Care of Clients with Genito-Urinary Disorders

a. Cardiac arrest

If the client's serum potassium continues to rise in acute renal failure, the nurse should be prepared for which of the following emergency situations? a. Cardiac arrest b. Pulmonary edema c. Circulatory collapse d. Hemorrhage

b. Frequency and burning on urination.

A 24 year old female client comes to an ambulatory care clinic in moderate distress with a probable diagnosis of acute cystitis. Which of the following symptoms would the nurse most likely expect the client to report during assessment? a. Fever and chills. b. Frequency and burning on urination. c. Flank pain and nausea. d. Hematuria.

c. Alleviation of pain

A client is admitted to the hospital with a diagnosis of renal calculi. She js experiencing severe flank pain and complains of nausea. Her temperature is 100.6 F (38. 1 C). Which of the following would be a priority outcome for this client? a. Prevention of urinary tract complications. b. Alleviation of nausea. c. Alleviation of pain d. Maintenance of fluid and electrolyte balance

b. Chills

A client is to have cystoscopy to rule out cancer of the bladder. Which of the following symptoms would indicate that the client has developed a complication after cystoscopy? a. Dizziness b. Chills c. Pink — tinged urine d. Bladder spasms

c. Conveys urine from the ureters to a stoma opening on 'the abdomen.

A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively, the nurse reinforces the client's understanding of the surgical procedure by explaining that an ileal conduit a. Is a temporary procedure that can be reversed later. b.Diverts urine into the sigmoid colon, where it is expelled through the rectum. c. Conveys urine from the ureters to a stoma opening on 'the abdomen. d. Creates an opening in the bladder that allows urine to drain into an external pouch

d. Disturbed body image related to creation of a urinary diversion.

A female client who has urinary diversion tells the nurse, "This urinary pouch is embarrassing. Everyone will know that I'm not normal." The most appropriate nursing diagnosis for this client is: a. Anxiety related to the urinary diversion. b. Deficient knowledge about how to care for the urinary diversion. c. Low self — esteem related to feelings of worthlessness. d. Disturbed body image related to creation of a urinary diversion.

b. Encouraging adequate fluid intake.

After an IVP, the nurse should anticipate to incorporate which of the following measures into the client's plan of care? a. Maintaining bed rest. b. Encouraging adequate fluid intake. c. Assessing for hematuria. d. Administering a laxative.

b. Thrombophlebitis

After surgery for an ileal conduit, the nurse should closely evaluate the client for the occurrence of which of the following complications related to pelvic surgery? a. Peritonitis b. Thrombophlebitis c. Ascites d. Inguinal hernia

c. To bind phosphate in the intestines.

Aluminum hydroxide gel (Amphogel) is prescribed for the client with chronic renal failure to take at home. What is the purpose of giving this drug to a client with chronic renal failure? a. To relieve the pain of gastric hyperacidity. b. To prevent Curling's stress ulcers. c. To bind phosphate in the intestines. d. To reverse metabolic acidosis

a. Milk, apples, tomatoes and corn.

Because a client's renal stone was found to be composed of uric acid, a low purine, alkaline — ash diet was ordered. Incorporation of which of the following food items into the home diet would indicate that the client understands the necessary diet modifications? a. Milk, apples, tomatoes and corn. b. Eggs, spinach, dried peas and gravy. c. Salmon, chicken, caviar and asparagus. d. Grapes, corn, cereals and liver.

b. Turn the client from side to side

During dialysis, the nurse observes that the flow of dialysate stops before all the solution has drained out. The nurse should: a. Have the client sit on a chair b. Turn the client from side to side c. Reposition the peritoneal catheter d. Have the client walk

a. Pulmonary edema

In the oliguric phase of acute renal failure, the nurse should anticipate the development of which of the following complications? a. Pulmonary edema b. Metabolic alkalosis c. Hypotension d. Hypokalemia

b. Suggest using alternative forms of sexual expression and intimacy.

Sexual problems can be troublesome to clients with chronic renal failure. Which one of the following strategies would be most useful in helping a client cope with such a problem? a. Help the client to accept that sexual activity will be decreased. b. Suggest using alternative forms of sexual expression and intimacy. c. Tell the client to plan rest periods after sexual activity. d. Suggest that the client avoid sexual activity to prevent embarrassment.

d. Decreased serum uric acid level.

The client has a clinic appointment scheduled for 10 days after discharge. Which laboratory finding at that time would indicate that allopurinol (Zyloprim) has had a therapeutic effect? a. Decreased urinary alkaline phosphatase level. b. Increased urinary calcium excretion. c. Increased serum calcium level. d. Decreased serum uric acid level.

c. Checking the client's history for allergy to iodine.

The client is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi. Which of the following measures would be most important for the nurse to include in pretest preparation? a. Ensuring adequate fluid intake on the day of the test. b. Preparing the client for the possibility of bladder spasms during the test. c. Checking the client's history for allergy to iodine. d. Determining when the client last had a bowel movement.

c. An enema will be given before the examination.

The client is scheduled to have a kidney, ureter and bladder (KUB) radiograph. Which of the following would be ordered to prepare the Client for this radiograph? a. Fluid and food will be withheld the morning of the examination. b. A tranquilizer will be given before the examination. c. An enema will be given before the examination. d. No special preparation is required for the examination.

b. Accumulation of waste products in the blood.

The client with chronic renal failure complains of feeling nauseated at least part of every day, The nurse should explain that the nausea is the result of: a. Acidosis caused by the medications. b. Accumulation of waste products in the blood. c. Chronic anemia and fatigue d. Excess fluid load

a. Milk of magnesia can cause magnesium intoxication.

The client with chronic renal failure told the nurse, he takes magnesium hydroxide (milk of magnesia) at home for constipation. The nurse suggests that the client switch to psyllium hydrophilic mucilloid (Metamucil) because: a. Milk of magnesia can cause magnesium intoxication. b. Milk of magnesia is too harsh on the bowel. c. Metamucil is more palatable. d. Milk of magnesia is high in sodium.

c. Providing an analgesic effect on the bladder mucosa.

The client with cystitis is also given a prescription of phenazopyridine hydrochloride (Pyridium). The nurse should teach the client that this drug is used to treat urinary tract infections by? a. Releasing formaldehyde and providing bacteriostatic action. b. Potentiating the action of the antibiotic. c. Providing an analgesic effect on the bladder mucosa. d. Preventing the crystallization that can occur with sulfa drugs.

d. Exchange sodium for potassium ions in the colon

The client's serum potassium is elevated in acute renal failure, and the nurse administers sodium polyeterene (Kayexalate). The drug acts to: a. Increase potassium excretion from the colon b. Release hydrogen ions for sodium ions c. Increase calcium absorption in the colon. d. Exchange sodium for potassium ions in the colon

a. Encourage the removal of serum area

The dialysis solution is warmed before use in peritoneal dialysis primarily to? a. Encourage the removal of serum area b. Force potassium back into the cells c. Add extra warmth to the body d. Promote abdominal muscle relaxation

a. Excess fluid volume related to the kidney's inability to maintain fluid balance.

The nurse assesses the client who has chronic renal failure and notes the following: crackles in the lung bases, elevated blood pressure, and weight gain of 2 pounds in 1 day. Based on these data, which of the following nursing diagnosis is appropriate? a. Excess fluid volume related to the kidney's inability to maintain fluid balance. b. Increased cardiac output related to fluid overload. c. Ineffective tissue perfusion related to interrupted arterial blood flow. d. Ineffective therapeutic regimen management related to lack Of knowledge about therapy.

a. Discard the urine and obtain a new specimen.

The nurse finds a container with the client's urine specimen sitting on a comer in the bathroom. The client states that the specimen has been sitting in the bathroom for at least 2 hours. What would be the nurse's most appropriate action? a. Discard the urine and obtain a new specimen. b. Send the urine to the laboratory as quickly as possible. c. Add fresh urine to the collected specimen and send the specimen to the laboratory. d. Refrigerate the specimen until it can be transported to the laboratory.

c. Low protein, low sodium, low potassium

The nurse helps the client with chronic renal failure develop a home diet plan with the goal of helping the client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a client with chronic renal failure? a. High carbohydrate, high protein. b. High calcium, high potassium, high protein c. Low protein, low sodium, low potassium d. Low protein, high potassium.

a. Disequilibrium syndrome

The nurse initiates the client's first hemodialysis treatment. The client develops a headache, confusion and nausea. These symptoms indicate which of the following potential complications? a. Disequilibrium syndrome b. Myocardial infarction c. Air embolism d. Peritonitis

b. Urine output, 20 mL/hour.

The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of the following findings would be most important for the nurse to report to the physician? a. Temperature, 99.8 F (37.7 C). b. Urine output, 20 mL/hour. c. Absence of bowel sounds. d. A 2x2 — inch area of serosanguineous drainage on the flank dressing.

c. "I will ask the client to cleanse her labia, void into the toilet, and then into the specimen cup.'

The nurse is instructing the unlicensed assistant on the correct technique for obtaining a clean - catch urine culture from a client. Which of the following statements indicates that the assistant has understood the instructions? a. "I will have the client completely empty her bladder into the b. "I will need to catheterize the client to get the urine c. "I will ask the client to cleanse her labia, void into the toilet, and then into the specimen cup.' d. "I will obtain the specimen in the afternoon after the client has had plenty of fluids.

c. Peritonitis

What is the most potentially dangerous complication of peritoneal dialysis? a. Abdominal pain b. Gastrointestinal bleeding. c. Peritonitis d. Muscle cramps

c. Decreased hemoglobin

Which of the following abnormal blood values would not be improved by dialysis treatment? a. Elevated serum creatinine b. Hyperkalemia c. Decreased hemoglobin d. Hypernatremia

c. Painless hematuria

Which of the following is the most common clinical finding associated with bladder cancer? a. Suprapubic pain b. Dysuria c. Painless hematuria d. Urinary retention

a. Cloudy dialysate fluid.

Which of the following is the most significant sign of peritoneal infection? a. Cloudy dialysate fluid. b. Swelling in the legs. c. Poor drainage of the dialysate fluid d. Redness at the catheter insertion site.

b. Monitor client's blood pressure

Which of the following nursing interventions should be included in the client's care plan during dialysis therapy? a. Limit the client's visitors b. Monitor client's blood pressure c. Pad the side rails of the bed d. Keep the client NPO

b. Vinegar

Which of the following solutions will be useful to help control odor in the urine collecting bag after it has been cleaned? a. Salt water b. Vinegar c. Ammonia d. Bleach

b. "I take a tub bath every evening."

Which of the following statements by the client would indicate that she is at high risk for the recurrence of cystitis? a. "I can usually go 8 to 10 hours without needing to empty my bladder." b. "I take a tub bath every evening." c. "I wipe from front to back after voiding." d. "I drink a lot of water during the day."

d. Oliguria

Which of the following urinary symptoms is the most common initial manifestation of acute renal failure? a. Dysuria b. Anuria c. Hematuria d. Oliguria