Chapter 45 - Renal and Urologic Problems
what is the most common cause of acute pyelonephritis resulting from an ascending infection from the lower urinary tract? a. the kidney is scarred and fibrotic b. the organism is resistant to antibiotics c. there is a preexisting abnormality of the urinary tract d. the patient does not take all of the antibiotics for treatment of a UTI
c. there is a preexisting abnormality of the urinary tract
a female patient with a UTI also has renal calculi. The nurse knows that these are most likely which type of stone? a. cystine b. struvite c. uric acid d. calcium phosphate
b. struvite
Which disease causes connective tissue changes that cause glomerulonephritis? a. Gout b. Amyloidosis c. Diabetes mellitus d. Systemic lupus erythematosus
d. Systemic lupus erythematosus
The nurse will anticipate teaching a patient with nephrotic syndrome who develops flank pain about treatment with a. antibiotics. b. antifungals. c. anticoagulants. d. antihypertensives.
c. anticoagulants.
in planning nursing interventions to increase bladder control in the patient with urinary incontinence, the nurse includes.. a. teaching the patient to use Kegel exercises b. clamping and releasing a catheter to increase bladder tone c. teaching the patient biofeedback mechanisms to suppress the urge to void d. counseling the patient concerning choice of incontinence containment device
a. teaching the patient to use Kegel exercises
which classification of urinary tract infection (UTI) is described as infection of the renal parenchyma, renal pelvis, and ureters? a. upper UTI b. lower UTI c. complicated UTI d. uncomplicated UTI
a. upper UTI
a female patient, weighing 180lbs, with a UTI has a nursing diagnosis of risk for infection related to lack of knowledge regarding prevention of recurrence. What should the nurse include in the teaching plan instructions for this patient? a. empty the bladder at least 4 times a day b. drink at least 2 quarts of water every day c. wait to urinate until the urge is very intense d. clean the urinary meatus with an antiinfective agent after voiding
b. drink at least 2 quarts of water every day
Which nursing action is of highest priority for a 68-year-old patient with renal calculi who is being admitted to the hospital with gross hematuria and severe colicky left flank pain? a. Administer prescribed analgesics. b. Monitor temperature every 4 hours. c. Encourage increased oral fluid intake. d. Give antiemetics as needed for nausea.
a. Administer prescribed analgesics.
A 44-year-old patient is unable to void after having an open loop resection and fulguration of the bladder. Which nursing action should be implemented first? a. Assist the patient to soak in a 15-minute sitz bath. b. Insert a straight urethral catheter and drain the bladder. c. Encourage the patient to drink several glasses of water. d. Teach the patient how to do isometric perineal exercises.
a. Assist the patient to soak in a 15-minute sitz bath.
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider? a. Complaint of flank pain b. Blood pressure 90/48 mm Hg c. Cloudy and foul-smelling urine d. Temperature 100.1° F (57.8° C)
b. Blood pressure 90/48 mm Hg
A 22-year-old female patient seen in the clinic for a bladder infection describes the following symptoms. Which information is most important for the nurse to report to the health care provider? a. Urinary urgency b. Left-sided flank pain c. Intermittent hematuria d. Burning with urination
b. Left-sided flank pain
a patient is admitted to the hospital with severe renal colic. The nurse's first priority in management of the patient is to.. a. administer opioids as prescribed b. obtain supplies for straining all urine c. encourage fluid intake of 3 to 4 L/day d. keep the patient NPO in preparation for surgery
a. administer opioids as prescribed
which infection is asymptomatic in the male patient at first and then progresses to cystitis, frequent urination, burning on voiding, and epididymitis? a. urosepsis b. urethral diverticula c. goodpasture syndrome d. genitourinary tuberculosis
d. genitourinary tuberculosis
when obtaining a nursing history from a patient with cancer of the urinary system, what does the nurse recognize as a risk factor associated with both kidney cancer and bladder cancer? a. smoking b. family history of cancer c. chronic use of phenacetin d. chronic, recurrent nephrolithiasis
a. smoking
the nurse identifies a risk factor for kidney and bladder cancer in a patient who relates a history of.. a. aspirin use b. tobacco use c. chronic alcohol abuse d. use of artificial sweeteners
b. tobacco use
which characteristics are associated with urge incontinence? (select all) a. treated with Kegel exercises b. found following prostatectomy c. common in postmenopausal women d. involuntary urination preceded by urgency e. caused by overactivity of the detrusor muscle f. bladder contracts by reflex, overriding central inhibition
d. involuntary urination preceded by urgency e. caused by overactivity of the detrusor muscle f. bladder contracts by reflex, overriding central inhibition
With which diagnosis will the patient benefit from being taught to do self-catheterization? a. Renal trauma b. Urethral stricture c. Renal artery stenosis d. Accelerated nephrosclerosis
b. Urethral stricture
A 58-year-old male patient who weighs 242 lb (110 kg) undergoes a nephrectomy for massive kidney trauma due to a motor vehicle crash. Which postoperative assessment finding is most important to communicate to the surgeon? a. Blood pressure is 102/58. b. Urine output is 20 mL/hr for 2 hours. c. Incisional pain level is reported as 9/10. d. Crackles are heard at bilateral lung bases.
b. Urine output is 20 mL/hr for 2 hours.
The nurse teaches a 64-year-old woman to prevent the recurrence of renal calculi by a. using a filter to strain all urine. b. avoiding dietary sources of calcium. c. choosing diuretic fluids such as coffee. d. drinking 2000 to 3000 mL of fluid a day.
d. drinking 2000 to 3000 mL of fluid a day.
what manifestation in the patient will indicate the need for restriction of dietary protein in management of acute poststreptococcal glomerulonephritis (APSGN)? a. hematuria b. proteinuria c. hypertension d. elevated blood urea nitrogen (BUN)
d. elevated blood urea nitrogen (BUN)
A teaching plan developed by the nurse for the patient with a new ileal conduit includes instructions to do what? a. Clean the skin around the stoma with alcohol every day. b. Use a wick to keep the skin dry during appliance changes. c. Use sterile supplies and technique during care of the stoma. d. Change the appliance every day and wash it with soap and warm water.
b. Use a wick to keep the skin dry during appliance changes.
what results in the edema associated with nephrotic syndrome? a. hypercoagulability b. hyperalbuminemia c. decreased plasma oncotic pressure d. decreased glomerular filtration rate
c. decreased plasma oncotic pressure
what can patients at risk for nephrolithiasis do to prevent the stones in many cases? a. lead an active lifestyle b. limit protein and acidic foods in the diet c. drink enough fluids to produce dilute urine d. take prophylactic antibiotics to control UTIs
c. drink enough fluids to produce dilute urine
A 58-year-old male patient who is diagnosed with nephrotic syndrome has ascites and 4+ leg edema. Which nursing diagnosis is a priority for the patient? a. Activity intolerance related to rapidly increased weight b. Excess fluid volume related to low serum protein levels c. Disturbed body image related to peripheral edema and ascites d. Altered nutrition: less than required related to protein restriction
b. Excess fluid volume related to low serum protein levels
A patient has been diagnosed with urinary tract calculi that are high in uric acid. Which foods will the nurse teach the patient to avoid (select all that apply)? a. Milk b. Liver c. Spinach d. Chicken e. Cabbage f. Chocolate
b. Liver d. Chicken
Which action will the nurse anticipate taking for an otherwise healthy 50-year-old who has just been diagnosed with Stage 1 renal cell carcinoma? a. Prepare patient for a renal biopsy. b. Provide preoperative teaching about nephrectomy. c. Teach the patient about chemotherapy medications. d. Schedule for a follow-up appointment in 3 months.
b. Provide preoperative teaching about nephrectomy.
Which information will the nurse include when teaching the patient with a urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)? a. Pyridium may cause photosensitivity b. Pyridium may change the urine color. c. Take the Pyridium for at least 7 days. d. Take Pyridium before sexual intercourse.
b. Pyridium may change the urine color.
A 56-year-old female patient is admitted to the hospital with new onset nephrotic syndrome. Which assessment data will the nurse expect? a. Poor skin turgor b. Recent weight gain c. Elevated urine ketones d. Decreased blood pressure
b. Recent weight gain
In providing care for the patient with adult-onset polycystic kidney disease, what should the nurse do? a. Help the patient to cope with the rapid progression of the disease b. Suggest genetic counseling resources for the children of the patient c. Expect the patient to have polyuria and poor concentration ability of the kidneys d. Implement measures for the patient's deafness and blindness in addition to the renal problems
b. Suggest genetic counseling resources for the children of the patient
The nurse is caring for a patient who has had an ileal conduit for several years. Which nursing action could be delegated to unlicensed assistive personnel (UAP)? a. Change the ostomy appliance. b. Choose the appropriate ostomy bag. c. Monitor the appearance of the stoma. d. Assess for possible urinary tract infection (UTI).
a. Change the ostomy appliance.
A patient is admitted to the emergency department with possible renal trauma after an automobile accident. Which prescribed intervention will the nurse implement first? a. Check blood pressure and heart rate. b. Administer morphine sulfate 4 mg IV. c. Transport to radiology for an intravenous pyelogram. d. insert a urethral catheter and obtain a urine specimen.
a. Check blood pressure and heart rate.
A 76-year-old with benign prostatic hyperplasia (BPH) is agitated and confused, with a markedly distended bladder. Which intervention prescribed by the health care provider should the nurse implement first? a. Insert a urinary retention catheter. b. Schedule an intravenous pyelogram (IVP). c. Draw blood for a serum creatinine level. d. Administer lorazepam (Ativan) 0.5 mg PO.
a. Insert a urinary retention catheter.
Which urinary diversion is a continent diversion created by formation of an ileal pouch with a stoma for catheterization? a. Kock pouch b. Ileal conduit c. Orthotopic neobladder d. Cutaneous ureterostomy
a. Kock pouch
After change-of-shift report, which patient should the nurse assess first? a. Patient with a urethral stricture who has not voided for 12 hours b. Patient who has cloudy urine after orthotopic bladder reconstruction c. Patient with polycystic kidney disease whose blood pressure is 186/98 mm Hg d. Patient who voided bright red urine immediately after returning from lithotripsy
a. Patient with a urethral stricture who has not voided for 12 hours
The patient has a thoracic spinal cord lesion and incontinence that occurs equally during the day and night. What type of incontinence is this patient experiencing? a. Reflex incontinence b. Overflow incontinence c. Functional incontinence d. Incontinence after trauma
a. Reflex incontinence
A patient in the urology clinic is diagnosed with monilial urethritis. Which action will the nurse include in the plan of care? a. Teach the patient about the use of antifungal medications. b. Tell the patient to avoid tub baths until the symptoms resolve. c. Instruct the patient to refer recent sexual partners for treatment. d. Teach the patient to avoid nonsteroidal antiinflammatory drugs (NSAIDs).
a. Teach the patient about the use of antifungal medications.
besides being mixed with struvite or oxalate stones, what characteristic is associated with calcium phosphate calculi? a. associated with alkaline urine b. genetic autosomal recessive defect c. three times as common in women as in men d. defective gastrointestinal (GI) and kidney absorption
a. associated with alkaline urine
which characteristic is more likely with acute pyelonephritis than with a lower UTI? a. fever b. dysuria c. urgency d. frequency
a. fever
the nurse plans care for the patient with APSGN based on what knowledge? a. most patients with APSGN recover completely or rapidly improve with conservative management b. chronic glomerulonephritis leading to renal failure is a common sequela to acute glomerulonephritis c. pulmonary hemorrhage may occur as a result of antibodies also attacking the alveolar basement membrane d. a large percentage of patients with APSGN develop rapidly progressive glomerulonephritis, resulting in kidney failure
a. most patients with APSGN recover completely or rapidly improve with conservative management
One of the nurse's most important roles in relation to acute poststreptococcal glomerulonephritis is to.. a. promote early diagnosis and treatment of sore throats and skin lesions. b. encourage patients to obtain antibiotic therapy for upper respiratory tract infections. c. teach patients with APSGN that long-term prophylactic antibiotic therapy is necessary to prevent recurrence. d. monitor patients for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane.
a. promote early diagnosis and treatment of sore throats and skin lesions.
the male patient is Jewish, has a history of gout, and has been diagnosed with renal calculi. Which treatment will be used with this patient? (select all) a. reduce dietary oxalate b. administer allopurinol c. administer a-penicillamine d. administer thiazide diuretics e. reduce animal protein intake f. reduce intake of milk products
b. administer allopurinol e. reduce animal protein intake
The nurse will plan to teach a 27-year-old female who smokes 2 packs of cigarettes daily about the increased risk for a. kidney stones. b. bladder cancer. c. bladder infection. d. interstitial cystitis.
b. bladder cancer.
during assessment of the patient who had an open nephrectomy, what should the nurse expect to find? a. shallow, slow respirations b. clear breath sounds in all lung fields c. decreased breath sounds in the lower left lobe d. decreased breath sounds in the right and left lower lobes
b. clear breath sounds in all lung fields
The immunologic mechanisms involved in acute poststreptococcal glomerulonephritis include.. a. tubular blocking by precipitates of bacteria and antibody reactions. b. deposition of immune complexes and complement along the GBM. c. thickening of the GBM from autoimmune microangiopathic changes. d. destruction of glomeruli by proteolytic enzymes contained in the GBM.
b. deposition of immune complexes and complement along the GBM.
A patient who had surgery for creation of an ileal conduit 3 days ago will not look at the stoma and requests that only the ostomy nurse specialist does the stoma care. The nurse identifies a nursing diagnosis of a. anxiety related to effects of procedure on lifestyle. b. disturbed body image related to change in function. c. readiness for enhanced coping related to need for information. d. self-care deficit, toileting, related to denial of altered body function.
b. disturbed body image related to change in function.
following electrohydraulic lithotripsy for treatment of renal calculi, the patient has a nursing diagnosis of risk for infection related to the introduction of bacteria following manipulation of the urinary tract. What is the most appropriate nursing intervention for this patient? a. monitor for hematuria b. encourage fluid intake of 3 L/day c. apply moist heat to the flank area d. strain all urine through gauze or a special strainer
b. encourage fluid intake of 3 L/day
a patient with a ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes.. a. encouraging the patient to drink fruit juices and milk b. encouraging fluids of at least 2 to 3 L/day after nausea has subsided c. irrigating the nephrostomy tube with 10mL of normal saline solution as needed d. notifying the physician if nephrostomy tube drainage is more than 30 mL/hr
b. encouraging fluids of at least 2 to 3 L/day after nausea has subsided
A 34-year-old male patient seen at the primary care clinic complains of feeling continued fullness after voiding and a split, spraying urine stream. The nurse will ask about a history of a. recent kidney trauma. b. gonococcal urethritis. c. recurrent bladder infection. d. benign prostatic hyperplasia.
b. gonococcal urethritis.
a patient has a right urethral catheter placed following a lithotripsy for a stone in the ureter. In caring for the patient immediately after the procedure, what is the most appropriate nursing action? a. milk or strip the catheter every 2 hours b. measure urethral urinary drainage every 1 to 2 hours c. irrigate the catheter with 30 mL sterile saline every 4 hours d. encourage ambulation to promote urinary peristaltic action
b. measure urethral urinary drainage every 1 to 2 hours
When planning teaching for a 59-year-old male patient with benign nephrosclerosis the nurse should include instructions regarding a. preventing bleeding with anticoagulants. b. monitoring and recording blood pressure. c. obtaining and documenting daily weights. d. measuring daily intake and output volumes.
b. monitoring and recording blood pressure.
It is most important that the nurse ask a patient admitted with acute glomerulonephritis about a. history of kidney stones. b. recent sore throat and fever. c. history of high blood pressure. d. frequency of bladder infections.
b. recent sore throat and fever.
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to avoid eating a. milk and cheese. b. sardines and liver. c. legumes and dried fruit. d. spinach, chocolate, and tea.
b. sardines and liver.
The nurse teaches the female patient who has frequent UTIs that she should.. a. take tub baths with bubble bath b. urinate before and after sexual intercourse c. take prophylactic sulfonamides for the rest of her life d. restrict fluid intake to prevent the need for frequent voiding
b. urinate before and after sexual intercourse
The home health nurse teaches a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying. Which patient statement indicates that the teaching has been effective? a. "I will buy seven new catheters weekly and use a new one every day." b. "I will use a sterile catheter and gloves for each time I self-catheterize." c. "I will clean the catheter carefully before and after each catheterization." d. "I will need to take prophylactic antibiotics to prevent any urinary tract infections."
c. "I will clean the catheter carefully before and after each catheterization."
The nurse determines that further instruction is needed for a patient with interstitial cystitis when the patient says which of the following? a. "I should stop having coffee and orange juice for breakfast." b. "I will buy calcium glycerophosphate (Prelief) at the pharmacy." c. "I will start taking high potency multiple vitamins every morning." d. "I should call the doctor about increased bladder pain or odorous urine."
c. "I will start taking high potency multiple vitamins every morning."
Which information about a patient with Goodpasture syndrome requires the most rapid action by the nurse? a. Blood urea nitrogen level is 70 mg/dL. b. Urine output over the last 2 hours is 30 mL. c. Audible crackles bilaterally over the posterior chest to the midscapular level. d. Elevated level of antiglomerular basement membrane (anti-GBM) antibodies.
c. Audible crackles bilaterally over the posterior chest to the midscapular level.
a patient has had a cystectomy and ileal conduit diversion performed. Four days postoperatively, mucous shreds are seen in the drainage bag. The nurse should.. a. notify the physician b. notify the charge nurse c. irrigate the drainage tube d. document it as a normal observation
d. document it as a normal observation
Nursing staff on a hospital unit are reviewing rates of hospital-acquired infections (HAI) of the urinary tract. Which nursing action will be most helpful in decreasing the risk for HAI in patients admitted to the hospital? a. Encouraging adequate oral fluid intake b. Testing urine with a dipstick daily for nitrites c. Avoiding unnecessary urinary catheterizations d. Providing frequent perineal hygiene to patients
c. Avoiding unnecessary urinary catheterizations
Which type of urinary tract calculi are the most common and frequently obstruct the ureter? a. Cystine b. Uric acid c. Calcium oxalate d. Calcium phosphate
c. Calcium oxalate
After a ureterolithotomy, a female patient has a left ureteral catheter and a urethral catheter in place. Which action will the nurse include in the plan of care? a. Provide teaching about home care for both catheters. b. Apply continuous steady tension to the ureteral catheter. c. Call the health care provider if the ureteral catheter output drops suddenly. d. Clamp the ureteral catheter off when output from the urethral catheter stops.
c. Call the health care provider if the ureteral catheter output drops suddenly.
A 68-year-old male patient who has bladder cancer had a cystectomy with creation of an Indiana pouch. Which topic will be included in patient teaching? a. Application of ostomy appliances b. Barrier products for skin protection c. Catheterization technique and schedule d. Analgesic use before emptying the pouch
c. Catheterization technique and schedule
The nurse observes unlicensed assistive personnel (UAP) taking the following actions when caring for a female patient with a urethral catheter. Which action requires that the nurse intervene? a. Taping the catheter to the skin on the patient's upper inner thigh b. Cleaning around the patient's urinary meatus with soap and water c. Disconnecting the catheter from the drainage tube to obtain a specimen d. Using an alcohol-based gel hand cleaner before performing catheter care
c. Disconnecting the catheter from the drainage tube to obtain a specimen
A 28-year-old male patient is diagnosed with polycystic kidney disease. Which information is most appropriate for the nurse to include in teaching at this time? a. Complications of renal transplantation b. Methods for treating severe chronic pain c. Discussion of options for genetic counseling d. Differences between hemodialysis and peritoneal dialysis
c. Discussion of options for genetic counseling
A 32-year-old patient with a history of polycystic kidney disease is admitted to the surgical unit after having shoulder surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider? a. Infuse 5% dextrose in normal saline at 75 mL/hr. b. Order regular diet after patient is awake and alert. c. Give ketorolac (Toradol) 10 mg PO PRN for pain. d. Draw blood urea nitrogen (BUN) and creatinine in 2 hours.
c. Give ketorolac (Toradol) 10 mg PO PRN for pain.
A 63-year-old male patient had a cystectomy with an ileal conduit yesterday. Which new assessment data is most important for the nurse to communicate to the physician? a. Cloudy appearing urine b. Hypotonic bowel sounds c. Heart rate 102 beats/minute d. Continuous stoma drainage
c. Heart rate 102 beats/minute
A 46-year-old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take? a. Teach the patient to take the prescribed Bactrim for 3 more days. b. Remind the patient about the need to drink 1000 mL of fluids daily. c. Obtain a midstream urine specimen for culture and sensitivity testing. d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.
c. Obtain a midstream urine specimen for culture and sensitivity testing.
To assist the patient with stress incontinence, what is the best thing the nurse should teach the patient to do? a. Void every 2 hours to prevent leakage. b. Use absorptive perineal pads to contain urine. c. Perform pelvic floor muscle exercises 40 to 50 times per day. d. Increase intraabdominal pressure during voiding to empty the bladder completely.
c. Perform pelvic floor muscle exercises 40 to 50 times per day
A patient admitted to the hospital with pneumonia has a history of functional urinary incontinence. Which nursing action will be included in the plan of care? a. Demonstrate the use of the Credé maneuver. b. Teach exercises to strengthen the pelvic floor. c. Place a bedside commode close to the patient's bed. d. Use an ultrasound scanner to check postvoiding residuals.
c. Place a bedside commode close to the patient's bed.
Which information from a patient who had a transurethral resection with fulguration for bladder cancer 3 days ago is most important to report to the health care provider? a. The patient is voiding every 4 hours. b. The patient is using opioids for pain. c. The patient has seen clots in the urine. d. The patient is anxious about the cancer.
c. The patient has seen clots in the urine.
Following rectal surgery, a patient voids about 50 mL of urine every 30 to 60 minutes for the first 4 hours. Which nursing action is most appropriate? a. Monitor the patient's intake and output over night. b. Have the patient drink small amounts of fluid frequently. c. Use an ultrasound scanner to check the postvoiding residual volume. d. Reassure the patient that this is normal after rectal surgery because of anesthesia.
c. Use an ultrasound scanner to check the postvoiding residual volume
which drugs are used to treat overflow incontinence? (select all) a. baclofen (Lioresal) b. anticholinergic drugs c. a-Adrenergic blockers d. 5a-reducatase inhibitors e. Bethanechol (Urecholine)
c. a-Adrenergic blockers d. 5a-reducatase inhibitors e. Bethanechol (Urecholine)
glomerulonephritis is characterized by glomerular damage caused by.. a. growth of microorganisms in the glomeruli b. release of bacterial substances toxic to the glomeruli c. accumulation of immune complexes in the glomeruli d. hemolysis of red blood cells circulating in the glomeruli
c. accumulation of immune complexes in the glomeruli
thirty percent of patients with kidney cancer have metastasis at the time of diagnosis. Why does this occur? a. the only treatment modalities for the disease are palliative b. diagnostic tests are not available to detect tumors before they metastasize c. classic symptoms of hematuria and palpable mass do not occur until the disease is advanced d. early metastasis to the brain impairs the patient's ability to recognize the seriousness of symptoms
c. classic symptoms of hematuria and palpable mass do not occur until the disease is advanced
a woman with no history of UTI who us experiencing urgency, frequency, and dysuria comes to the clinic, where a dipstick and microscopic urinalysis indicate bacteriuria. What should the nurse anticipate for this patient? a. obtaining a clean-catch midstream urine specimen for culture and sensitivity b. no treatment with medication unless she develops fever, chills, and flank pain c. empirical treatment with trimethoprim-sulfamethoxazole (Bactrim) for 3 days d. need to have a blood specimen drawn for a complete blood count (CBC) and kidney function tests
c. empirical treatment with trimethoprim-sulfamethoxazole (Bactrim) for 3 days
When preparing a female patient with bladder cancer for intravesical chemotherapy, the nurse will teach about a. premedicating to prevent nausea. b. obtaining wigs and scarves to wear. c. emptying the bladder before the medication. d. maintaining oral care during the treatments.
c. emptying the bladder before the medication.
on assessment of the patient with a renal calculus passing down the ureter, what should the nurse expect the patient to report? a. a history of chronic UTIs b. dull, costovertebral flank pain c. sever, colicky back pain radiating to the groin d. a feeling of bladder fullness with urgency and frequency
c. sever, colicky back pain radiating to the groin
what is included in nursing care that applies to the management of all urinary catheters in hospitalized patients? a. measuring urine output every 1 to 2 hours to ensure patency b. turning the patient frequently from side to side to promote drainage c. using strict sterile technique during irrigation and obtaining culture specimens d. daily cleaning of the catheter insertion site with soap and water and application of lotion
c. using strict sterile technique during irrigation and obtaining culture specimens
while caring for a 77yr old woman who has a urinary catheter, the nurse monitors the patient for the development of a UTI. What clinical manifestations is the patient likely to experience? a. cloudy urine and fever b. urethral burning and bloody urine c. vague abdominal discomfort and disorientation d. suprapubic pain and slight decline in body temperature
c. vague abdominal discomfort and disorientation
The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) has been effective for a 22-year-old female patient with cystitis when the patient states which of the following? a. "I can use vaginal antiseptic sprays to reduce bacteria." b. "I will drink a quart of water or other fluids every day." c. "I will wash with soap and water before sexual intercourse." d. "I will empty my bladder every 3 to 4 hours during the day."
d. "I will empty my bladder every 3 to 4 hours during the day."
A 68-year-old female patient admitted to the hospital with dehydration is confused and incontinent of urine. Which nursing action will be best to include in the plan of care? a. Restrict fluids between meals and after the evening meal. b. Apply absorbent incontinent pads liberally over the bed linens. c. Insert an indwelling catheter until the symptoms have resolved. d. Assist the patient to the bathroom every 2 hours during the day.
d. Assist the patient to the bathroom every 2 hours during the day.
Which assessment data reported by a 28-year-old male patient is consistent with a lower urinary tract infection (UTI)? a. Poor urine output b. Bilateral flank pain c. Nausea and vomiting d. Burning on urination
d. Burning on urination
Which finding by the nurse will be most helpful in determining whether a 67-year-old patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)? a. Bladder distention b. Foul-smelling urine c. Suprapubic discomfort d. Costovertebral tenderness
d. Costovertebral tenderness
Which assessment finding is most important to report to the health care provider regarding a patient who has had left-sided extracorporeal shock wave lithotripsy? a. Blood in urine b. Left flank bruising c. Left flank discomfort d. Decreased urine output
d. Decreased urine output
A patient with bladder cancer undergoes cystectomy with formation of an ileal conduit. During the patient's first postoperative day, what should the nurse plan to do? a. Measure and fit the stoma for a permanent appliance. b. Encourage high oral intake to flush mucus from the conduit. c. Teach the patient to self-catheterize the stoma every 4 to 6 hours. d. Empty the drainage bag every 2 to 3 hours and measure the urinary output.
d. Empty the drainage bag every 2 to 3 hours and measure the urinary output.
Prevention of calcium oxalate stones would include dietary restriction of which foods or drinks? a. Milk and milk products b. Dried beans and dried fruits c. Liver, kidney, and sweetbreads d. Spinach, cabbage, and tomatoes
d. Spinach, cabbage, and tomatoes
A 55-year-old woman admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which intervention is most appropriate to include in the care plan? a. Assist the patient to the bathroom q3hr. b. Place a commode at the patient's bedside. c. Demonstrate how to perform the Credé maneuver d. Teach the patient how to perform Kegel exercises.
d. Teach the patient how to perform Kegel exercises.
Which finding for a patient admitted with glomerulonephritis indicates to the nurse that treatment has been effective? a. The patient denies pain with voiding. b. The urine dipstick is negative for nitrites. c. The antistreptolysin-O (ASO) titer is decreased. d. The periorbital and peripheral edema is resolved.
d. The periorbital and peripheral edema is resolved.
The nurse recommends genetic counseling for the children of a patient with.. a. nephrotic syndrome. b. chronic pyelonephritis. c. malignant nephrosclerosis. d. adult-onset polycystic kidney disease.
d. adult-onset polycystic kidney disease.
in teaching a patient with pyelonephritis about the disorder, the nurse informs the patient that the organisms that cause pyelonephritis most commonly reach the kidneys through.. a. the bloodstream b. the lymphatic system c. a descending infection d. an ascending infection
d. an ascending infection
The edema that occurs in nephrotic syndrome is due to.. a. increased hydrostatic pressure caused by sodium retention. b. decreased aldosterone secretion from adrenal insufficiency. c. increased fluid retention caused by decreased glomerular filtration. d. decreased colloidal osmotic pressure caused by loss of serum albumin.
d. decreased colloidal osmotic pressure caused by loss of serum albumin.
a patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis (IC)? a. residual urine greater than 200 mL b. a large, atonic bladder on urodynamic testing c. a voiding pattern that indicates psychogenic urinary retention d. pain with bladder filling that is transiently relieved by urination
d. pain with bladder filling that is transiently relieved by urination
which test is required for a diagnosis of pyelonephritis? a. renal biopsy b. blood culture c. intravenous pyelogram (IVP) d. urine for culture and sensitivity
d. urine for culture and sensitivity
when caring for the patient with IC, what can the nurse teach the patient to do? a. avoid foods that make the urine more alkaline b. use high-potency vitamin therapy to decrease the autoimmune effects of the disorder c. always keep a voiding diary to document pain, voiding frequency, and patterns of nocturia d. use the dietary supplement calcium glycerophosphate (Prelief) to decrease bladder irritation
d. use the dietary supplement calcium glycerophosphate (Prelief) to decrease bladder irritation
when working with patients with urologic problems, which nursing interventions could be delegated to UAP? (select all) a. assess the need for catheterization b. use bladder scanner to estimate residual urine c. teach the patient pelvic floor muscle (Kegel) exercises d. insert indwelling catheter for uncomplicated patient e. assist incontinent patient to commode at regular intervals f. provide perineal care with soap and water around a urinary catheter
e. assist incontinent patient to commode at regular intervals f. provide perineal care with soap and water around a urinary catheter
