Urinary/Renal Quiz
is the nurses best response when a client with renovascular disease asks why the endovascular procedure, stent placement, is preferable to surgery to correct his or her condition?
"Stent placement is less risky and requires less time for recovery than does renal artery bypass surgery.' `
■What is the nurses best response when a client with kidney cancer, who had a nephrectomy. asks if the remaining kidney can take over kidney function immediately?
"The kidney you have left will provide adequate function, but it may take a few or weeks."
Which home care instructions will the nurse provide the client who receives intravesical instillation of bacille Calmette-Guerin. At the outpatient clinic to prevent recurrence of superficial bladder cancer?
' For 24 hours others should not share your / toilet and then you should clean it with 10% bleach before anyone else uses it."
Which questions will the nurse ask a client suspected of having polycystic kidney disease (PKD)?
"Do you have a family history of PKD or kidney disease?" "Do you have any problems with headaches?" 'Have you had any difficulty with constipation or abdominal discomfort?" 'Have you noticed any changes in the. color or frequency of urine?"
What priority question will the nurse be sure to ask a client at risk for acute pyelonephritis?
"Have you recently been treated for a urinary tract infection?*
When a client with glomerulonephritis has a urine output over the past 24 hours of 1050 mL, how much fluid will the nurse allow the client during the next 24-hour period?
1550 to 1650 ml
For which client is it appropriate for the nurse to teach intermittent self-catheterization?
25'year-old male client with paraplegia
Which client does the nurse monitor carefully because of high risk for developing a complicated urinary tract infection (UTI?
28 year-old male who has a neurogenic bladder due to a spinal cord injury
Which client will the nurse monitor carefully for highest risk of developing acute pyelonephritis?
34'Year-old woman with diabetes mellitus in the second trimester of pregnancy
Which client would the nurse expect is at highest risk for development of bladder cancer?
64 year-old man who smokes two packs of cigarettes a day and works in a chemical factory
For which client prescription for urinary incontinence would the nurse be sure to question the health care provider*
74'Year-old male client with bilateral glaucoma prescribed oxybutynin
Which circumstance is cause for the nurses greatest concern when several clients in the long-term facility have developed urinary tract infections (UTls)>
A large percentage of residents have indwelling urinary catheters.
In which situations will the nurse appropriately insert a urinary catheter into a client?
Acute urinary retention or bladder obstruction Accurate measurement of urine volume in critically ill clients To assist in healing of open sacral wounds in incontinent clients To provide comfort at end of life Perioperatively for gynecological surgeries
Which nursing and collaborative actions are implemented by the nurse when caring for a client with nephrotic syndrome ^NS) ?
Administration of mild diuretics > Frequent assessment of hydration status Administration of angiotensin-converting enzyme inhibitors ' Assessment for periorbital swelling
Which interventions will the nurse expect to implement for management of infection as the cause for glomerulonephritis (GN)?
Antibiotics Personal hygiene Handwashing
is the nurses next action after assessing a client with glomerulonephritis (GN) who re' ports mild shortness of breath and finding crackles in all lung fields, distended neck veins?
Assessing carefully for additional signs of..: fluid overload
Which symptoms will the nurse expect to find on assessment when a client with chronic giomerulonephritis (GN) develops uremia?
Ataxia Slurred speech Asterixis Itching
What diagnostic test does the nurse expect the urologist to prescribe for a client with a urinary tract infection (UTI) who developed signs and symptoms of urosepsis (bacteremia)?
Blood cultures
Which outcome statement indicates to the nurse that the client's goal for pelvic floor (Kegel) exercises has been met?
Client has no urinary leakage between voidings.
Which report or manifestation indicates to the nurse that a clients treatment for renal colic has been successful?
Client reports that pain is relieved.
Which self- care management techniques will the nurse teach a client with polycystic kidney disease (PKD) to prevent constipation?
Consume adequate fluid intake of 2 to 3 liters daily. Use stool softeners .daily.; Maintain your fiber intake and exercise regularly.
Which clients diagnosed with urinary tract infection (UTI) may need longer antibiotic treatment
Diabetic woman Immunosuppressed male -- Pregnant woman Older male with complicated UTI
When the nurse takes a history from an older adult, which drugs will he or she recognize as possible contributing factors to urinary incontinence?
Diuretics Opioid analgesics . Anticholinergic drugs *
Which questions will the nurse ask to provide effective screening for urinary incontinence by asking clients to respond "always," "sometimes,' or ' never"'?
Do You ever leak urine or water when You don't want to? Do you ever leak urine or water when you cough, sneeze, laugh, or exercise? Do You ever leak urine or water on the way to the toilet? Do you ever use pads, tissue, or cloth in. your underwear to catch urine?
What is the nurse's best advice to a client 'with urge incontinence regarding fluid intake?
Drink 120 mL every hour or 240 mL every 2 hours and limit fluid intake after dinner.
Which priority instructions will the nurse teach the client and family to prevent harm from urinary tract infections (UTls) after discharge?
Drink fluids liberally, as much as 2 to 3 liters daily if not contraindicated bY health problems. Be sure to get enough sleep, rest, and nutrition daily to maintain immunologic health. Do not routinely delay urination because the flow of urine can help remove bacteria that may be colonizing the urethra or bladder. For both men and women, gently wash perineal area before intercourse. If spermicides are used, consider changing to another method of contraception.
What priority finding will the nurse assess for when inspecting the hands, face, and eyelids of a client with possible acute glomerulonephritis GN)?
Edema
Which intracollaborative therapy does the nurse expect the health care provider to prescribe for a postmenopausal client diagnosed with noninfectious urethritis?
Estrogen vaginal cream
Which information will the nurse include when teaching a client self-care measures after shock wave lithotripsy for kidney stone;
Finish the entire prescription of _ antibiotics to prevent infection. Balance regular exercise with adequate sleep and rest. Drink at the very least 3 liters of fluids every day. Your urine may appear bloody for a few days after the procedure.
Which finding will the nurse associate with an obstruction in the urinary system specifically associated with hydronephrosis?
Flank asymmetry
Which are the most common signs and symptoms of urinary tract infection that the nurse will recognize when assessing a client?
Frequency Urgency Dysuria
Which statement by a client to the nurse indicates that treatment for urge incontinence has been successful?
I had a little trouble at first, but now I go to the toilet every 3 hours.'
Which client findings cause the nurse to suspect the possibility of chronic pyelonephritis?
Inability to conserve sodium Decreased urine-concentrating ability and nocturia Hypertension Hyperkalemia and acidosis
What is the nurses priority concern for an older client with urinary incontinence, who is alert and oriented, but refuses to call for help and has fallen while trying to get to the bathroom alone?
Initiating fall precautions
What problem will the nurse suspect when a client reports urgency, frequency, and bladder pain but the urinalysis shows a few white blood cells and red blood cells, but no bacteria and the urine culture results are negative?
Interstitial cystitis
Which actions will the nurse implement to minimize catheter-associated, urinary tract infections (CAUTI) on a client care unit?
Leaving urinary catheters in place only as long as needed Using sterile equipment in the acute care setting when inserting a urinary catheter Maintaining a closed system by ensuring that catheter tubing connections are sealed securely Emptying the bag regularly* using a separate, clean container for each client Ensuring that the drainage spigot does not come into contact with nonsterile surfaces Securing the catheter to the client's thigh (women) or lower abdomen (men)
Which postoperative action will the nurse take a client who had a nephrostomy and a nephrostomy tube is now in place?
Monitor the amount of drainage in the collection bag.
What is the priority action the nurse will take for a client admitted with nephrotic syndrome (NS) who has proteinuria, hypertension, lipidemia> and facial edema?
Monitoring client s fluid volume and hydration status
Which health problem does the nurse suspect when a client with decreased kidney function has increased proteinuria, decreased serum albumin, lipids in blood and urine, increased aPTT and INR, facial edema, and hypertension?
Nephrotic syndrome
What early sign would the nurse expect when a client is suspected of autosomal dominant polycystic kidney disease (ADPKD)?
Nocturia
What is the nurses priority concern when aring for clients with hydronephrosis or hydroureter?
Obstruction
Which factors promote long-term adherence to the prescribed antihypertensive drug therapy for a client diagnosed with nephrosclerosis?
Once-a-day dosing Low cost Minimal side effects
Which findings will the nurse assess when a client is experiencing problems with urinary elimination caused by acute pyelonephritis?
Pain and burning with urination Client reports back, flank, or loin pain . Urine is cloudy and has a foul odor Urine sample is dark or smoky colored
Which urinary characteristic most concerns the nurse when assessing a client whose lifestyle choices and occupational exposure indicate a high risk for bladder cancer?
Painless hematuria
What priority information will the nurse teach a client and family about self-catheterization. the long-term problem of incomplete bladder emptying?
Perform careful handwashing and cleaning of the catheter to prevent risk for infection.
What factors will the nurse recognize as contributors to a client diagnosis of complicated urinary tract infection (UTI)?
Pregnancy Obstruction Diabetes Chronic kidney disease Decreased immunity
Which therapy does the nurse expect after a Lent's nephrectomy to prevent an adrenal complication?
Prescription for steroid supplement
Which action associated with a habit training bladder program for an older client who is alert but mildly confused will the nurse delegate to the assistive personnel (Ap)?
Remind the client when it is time to use the bathroom and assist him or heron a regular schedule.
For which minimal risk diagnostic test will the nurse prepare the client with polycystic kidney disease to have as initial screening?
Renal ultrasonography
Which circumstance does the nurse recognize as creating the greatest risk of recurrent urolithiasis when a client is admitted for an ortho' pedic procedure?
Restricting foods and fluids for extended v periods of time
Which information is most important for the nurse to include when teaching a client and family about home care for acute pyelonephritis?
Role of nutrition and adequate fluid intake Need for a balance between rest and ' activity Signs and symptoms of disease recurrence Use of successful coping mechanisms Drug regimen (purpose, timing, frequency, duration, and possible side effects)
When the nurse reviews laboratory values for a client with chronic glomerulonephritis, and the serum phosphorus level is 5.3 mg/dL, which other change does the nurse« expect to see^
Serum calcium level is low normal or . - slightly below normal
What is the priority nursing concern when a client is admitted with a history of kidneY stones and presents with severe flank pain.nausea and vomiting, pallor, and diaphoresis?
Severe pain
Which essential nursing intervention will the nurse implement when a client returns from having shock wave lithotripsy?
Strain the urine to monitor for the passage of stone fragments.
What type of incontinence does the nurse recognize when a 45-year-old female client reports loss of small amounts of urine during coughing, sneezing, jogging, or lifting?
Stress incontinence
Which client signs and symptoms cause the nurse to suspect the possibility of renovascular disease?
Sudden onset of hypertension Difficult to control hypertension Sustained hypergtycemia Elevated serum creatinine Decreased glomerular filtration rate
Which nonsurgical actions would the nurse include in the care of a middle-age female client with stress incontinence?
Suggest keeping a diary of urine leakage, activities, and foods eaten. Teach performance of pelvic floor (Kegel) exercise therapy. Encourage the client to take in adequate .fluids, especially water. Refer to a registered dietitian nutritionist diet or weight loss therapy.
Which action will the nurse avoid to prevent harm for a client with overflow incontinence?
The Valsalva maneuver when a client has heart disease
What does the nurse suspect when assessment reveals a distended bladder and the client reports passing very small amounts of urine today despite a normal fluid intake and feeling the urge to urinate?
Urethral stricture
Which laboratory tests would the nurse expect the health care provider to order when a client has acute pyelonephritis?
Urine culture for specific infective organism to be treated Complete blood count with differential to monitor for increased WBCs Urinalysis for bacteria, leucocyte esterase, nitrate, and RBCs C-reactive protein and erythrocyte sedimentation rate (ESR) to determine immune response and inflammation Blood urea nitrogen (BUN) and serum creatinine levels to monitor for elevation Test to determine whether a woman is pregnant
Which condition best indicates to the nurse that a client's fluid intake is sufficient to manage acute pyelonephritis?
Urine output is clear yellow and dilute.
What is the nurses best interpretation when a client is admitted with flank pain, and the urine report indicates turbidity* foul odor, rust color, presence of white and red blood cells as well as bacteria, and microscopic crystals?
Urolithiasis and infection
What will the nurse teach a client and family about prevention of kidney and genitourinary trauma
Wear a seat belt. Practice safe walking habits. Use caution when riding bicycles and motorcycles. Wear appropriate protective clothing when participating in contact sports. Avoid all contact sports and high-risk activities if you only have one kidney'
Which actions will the nurse delegate to the assistive personnel (AP) for appropriate care of a client with acute glomerulonephritis?
Weighing the client every morning with , the same scale
assessment findings will the nurse expect to see documented when a client is first admitted with renal cell carcinoma?
flank pain, blood in the urine, palpable renal mass, and renal bruit
For which symptoms or changes will the nurse instruct a client with polycystic kidney disease PKD) to contact the health care provide immeciately?
presence of a foul urine odor Development of a headache that does not * go away Experiencing a sudden weight gain
"What results will the nurse expect from a 24-hour urine test for total protein when a client is diagnosed with glomerulonephritis (GN)?
protein excretion rate may be increased • from 500 mg/24 hr to 3 g/24 hr.
Which is the nurse's best action far an amhulatory obese older client with incontinence and dementia?
provide the client assistance with toileting every 2 hours.
