EAQ: Content Area > M/S Nrsg > Urinary/Reproductive

When teaching a client, scheduled for a renal transplant, about the need for immunosuppressive medications, which client's statement indicates understanding of the nurse's teachings? A. "I must take these medications for the rest of my life." B. "I must take these medications until the surgery is over." C. "I must take these medications until the anastomosis heals." D. "I must take these medications during the intraoperative period."

A. "I must take these medications for the rest of my life." Rationale: These drugs must be taken continuously to prevent rejection of the transplanted organ. The danger of rejection always exists. The client must take the medications longer than after the surgery or until the anastomosis heals or during the intraoperative period.

When the nurse provides a client, who receives dialysis for end-stage renal disease, information about restricting dietary protein, sodium, and potassium, which client statement indicates effective teaching? A. "I should avoid using salt substitutes." B. "I should exclude meat from my diet." C. "I may not add seasoning to my food." D. "I may eat low-sodium canned vegetables."

A. "I should avoid using salt substitutes." Rationale: Commercially prepared salt substitutes are high in potassium. Some complete protein foods must be included in the diet. Seasoning that contains neither sodium nor potassium such as lemon juice, pepper, and herbs can be used to make food more palatable. Low-sodium canned vegetables contain high potassium concentrations.

When a client, with a history of benign prostatic hypertrophy, asks if cranberry juice prevents bladder infections, which response would the nurse provide the client? A. Cranberry juice increases acidity of the urine B. Cranberry juice soothes irritated bladder walls C. Cranberry juice improves glomerular filtration rate D. Cranberry juice destroys microorganisms in the bladder

A. Cranberry juice increases acidity of the urine Rationale: Cranberries lower the pH of the urine and discourage pathogenic growth. Acidic urine does not soothe bladder walls. The glomerular filtration rate is not affected. An acid medium will discourage further growth but will not kill existing organisms.

When preparing a client for a discharge home after lithotripsy for a renal calculus, the nurse would include which instruction during the discharge process? A. Drink at least 3 L of fluid daily for 4 weeks B. Eliminate organ meats from the diet for 6 weeks C. Increase the intake of dairy products for 5 days D. Restrict movement for 3 days before resuming usual activities

A. Drink at least 3 L of fluid daily for 4 weeks Rationale: Increasing fluid intake aids in the passage of fragments of the calculus remaining after the lithotripsy. Organ meats are high in purine, which is an amino acid that is a causative factor in the formation of uric acid crystals and should be avoided by people with gout. Calcium is the major component of the most common type of calculus, and the intake of dairy products (who are high in calcium) should be limited. Early ambulation is encouraged to aid in the passage of fragments of the calculus that remain after a lithotripsy.

Which finding would the nurse associate with a client who may be rejecting their renal transplant? A. Fever B. Hematuria C. Moon face D. Yellow sclera

A. Fever Rationale: Fever is a characteristic of the systemic inflammatory response to the antigen (transplanted kidney). Hematuria is not indicative of rejection. However, its occurrence necessitates further investigation. A moon face (moon facies) is an effect of steroid therapy and does not indicate rejection. Jaundice is unrelated to rejection of a transplanted kidney.

When teaching a class about anatomy, the nurse explains the structure, identified in the given figure, has which function? A. Holds the testes B. Produces sperm C. Secretes semen D. Transports sperm

A. Holds the testes Rationale: Label A in the figure indicates the scrotum, which holds the testes by forming a protective sac around it. Sperm is produced by the seminiferous tubules within the testes. Cowper glands, the prostate gland, and the seminal vesicles produce and secrete semen. The epididymis transports sperm during maturation.

Which finding would indicate an acute rejection of a transplanted kidney? Select all that apply. One, some, or all responses may be correct. A. Hypertension B. Fever and chills C. Pain at graft site D. Overnight weight gain E. Decreased urine output

A. Hypertension B. Fever and chills C. Pain at graft site D. Overnight weight gain E. Decreased urine output Rationale: The signs that a transplanted kidney is not functioning and is most probably being rejected include hypertension, fever and chills, pain at graft site, overnight weight gain, and decreased urine output.

When providing care for a client who underwent a radical cystectomy with urinary diversion via an ill conduit, which specialist would the nurse consult about post-discharge care of the ileal conduit? A. Ostomy nurse B. Hospice nurse C. Oncology nurse D. Nurse practitioner

A. Ostomy nurse Rationale: An ileal conduit is an internal pouch that comes to the surface of the skin forming a stoma, and the nurse would consult the ostomy nurse. Hospice would be consulted if the client was terminally ill. The oncology nurse would be responsible for administering chemotherapy. The nurse practitioner would coordinate care with the health care providers.

Which structure would the nurse include when describing external genitalia? Select all that apply. One, some, or all responses may be correct. A. Penis B. Testes C. Scrotum D. Urethra E. Seminal vesicles

A. Penis C. Scrotum Rationale: The male reproductive system is divided into primary reproductive organs and secondary reproductive organs. Secondary reproductive organs include ducts, sex glands, and external genitalia. The external genitalia consist of the penis and the scrotum. Testes are the primary reproductive organs. The urethra is the duct and the seminal vesicles are sex glands.

To encourage voiding by hospitalized clients, the nurse recalls which action as the most effective? A. Provide privacy B. Warm a bedpan C. Have the client listen to running water D. Place the client's hands in warm water

A. Provide privacy Rationale: A strange environment and the anxiety associated with private body functions like elimination may interfere with the client's ability to relax the urinary sphincter to void. warming a bedpan, having the client listen to running water, or placing the client's hands in warm water might be helpful in some situations. These methods do not take into account the common anxiety of voiding in a strange environment.

At which anatomical location would the nurse identify the epididymis? A. Superior to the testes B. Above the urinary bladder C. Behind the urinary bladder D. Suspended from the exterior abdominal wall

A. Superior to the testes Rationale: The epididymis is a ductal system that lies superior to the testis and extends posteriorly. The ductus deferent lies above the urinary bladder and joins with the ejaculatory duct. The ejaculatory duct lies behind the urinary bladder and connects the ductus deferent and seminal vesicle to the prostatic portion of the urethra. The scrotum is suspended from the exterior abdominal wall.

Which finding would the nurse anticipate when examining a client with uterine prolapse? A. Tissue protruding from the vaginal opening B. Mass bulging through the posterior vaginal wall C. Mass protruding into the upper posterior vaginal wall D. Protrusion downward through the anterior vaginal wall

A. Tissue protruding from the vaginal opening Rationale: The nurse anticipates finding a protrusion of tissue (the uterus) through the opening of the vaginal canal. A rectocele occurs when the rectum sags and pushes against or into the posterior vaginal wall. An enterocoele occurs when the small intestine bulges through the upper posterior vaginal wall (especially when straining). A cystocele is a protrusion of the posterior bladder wall downward through the anterior vaginal wall.

For a male client with a history of recurrent urinary tract infections (UTI), which UTI indicator would the nurse provide as part of the discharge instructions after a ureterolithotomy? A. Urgency or frequency of urination B. The inability to maintain an erection C. Pain radiating to the external genitalia D. An increase in the alkalinity of the urine

A. Urgency or frequency of urination Rationale: Urgency or frequency of urination occur with a urinary tract infection because of bladder irritability. Burning on urination and fever are additional signs of a UTI. The inability to maintain an erection is not related to a UTI. Pain radiating to the external genitalia is a symptom of a urinary calculus and not an infection. An increase in alkalinity or acidity of urine is not a sign of a UTI.

To confirm a diagnosis of a urinary tract infection for a client who develops chills, fever, flank pain, and malaise while recovering from deep partial-thickness burns, which prescribed diagnostic test would the nurse anticipate? A. Urinalysis and urine culture and sensitivity B. Cystoscopy and bilirubin level C. Creatinine clearance and albumin/globulin (A/G) ratio D. Specific gravity and pH of the urine

A. Urinalysis and urine culture and sensitivity Rationale: The client's manifestations may indicate a urinary tract infection, and a culture of the urine will identify the microorganism. A cystoscopy is too invasive as a screening procedure. Altered bilirubin results indicate liver or biliary problems, not urinary signs and symptoms. Creatinine clearance reflects renal function and A/G ratio reflects liver function. An increased urine specific gravity may indicate red blood cells (RBCs), white blood cells (WBCs), or casts in the urine and are associated with urinary tract infection, but it will not identify the causative organism.

When teaching a client about health practices to help decrease future urinary tract infections, which information would the nurse include? A. Wear cotton underpants. B. Void at least every 6 hours. C. Increase alkaline foods in the diet. D. Wipe from back to front after toileting.

A. Wear cotton underpants Rationale: Cotton allows air to circulate and does not retain moisture the way synthetic fabrics do (microorganisms multiply in warm, moist environments). Drinking 3 L of fluids a day and voiding every 2 hours help to flush ascending microorganisms from the bladder, thus reducing the risk of urinary tract infections. Alkaline foods will not decrease the risk of UTI. Wiping from back to front after toileting may transfer bacteria from the perianal area toward the urinary meatus and increase the risk of urinary tract infection.

For a client scheduled for a transurethral resection of the prostate, which information would the nurse provide regarding post-surgical expectations? A. "Urinary control may be permanently lost to some degree." B. "An indwelling urinary catheter is required for at least a day." C. "Your ability to perform sexually will be impaired permanently." D. "Burning on urination will last while the cystotomy tube is in place."

B. "An indwelling urinary catcher is required for at least a day." Rationale: An indwelling urethral catheter is used because surgical trauma can cause edema and urinary retention. This can lead to additional complications such as bleeding. Urinary control is not lost in most cases, and loss of control usually is temporary if it does occur. Sexual ability usually is not affected. Sexual ability is maintained if the client was able to perform before surgery. A cystotomy tube is not used if a client has a transurethral resection. However, it is used if a suprapubic resection is done.

The night before a scheduled extracorporeal shock-wave lithotripsy, the client frequently uses the call light and has many demands. In responses, which statement would the nurse use in this situation? A. "I know how you feel. I have this same procedure last year." B. "You are facing a new experience tomorrow. Tell me what concerns you have." C. "We'll take good care of you. You have nothing to worry about." D. "Your behavior tells me you are scared of what you are facing tomorrow."

B. "You are facing a new experience tomorrow. Tell me what concerns you have." Rationale: The response "You are facing a new experience tomorrow" acknowledges the client's situation and allows the patient to discuss feelings and fears related to the surgery. The response "I know how you feel" is inaccurate as each client's experience is unique. The response "We'll take good care of you" minimizes the client's feelings and provides false reassurance. The response beginning with "Your behavior" may not be an accurate interpretation of the client's behavior.

A client received general anesthesia for a surgical procedure today and reports an inability to void. At which point after surgery would the nurse notify the healthcare provider of the client's inability to micturate? A. 4 hours B. 8 hours C. 12 hours D. 16 hours

B. 8 hours Rationale: Decreased bladder muscle tone results from the depressant effects of anesthesia and the handling of tissues and adjacent organs during surgery. Catheterization may be necessary to prevent over distention of the bladder. Four hours may be too early to expect recovery from the depressant effects of anesthesia. 12 and 16 hours are too long to wait to call the health care provider. This length of time without voiding may result in over-distention of the bladder.

Which sexually transmitted infection must be reported to the local health department? A. Cervicitis B. Chlamydia C. Prostatitis D. Cirrhosis

B. Chlamydia Rationale: Reporting sexually transmitted infections (STIs) to the local health department is done to identify and treat infected individuals so that transmission can be slowed. Reportable STIs include chlamydia, acquired immunodeficiency syndrome, human immunodeficiency virus, gonorrhea, syphilis, chancroid, and viral hepatitis. Cervicitis is inflammation of the cervix that could be caused by chemical or physical irritations, allergies, or infections. Cervicitis has many causes and is only reportable when associated with an STI. Prostatitis is inflammation of the prostate in men and often causes painful urination. Prostatitis is usually associated with urinary tract infections rather than STIs. Cirrhosis is late stage scarring of the liver caused by many conditions such as excessive alcohol consumption or chronic hepatitis.

When a client arrives at a health clinic reporting hematuria, frequency, urgency, and pain on urination, which condition would the nurse suspect? A. Chronic glomerulonephritis B. Cystitis C. Nephrotic syndrome D. Pyelonephritis

B. Cystitis Rationale: Cystitis is an inflammation of the bladder that causes frequency and urgency of urination, pain on micturition, and hematuria. Chronic glomerulonephritis is scarring of the glomeruli due to long-term inflammation. Nephrotic syndrome is a condition of increased glomerular permeability characterized by severe proteinuria. Pyelonephritis is a diffuse, orogenic infection of the pelvis and parenchyma of the kidney that causes flank pain, chills, fever, and weakness.

During the early postoperative period after a radical nephrectomy, for which acute life-threatening complication would the nurse monitor the client? A. Sepsis B. Hemorrhage C. Renal failure D. Paralytic ileus

B. Hemorrhage Rationale: The kidney is an extremely vascular organ that receives a large percentage of the blood flow, and hemorrhage from the operative site can occur. Sepsis and renal failure may occur later in the postoperative period. Paralytic ileus can occur, but it is not life threatening.

When a client has renal calculi secondary to hyperparathyroidism, for which type of diet would the nurse gather discharge information? A. Low purine B. Low calcium C. High phosphorus D. High alkaline ash

B. Low calcium Rationale: Calcium and phosphorus are components of these stones, and foods high in calcium and phosphorus should be avoided. Low purine and high alkaline ash diets may be indicated for clients with gout. Foods high in phosphorus must be avoided.

Which initial action would a nurse take when providing care for an older adult client who is bedridden and incontinent of urine? A. Restrict fluid intake B. Offer urinal or bedpan regularly C. Apply incontinence pants D. Insert an indwelling urinary catheter

B. Offer urinal or bedpan regularly Rationale: Retraining the bladder includes a routine pattern of attempts to void. Frequently offering a urinal or bedpan may produce a conditioned response and increase bladder muscle tone. Restricting fluid intake can result in dehydration and a urinary tract infection in an older client. Applying incontinence pants does not address the cause of the incontinence. Incontinence also induces skin breakdown and may lower self-esteem. Inserting an indwelling urinary catheter increases the risk of a urinary tract section, promotes an atonic bladder, and prolongs incontinence. It also requires a health care provider's prescription.

For a client receiving trimethoprim-sulfamethoxazole for a urinary tract infection, which additional medication would the health care provider prescribe to help relieve dysuria and urinary frequency? A. Ibuprofen B. Phenazopyridine C. Acetaminophen with codeine D. Nitrofurantoin

B. Phenazopyridine Rationale: Phenzopyridine may be prescribed in conjunction with an antibiotic for painful bladder infections to relieve pain, spasms, and frequency because of its local anesthetic action on the urinary mucosa. Ibuprofen and acetaminophen with codeine are analgesics, but they do not exert a direct effect on the urinary mucosa. Nitrofurantoin is a urinary antiseptic with no analgesic properties.

Vasopressin causes which physiological response? A. Promotes sodium reabsorption B. Reabsorption of water into the capillaries C. Promotes tubular secretion of sodium D. Stimulates bone marrow to make red blood cells

B. Reabsorption of water into the capillaries Rationale: Vasopressin is also known as an antidiuretic hormone (ADH), which helps in the reabsorption of water into the renal capillaries. Aldosterone promotes sodium reabsorption. Natriuretic hormones promote tubular secretion of sodium. Erythropoietin stimulates bone marrow to make red blood cells (RBCs).

When providing discharge instructions for a client, treated with a radium implant for cancer of the cervix, which essential information would the nurse include? A. Limit daily fluid intake. B. Return for follow-up care C. Continue a regular diet D. Take daily mineral supplements

B. Return for follow-up care. Rationale: Instructing the client to return for follow-up care at specified intervals is essentials for the nurse to include in the discharge instructions. Fluids are not reduced unless cardiac or renal pathology is present. When the implant is in place, a low-residue diet is indicated to avoid pressure from a distended colon. When the radium implant is removed the client can return to a regular diet. Mineral supplements are unnecessary if the diet is adequate.

Which test would the nurse identify as beneficial in identifying prostate cancer? A. Mammography B. Ultrasonography C. Endometrial biopsy D. Radiographic examination

B. Ultrasonography Rationale: An ultrasonography is a diagnostic imaging technique based on the application of ultrasound. An ultrasound of the prostate combined with rectal examination and prostate-specific antigen blood testing can be useful in diagnosing prostate cancer. A mammography is done to identify various benign and neoplastic processes associated with breast cancer. An endometrial biopsy is performed to collect tissue for the diagnosis of endometrial cancer and for infertility studies. A radiographic examination is too general to confirm prostate cancer.

When a client with sexual dysfunction reports, "Well, I guess my sex life is over," which response would the nurse make? A. "I'm sorry to hear that." B. "Oh, you have a lot of good years left." C. "You are concerned about your sex life?" D. "Have you asked your health care provider about that?"

C. "You are concerned about your sex life?" Rationale: The response "You are concerned about your sex life?" explores the meaning of the statement and allows further expression of concern. The response "I'm sorry to hear that" does not allow an explanation of feelings and cuts off communication. The response "Oh, you have a lot of good years left" lacks both empathy and understanding and also cuts communication. The response "Have you asked your health care provider about that?" shrinks responsibility. The client may be embarrassed to ask the health care provider and needs the nurse to act as facilitator.

For a client with end-stage renal disease, of which indicator would the nurse monitor development? A. Polyuria B. Jaundice C. Azotemia D. Hypotension

C. Azotemia Rationale: Azotemia is an increase in nitrogenous waste (particularly urea) in the blood that is common with end-stage renal disease. Excessive nephron damage in end-stage renal disease causes oliguria. Excessive urination is common in early kidney insufficiency because of the inability to concentrate urine. Jaundice is common to biliary obstruction. Blood pressure may be elevated as a result of hypervolemia associated with increased total body fluid.

For a client with a urinary retention catheter reporting bladder and urethra discomfort, the nurse providing care would take which action? A. Milk the tubing gently. B. Notify the health care provider. C. Check the patency of the catheter. D. Irrigate the catheter with prescribed solutions.

C. Check the patency of the catheter. Rationale: Checking the patency of the catheter ensures drainage and prevents bladder distention and other complications. Patency of the catheter should be established before any other intervention. Milking the tubing gently is premature. This may be necessary if the catheter is clogged and usually is required when the drainage is viscous rather than liquid. Assessment is necessary before consultation with the health care provider. Irrigation is avoided if possible because of the associated risk for infection.

Which test enables direct visualization of the cervix and vagina? A. Biopsy B. Culdoscopy C. Colposcopy D. Laparoscopy

C. Colposcopy Rationale: A colposcopy provides direct visualization of the vagina and cervix under low-power magnification. A biopsy involves a sample tissue taken to observe masses, ectopic pregnancies, and pelvic inflammatory diseases. A culdoscopy involves the insertion of a culdoscope through the posterior vaginal vault into the cul-de-sac for the visualization of the Fallopian tubes and ovaries. A laparoscopy involves the insertion of a small laparoscope through the abdominal wall to view the pelvic organs.

Which characteristic would the nurse associate with menopause? A. Hot flashes are a result of an increase in estrogen. B. Menopause usually occurs in women between 18 and 22 years of age. C. During menopause, menstrual flow ceases and hormone levels decrease D. Cigarette smoking, family history, and surgical interventions are all associated with delayed menopause

C. During menopause, menstrual flow ceases and hormone levels decrease Rationale: During menopause menstruation ceases and estrogen and progesterone hormone levels decrease. The reduction in estrogen results in hot flashes. Menopause usually occurs in women between 42 and 58 years of age. Cigarette smoking, family history, and surgical intervention are all associated with early menopause.

Which physiological response would the nurse expect when providing care for a client receiving furosemide to relieve edema? A. Retention of sodium ions B. Negative nitrogen balance C. Excessive loss of potassium ions D. Increase in the urine specific gravity

C. Excessive loss of potassium ions Rationale: Furosemide is a potent diuretic used to provide rapid diuresis. It acts in the loop of Henle and causes depletion of electrolytes such as potassium and sodium. Furosemide inhibits the reabsorption of sodium. Furosemide does not affection protein metabolism. The specific gravity of the fluid more likely will be low with edema.

Which hormone acts with luteinizing hormone to stimulate the production of sperm during puberty? A. Somatropin B. Testosterone C. Follicle-stimulating hormone D. Gonadotropin-releasing hormone

C. Follicle-stimulating hormone Rationale: Follicle-stimulating hormone and luteinizing hormone act upon the testicular cells and stimulate the production of sperm. Somatropin (growth hormone) stimulates the growth of the body. Testosterone and other androgens promote the growth of the penis, scrotum, prostate, and seminal vesicles of the testicles. Gonadotropin-releasing hormone triggers the production and secretion of follicle-stimulating hormone and luteinizing hormone.

For a client with acute glomerulonephritis, which item would the nurse provide a client reporting thirst? A. Ginger ale B. Milkshake C. Hard candy C. Cup of broth

C. Hard candy Rationale: Sucking on a hardy candy will relieve thirst and increase carbohydrates and does not supply extra fluid. The goal is to minimize unnecessary fluid intake. carbonated beverages contain sodium and provide additional fluid, which must be restricted. A milkshake contains both fluid and protein, which must be restricted. Broth contains sodium, which increases fluid retention.

For a client with a chronic kidney disease, for which life-threatening complication would the nurse monitor potential development? A. Anemia B. Weight loss C. Hyperkalemia D. Platelet dysfunction

C. Hyperkalemia Rationale: Decreased glomerular filtration leads to hyperkalemia, which may cause lethal dysrhythmias such as cardiac arrest. Anemia may occur but is not the most serious complication and should be treated in relation to the client's clinical manifestations. Erythropoietin and iron supplements usually are used. Weight loss alone is not life-threatening. Platelet dysfunction may occur because of decreased cell surface adhesiveness, but it is not as life threatening as hyperkalemia.

To prevent future development of renal calculi for a client with ureteral colic, which action would the nurse include in the plan of care? A. Interventions to decrease the serum creatinine level B. Excluding milk products from the diet C. Instructing the client to drink 8 to 10 glasses of water daily D. A goal of 2000mL/24 hours urinary output

C. Instructing the client to drink 8 to 10 glasses of water daily Rationale: Increasing fluid intake dilutes the urine and crystals are less likely to coalesce and form calculi. An elevated serum creatinine has no relationship to the formation of renal calculi. Calcium restriction is necessary only if calculi have a calcium phosphate or calcium oxalate basis. Producing only 2000 mL of urine per 24 hours is inadequate as urine output should be maintained at 3000 to 4000 mL to limit calculus formation.

For a client experiencing difficulty in voiding after removal of an indwelling urinary catheter, which likely cause would the nurse identify? A. Fluid imbalance B. Sedentary lifestyle C. Interruption in previous voiding habits D. Nervous tension following the procedure

C. Interruption in previous voiding habits Rationale: An indwelling catheter dilates the urinary sphincters, keeps the bladder empty, and short-circuits the reflex mechanism based on bladder distention. When the catheter is removed, the body must adapt to functioning once again. Although fluid imbalance may cause difficulty in voiding, there are no data presented to draw this conclusion. A sedentary lifestyle and nervous tension will not cause this problem.

A client, injured in a motor vehicle accident and admitted for observation, has obvious bladder damage. Which finding would lead the nurse to conclude the client is at increased risk of bladder rupture? A. Multiple bouts of cystitis B. Familial history of bladder cancer C. Not Having voided for six hours D. Drank two 8-oz cups of coffee during six-hour trip

C. Not having voided for six hours Rationale: The walls of a full bladder are stretched thinner and are more susceptible to rupture when traumatized. A history of cystitis predisposes the client to developing future bladder infections not to rupturing the bladder. A family member with bladder cancer might increase the risk of cancer. It will not predispose the client to bladder rupture. Drinking two cups of coffee will not result in a significant amount of urine production.

For a client with prostate cancer, which factor would the nurse associate with urinal requests at frequent intervals followed by either non-voiding or voiding only in very small amounts? A. Edema B. Dysuria C. Retention D. Suppression

C. Retention Rationale: An enlarged prostate constricts the urethra interfering with urine flow and causing retention. When the bladder fills and approaches capacity, small amounts can be voided but the bladder never empties completely. Edema does not cause the client to void frequently in small amounts. Dysuria is painful or difficult urination, which is not part of the client's responses. The urge to void is caused by stimulation of the stretch receptors as the bladder fills with urine. In suppressing, little or no urine is produced.

When a client asks what to expect after a transurethral resection of the prostate (TURP), which response would the nurse give? A. "You will have an abdominal incision and a dressing." B. "Your urine will be pink and free of clots." C. "There will an incision between your scrotum and rectum." D. "There will be an indwelling urinary catheter and a continuous bladder irrigation in place."

D. "There will be an indwelling urinary catheter and a continuous bladder irrigation in place." Rationale: The presence of an indwelling urinary catheter and a continuous bladder irrigation are routine postoperative expectations after a TURP and provide for hemostasis and urinary excretion. An abdominal incision and dressing re present with a suprapubic (not transurethral) prostatectomy. TURP is associated with initial hematuria and some blood clots. The continuous bladder irrigation keeps the bladder free of clots and the catheter patent. An incision between the scrotum and rectum is associated with a perineal prostatectomy.

The nurse would identify which specific gravity of urine as an abnormal level? A. 1.006 B. 1.012 C. 1.028 D. 1.041

D. 1.041 Rationale: The normal specific gravity of line lies between 1.005 and 1.030. A specific gravity value of 1.041 is higher than the normal range and is abnormal. Specific gravity values of urine such as 1.006, 1.012, and 1.028 lie in the normal range.

Which statement describes a transgendered individual? A. An individual who cross-dresses as an entertainment performance B. An individual who periodically dresses like a women C. An individual who is persistently attracted to people of the same sex D. An individual whose inward gender identity does not match the anatomical sex of their body

D. An individual whose inward gender identity does not match the anatomical sex of their body Rationale: A transgendered person's inward gender identity doe snot match the anatomical sex of his or her body. Cross-dressing as a public performance is not necessarily associated with being transgendered. A heterosexual man who periodically dresses like a woman is called transvestite. An individual who has a persistent attraction to people of the same sex is regarded as homosexual.

Which term may the nurse use to refer to the Cowper gland? A. Skene gland B. Prostate gland C. Bartholin gland D. Bulbourethral gland

D. Bulbourethral gland Rationale: Cowper glands are accessory glands of the male reproductive system and also referenced as bulbourethral glands. Scene glands are a part of the female reproductive system. The prostate gland is also a gland of the male reproductive system. Bartholin glands are part of the female reproductive system.

A client, ending a hysterectomy for cervical cancer, is upset about the inability to have a third child. Which action would the nurse take? A. Evaluate willingness to pursue adoption B. Encourage focusing on personal own recovery C. Emphasize having two children already D. Ensure exploration of other treatment options

D. Ensure exploration of other treatment options Rationale: Although a hysterectomy may be performed, conservative management may include cervical ionization and laser treatment that do not preclude future pregnancies. Clients have a right to be informed by their health care provider of all treatment options. Willingness to pursue adoption currently is not the issue for this client. Encouraging the client to focus on personal recovery and emphasizing having two children already negate the client's feelings.

For which symptom would the nurse assess in a client recently admitted with renal colic? A. Uremia B. Nausea C. Voiding at night D. Flank discomfort

D. Flank discomfort Rationale: A subjective symptom must be experienced and described by the client. Flank pain, pain on the side of the body between the ribs and the ileum accompanies renal colic. Uremia and voiding at night are objective signs that can be verified by observation or measurement. Although nausea is a subjective symptom and can occur with the severe pain associated with renal colic, it is not as significant or specific as flank pain.

Which structure extends from he mons pubis to the perineal floor? A. Rugae B. Hymen C. Vestibule D. Labia majora

D. Labia majora Rationale: The labia major are two large folds that extend from the mons pubis to the perineal floor. The walls of the vagina normally lie in folds called rug. The external opening of the vagina is covered by a fold of mucus membrane, skin, and fibrous tissue called a hymen. The vestibule is the space enclosing the structures located beneath the labia minora.

For the client within a long-term care facility, which action would a nurse plan to take before initiating prescribed antibiotic therapy for urethritis? A. Prepare for urinary catheterization B. Teach the client how to perform perineal care C. Start a 24-hour urine collection D. Obtain a urine specimen for culture and sensitivity

D. Obtain a urine specimen for culture and sensitivity

Which type of incontinence would the nurse document for a client experiencing an involuntary loss of small amounts (25 to 35 mL) of urine from an over-distended bladder? A. Urge B. Stress C. Reflex D. Overflow

D. Overflow Rationale: Overflow incontinence describes what is happening with this client. Overflow incontinence occurs with retention of urine and overflow of urine. Urge incontinence describes a strong need to void that leads to involuntary urination. Stress incontinence occurs when a small amount of urine is expelled because of an increase in intraabdominal pressure that occurs with coughing, lifting, or sneezing. Reflex incontinence is an involuntary loss of urine at fairly predictable intervals when certain urinary bladder intervals are reached.

Which symptom is a commonly reported clinical finding associated with bladder cancer? A. Dysuria B. Suprapubic pain C. Urinary retention D. Painless hematuria

D. Painless hematuria Rationale: Painless hematuria is the most common clinical finding in bladder cancer. Other symptoms include dysuria, frequency, and urgency, but these are not as common as the hematuria. Suprapubic pain and urinary retention do not occur in bladder cancer.

When reviewing the laboratory reports for a client with end-stage renal disease, which test result would the nurse anticipate? A. Arterial pH 7.5 B. Hematocrit of 54% C. Creatinine of 1.2 mg/dL D. Potassium of 6.3 mEq/L

D. Potassium 6.3 mEq/L Rationale: Clients with end-stage renal disease have impaired potassium excretion so the nurse should anticipate a potassium level more than the expected range of 3.5 to 5 mEq/L. Clients with end-stage renal disease usually have a serum pH that is less than 7.35 due to metabolic acidosis. A pH of 7.5 that exceeds the expected range of 7.35 to 7.45 is not anticipated. Clients with end-stage renal disease have decreased erythropoietin which leads to decreased red blood cell production and hematocrit (HCT). A hematocrit of 54% exceeds the expected range which is 42% to 52% for males and 35% to 47% for females. Clients with end-stage renal disease have a decreased ability to eliminate nitrogenous wastes leading to increased creatinine levels. A creatinine level of 1.2 mg/dL is within the expected range of 0.7-1.4 mg/dL and therefore is not anticipated.

For the client with chronic kidney disease (CKD), which finding indicates the effectiveness of sodium polystyrene sulfonate (Kayexalate)? A. Constipation B. Improved mental status C. Sodium increases to 137 mEq/L D. Potassium decreases to 4.2 mEq/L

D. Potassium decreases 4.2 mEq/L Rationale: This resin exchanges sodium ions for potassium in the large intestine to lower the serum potassium level. A value of 4.2 mEq/L is in the expected range for potassium. Frequent, loose stools is a common side effect. Mental status improvement is not a therapeutic effect of the drug. Sodium retention is an adverse effect. A value of 137 mEq/L is in the expected range for sodium.

Which statement would the nurse associate with clients who have a mastectomy? A. A mastectomy does not cause emotional trauma. B. A mastectomy helps a woman have a proper figure. C. A mastectomy does not affect the ability to nurse an infant. D. Radiation therapy after a mastectomy also affects the physiology of the vagina

D. Radiation therapy after a mastectomy also affects the physiology of the vagina Rationale: The physiology of the vagina deteriorates as a result of radiation therapy that is administer after a mastectomy. A mastectomy results in both physical and emotional trauma. A mastectomy results in disfigurement and affects the ability to nurse an infant.

Which part of the male reproductive system produces sperm cells? A. Epididymis B. Prostate gland C. Ductus deferens D. Seminiferous tubules

D. Seminiferous tubules Rationale: Each testis contains as many as 900 seminiferous tubes that produce millions of sperm cells daily. The epididymis is a tightly coiled tubelike structure that connects testes to the ductus deferences and is responsible for sperm maturation. The prostate gland is responsible for the secretion of an alkaline substance that aids in sperm motility. The ductus deferent are a pair of ducts that carry ejaculatory fluid and sperm out of the epididymis.

Which approach would the nurse take regarding sexual identity? A. The nurse should always have a single belief about sexual ethics. B. The nurse may judge sexual decisions as immoral on the basis of religious standards. C. The nurse should view any private sexual act between consenting adults as immoral. D. The nurse should maintain a nonjudgmental attitude about sexuality while providing care for all clients.

D. The nurse should maintain a nonjudgmental attitude about sexuality while providing care for all clients. Rationale: The nurse should maintain a nonjudgmental attitude in regard to sexual variations, contraception, abortion, and premarital or extramarital intercourse while caring for clients. The nurse should not judge consenting private acts between individuals based on religious or moral beliefs.

When discussing nutrition with a female client who is postmenopausal, which nurse's statement would be the most appropriate? A. "Be sure to take a calcium supplement every day." B. "Make sure to eat cereal fortified with folic acid and B vitamins." C. "Vitamin C is most important every day for postmenopausal women." D. "Eating two servings of red meat every day will provide all the iron that you need."

A. "Be sure to take a calcium supplement every day." Rationale: The most appropriate statement by the nurse discussing nutrition with a postmenopausal client is that calcium is important throughout life. Prevention of osteoporosis with daily calcium supplementation is indicated in the postmenopausal woman and is a priority. Folic acid, vitamin B and vitamin C are important for any client but not a priority in the postmenopausal client. Iron might be important for this client for other reasons but especially important for women if they are experiencing any heavy menstrual bleeding.

Regarding population health, the nurse would identify which client as having the most risk of developing prostate cancer? A. A black 55-year-old B. A white 45-year-old C. An Asian 55-year-old D. A Hispanic 45-year-old

A. A black 55-year-old Rationale: Cause of the prostate is rare before age 50 but increases with each decade, and black men develop cancer of the prostate twice as often and at an earlier age than white men. White men develop prostatic cancer half as often as black men and more commonly than Asian or Hispanic men. Asian and Hispanic men have a lower incidence of prostatic cancer and a lower mortality rate than white and black men.

For a client taking nitrofurantoin 50 mg orally every evening to manage recurrent urinary tract infections, which instruction would the nurse provide? A. Increase the intake of fluids B. Strain the urine for crystals and stones. C. Stop the drug if urinary output increases D. Maintain the exact time schedule for taking the drug

A. increase the intake of fluids Rationale: The client should have sufficient intake to produce 1000 to 1500 mL of urine daily while taking this drug to prevent crystal formation. Straining urine is not indicated when the client is taking a urinary antiinfective. Urinary decrease is of concern because it may indicate renal failure. The client's output should increase when fluids are encouraged. The drug need not be taken on a strict daily schedule.

A client is taught how to change the dressing and care for a recently inserted nephrostomy tube. On the day of discharge, the client states "I hope I can handle all this at home. It's a lot to remember." Which response would nurse utilize? A. "I'm sure you can do it." B. "Oh, a family member can do it for you." C. "You seem to be nervous about going home." D. "Perhaps you can stay in the hospital another day."

C. "You seem to be nervous about going home." Rationale: Reflection conveys acceptance and encourages further communication. The response "I'm sure you can do it" is false reassurance that does not help to reduce anxiety. The response "Oh, a family member can do it for you" provides false reassurance and removes the focus from the client's needs. The response "Perhaps you can stay in the hospital another day" is unrealistic and it is too late to suggest this.

The treatment regimen for a client diagnosed with stage III Hodgkin disease begins with nodal irradiation. The client and significant other have been trying to conceive a child and become visibly anxious upon learning radiation therapy includes the pelvic nodal area. The nurse refers the client to the primary health care provider when the couple begins questioning the treatment. Which rationale supports the nurse's action? A. Radiation used is not radical enough to destroy ovarian function. B. Intermittent radiation to the area does not cause permanent sterilization. C. Reproductive ability may be preserved through a variety of interventions. D. Ovarian function will be destroyed temporarily but will return in about 6 months

C. Reproductive ability may be preserved through a variety of interventions. Rationale: Reproductive ability may be preserved through shielding the ovaries or harvesting ova. Radiation can influence or destroy ovarian functioning. Sterilization can occur. Women in childbearing years should be informed of all options available to preserve ovarian function. Once ova are destroyed they cannot regenerate.

To determine the therapeutic effectiveness of trimethoprim-sulfamethoxazole, administered to a client with a urinary tract infection, for which parameter would the nurse monitor? A. Breath sounds B. Hemoglobin level C. Consistency of stool D. White blood cell (WBC) count

D. White blood cell (WBC) count Rationale: Trimethoprim-sulfamethoxazole blocks two consecutive steps in the bacterial synthesis of essential nucleic acids and protein. Resolution of infection is reflected by a WBC count in the expected range. Breath sounds and consistency of stool will not reflect therapeutic effectiveness. Bactrim may cause hemolytic anemia resulting in a lowered hemoglobin level but this is a side effect.