Genitourinary Prep-U (EXAM 4)

A middle-aged male client comes to the clinic for an evaluation of difficulty urinating and nocturia. His father died from prostate cancer. He asks the nurse what he can do to ensure early detection of this disease. Which of the following questions should the nurse ask next?

"Do you have a digital rectal examination and prostate-specific antigen (PSA) tests yearly?"

A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs). Which statement indicates the client understands the teaching about preventing UTIs?

"I should take at least 1,000 mg of vitamin C each day."

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?

"Increase your fluid intake to 2 to 3 L per day."

The nurse is caring for a client diagnosed with genitourinary tuberculosis (TB). Which statement, made by the client, about genitourinary TB demonstrates an understanding?

"It's a late manifestation of respiratory tuberculosis."

The nurse is teaching the client with an ileal conduit how to prevent a urinary tract infection. Which measure would be most effective?

Maintain a daily fluid intake of 2,000 to 3,000 mL.

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

Assessing present voiding patterns

A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged I.V. pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow?

Evaluating patency of the drainage lumen

When providing discharge teaching for a client with uric acid calculi, the nurse should include an instruction to avoid which type of diet?

High purine

A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instructions should the nurse include in the client's discharge teaching plan?

Increase daily fluid intake to at least 2 to 3 L.

During the first hemodialysis treatment, the client develops a headache, confusion, and nausea. The nurse should assess the client further for:

Disequilibrium syndrome. Rationale: Common symptoms of disequilibrium syndrome include headache, nausea and vomiting, confusion, and even seizures. Disequilibrium syndrome typically occurs near the end or after the completion of hemodialysis treatment. It is the result of rapid changes in solute composition and osmolality of the extracellular fluid.

A postmenopausal woman is worried about pain in the upper outer quadrant of her left breast. The nurse's best course of action is to:

Do a breast examination and report the results to the physician.

A client is diagnosed with pyelonephritis. Which nursing action is a priority for care now?

Ensure sufficient hydration.

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?

Pulse

A school nurse is teaching a class about sexually transmitted infections (STIs). Which statement is correct regarding STIs?

STIs are most prevalent among teenagers and young adults.

A nurse is caring for a client who's ordered continuous ambulatory peritoneal dialysis (CAPD). Which finding should lead the nurse to question the client's suitability for CAPD?

The client has a history of diverticulitis.

A 20-year-old female client says, "I feel that my vaginal opening constricts whenever I am about to have intercourse. I seem to have no control over it." Which of the following terms should the nurse use to document the client's condition?

Vaginismus.

On the second day following an abdominal hysterectomy, a client reports she has had three brown, loose stools in moderate amount. The morning medications include an order for 100 mg of docusate sodium daily or as needed. What should the nurse do next?

Withhold the medication, and document the client's report of loose stools.

After teaching the mother of a young child with a peritoneal catheter about the signs and symptoms of peritonitis, the nurse determines that the mother has understood the teaching when she identifies which finding as an important sign?

cloudy dialysate drainage return

A client is receiving continuous ambulatory peritoneal dialysis (CAPD). The nurse should assess the client for which sign of peritoneal infection?

cloudy dialysate fluid

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include:

continuous inflow and outflow of irrigation solution.

The nurse determines that interventions for decreasing fluid retention have been effective when the nurse makes which assessment in child with nephrotic syndrome?

decreased abdominal girth

A client with benign prostatic hypertrophy (BPH) has an elevated prostate-specific antigen (PSA) level. The nurse should:

determine if the prostatic palpation was done before or after the blood sample was drawn.

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to:

help the client cope with the anxiety associated with changes in body image.

A nurse is assessing a client with nephrotic syndrome. The nurse should assess the client for which condition?

massive proteinuria

The nurse is caring for a client with end-stage kidney disease. What arterial blood gas results are most closely associated with this disorder?

pH 7.20, PaCO2 36, HCO3 14-

When emptying the client's bladder during a urinary catheterization, the nurse should allow the urine to drain from the bladder slowly to prevent:

possible shock.

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is:

renal calculi.

A client asks the nurse to explain the meaning of her abnormal Papanicolaou (Pap) smear result of atypical squamous cells. The nurse should tell the client that an atypical Pap smear means that:

the cells could cause various conditions and help identify a problem early.

To prevent recurrence of cystitis, the nurse should plan to encourage the female client to include which measure in her daily routine?

wearing cotton underpants

The nurse is collecting data on a client with a urinary tract infection (UTI). Which statements should the nurse expect the client to make? Select all that apply.

• "I need to urinate frequently." • "I need to urinate urgently." • "It burns when I urinate."

A client who had undergone an abdominal hysterectomy is in the recovery room. The surgeon has prescribed a 250-mL bolus of normal saline over 1 hour to replace blood loss. The IV solution infusing in the client was 1,000 mL normal saline with 40 mEq of potassium chloride at 100 mL/h. What should the nurse do? Select all that apply.

• Connect a 250-mL bag of normal saline to the Y-connection, and calculate to infuse over 1 hour. • Contact the health care provider (HCP) regarding continuation of the primary IV infusion during the bolus infusion. • Administer the normal saline bolus via an IV infusion pump.

A client was treated for a streptococcal throat infection 2 weeks ago. The client now has been diagnosed with acute poststreptococcal glomerulonephritis. The client asks the nurse how he could have prevented this condition. What should the nurse tell the client?

"See your health care provider (HCP) for an early diagnosis and treatment of a sore throat."

A client who is to have a vaginal radium implant tells the nurse she is concerned about being radioactive. The nurse should tell the client:

"The radioactive material is controlled and stays with the source; once the material is removed, no radioactivity will remain."

A woman is using progestin injections for contraception. The nurse instructs the client to return for an appointment in:

3 months

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

Acute pain

The client asks the nurse, "Is it really possible to lead a normal life with an ileostomy?" Which action by the nurse would be the most effective to address this question?

Arrange for a person with an ostomy to visit the client preoperatively.

Six hours after undergoing an abdominal hysterectomy, a client has a strong urge to void and voids 25 ml into the bedpan. Based on these data, the nurse determines that the client:

Is experiencing urine retention and needs to be catheterized.

A client diagnosed with cancer of the cervix in situ is scheduled to have a conization. Which of the following is a priority during the first 24 postoperative hours?

Monitoring vaginal bleeding.

A client is voiding small amounts of urine every 30 to 60 minutes. What should the nurse do first?

Palpate for a distended bladder.