Deck 47: Nursing Assessment Urinary System

Question 1

The nurse is teaching a client scheduled for a cystoscopy about the procedure. Which of the following statements should the nurse include in the teaching plan?

A)"Your health care provider will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney."
B)"Your health care provider will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys."
C)"Your health care provider will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked."
D)"Your health care provider will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."

Answer 1

"Your health care provider will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."

Question 2

Aclient's urine dipstick indicates a small amount of protein in the urine. Which of the following actions should the nurse take next?

A)Check which medications the client is currently taking.
B)Obtain a clean-catch urine specimen for culture and sensitivity testing.
C)Ask the client about any family history of chronic renal failure.
D)Send a urine specimen to the laboratory to test for ketones and glucose.

Answer 2

Check which medications the client is currently taking.

Question 3

The nurse is reviewing the result of a client's creatinine clearance test which is 60 mL/minute. Which of the following values is the client's glomerular filtration rate (GFR) in mL/minute?

A)30
B)60
C) 120
D) 240

Answer 3

60

Question 4

During assessment of a client with decreased renal function, which of the following medications taken by the client at home is of most concern to the nurse?

A)Ibuprofen
B)Warfarin
C)Folic acid
D)Penicillin

Question 5

The nurse is caring for a client with an elevated blood urea nitrogen (BUN) and serum creatinine who is scheduled for a renal arteriogram. Which of the following bowel preparation prescriptions should the nurse question?

A)Fleet enema
B)Tap-water enema
C)Bisacodyl tablets
D)Castor oil

Question 6

The nurse is caring for a client with diabetic nephropathy who is scheduled for a right renal biopsy. Immediately after the biopsy, which of the following actions is essential?

A)Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function.
B)Check blood glucose to assess for hyperglycemia or hypoglycemia.
C)Insert a straight catheter to check for gross or microscopic hematuria.
D)Apply a pressure dressing and keep the client prone for 30-60 minutes.

Question 7

For which of the following purposes does the nurse use auscultation during assessment of the urinary system?

A)Check for ureteral peristalsis.
B)Assess for bladder distension.
C)Identify renal artery or aortic bruits.
D)Determine the position of the kidneys.

Question 8

The nurse is preparing a client with a decreased glomerular filtration rate for an intravenous pyelogram (IVP). Which of the following actions should be included in the plan of care?

A)Monitor the urine output after the procedure.
B)Assist with monitored anesthesia care (MAC).
C)Give oral contrast solution before the procedure.
D)Insert a large size urinary catheter before the IVP.

Question 9

The nurse is admitting an older-adult client with benign prostatic hyperplasia. Which of the following actions should be included in the nursing plan of care?

A)Limit fluid intake to no more than 1 500 mL/day.
B)Leave a light on in the bathroom during the night.
C)Pad the client's bed to accommodate overflow incontinence.
D)Ask the client to use a urinal so that all urine can be measured.

Question 10

The nurse is assessing a client's urinary system and is unable to palpate either kidney. Which of the following actions should the nurse take next?

A)Obtain a urine specimen to check for hematuria.
B)Document the information on the assessment form.
C)Ask the client about any history of recent sore throat.
D)Ask the health care provider about scheduling a renal ultrasound.

Question 11

The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a client with a suspected urinary tract infection (UTI). Which of the following actions should the nurse implement to obtain the specimen?

A)Teach the client to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
B)Have the client empty the bladder completely, and then obtain the next urine specimen that the client is able to void.
C)Insert a short, small "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen.
D)Clean the area around the meatus with a povidone-iodine swab, and then have the client void into a sterile container.

Question 12

The nurse is reviewing the results of a client's urinalysis. Which of the following information indicates that the nurse should notify the health care provider?

A)pH 6.2
B)Trace protein
C)WBC: 20-26/hpf
D)Specific gravity: 1.021

Question 13

Which of the following actions should the nurse plan to take first when admitting a client who has a history of neurogenic bladder as a result of a spinal cord injury?

A)Ask about the usual urinary pattern and any measures used for bladder control.
B)Assist the client to the toilet at scheduled times to help ensure bladder emptying.
C)Check the client for urinary incontinence every 2 hours to maintain skin integrity.
D)Use intermittent catheterization on a regular schedule to avoid the risk of infection.

Question 14

Acreatinine clearance test is ordered for a hospitalized client with possible renal insufficiency. Which of the following equipment will the nurse need to obtain?

A)Sterile specimen cup
B)Large container for urine
C)Foley catheter and drainage bag
D)Towelettes for perineal cleaning

Question 15

The nurse is preparing to conduct an annual health and physical examination on a client who is employed as a hairdresser and has a 10 pack-year history of cigarette smoking. Which of the following conditions should the nurse plan to teach the client about theincreased risk for based upon the client history?

A)Renal failure
B)Kidney stones
C)Pyelonephritis
D)Bladder cancer

Question 16

Which of the following techniques should the nurse use to assess the flank area of a client with pyelonephritis for tenderness?

A)Push gently into the two lowest intercostal spaces.
B)Palpate along both sides of the lumbar vertebral column.
C)Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
D)Use two fingers to percuss the area between the iliac crest and ribs along the midaxillary line.

Question 17

The nurse is preparing a client for a cystoscopy. Which of the following postprocedural information should the nurse include in the teaching plan?

A)NPO for 8 hours to prevent nausea and vomiting
B)Strict bed rest for about 4-6 hours
C)Request prescribed opioids as necessary for pain.
D)May experience blood-tinged urine and urinary frequency.

Question 18

A client with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine specimen that is a red-orange colour. Which of the following actions should the nurse take first?

A)Notify the client's health care provider.
B)Ask the client about use of any medications.
C)Question the client about any UTI risk factors.
D)Teach about the correct procedure for midstream urine collection.

Question 19

The nurse is preparing a client for an intravenous pyelogram (IVP) and obtains the nurse the following information. Which information has the most immediate implications for the client's care?

A)The client describes allergies to shellfish and penicillin.
B)The client has not had anything to eat or drink for 8 hours.
C)The client complains of costovertebral angle (CVA) tenderness.
D)The client used a bisacodyl tablet the previous night.

Question 20

The nurse is reviewing a client's chart and notes that the client has dysuria. To assess whether there is any improvement, which of the following questions should the nurse ask?

A)"Do you have any blood in your urine?"
B)"Do you have to urinate very frequently?"
C)"Do you have any pain when you urinate?"
D)"Do you have to get up at night to urinate?"

Question 21

A client who had a cystoscopy the previous day calls the urology clinic and gives the nurse all the following information. Which of the following client statements should be reported immediately to the health care provider?

A)"My urine still looks pink."
B)"My IV site is still bruised."
C)"I have a temperature of 38.3°C (100.9°F)."
D)"I did not sleep well last night."

Question 22

The nurse is caring for a client following an intravenous pyelogram (IVP) and obtains all of the following assessment data. Which of the following findings require immediate action by the nurse?

A)The heart rate is 58 beats/minute.
B)The respiratory rate is 38 breaths/minute.
C)The client complains of a dry mouth.
D)The urine output is 400 mL in the first 2 hours.