Urinary NCLEX Questions

The nurse is teaching a client who is scheduled for a neobladder and a Kock pouch. Which client statement indicates a correct understanding of these procedures?

"I will have to drain my pouch with a catheter."

During an abdominal assessment of a male client, the nurse palpates a a large, round mass in the hypogastric region. What is the nurse palpating?

A distended or full bladder

The nurse in the urology clinic is providing teaching for a female client with cystitis. Which instructions does the nurse include in the teaching plan? (Select all that apply.)

Try to take in 64 ounces of fluid each day. Correct Be sure to complete the full course of antibiotics. Correct If urine remains cloudy, call the clinic.

In postoperative care of the patient with an arteriovenous shunt, the nurse should:

Use strict surgical asepsis for dressing changes.

Which problem constitutes a medical emergency?

Anuria

The nurse has these client assignments. Which client does the nurse encourage to consume 2 to 3 liters of fluid each day?

Client with hyperparathyroidism A major feature of hyperparathyroidism is hypercalcemia, which predisposes a client to kidney stones; this client should remain hydrated.

The most comon cause of renal failure is:

DM

Which age-related change can cause nocturia?

Decreased ability to concentrate urine Nocturia may result from decreased kidney-concentrating ability associated with aging.

The nurse making rounds discovers that there is no urine drainage from a postoperative patient's Foley catheter. The first nursing action is to:

Ensure patency

The nurse recognizes tha the most common causative organism in pyelonephritis is:

Escherichia coli.

The primary function of the kidney is:

Filtration of water and blood products

To determine glomerular filtration rate for a patient with chronic renal disease, the nurse plans to:

Initate a 24-hour collection of the patient's urine.

When caring for a client with uremia, the nurse assesses for which symptom?

Manifestations of uremia include anorexia, nausea, vomiting, weakness, and fatigue.

When calculating actual urinary output during continous bladder irrigations, the nurse would:

Measure the total output and deduct the amount of irrigation solution used.

The nursing care plan includes teaching the patient Kegel exercises. The nurse teaches the patient to alternately tighten and relax which group of muscles?

Perineal floor

After renal angiography, the patient assessment priority is the:

Puncture site

Renal calculi may result from:

Stasis of urine caused by obstruction or quadriplegia. Infections of urinary tract. Hyperparathyroidism, which causes increase in calcium metabolism.

A patient gives the nurse health information before a scheduled intravenous pyelogram (IVP). Which item has the most immediate implications for the patient's care? a. The patient has not had food or drink for 8 hours. b. The patient lists allergies to shellfish and penicillin. c. The patient complains of costovertebral angle (CVA) tenderness. d. The patient used a bisacodyl (Dulcolax) tablet the previous night.

b

When scheduling the administration of furosemide (Lasix), it would be in the patient's best interest to schedule the medication to be given at:

9 AM

The Doctor has order an indwelling catheter inserted in a hospitalized male "PT". The nurse is aware of which of the following considerations? A)The male urethra is more vulnerable to injury during insertion B)In the hospital, a clean technique is used for catheter insertion C)The catheter is inserted 2" to 3" into the meatus D)Since it uses a closed system, the risk for urinary infection is absent

A)The male urethra is more vulnerable to injury during insertion Because of its length the male urethra is more prone to injury and requires that the catheter be inserted 6" to 8". This procedure requires surgical asepsis to prevent introducing bacterica into the urinary tract. The placement of an indwelling catheter has a risk of UTI

The most important factor to foster patient compliance with the treatment plan is to provide te patient with:

An active role in the planning

A patient taking Phenazopyridine (pyridium, a urinary track analgesic) Should be cautioned that her year and may change to what color? A) Pale yellow B) Green C) Orange red D) Brown

C) Orange red Pyridium Is noted for turning the year and orange red, and the patient needs to be aware of this

cranberry juice effect on UTIs

Cranberry juice is excreted as hippuric acid, which helps acidify the urine (decrease the pH) and inhibit bacterial growth. Although bacterial growth may be inhibited, bacteria are not destroyed. Glomerular filtration is unaffected by cranberry juice. Cranberry juice acidifies the urine and may increase the burning sensation associated with urination when an infection is present.

Which patient report indicates that phenazopyridine hydrochloride (Pyridium) is being effective?

Decrease in buring

The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). Which concepts does the nurse explain in the presentation? (Select all that apply.)

Dysuria Correct Frequency Correct Nocturia Correct Urgency

A client diagnosed with stress incontinence is started on propantheline (Pro-Banthine). What interventions does the nurse suggest to alleviate the side effects of this anticholinergic drug?

Encourage increased fluids. Correct Increase fiber intake. Correct Use hard candy for dry mouth. Anticholinergics cause constipation; increasing fluids and fiber intake will help with this problem.

Reason the dialysis solution is warmed to body temperature before it is instilled into the peritoneal cavity

Encouraging the removal of serum urea by preventing constriction of peritoneal blood vessels promotes vasodilation so that urea, a large-molecular substance, is shifted from the body into the dialyzing solution. Heat does not affect the shift of potassium into the cells. The removal of metabolic wastes is affected in kidney failure, not the metabolic processes. Excess serum potassium is removed by dialyzing with a potassium-free solution, not by heat.

hemodialysis

Following hemodialysis the client's vital signs are monitored to determine whether the client is remaining hemodynamically stable and for comparison to predialysis measurements. The client's blood pressure and weight are expected to be reduced as a result of fluid removal. Laboratory studies are done as per protocol but are not necessarily done after the hemodialysis treatment has ended.

Careful preparation of the patient for an IVP is necessary. Nursing interventions would include:

NPO for about 12 hours before examination. Giving prescribed bowel prep. Instructing patient concerning IVP.

Which nursing activity illustrates proper aseptic technique during catheter care?

Positioning the collection bag below the height of the bladder

The teaching priority for the patient with acute renal failure is:

Prevention of infection

The goal for peritoneal dialysis is to:

Remove toxins and metabolic waste

What activity would be harmful for the incontinent patient?

Restricting fluid intake

Assessment of the patient with a urinary disorder may be complicated by:

Social taboos surrounding sexuality

Which assessment finding alarms the nurse immediately after a client returns from the operating room for cystoscopy performed under conscious sedation?

Temperature of 100.8° F sign of infection!!!!

2. Bladder spasms are common, but being relieved with medication indicates the condition is improving.

The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving? 1.The client is using the maximum amount allowed by the PCA pump. 2.The client's bladder spasms are relieved by medication. 3.The client's scrotum is swollen and tender with movement. 4.The client has passed a large, hard, brown stool this morning.

The clinical findings in the oliguric phase of acute renal failure include:

Urinary output increases

4. This is a potentially life-threatening problem.

Which nursing diagnosis is priority for the client who has undergone a TURP? 1.Potential for sexual dysfunction. 2.Potential for an altered body image. 3.Potential for chronic infection. 4.Potential for hemorrhage.

A patient has elevated blood urea nitrogen (BUN) and serum creatinine levels. Which bowel preparation order would the nurse question for this patient who is scheduled for a renal arteriogram? a. Fleet enema b. Tap-water enema c. Senna/docusate (Senokot-S) d. Bisacodyl (Dulcolax) tablets

a High-phosphate enemas, such as Fleet enemas, should be avoided in patients with elevated BUN and creatinine because phosphate cannot be excreted by patients with renal failure

The mother of a 2 year old tells the nurse her child was born deaf. The most appropriate action for the nurse is to

assess the child's urinary elimination patterns

When a patient's urine dipstick test indicates a small amount of protein, the nurse's next action should be to a. send a urine specimen to the laboratory to test for ketones. b. obtain a clean-catch urine for culture and sensitivity testing. c. inquire about which medications the patient is currently taking. d. ask the patient about any family history of chronic renal failure.

c- some medications may give false-positive readings.

To assess whether there is any improvement in a patient's dysuria, which question will the nurse ask? a. "Do you have to urinate at night?" b. "Do you have blood in your urine?" c. "Do you have to urinate frequently?" d. "Do you have pain when you urinate?"

d

The nurse is assessing the client for urinary incontinence. The client is at risk for

psychosocial problems

Which instruction does the nurse give a client who needs a clean-catch urine specimen?

"Do not touch the inside of the container." A clean-catch specimen is used to obtain urine for culture and sensitivity of organisms present; contamination by the client's hands will render the specimen invalid and alter results.

A patient with diabetes is admitted for evaluation of kidney function becasue of recent fatigue, weakness, and elevated BUN and serum creatinine levels. While obtaining a nursing history, the nurse identifies an early symptoms of renal insufficiency when the patient states:

"I get up several times every night to urinate."

The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which client statement shows a correct understanding of what the nurse has taught?

"I should be drinking at least 1.5 to 2.5 liters of fluids every day."

When assessing a patient with a urinary tract infection, where would the nurse percuss to assess for possible pyelonephritis?

At the Costovertebral angle (CVA) (on back/flank between the twelfth rib and the vertebral column). Tenderness with percussion suggests pyelonephritis or polycystic kidney disease.

Which of the following terms did note a patient's inability to void even though the kidneys are producing urine that enters the bladder? A) Urgency B) Retention C)Oliguria D)Dysuria

B) Retention Urgency is a strong desire to void. Oliguria is scanty or greatly diminished amount of urine voided in a given time. Dysuria is difficulty urinating

Data must be collected to evaluate the effectiveness of a plan to reduce urinary incontinence and a older adult patient. Of the information below, which is the least important for the evaluation process? A) The incontinence pattern B) State of physical mobility C) Medications being taken D) Age of patient

D) Age of patient Incontinence is not a natural consequence of the aging process. All the other factors are necessary information for the plan of care.

A client with a urinary tract infection is prescribed trimethoprim/sulfamethoxazole (Bactrim). What information does the nurse provide to this client about taking this drug? (Select all that apply.)

Drink at least 3 liters of fluids every day." Correct "Take this drug with 8 ounces of water." Correct "You will need to take all of this drug to get the benefits." C

An older adult client diagnosed with stress incontinence is prescribed the medication oxybutynin (Ditropan). Which side effects does the nurse tell the client to expect? (Select all that apply.)

Dry mouth Increased intraocular pressure Correct Constipation Correct Oxybutynin is an anticholinergic/antispasmodic. Side effects include dry mouth, urinary retention, constipation, and risk for increased intraocular pressure with the potential to make glaucoma worse.

Which urinary assessment information for a client indicates the potential need for increased fluids?

Increased blood urea nitrogen Increased blood urea nitrogen can indicate dehydration. Increased creatinine indicates kidney impairment.

A client is in the emergency department for an inability to void and for bladder distention. What is most important for the nurse to provide to the client?

Privacy The nurse should provide privacy, assistance, and voiding stimulants, such as warm water over the perineum, as needed, for the client with urinary problems. Increased oral fluids and IV fluids would exacerbate the client's problem.

he nurse is instructing an older adult female client about interventions to decrease the risk for cystitis. Which client comment indicates that the teaching was effective?

"I should drink 2½ liters of fluid every day."

A patient diagnosed with ESRD is treated with conservative management, including erythropoietin injections. After teaching the patient about management of ESRD, the nurse determiness teaching has been effective when the patient states:

"I wil measure my urinary output each day to help calculate the amount I drink."

What statement by the patient indicates the need for further teaching before renal angiography?

"I'm glad I don't have to stay in bed after the test."

The physician has talked to te patient and his wife about the treatment plan for his bladder cancer. Later, the patient tells the nurse he does not understand what the doctor is going to do. The most appropriate response by the nurse would be:

"Tell me what you know abot the treatment."

Which of the following is a nursing priority when caring for a male patient with a condom catheter? A) Preventing the tubing from kinking to maintain free urinary drainage B) Not removing the catheter for any reason C) Fastening the condom tightly to prevent the possible ability of leakage D) Maintaining bed rest at all times to prevent the catheter from slipping off

A) Preventing the tubing from kinking to maintain free urinary drainage The catheter should be allowed to drain freely through toothing that is not king. It also should be removed daily to prevent skin excoriation And should not be fastened to tightly or restriction of blood vessels in the area is likely. Confining a patient to bed rest increases the risk for other hazards related to immobility

When a person as a fever or diaphortesis, how would the urine output be described? A)Decreased and highly concentrated B)Decreased and highly dilute C)Increased and concentrated D)Increased and dilute

A)Decreased and highly concentrated Fever and diaphoresis cause the kidneys to conserve body fluids, Thus, the urine is concentrated and decreased in amount

During postoperative care of the patient with an ileoconduit, which finding represents an emergency?

Absence of bowel sounds

A client who is admitted with urolithiasis reports "spasms of intense flank pain, nausea, and severe dizziness." Which intervention does the nurse implement first

Administer morphine sulfate 4 mg IV.

transurethral resection of the prostate

An indwelling urethral catheter is used because surgical trauma can cause edema and urinary retention, leading to additional complications, such as bleeding. Urinary control is not lost in most cases; loss of control usually is temporary if it does occur. Sexually 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 patient with ESRD receiving hemodialysis is at risk for:

Anemia

The client with urge incontinence asks you "How can I get rid of this process?" Which is the best response to this client? A) "It's important to accept that this is a natural part of aging" B) "You should avoid artificial sweeteners, caffeine, and alcohol" C) "It could help to void after every time you think of it" D) "Make sure you take your diuretic at bedtime. This will help you pea better"

Answer: B. these substances are bladder irritants and should be avoided. A voiding schedule is best for patient with incontinence, and patients may or not remember to void. Urinary incontinence is not a natural part of aging, and diuretics should not be taken after 4 p.m.

A patient has a nursing diagnoses of in paired urinary illumination related to maturational enuresis. You recognize that your patient Is which of the following? A) An older adult that is 65 years of age is incontinent B) a child older than four years of age who has an voluntary urination C) A 12-month-old child who is in voluntary urination D) A patient with Neurological damage resulting in bladder dysfunction

B) a child older than four years of age who has an voluntary urination Maturational Enuresis Is in voluntary urination after an age when content should be present. A 12-month-old child is not expected to be continent, and Incontinence and neurological damage are not maturational problems

A client is admitted for extracorporeal shock wave lithotripsy (ESWL). What information obtained on admission is most critical for a nurse to report to the health care provider before the ESWL procedure begins?

I take over-the-counter naproxen (Aleve) twice a day for joint pain." Because a high risk for bleeding during ESWL has been noted, clients should not take nonsteroidal anti-inflammatory drugs before this procedure; the ESWL will have to be rescheduled for this client.

The collection of subjective and objective data for the patient with acute glomerulonephritis could include:

Periorbital edema. Anorexia. Frankly sanguineous urine.

dietary instructions to a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD)

Proteins eaten should be high quality to replace those lost during dialysis. A high-calorie diet is encouraged. Usually there is a modest restriction of fluids when the client is on dialysis. Usually there is a restriction of high-potassium foods when the client is on dialysis.

Which goal would have priority in planning care of the aging patient with urinary incontinence?

Recognizes the urge to void

Which nursing intervention or practice is most effective in helping to prevent urinary tract infection (UTI) in hospitalized clients?

Studies have shown that re-evaluating the need for indwelling catheters in clients is the most effective way to prevent UTIs in the hospital setting.

3. This is usually the length of time clients need to wait prior to having sexual intercourse; this is the information the client wants to know.

The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse? 1."You seem anxious about your surgery." 2."Tell me about your fears of impotency." 3."Potency can return in six (6) to eight (8) weeks." 4."Did you ask your doctor about your concern?"

1. Clients who have urinary incontinenceare often embarrassed, so it is the responsibility of the nurse to approach this subject with respect and consideration.

The elderly client being seen in the clinic has complaints of urinary frequency,urgency, and "leaking." Which priority intervention should the nurse implement when interviewing the client? 1.Ensure communication is nonjudgmental and respectful. 2.Set the temperature for comfort in the examination room. 3.Speak loudly to ensure the client understands the nurse. 4.Ensure the examining room has adequate lighting.

1. A client with a peaked T wave could be experiencing hyperkalemia. Changes in potassium levels can initiate cardiac dysrhythmias and instability.

The telemetry monitor technician notifies the nurse of the morning telemetry readings. Which client should the nurse assess first? 1.The client in normal sinus rhythm with a peaked T wave. 2.The client diagnosed with atrial fibrillation with a rate of 100. 3.The client diagnosed with a myocardial infarction who has occasional PVCs. 4.The client with a first-degree atrioventricular block and a rate of 92.

4. Clients with acute bacterial prostatitis will frequently experience a sudden onset of fever and chills. Clients with chronic prostatitis have milder symptoms.

Which data support to the nurse the client's diagnosis of acute bacterial prostatitis? 1.Terminal dribbling. 2.Urinary frequency. 3.Stress incontinence. 4.Sudden fever and chills.

The nurse caring for a patient after cystoscopy plans that the patient a. learns to request narcotics for pain. b. understands to expect blood-tinged urine. c. restricts activity to bed rest for a 4 to 6 hours. d. remains NPO for 8 hours to prevent vomiting.

b

The nurse completing a physical assessment for a newly admitted male patient is unable to feel either kidney on palpation. Which action should the nurse take next? a. Obtain a urine specimen to check for hematuria. b. Document the information on the assessment form. c. Ask the patient about any history of recent sore throat. d. Ask the health care provider about scheduling a renal ultrasound.

b 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

A 32-year-old patient who is employed as a hairdresser and has a 15 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for a. renal failure. b. kidney stones. c. pyelonephritis. d. bladder cancer.

d Exposure to the chemicals involved with working as a hairdresser and in smoking both increase the risk of bladder cancer

Which medication does the nurse plan to administer before the procedure?

Acetylcysteine (Mucosil) This client has kidney impairment demonstrated by increased creatinine. Acetylcysteine (an antioxidant) may be used to prevent contrast-induced nephrotoxic effects.

Which of the following symptoms would the nurse expect to find in the patient diagnosed with bladder cancer? A) Dysuria and urgency B) Painless hematuria C) Suprapubic pain with nausea and vomiting D) Pyuria and incontinence

Answer: B. Painless gross hematuria is the most common symptom of bladder cancer. Dysuria and urgency are common findings in UTI. Suprapubic pain with nausea and vomiting may be found with nephrolithiasis (kidney stones). Pyuria and incontinence are not associated with bladder cancer.

You are helping the patient who has just had a foley catheter removed to retrain their bladder. As the nurse you would do all of the following except: A) Encourage the patient to drink measured amounts of fluids B) Palpate the bladder to assess for distention C) Teach the client to report any sweating, cold hands, or feelings of anxiety D) Straight cath the patient if the residual urine is more than 50 mL

Answer: D. A straight catheter should only be used if the residual urine is more than 100 mL (urinary retention). Immediately after the voiding attmpt the bladder should be scanned to assess for urinary retention. All other strategies can be used.

After surgery, Ms.Young is having difficultly voiding. Which nursing action would most likely lead to an increased difficulty with voiding? A)Pouring warm water over Ms.Young's fingers B)Having Ms.Young ignore the urge to void until her bladder is full C)Using a warm bedpan when MS.Young feels the urge to void D)Stroking Ms.Young's leg or thigh

B)Having Ms.Young ignore the urge to void until her bladder is full Ignoring the urge to void makes urination even more difficult and should be avoided. The other actives are all recommend nursing actions to help promotes urination.

The nurse performs a catheterization immediately after the patient voids and obtains 30 ml residual urine. The next step would be to:

Document the procedure with outcome data.

When reading the urinalyis report, the nurse recognizes this result as abnormal:

Red Blood Cells, 15-20

2. Increasing the irrigation fluid will flush out the clots and blood.

The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement? 1.Remove the indwelling catheter. 2.Titrate the NS irrigation to run faster. 3.Administer protamine sulfate IVP. 4.Administer vitamin K slowly.

What glomerular filtration rate (GFR) would the nurse estimate for a 30-year-old patient with a creatinine clearance result of 60 mL/min? a. 60 mL/min b. 90 mL/min c. 120 mL/min d. 180 mL/min

a The creatinine clearance approximates the GFR

A male patient in the clinic provides a urine sample that is red-orange in color. Which action should the nurse take first? a. Notify the patient's health care provider. b. Teach correct midstream urine collection. c. Ask the patient about current medications. d. Question the patient about urinary tract infection (UTI) risk factors.

c A red-orange color in the urine is normal with some over-the-counter (OTC) medications such as phenazopyridine (Pyridium).

Which information from a patient's urinalysis requires that the nurse notify the health care provider? a. pH 6.2 b. Trace protein c. WBC 20 to 26/hpf d. Specific gravity 1.021

c The increased number of white blood cells (WBCs) indicates the presence of urinary tract infection or inflammation

A 55 year old female tells the nurse "Since I stopped having my menstrual periods about a year ago I've noticed a leakage of urine". What should the nurse explain to the client?

there is a decrease in estrogen after menopause which affects the strength of the pubic muscles and can lead to urine leakage

A client three weeks postpartum comes into a clinic with complains of urinary frequency and burning with urination. What can the nurse explain to the patient about these symptoms?

these are consistent with a UTI, after having a baby the bladder may not completely empty, increasing risk of UTI

The nurse receives the change-of-shift report on four clients. Which client does the nurse decide to assess first?

A 28-year-old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours

The priority treatment option for Miss Jones would most likely involve which of the following? A) Behavioral techniques B) Pharmacological measures C) Surgical intervention D) Use of absorbent products

A) Behavioral techniques The least invasive intervention should be attempted first. Phonological and surgical interventions are not recommended until behavioral techniques have been attempted. Using absorbent products may remove motivation from the patient and caregiver to seek Evaluation and treatment of the incontinence. They should be used only after careful evaluation by a healthcare provider

The nurse is teaching the female client how to perform self-catheterization. Which of the following instructions is incorrect? A) It is important to maintain ascetic technique when performing this process. B) The catheterization should be performed every 4-6 hours C) If you have the urge to void in the middle of the night, try to pea. If that doesn't work, you may self-catheterize. D) Always dispose of the catheter after use

Answer: A. Patients who self-catheterize are instructed to use clean technique as aseptic technique is not feasible or as needed in the home setting. Catheterization should be performed at regular intervals. It can be performed in the middle of the night as necessary. The catheter should be disposed of after use, never reused.

The patients passed his kidney stone! During stone analysis, it is determined that the stone is composed of uric acid. Which of the following dietary restrictions would be recommended for this patient? A) Avoiding all shellfish B) Limiting calcium intake C) Restricting protein intake D) Drinking less than 1000 ml of water

Answer: A. Stones that are composed of uric acid can be prevented by consuming a low-purine diet (similar for gout). Foods high in purine include shellfish, organ meat, asparagus, and mushrooms. Limiting calcium or protein intake may be appropriate for the stone composed of calcium. Patients with previous kidney stones should be encouraged to drink plenty of fluids, more than 2 L a day

Which of the following signs and symptoms would the nurse expect to see in the elderly patient with a UTI? A) Back pain B) High Fever C) ALOC D) Anorexia E) Tachypnea

Answer: C, D, and E. In elderly patients, the nurse would expect to see more nonspecific signs of urinary tract infection including changes in level of consciousness, lethargy, anorexia, new incontinences, hyperventilation, and low-grade fever. Back pain may be present with UTI, but is not common in elderly patients. High fever is typically not present.

The nurse is teaching the patient who has just been given a urinary diversion (ileal conduit). Which of the following statements, if made by the patient, indicates the need for further teaching? A) I should not expect to feel pain at the stoma B) The stoma could bleed when I clean it C) I should report any signs of mucous in the urine to my doctor D) The stoma should be pink and moist

Answer: C. Because a segment of the GI system is typically used to create a urinary diversion, mucous would be expected in the urine. The stoma is vascular, and could bleed when cleaned. There are no nerve endings at the stoma, so there should be no pain. The stoma should be pink and moist like the inside of the mouth.

You are teaching a patient with urinary incontinence about the importance of increasing fluid intake. Which statement, if made by the patient, indicates correct understanding? A) "Increasing my fluid intake will help flush toxins out of my kidneys which helps prevent incontinence" B) "I should double my fluid intake over the next several days" C) "Increased fluids can help with my urinary incontinence by preventing constipation" D) "Like you said, if I drink more water my pea will no longer be bothersome to my bladder"

Answer: C. Increased fluids help by preventing constipation, reduce urge by lowering concentration of urine, and help prevent infection. Although drinking fluids can help promote excretion of toxins out of the body, this does not affect incontinence. Doubling fluid intake may be effective, but we are not aware of the patient's previous intake. Patients should be encouraged do drink 2000-3000 mL if they have no other fluid restrictions.

Ms. White, the nursing instructor, is teaching her students how to prevent infection in patients with an indwelling catheter. Which student demonstrates correct understanding? A) "Hanging the urine bag above the bladder will help prevent infection" B) "It's important to avoid using soap to clean the perineum in the patient with a catheter" C) "The urine bag should be emptied at least every 8 hours" D) "The tubing to the urinary catheter should never be unhooked unless a specimen needs to be taken"

Answer: C. The bag should be emptied at least every eight hours (more if there are large amounts of urine) to prevent the risk of bacterial proliferation. The bag should NEVER be hung above the level of the bladder or set on the ground. Soap and water can be used to clean the perineal area and around the catheter, and should be done twice a day. The tubing of the catheter should NEVER be disconnected, even for a specimen.

The nurse knows that all but which of the following are measures to promote urinary continence: A) Stopping smoking B) Pelvic floor exercises C) Avoiding constipation D) Taking showers not baths

Answer: D. Taking showers and not baths would be appropriate for the patient with recurrent UTI's. Smoking can increase cough which can in turn increase incontinence. Pelvic floor exercises help strengthen muscles and will help with incontinence. Constipation should be avoided as this can promote incontinence.

The patient who has just undergone knee surgery has been found to have not peed in six hours. The nurse can do all of the following to encourage the patient to void except? A) Apply a warm compress to perineum B) Offering hot fluids C) Run water in background D) Helping the patient onto the bedpan

Answer: D. The bedpan is evil for people with urinary retention. It is much more comfortable to pee in a sitting or standing position. Warmth in the form of compresses and hot beverages can help stimulate urination. Running water from a faucet may also trigger the patient to pee. IF the patient cannot void, the bladder should be scanned and catheterization may be necessary.

The client you are taking care of has just been diagnosed with nephrolithiasis. Upon assessment, which priority question should the nurse ask the client? A) Have you seen any blood in your urine? B) Are you have any pain? C) What is your typical diet? D) Have you had any burning pea?

Answer: D. This question assesses for the possibility of developing an infection, a complication of nephrolithiasis (kidney stones). Pain and hematuria would be expected in this patient. Diet can be helpful in preventing kidney stone formation, but it is not a priority question.

A client has returned from a captopril renal scan. Which teaching does the nurse provide when the client returns?

Arise slowly and call for assistance when ambulating." Captopril can cause severe hypotension during and after the procedure, so the client should be warned to avoid rapid position changes and about the risk for falling as a result of orthostatic (positional) hypotension.

When collecting a urine specimen for routine urinalysis from a "PT", the nurse must keep in mind which of the following? A)A sterile specimen is required for collection B)Results may be altered of a sample if left standing at room temperature for a long time C)The external meatus requires cleaning with antiseptic soap and water before voiding D)A clean-catch midstream specimen is necessary

B)Results may be altered of a sample if left standing at room temperature for a long time Urine chemistry it altered after urine stands at room temperature for a long period of time. For a routine urinalysis, a clean specimen is adequate. The external meatus does not need to be cleaned with an antiseptic, as is required for a clean-catch midstream specimen

Miss Jones is alert, ambulatory, older nursing home resident, who frequently has difficulty making it to the bathroom in time. The nurse planning her care is aware of the following? A) Incontinence is to be expected and a woman of Mrs Jones age. B)One of every 10 nursing home residents is incontinent C) Keagle exercises performed at regular intervals throughout the day maybe helpful D) An indwelling catheter should be inserted as soon as possible

C) Keagle exercises performed at regular intervals throughout the day maybe helpful Keagle exercises may help "pt" Regain control of the micturition process. Incontinence is not a normal consequence of aging, And at least half of nursing home residents may be incontinent. An indwelling catheter is the last choice of treatment

Mr. Bales is 60 years old and alert. He is timid and reluctant to talk about his urinary retention problem. Which part of this plan could create stress for Mr. Bales and possibly increase his inability to urinate? A) Assisting him in assuming his normal voiding position B) Pulling curtains around him to provide privacy during voiding C) Staying with him while voiding D) Offering a urinal or a regular schedule

C) Staying with him while voiding Mr. Bales will probably be embarrassed if the nurse remains with him as he attempts to void and is more likely to have difficulty voiding

Nursing care for a "PT" with an indwelling catheter includes which of the following A)Irrigation of the catheter with a 30mL of normal saline solution every 4hours B)Disconnecting and reconnecting the drainage system quickly to obtain a urine sample C)Encourage a generous fluid intake of not contraindicate by the "PT" conduction. D)Telling the "PT" that burning and irritation are normal, subsiding within a few days

C)Encourage a generous fluid intake of not contraindicate by the "PT" conduction. A generous fluid intake promotes healthy urinary tract function. Irrigation may introduce bacteria into the urinary tract and is not routinely ordered. The drainage system should never be disconnected to obtain a sample, this could allow bacteria to enter into the urinary tract. Burning and irritation may indicate that an infection is present and should never be disregarded.

Chronic kidney disease

Chronic kidney disease is a condition in which the kidneys are unable to excrete wastes, concentrate urine, and conserve electrolytes. A component of treatment is hemodialysis. Hemodialysis requires the use of a dialyzer that is connected to a shunt, fistula, or other device that allows access to the client's bloodstream. The client's blood is transported from the body through the dialyzer, which removes wastes and excess fluids from the blood. The cleaned blood is then returned to the client's body. You will learn about chronic kidney disease and hemodialysis in your medical-surgical nursing course when you study renal disorders.

Which technique does the nurse use to obtain a sterile urine specimen from a client with a Foley catheter?

Clamp the tubing, attach a syringe to the specimen, and withdraw at least 5 mL of urine. Clamping the tubing, attaching a syringe to the specimen, and withdrawing at least 5 mL of urine is the correct technique for obtaining a sterile urine specimen from the client with a Foley catheter.

Which of the following would the nurse incorporate into the teaching plan for a "PT" to promote healthy urinary function? A)Drinking more then 2,000mL per day will cause fluid retention B)The healthy adult should drink four to six 8oz glasses of water per day C)Children need fewer reminds to drink because of a greater thirst sensitivity D)Caffeine-containing beverages should be monitored to prevent excess intake

D)Caffeine-containing beverages should be monitored to prevent excess intake Caffeine intake should be limited because it is irritating to the bladder mucosa. It is recommend that the healthy adult drink 8-10 8 oz glasses of water. Unless a disease process is present

Mr.Chang, a hospitalized "PT" with diabetes mellitus, has developed a UTI. He is 80 years old and has an indwelling catheter in place. Which factor is most likely the cause of the UTI? A)The close proximity of the male genitalia to the rectum B)Decreased immunity C)A high urine glucose level D)The indwelling urinary catheter

D)The indwelling urinary catheter Most UTI in hospitalized "PT" are caused by the presence of indwelling catheters. Additional, although less significant, causes of UTI include a decrease in immunity elder people in the presence of glucose in the urine, Essena diabetes.

continuous ambulatory peritoneal dialysis (CAPD) treatment

Dialysate is introduced into the peritoneal cavity, where fluids, electrolytes, and wastes are exchanged through the peritoneal membrane. The client can dialyze alone in any location without the need for machinery and continuous technical supervision. Hemodialysis is not necessary with this procedure. Each exchange involves 2 to 3 L of dialysate intraperitoneally, not interperitoneally, for a specified time (dwell time) before being drained.

As the nursse reviews a diet plan with a patient with diabetes mellitus and renal insufficiency, the patient states that with diabetes and renal failure there is nothing that is good to eat. The patient says,"I am going to eat what I want; I'm goingto die anyway!" The best nursing diagnosis for this patient is:

Grieving, related to actual and perceived losses.

The priority short-term goal for disorders of the urinary system is:

Normal patterns of urinary elimation

A client is scheduled for a cystoscopy later this morning. The consent form is not signed, and the client has not had any preoperative medication. The nurse notes that the provider visited the client the day before. What action does the nurse take?

Notifies the department and the provider he client may be asked to sign the consent form in the department; notifying both the provider and the department ensures communication across the continuum of care, with less likelihood of omission of information

the nurse visualizes blood clots in a client's urinary catheter after a cystoscopy. What nursing intervention does the nurse perform first?

Notify the health care provider. Bleeding and/or blood clots are potential complications of cystoscopy and may obstruct the catheter and decrease urine output. The nurse should monitor urine output and notify the health care provider of obvious blood clots or a decreased or absent urine output.

The nurse has instructed a patient who is receiving hemodialysis about dietary manageent. Which diet choices by the patient indicate that the teaching has been successful?

Scrambled eggs, English muffin, and apple juice.

renal colic

Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by ureteral distention and smooth muscle spasm; relief from pain is the priority. Although the client is overweight and weight loss is desirable, it is a long-term goal. Although hematuria needs to be monitored, blood loss usually is not massive with ureteral colic. Mild hypertension is not the priority when a client is in severe pain.

The certified Wound, Ostomy, and Continence Nurse or enterostomal therapist teaches a client who has had a cystectomy about which care principles for the client's post-discharge activities?

Stoma and pouch care

Choose all of the correct patient teachings for the patient with cystitis.

Teach the patient to drink cranberry juice to treat and prevent UTIs. Teach the female patient to cleanse the perineal area from anterior to posterior to prevent rectal E. Coli contamination of the urethra. Encourage the patient to drink 2000 ml of fluid per day, unless contraindicated.

2. These crystals are uremic frost resulting from irritating toxins deposited in the client's tissues. Bathing in cool water will remove the crystals, promote client comfort, and decrease the itching resulting from uremic frost.

The UAP tells the nurse the client with ARF has a white crystal-like layer on top of the skin. Which intervention should the nurse implement? 1.Have the assistant apply a moisture barrier cream to the skin. 2.Instruct the UAP to bathe the client in cool water. 3.Tell the UAP not to turn the client in this condition. 4.Explain this is normal and do not do anything for the client.

client with acute kidney failure who is receiving a protein restricted diet

The amount of protein permitted in the diet (usually less than 50 g) depends on the extent of kidney function; excess protein causes an increase in urea concentration, which should be avoided Adequate calories are provided to prevent tissue catabolism that also results in an increase in metabolic waste products. In kidney failure the kidneys are unable to eliminate the waste products of a high-protein diet. The body is able to synthesize the nonessential amino acids. Urea is a waste product of protein metabolism; the body is able to synthesize the nonessential amino acids.

1. An elevated PSA can be from urinary retention, BPH, prostate cancer, or prostate infarct.

The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response? 1.An elevated PSA can result from several different causes. 2.An elevated PSA can be only from prostate cancer. 3.An elevated PSA can be diagnostic for testicular cancer. 4.An elevated PSA is the only test used to diagnose BPH.

4. Normal potassium level is 3.5 to5.5 mEq/L. A level of 6.8 mEq/L is life threatening and could lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to decrease the potassium level quickly. This requires a health-careprovider order, so it is a collaborative intervention.

The client diagnosed with ARF has a serum potassium level of 6.8 mEq/L. Which collaborative treatment should the nurse anticipate for the client? 1.Administer a phosphate binder. 2.Type and crossmatch for whole blood. 3.Assess the client for leg cramps. 4.Prepare the client for dialysis.

3. Carbohydrates are increased to provide for the client's caloric intake and protein is restricted to minimize protein breakdown and to prevent accumulation of toxic waste products.

The client diagnosed with ARF is admitted to the intensive care unit and placed on a therapeutic diet. Which diet is most appropriate for the client? 1.A high-potassium and low-calcium diet. 2.A low-fat and low-cholesterol diet. 3.A high-carbohydrate and restricted-protein diet. 4.A regular diet with six (6) small feedings a day.

3. Regular insulin, along with glucose, will drive potassium into the cells,thereby lowering serum potassium levels temporarily.

The client diagnosed with ARF is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level? 1.Erythropoietin. 2.Calcium gluconate. 3.Regular insulin. 4.Osmotic diuretic.

2. Bed rest reduces exertion and the metabolic rate, thereby reducing catabolism and subsequent release of potassium and accumulation of endogenous waste products (urea and creatinine).

The client diagnosed with ARF is placed on bed rest. The client asks the nurse, "Why do I have to stay in bed? I don't feel bad." Which scientific rationale supports the nurse's response? 1.Bed rest helps increase the blood return to the renal circulation. 2.Bed rest reduces the metabolic rate during the acute stage. 3.Bed rest decreases the workload of the left side of the heart. 4.Bed rest aids in reduction of peripheral and sacral edema.

4. The white blood cell count is elevated;normal is 5,000 to 10,000/mm3.

The client had surgery to remove a kidney stone. Which laboratory assessment data warrant immediate intervention by the nurse? 1.A serum potassium level of 3.8 mEq/L. 2.A urinalysis shows microscopic hematuria. 3.A creatinine level of 0.8 mg/100 mL. 4.A white blood cell count of 14,000/mm3.

3. Dehydration results in concentrated serum, causing laboratory values to increase because the blood has normal constituents but not enough volume to dilute the values to within normal range or possibly lower.

The client is admitted to a nursing unit from a long-term care facility with a hematocrit of 56% and a serum sodium level of 152 mEq/L. Which condition is a cause for these findings? 1.Overhydration. 2.Anemia. 3.Dehydration. 4.Renal failure.

3. Venison, sardines, goose, organ meats,and herring are high-purine foods, which should be eliminated from the diet to help prevent uric acid stones.

The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent re-occurrence? 1.Beer and colas. 2.Asparagus and cabbage. 3.Venison and sardines. 4.Cheese and eggs.

2. Elevating the scrotum on a towel for support is a task which can be delegated to the UAP.

The client is one (1) day postoperative TURP. Which task should the nurse delegate to the UAP? 1.Increase the irrigation fluid to clear clots from the tubing. 2.Elevate the scrotum on a towel roll for support. 3.Change the dressing on the first postoperative day. 4.Teach the client how to care for the continuous irrigation catheter.

1 Fever, chills, and costovertebral pain are symptoms of a urinary tract infection (acute pyelonephritis), which requires a urine culture first to confirm the diagnosis.

The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first? 1.A midstream urine for culture. 2.A sonogram of the kidney. 3.An intravenous pyelogram for renal calculi. 4.A CT scan of the kidneys.

1. The nurse should place the client's chair with the head lower than thebody, which will shunt blood to the brain; this is the Trendelenburg position.

The client receiving dialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first? 1.Place the client in the Trendelenburg position. 2.Turn off the dialysis machine immediately. 3.Bolus the client with 500 mL of normal saline. 4.Notify the health-care provider as soon as possible.

1, 3, 4 The nurse should assess the drain postoperatively. The head of the bed should be lowered and the foot should be elevated to shunt blood to the central circulating system. The surgeon needs to be notified of the change in condition.

The client returned from surgery after having a TURP and has a P 110, R 24, BP90/40, and cool and clammy skin. Which interventions should the nurse implement?Select all that apply. 1.Assess the urine in the continuous irrigation drainage bag. 2.Decrease the irrigation fluid in the continuous irrigation catheter. 3.Lower the head of the bed while raising the foot of the bed. 4.Contact the surgeon to give an update on the client's condition. 5.Check the client's postoperative creatinine and BUN.

4. The nurse should always assess any complaint before dismissing it as a commonly occurring problem.

The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first? 1.Call the surgeon to inform the HCP of the client's complaint. 2.Administer the client a narcotic medication for pain. 3.Explain to the client this sensation happens frequently. 4.Assess the continuous irrigation catheter for patency.

3 Glomerular filtration rate (GFR) is approximately 120 mL/min. If the GFR is decreased to 40 mL/min, the kidneys are functioning at about one-third filtration capacity.

The elderly client is diagnosed with chronic glomerulonephritis. Which laboratory value indicates to the nurse the condition has become worse? 1.The blood urea nitrogen is 15 mg/dL. 2.The creatinine level is 1.2 mg/dL. 3.The glomerular filtration rate is 40 mL/min. 4.The 24-hour creatinine clearance is 100 mL/min.

4. Use of the bladder training drill is helpful in stress incontinence. The client is instructed to void at scheduled intervals. After consistently being dry, the interval is increased by 15 minutes until the client reaches an acceptable interval.

The elderly client recovering from a prostatectomy has been experiencing stress incontinence. Which independent nursing intervention should the nurse discuss with the client? 1.Establish a set voiding frequency of every two (2) hours while awake. 2.Encourage a family member to assist the client to the bathroom to void. 3.Apply a transurethral electrical stimulator to relieve symptoms of urinary urgency. 4.Discuss the use of a "bladder drill," including a timed voiding schedule.

4 Coffee, tea, cola, and alcoholic beverages are urinary tract irritants.

The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI? 1.Clean the perineum from back to front after a bowel movement. 2.Take warm tub baths instead of hot showers daily. 3.Void immediately preceding sexual intercourse. 4.Avoid coffee, tea, colas, and alcoholic beverages.

2. This client's dialysis access is compromised and he or she should be assessed first.

The nurse in the dialysis center is initiating the morning dialysis run. Which client should the nurse assess first? 1.The client who has hemoglobin of 9.8 g/dL and hematocrit of 30%. 2.The client who does not have a palpable thrill or auscultated bruit. 3.The client who is complaining of being exhausted and is sleeping. 4.The client who did not take antihypertensive medication this morning.

1. Blood urea nitrogen (BUN) levels reflect the balance between the production and excretion of urea from the kidneys. Creatinine is a by-product of the metabolism of the muscles and is excreted by the kidneys. Creatinine is the ideal sub-stance for determining renal clearance because it is relatively constant in the body and is the laboratory value most significant in diagnosing renal failure.

The nurse is caring for a client diagnosed with ARF. Which laboratory values are most significant for diagnosing ARF? 1.BUN and creatinine. 2.WBC and hemoglobin. 3.Potassium and sodium. 4.Bilirubin and ammonia level.

2. Hypotension, which causes a decreased blood supply to the kidney, is one of the most common causes of pre-renal failure(before the kidney).

The nurse is caring for a client diagnosed with rule-out ARF. Which condition predisposes the client to developing prerenal failure? 1.Diabetes mellitus. 2.Hypotension. 3.Aminoglycosides. 4.Benign prostatic hypertrophy

2. When an elderly client's mental status changes to confused and irritable, the nurse should seek the etiology, which may be a UTI secondary to an indwelling catheter. Elderly client soften do not present with classic signs and symptoms of infection.

The nurse is caring for an elderly client who has an indwelling catheter. Which data warrant further investigation? 1.The client's temperature is 98.0˚F. 2.The client has become confused and irritable. 3.The client's urine is clear and light yellow. 4.The client feels the need to urinate.

3 The client should be taught to take all the prescribed medication anytime a prescription is written for antibiotics.

The nurse is discharging a client with a health-care facility acquired urinary tract infection. Which information should the nurse include in the discharge teaching? 1.Limit fluid intake so the urinary tract can heal. 2.Collect a routine urine specimen for culture. 3.Take all the antibiotics as prescribed. 4.Tell the client to void every five (5) to six (6) hours.

3. The drainage bag should be kept below the level of the bladder to prevent reflux of urine into the renal system; it should not be placed on the bed.

The nurse is observing the UAP providing direct care to a client with an indwelling catheter. Which data warrant immediate intervention by the nurse? 1.The UAP secures the tubing to the client's leg with tape. 2.The UAP provides catheter care with the client's bath. 3.The UAP puts the collection bag on the client's bed. 4.The UAP cares for the catheter after washing the hands.

3 A long-term complication of glomerulonephritis is it can become chronic if unresponsive to treatment,and this can lead to end-stage renal disease. Maintaining renal function is an appropriate long-term goal.

The nurse is preparing a plan of care for the client diagnosed with acute glomerulonephritis. Which statement is an appropriate long-term goal? 1.The client will have a blood pressure within normal limits. 2.The client will show no protein in the urine. 3.The client will maintain normal renal function. 4.The client will have clear lung sounds.

The nurse is teaching a client how to provide a clean-catch urine specimen. Which statement by the client indicates that teaching was effective?

To provide a clean-catch urine sample, the client should initiate voiding, then stop, then resume voiding into the container.

4. The nephrostomy tube should never be clamped or have kinks because an obstruction can cause pyelonephritis.

Which intervention should the nurse implement when caring for the client with a nephrostomy tube? 1.Change the dressing only if soiled by urine. 2.Clean the end of the connecting tubing with Betadine. 3.Clean the drainage system every day with bleach and water. 4.Assess the tube for kinks to prevent obstruction.

What information will the nurse provide to a client who is scheduled for extracorporeal shock wave lithotripsy? (Select all that apply.)

Your urine will be strained after the procedure." Correct "Be sure to finish all of your antibiotics." "Remember to drink at least 3 liters of fluid a day to promote urine flow."

A female patient being admitted with pneumonia has a history of neurogenic bladder as a result of a spinal cord injury. Which action will the nurse plan to take first? a. Ask about the usual urinary pattern and any measures used for bladder control. b. Assist the patient to the toilet at scheduled times to help ensure bladder emptying. c. Check the patient for urinary incontinence every 2 hours to maintain skin integrity. d. Use intermittent catheterization on a regular schedule to avoid the risk of infection.

a

Which medication taken at home by a 47-year-old patient with decreased renal function will be of most concern to the nurse? a. ibuprofen (Motrin) b. warfarin (Coumadin) c. folic acid (vitamin B9) d. penicillin (Bicillin LA)

a NSAIDs are nephrotoxic and should be avoided in patients with impaired renal function

The nurse is caring for a 68-year-old hospitalized patient with a decreased glomerular filtration rate who is scheduled for an intravenous pyelogram (IVP). Which action will be included in the plan of care? a. Monitor the urine output after the procedure. b. Assist with monitored anesthesia care (MAC). c. Give oral contrast solution before the procedure. d. Insert a large size urinary catheter before the IVP.

a Patients 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 patient's urine output.

A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will a. have the patient empty the bladder completely, then obtain the next urine specimen that the patient is able to void. b. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup. c. insert a short sterile "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen. d. clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have the patient void into a sterile container.

b

How will the nurse assess for flank tenderness in a 30-year-old female patient with suspected pyelonephritis? a. Palpate along both sides of the lumbar vertebral column. b. Strike a flat hand covering the costovertebral angle (CVA). c. Push fingers upward into the two lowest intercostal spaces. d. Percuss between the iliac crest and ribs along the midaxillary line.

b Checking for flank pain is best performed by percussion of the CVA and asking about pain.

A 79-year-old man has been admitted with benign prostatic hyperplasia. What is most appropriate to include in the nursing plan of care? a. Limit fluid intake to no more than 1000 mL/day. b. Leave a light on in the bathroom during the night. c. Ask the patient to use a urinal so that urine can be measured. d. Pad the patient's bed to accommodate overflow incontinence.

b The patient's age and diagnosis indicate a likelihood of nocturia

The nurse assessing the urinary system of a 45-year-old female would use auscultation to a. determine kidney position. b. identify renal artery bruits. c. check for ureteral peristalsis. d. assess for bladder distention.

b The presence of a bruit may indicate problems such as renal artery tortuosity or abdominal aortic aneurysm

Which assessment of a 62-year-old patient who has just had an intravenous pyelogram (IVP) requires immediate action by the nurse? a. The heart rate is 58 beats/minute. b. The patient complains of a dry mouth. c. The respiratory rate is 38 breaths/minute. d. The urine output is 400 mL after 2 hours.

c

A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate? a. "Your doctor will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys." b. "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney." c. "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray." d. "Your doctor will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked."

c In a cystoscope and cystogram procedure, 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.

A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a creatinine clearance test. Which equipment will the nurse need to obtain? a. Urinary catheter b. Cleaning towelettes c. Large container for urine d. Sterile urine specimen cup

c Because creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection

When working in the urology/nephrology clinic, which patient could the nurse delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? a. Patient who is scheduled for a renal biopsy after a recent kidney transplant b. Patient who will need monitoring for several hours after a renal arteriogram c. Patient who requires teaching about possible post-cystoscopy complications d. Patient who will have catheterization to check for residual urine after voiding

d

Which statement by a patient who had a cystoscopy the previous day should be reported immediately to the health care provider? a. "My urine looks pink." b. "My IV site is bruised." c. "My sleep was restless." d. "My temperature is 101."

d

Which nursing action is essential for a patient immediately after a renal biopsy? a. Check blood glucose to assess for hyperglycemia or hypoglycemia. b. Insert a urinary catheter and test urine for gross or microscopic hematuria. c. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function. d. Apply a pressure dressing and keep the patient on the affected side for 30 minutes.

d A pressure dressing is applied and the patient is kept on the affected side for 30 to 60 minutes to put pressure on the biopsy side and decrease the risk for bleeding.

A nurse is providing education to a patient with a history of renal caliculi. What should the nurse include?

drink enough fluids in 24 hours to produce 2 quarts of urine

Objectives of Healthy People 2020 is to reduce the rate of new cases of ESRD. What activities are recommended to achieve this?

early identification of people at risk, control of diabetes and hypertension, education related to diet and exercise

Where should the nurse place their stethoscope to assess the renal arteries for the presence of bruits?

extended midclavicular line

In discussion with the patient with ESRD about dietary needs, the nurse recognies that foods highest in potassium include:

grapefruit, tomatoes, oranges, and bananas.

When performing an assessment on a client the nurse notes tenderness to blunt percussion of the costovertebral angle. What might this finding suggest?

inflammation of the kidneys

An elderly female tells the nurse "I wish I could have a good night's sleep without having to get up every two hours to urinate." The nurse realizes that the client is experiencing

nocturia

An elderly client reports that is she incontinent of urine when she coughs of sneezes. The client is experiencing

stress incontinence

What findings might the nurse note when performing an assessment on a client with long standing renal disease?

the client appears fatigued, peripheral edema, indication of pruritis, crackles at the bases of the lungs

A client has been diagnosed with a kidney stone lodged within the medulla of the right kidney. What will the stone most likely affect?

the collection of urine

taping an indwelling catheter for a male client to prevent pressure on the urethra at the penoscrotal junction

the lower abdomen or the inner aspect of the thigh are the recommended sites to eliminate the penoscrotal angle and prevent the formation of a urethrocutaneous fistula

When performing an assessment on an adult client the nurse is unable to palpate both kidneys. What does this finding suggest?

this is a normal, expected finding

The mother of a 4 year old boy states "I can't believe he's still wetting the bed at night". The nurse tells the mother

this is not unusual for children of his age

One of the nurse's roles is talking to adult clients about urinary and sexual hygiene. Which words does the nurse use when referring to the client's reproductive body parts?

use words the client uses.