Question 1

The patient is on postoperative day 1 after having undergone a TURP procedure. He has continuous bladder irrigation (CBI). Actual urine output during continuous bladder irrigation is calculated by

Accepted Answer

To determine urine output, the nurse will subtract the amount of irrigation fluid used with the Foley catheter output to calculate urine output.

Question 2

The amount of water that is eliminated with the urine is regulated by a complex mechanism within the nephron and influenced by a hormone from the posterior pituitary gland called

Accepted Answer

ADH causes the cells of the distal convoluted tubules to increase their rate of water reabsorption.

Question 3

The patient is scheduled for a cystogram via a cystoscope. Which is the best explanation of this procedure by the nurse?

Accepted Answer

Cystoscopy is a visual examination to inspect, treat, or diagnose disorders of the urinary bladder and proximal structures.

Question 4

It is 2 days after a difficult patient's urinary diversion surgery. He continues to be critical of the hospital and the nursing care, even though the staff has spent time explaining the care to him. The most likely explanation for his behavior is that he

Accepted Answer

Patient teaching centers on tasks of lifestyle adaptation: care of the stoma, nutrition, fluid intake, maintaining self-esteem in light of altered body image, modifying sexual activities, and early detection of complications.

Question 5

A nursing intervention to assist the patient with chronic renal failure (CRF) in learning about available community resources would be a consultation with

Accepted Answer

Patient teaching-inform the patient of community resources.

Question 6

In teaching a patient how to decrease the chance of further problems with urolithiasis, barring any other contraindication, the nurse would encourage him to

Accepted Answer

Fluid intake should be encouraged to at least 2,000 mL of fluid in 24 hours, unless contraindicated.

Question 7

The patient is receiving continuous bladder irrigation after a transurethral resection of the prostate (TURP). He complains of a "spasmlike" pain over his lower abdomen. Which of these actions should the nurse perform first in response to this complaint?

Accepted Answer

The patient who has a TURP may have continuous closed bladder irrigation or intermittent irrigation to prevent occlusion of the catheter with blood clots, which would cause bladder spasms.

Question 8

The physician orders a urinalysis and urine culture. To obtain the urine specimen, the nurse would first instruct the patient about

Accepted Answer

Urinalysis is completed on a clean-catch or catheterized specimen.

Question 9

A patient, age 69, is admitted to the hospital with gross hematuria and history of a 20-pound weight loss during the last 3 months. The physician suspects renal cancer. In obtaining a nursing history from this patient, the nurse recognizes which factor as a significant risk factor for renal cancer?

Accepted Answer

Risk factors include smoking; familial incidence; and preexisting renal disorders such as adult polycystic kidney disease and renal cystic disease secondary to renal failure.

Question 10

A patient, age 71, has benign prostatic hypertrophy. He is recovering from a transurethral prostatic resection. The physician orders removal of the indwelling catheter 2 days after the TURP procedure. The patient should be instructed that at first he might experience

Accepted Answer

The patient is informed that initially he may experience frequency and voiding small amounts with some dribbling.

Question 11

When preparing to teach a patient about continuous bladder irrigation, the nurse notes that the most frequently used irrigant is

Accepted Answer

The irrigant is an isotonic solution.

Question 12

Chronic renal failure (CRF) affects both patients and their families because of the financial predicament and facing the death of a loved one. Which would be an appropriate nursing intervention to address these concerns?

Accepted Answer

Encourage verbalization of financial concerns and long term care options with representative from social services. Support groups are not designed to assist with financial concerns.

Question 13

The nurse notes the amount and color of the urine of the patient with urolithiasis. While using standard precautions, the nurse's next action would be to

Accepted Answer

All urine should be strained. Because stones may be any size, even the smallest speck must be saved for assessment.

Question 14

As the nurse and the dietitian review a patient's diet plan with her, she becomes very angry, shouting that with her diabetes and now the kidney failure, there is just nothing she can eat. She says she might as well eat what she wants, because these diseases will kill her anyway. Based on the patient's response, which nursing diagnosis does the nurse identify?

Accepted Answer

Diabetes mellitus is the most common cause of kidney failure, accounting for more than 40% of new cases. Emphasis is placed on emotional support for the patient who faces role changes.

Question 15

A patient with chronic renal failure (CRF) has a nursing diagnosis of Disturbed sensory perceptions related to central nervous system changes induced by uremic toxins. Which nursing intervention is appropriate for this problem?

Accepted Answer

Listen to the patient. Restricted protein intake will benefit acute renal failure but may not help CRF.

Question 16

The patient is scheduled for a transurethral resection of the prostate. During preoperative teaching, it is important to emphasize that after surgery he should expect

Accepted Answer

The patient and family need to know that hematuria is expected after prostatic surgery.

Question 17

When a patient on Lasix, a loop diuretic, complains of weakness and irregular pulse, there may be an electrolyte deficiency of

Accepted Answer

The loop diuretic prototype, furosemide (Lasix), affects electrolytes to cause hypokalemia,
the deficiency of the electrolyte can cause arrhythmias and muscle weakness.

Question 18

A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with an ileal conduit. An important aspect in nursing interventions of the patient with an ileal conduit is

Accepted Answer

Care of the patient with an ileal conduit is a nursing challenge because of the continual drainage of urine through the stoma. Complication of this procedure is wound infection, dehiscence, and urinary leakage.

Question 19

As the body breaks down protein, nitrogen wastes are broken down into urea, ammonia, and

Accepted Answer

As proteins break down, nitrogenous wastes-urea, ammonia, and creatinine-are produced.

Question 20

Because the kidneys are located in proximity to the vertebrae and are protected by the ribs, their location in documentation is referred to as

Accepted Answer

The kidneys lie behind the parietal peritoneum (retroperitoneal).

Quiz 10: Care of the Patient With a Urinary Disorder

The patient is on postoperative day 1 after having undergone a TURP procedure. He has continuous bladder irrigation (CBI) . Actual urine output during continuous bladder irrigation is calculated by