Deck 47: Nursing Assessment: Urinary System

Question 1

When admitting a patient who has a history of paraplegia as a result of a spinal cord injury,the nurse will plan to do which of the following?

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

Answer 1

Ask the patient about the usual urinary pattern and measures used for bladder control.

Question 2

The nurse should tell the patient undergoing cystoscopy that which of the following will occur following the procedure?

A) He will receive narcotics as necessary for pain.
B) He will be on nothing by mouth (NPO)status for 8 hours to prevent nausea and vomiting.
C) He may experience blood-tinged urine and urinary frequency.
D) He will be on bed rest for 12 to 24 hours following the procedure.

Answer 2

He may experience blood-tinged urine and urinary frequency.

Question 3

The physician orders a clean-catch urine specimen for culture and sensitivity testing for a female patient with a suspected urinary tract infection.When teaching the patient to obtain the specimen,what should the nurse instruct the patient to do?

A) Sit on a bedpan,and after she starts to urinate,the nurse will catch the remaining urine in a specimen cup.
B) Clean the urethral area,void a small amount into the toilet,and then void into a sterile specimen cup.
C) Insert a short,small,"mini" catheter attached to a collecting container into the urinary meatus to obtain urine for testing.
D) Wash the perineal area with soap and water,start the stream of urine,and then pass a clean specimen cup into the urine flow to catch the remainder of the urine.

Answer 3

Clean the urethral area,void a small amount into the toilet,and then void into a sterile specimen cup.

Question 4

When reading a patient's chart,the nurse notes that the patient has had dysuria.To assess whether there is any improvement,which question will the nurse ask?

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

Question 5

A patient's urine dipstick reveals a large amount of protein in the urine.What is the next nursing action?

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

Question 6

A 20-year-old patient who is employed as a hairdresser and has a 10-pack-year history of cigarette smoking is scheduled for an annual physical examination.The nurse will plan to teach the patient about the increased risk for which of the following?

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

Question 7

Which of the following is an age-related change in the urinary system?

A) Increased amount of renal tissue
B) Increased number of nephrons
C) Decreased function of the loop of Henle
D) Decreased prevalence of unstable bladder contractions

Question 8

For what purpose does the nurse use auscultation during assessment of the urinary system?

A) To determine the position of the kidneys
B) To assess fluid wave patterns in the bladder
C) To determine the level of a distended bladder
D) To identify renal artery and abdominal aortic bruits

Question 9

A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency.Which equipment will the nurse need to obtain?

A) Foley catheter and drainage bag
B) Towelettes for perineal cleaning
C) Basin of ice
D) Sterile specimen cup

Question 10

During assessment of a patient with a disorder of the urinary system,the nurse identifies a potentially nephrotoxic agent when the patient reports the use of which of the following drugs?

A) Anticoagulants
B) Vitamin supplements
C) Nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Prophylactic penicillin therapy

Question 11

While assessing a patient's urinary system,the nurse cannot palpate either kidney.What is the most appropriate interpretation of this finding?

A) It is a normal finding.
B) It is suggestive of hydronephrosis.
C) It is diagnostic for polycystic disease.
D) It indicates the presence of atrophied kidneys.

Question 12

The result of a patient's creatinine clearance test is 60 mL/min.The nurse equates this finding to which of the following glomerular filtration rates (GFRs)?

A) 30 mL/min
B) 60 mL/min
C) 120 mL/min
D) 240 mL/min

Question 13

Which one of the following tests identifies changes in cellular structures that are indicative of malignancy?

A) Concentration test
B) Residual urine
C) Quantitative test
D) Urine cytology

Question 14

When teaching a patient scheduled for a cystogram via a cystoscope about the procedure,which following statement would the nurse make to the patient?

A) "Your doctor will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys."
B) "Your doctor will insert a lighted tube into the bladder and inject a dye into your kidneys through little catheters inserted into the ureters."
C) "Your doctor will insert a lighted tube into the bladder through your urethra,inspect the bladder,and instill a dye that will outline your bladder on radiography."
D) "Your doctor will inject a dye into a vein in your arm that is carried to the urinary system.Then a lighted tube in your bladder will be used to see when the dye appears."

Question 15

Which of the following is an abnormal finding of the urinary system?

A) CVA tenderness
B) Nonpalpable kidney
C) No palpable masses
D) Nonpalpable bladder

Question 16

When analyzing the results of a patient's urinalysis,the nurse recognizes that a urinary tract infection is indicated by which of the following findings?

A) Protein 4+
B) Glucose 3+
C) White blood cell (WBC)count 20 to 26 cells per high-power field
D) Specific gravity 1.01

Question 17

A patient with an elevated BUN and serum creatinine is scheduled for a renal arteriogram.The nurse should question an order from the radiology department for which of the following bowel preparations?

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

Question 18

Which component of the nephron is responsible for the reabsorption of sodium and chloride?

A) Glomerulus
B) Proximal tubule
C) Loop of Henle
D) Distal tubule

Question 19

How will the nurse assess the flank area for tenderness?

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

Question 20

A patient with a possible renal cell tumour who is scheduled for an intravenous pyelogram (IVP)and computed tomography (CT)scanning of the abdomen gives the nurse all the following data.Which information has the most immediate implications for the patient's care?

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

Question 21

What one of the following would the nurse document when the physical assessment reveals a passage of urine containing gas?

A) Anuria
B) Enuresis
C) Pneumaturia
D) Polyuria