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?

Accepted Answer

With a cystoscopy, a cystoscope is inserted into the bladder for direct visualization, and then contrast solution is injected through the scope so that x-rays can be taken. The response beginning, "Your health care provider will place a catheter" describes a renal arteriogram procedure. The response beginning, "Your health care provider will inject a radioactive solution" describes a nuclear scan. The response beginning, "Your health care provider will insert a lighted tube into the bladder, and little catheters will be inserted" describes a retrograde pyelogram.

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?

Accepted Answer

Normally the urinalysis will show zero to trace amounts of protein, but some medications may give false-positive readings. The other actions by the nurse may be appropriate, but checking for medications that may affect the dipstick accuracy should be done first.

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?

Accepted Answer

The creatinine clearance approximates the GFR. The other responses are not accurate. DIF:Cognitive Level: ComprehensionTOP:Nursing Process: Assessment

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?

Accepted Answer

The nonsteroidal anti-inflammatory durgs (NSAIDs) are nephrotoxic and should be avoided in clients with impaired renal function. The nurse also should ask about reasons the client is taking the other medications, but the medication of most concern is the ibuprofen.

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?

Accepted Answer

High-phosphate enemas, such as Fleet enemas, should be avoided in clients with elevated BUN and creatinine because phosphate cannot be excreted by clients with renal failure. The other medications for bowel evacuation are more appropriate.

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?

Accepted Answer

After the procedure, a pressure dressing is applied, and the client is kept prone for 30-60 minutes. Usually bed rest is prescribed for 24 hours. The blood glucose and BUN/creatinine will not be affected by the biopsy. Although monitoring for hematuria is needed, there is no need for catheterization.

Question 7

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

Accepted Answer

The presence of a bruit may indicate problems such as renal artery tortuosity or abdominal aortic aneurysm. Auscultation would not be helpful in assessing for the other listed urinary tract information.

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?

Accepted Answer

Clients with impaired renal function are at risk for decreased renal function after IVP because the contrast medium used is nephrotoxic, so the nurse should monitor the client's urine output. MAC sedation and retention catheterization are not required for the procedure. The contrast medium is given intravenously, not orally.

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?

Accepted Answer

The client's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom is appropriate. Fluids should be encouraged because dehydration is more common in older clients. The information in the question does not indicate that measurement of the client's output is necessary or that the client has overflow incontinence.

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?

Accepted Answer

The kidneys are protected by the abdominal organs, ribs, and muscles of the back and may not be palpable under normal circumstances, so no action except to document the assessment information is needed. Asking about a recent sore throat, checking for hematuria, or obtaining a renal ultrasound may be appropriate when assessing for renal problems for some clients, but there is nothing in the question stem to indicate that they are appropriate for this client.

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?

Accepted Answer

Teach the client to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup best describes the technique for obtaining a clean-catch specimen. The answer beginning, "insert a short, small, 'mini' catheter attached to a collecting container" describes a technique that would result in a sterile specimen, but a health care provider's order for a catheterized specimen would be required. Using povidone-iodine before obtaining the specimen is not necessary and might result in suppressing the growth of some bacteria. And the technique described in the answer beginning "have the client empty the bladder completely" would not result in a sterile specimen.

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?

Accepted Answer

The increased number of white blood cells (WBCs) indicates the presence of urinary tract infection or inflammation. Normal WBC result in a urinalysis report is 0-5/hpf. The other findings are normal.

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?

Accepted Answer

Before planning any interventions, the nurse should complete the assessment and determine the client's normal bladder pattern and the usual measures used by the client at home. All the other responses may be appropriate, but until the assessment is complete, an individualized plan for the client cannot be developed.

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?

Accepted Answer

Since creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes, and a sterile specimen cup are not needed for this test.

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?

Accepted Answer

Exposure to the chemicals involved with working as a hairdresser and in smoking both increase the risk of bladder cancer, and the nurse should assess whether the client understands this risk. The client is not at increased risk for renal failure, pyelonephritis, or kidney stones.

Question 16

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

Accepted Answer

Checking for flank pain is best performed by percussion of the CVA and asking about pain. The other techniques would not assess for flank pain.

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?

Accepted Answer

Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common, but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required following cystoscopy.

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?

Accepted Answer

A red-orange colour in the urine is normal with some over-the-counter (OTC) medications such as phenazopyridine (Pyridium). The colour would not be expected with urinary tract infection, is not a sign that poor technique was used in obtaining the specimen, and does not need to be communicated to the health care provider until further assessment is done.

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?

Accepted Answer

Iodine-based contrast dye is used during IVP and for many computed tomography (CT) scans. The nurse will need to notify the health care provider before the procedures so that the client can receive medications such as antihistamines or corticosteroids before the procedures are started. The other information also is important to note and document but does not have immediate implications for the client's care during the procedures.

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?

Accepted Answer

Dysuria is painful urination. The alternate responses are used to assess other urinary tract symptoms: hematuria, nocturia, and frequency.

Quiz 47: Nursing Assessment Urinary System