank pain
D)weight loss

Question 48

A nurse is assessing the fistula in the arm of a client receiving hemodialysis for chronic renal failure.Which of the following indicates that the fistula is patent?

A)absence of a bruit on auscultation of the fistula
B)palpation of a thrill over the fistula
C)presence of a radial pulse in the wrist
D)capillary refill of less than 3 seconds