EAQ Mastery Quiz - GU

Before client examination, the registered nurse provides education for a student nurse regarding the gross anatomy and physiology of the kidneys. Which statement made by the student nurse indicates the need for additional teaching? 1. "The right kidney is a little longer and narrower than the left kidney." 2. "The existence of three kidneys with normal kidney function is normal." 3. "The presence of a single kidney with normal kidney function is normal." 4. "The urinary bladder lies directly behind the pubic bone."

1. "The right kidney is a little longer and narrower than the left kidney." Generally in a human body, the left-side kidney is slightly longer and narrower compared with the right-side kidney. The nurse should intervene to correct this misconception. All the other statements are correct. There could be three kidneys in a human body, and as long as the kidney function is normal, the client would be normal. A single horseshoe-shaped kidney could occasionally be found in certain clients, and this is normal if the kidney function is normal. The urinary bladder lies directly behind the pubic bone.

How long will a client's ovum stay viable for fertilization after its release? 1. 72 hours 2. 84 hours 3. 96 hours 4. 112 hours

1. 72 hours An ovum can be fertilized up to 72 hours after its release. The ovum disintegrates after 72 hours, and menstruation begins soon after. The ovum cannot be viable for 84, 96, or 112 hours, and fertilization will not occur.

Where is the blood pressure cuff placed on a client with a dialysis access fistula in the right arm? 1. On the left arm 2. Over the fistula 3. Below the fistula 4. Above the fistula

1. On the left arm If the fistula is located in the right arm, then the left arm should be used for blood pressure cuff placement. Blood pressure cuffs or any other restrictive devices should not be placed on the arm with a dialysis access fistula including above, below, or over the fistula site.

Which statement reflects the nurse's suspicions regarding a client's cloudy urine noted on a urinalysis report? 1. The client has a urinary infection. 2. The client has a biliary obstruction. 3. The client has diabetic ketoacidosis. 4. The client has been on a starvation diet.

1. The client has a urinary infection. The urine becomes cloudy when an infection is present due to the presence of leukocytes. The nurse concludes the client has a urinary infection. In cases of biliary obstruction, the urine contains bilirubin. The presence of ketones in the urine indicates diabetic ketoacidosis or prolonged starvation.

The nurse prepares a male client with a history of recurrent urinary tract infections (UTIs) for discharge after a ureterolithotomy. Which clinical manifestations of a UTI would the nurse teach this client to recognize? 1. Urgency or frequency of urination 2. An increase of ketones in the urine 3. The inability to maintain an erection 4. Pain radiating to the external genitalia

1. Urgency or frequency of urination Urgency or frequency of urination occurs with a urinary tract infection because of bladder irritability; burning on urination and fever are additional signs of a UTI. Increased ketones indicate diabetes mellitus, starvation, or dehydration. A UTI does not affect the ability of a male to maintain an erection. Pain radiating to the external genitalia is a symptom of a urinary calculus, not an infection.

Which instruction would the nurse include when teaching the client how to perform peritoneal dialysis and the importance of preventing peritonitis? Select all that apply. One, some, or all responses may be correct 1. Wear a mask during the procedure. 2. Clean the catheter exit site every day. 3. Maintain meticulous aseptic technique. 4. Wash your hands before the exchange. 5. Store supplies in a clean and dry location.

1. Wear a mask during the procedure. 2. Clean the catheter exit site every day. 3. Maintain meticulous aseptic technique. 4. Wash your hands before the exchange. 5. Store supplies in a clean and dry location. The location of the peritoneal dialysis catheter makes it a direct portal to the peritoneum, which increases the client's risk for peritonitis. The nurse would ensure that the client understands the importance of preventing peritonitis when providing instructions on performing peritoneal dialysis. The client would be instructed to wear a mask during the procedure, especially when changing connector sets. The nurse would show the client how to properly clean the area around the catheter exit site and instruct that this be done every day to remove secretions. The client must be aware that meticulous aseptic technique throughout all phases of the exchange is essential. Proper hand-washing technique would be demonstrated and the client instructed on the importance of hand washing before the exchange. Supplies would be stored in a clean and dry place.

Which term is used for the tip of a pyramid in the kidney? 1. Calyx 2. Papilla 3. Renal pelvis 4. Renal column

2. Papilla Pyramids are components of renal medulla, and the tip of each pyramid is called a papilla. A calyx is a structure that collects the urine at the end of each pyramid. The renal calices join together to form the renal pelvis. A renal column is a cortical tissue that separates the pyramids.

The day after receiving instructions regarding dressing changes and care of a recently inserted nephrostomy tube, the client states, "I hope I can handle all this at home; it's a lot to remember." Which response would the nurse use? 1. "I'm sure you can do it." 2. "Oh, a family member can do it for you." 3. "You seem to be nervous about going home." 4. "Perhaps you can stay in the hospital another day."

3. "You seem to be nervous about going home." The response "You seem to be nervous about going home" is the best reply. Reflection conveys acceptance and encourages further communication. The response "I'm sure you can do it" is false reassurance that does not help 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.

Which safety precaution would the nurse employ when assisting with the removal of a client's vaginal radium seeds? 1. Clean the radium in ether or alcohol. 2. Wear foil-lined rubber gloves while handling the radium. 3. Ensure long forceps are available for removing the radium. 4. Document how long the radium seeds were in the vaginal vault.

3. Ensure long forceps are available for removing the radium. Radium must be handled with long forceps because distance helps limit exposure. The nurse does not clean radium implants. Foil-lined rubber gloves do not provide adequate shielding from the gamma rays emitted by radium. The amount and duration of exposure are important in assessing the effect on the client; however, documentation will not affect safety during removal.

Which term would the nurse document in the client's medical record after observing reduced urinary output? 1. Anuria 2. Dysuria 3. Oliguria 4. Nocturia

3. Oliguria A reduced urinary output of less than 400 mL in a 24-hour interval is called oliguria. Anuria is the absence of urination. Painful or difficult urination is called dysuria. Frequent urination at night is called nocturia.

The client with a suprapubic prostatectomy for cancer of the prostate has continuous bladder irrigations (CBI) in place after surgery. Which primary goal is the nurse trying to achieve with the CBI? 1. Stimulate continuous formation of urine. 2. Facilitate the measurement of urinary output. 3. Prevent the development of clots in the bladder. 4. Provide continuous pressure on the prostatic fossa.

3. Prevent the development of clots in the bladder. A continuous flushing of the bladder dilutes the bloody urine and empties the bladder, preventing clots. Fluid instilled into the bladder does not affect kidney function. Urinary output can be measured regardless of the amount of fluid instilled. The urinary retention catheter is not designed to exert pressure on the prostatic fossa.

The nurse shares the discharge instructions with a client who has prostate cancer. The client asks, "How much more blood will they need? Don't they have enough?" Which laboratory test would the nurse discuss the need to monitor throughout the course of the disease? 1. Albumin 2. Creatinine 3. Blood urea nitrogen (BUN) 4. Prostate-specific antigen (PSA)

4. Prostate-specific antigen (PSA) The PSA is an indication of the presence of prostate cancer; the higher the level, the greater the tumor burden. The health care provider will monitor the PSA levels throughout the course of the disease and periodically thereafter. Albumin is a protein and an indicator of nutritional and fluid status. Creatinine and BUN levels indicate renal function and may elevate when blockage of the urethra occurs from an enlarged prostate, but the reports do not indicate metastasis or prostate cancer.