GU 36,37

28. A female patient is embarrassed because of not being able to walk to the bathroom in time before become incontinent of urine. Which type of incontinence should the nurse plan care for this patient? a. Urge b. Total c. Stress d. Functional

A

3. A patient has a glomerular filtration rate of 55%. What should this value indicate to the nurse? a. This is a normal value. b. The patient is in renal failure. c. The patient needs to be on a fluid restriction. d. The patient's other tests will be in the normal range.

D

3. The nurse is reviewing the history and physical of a patient who has an infection. What term should the nurse realize describes an infection of the kidneys? a. Cystitis b. Hepatitis c. Urethritis d. Pyelonephritis

D

29. The nurse is making a visit to the home of a patient with functional incontinence. Which observation indicates that teaching about the disorder has been effective? a. Patient wearing sweat pants b. Patient drinking a cup of coffee c. Patient sitting with the legs elevated d. Patient restricting fluid intake after 6 pm.

A

7. The nurse is reinforcing teaching provided to a patient about risk factors for the development of bladder cancer. What risk factor should the patient state that indicates understanding of this teaching? a. Smoking b. Hyperlipidemia c. Diet high in calcium d. Recurrent UTIs

A

7. The nurse needs to obtain a urine specimen from a female patient. What action should the nurse take when obtaining this specimen? a. Obtain the first voided urine of the day. b. Direct the patient to wash her perineum before collecting the urine specimen. c. Have the patient urinate into a bedpan, then pour the urine into the specimen container. d. Have the patient void, throw that urine away, and then collect another specimen at least 1 hour later.

A

8. The nurse is caring for a patient who has renal calculi. Which action is essential for the nurse to take? a. Strain all urine. b. Limit fluids at night. c. Record blood pressure. d. Obtain a sterile urine specimen.

A

9. The nurse is caring for a patient who has a nephrostomy tube. What action should the nurse take to maintain the integrity of this device? a. Ensure tube is not kinked or clamped. b. Limit fluids to 1000 mL per 24 hours. c. Keep collection bag taped to abdomen. d. Remove and clean the tube once daily.

A

9. The nurse is reviewing a patient's history and physical report. What term should the nurse recognize is being used to describe waste products building up in the blood? a. Uremia b. Septicemia c. Nitrosemia d. Proteinemia

A

24. The nurse determines that a patient's urine output is normal. How many mL of urine did the patient void within the last 24 hours? a. 150 to 400 mL b. 250 to 500 mL c. 750 to 1000 mL d. 1000 to 2000 mL

D

10. A patient hourly urine output is recorded. Which output rates should be brought to the attention of the registered nurse (RN) immediately? a. 15 mL/hr b. 40 mL/hr c. 60 mL/hr d. 80 mL/hr

A

13. A patient with chronic kidney disease is very weak due to low hemoglobin. What should the nurse understand as the best explanation for the anemia? a. Secretion of erythropoietin by the diseased kidney is reduced. b. There is loss of red blood cells in the urine with kidney disease. c. Chronic hypertension associated with chronic kidney disease suppresses the bone marrow. d. Metabolic acidosis associated with chronic kidney disease increases red blood cell fragility.

A

16. The nurse is collecting data from a patient who has returned from a dialysis session. After dialysis, the nurse should anticipate which patient finding? a. Weight loss b. Hypertension c. Increased energy d. Distended neck veins

A

18. A patient with pneumonia has a blood urea nitrogen (BUN) of 32 mg/dL and creatinine of 0.8 mg/dL. What should the nurse realize is the most probable explanation for this finding? a. The patient is dehydrated. b. The patient has septicemia. c. The patient is malnourished. d. The patient has kidney damage.

A

18. The nurse is reinforcing teaching about the most serious side effect of peritoneal dialysis with a patient scheduled for the first treatment. Which side effect should the patient state that indicates correct understanding? a. "Peritonitis." b. "Paralytic ileus." c. "Respiratory distress." d. "Cramps in the abdomen."

A

22. A patient recovering from radiological studies of the renal system has a nursing diagnosis of Impaired Urinary Elimination. Which outcome indicates that the nursing interventions have been effective? a. Patient voids 35 mL/hour of clear urine. b. Patient voids 30 mL/hour of cloudy urine. c. Patient voids 10 mL/hour of reddish urine. d. Patient voids an average of 15 mL/hour of dark-colored urine.

A

25. The nurse is catheterizing a patient after voiding to determine the amount of residual urine in the bladder. What should the nurse consider as being the normal amount of urine within the bladder after urination? a. 50 mL b. 75 mL c. 100 mL d. 150 mL

A

26. The nurse learns that a patient has a urine pH of 7.9. What question should the nurse ask the patient after learning of this laboratory value? a. "Are you a vegetarian?" b. "Are you lactose intolerant?" c. "How much protein do you eat each day?" d. "How much acetaminophen do you take each day?"

A

24. The nurse is caring for an unstable patient with acute kidney injury. What therapy should the nurse expect to be ordered? a. Hemodialysis b. Urinary catheter c. Peritoneal dialysis d. Continuous renal replacement therapy (CRRT)

D

8. A patient's urinalysis results are: white blood cells (WBC) 100+/hpf; red blood cells (RBC) 4/hpf; bacteria, moderate amount; nitrite, positive; specific gravity, 1.025; urine, cloudy. What should the nurse recognize these findings indicate? a. Dehydration b. Urinary tract infection c. Contamination from menstruation d. Contamination of the specimen from bacteria on the perineum

B

11. The nurse is collecting data from a patient with kidney disease. Which adventitious lung sound should the nurse recognize as being caused by fluid overload? a. Stridor b. Crackles c. Wheezes d. Pleural friction rub

B

13. The nurse is caring for a patient who is scheduled for a cystoscopy (C&P) with basket extraction of a stone. What is the most important postoperative care for the nurse to provide? a. Limiting fluid intake b. Measuring urine output c. Monitoring daily weights d. Observing for acute kidney injury

B

16. The nurse is caring for a male patient with functional incontinence. What action should the nurse take to help prevent incontinence? a. Teach the patient how to do Kegel exercises. b. Ensure that the patient has ready access to the urinal. c. Teach the patient to increase the time between voiding. d. Give the patient cranberry juice to keep the urine acidic.

B

17. A patient is being evaluated for renal dialysis. What creatinine clearance value should the nurse realize this patient must have to live without needing dialysis treatments? a. 5 mL b. 10 mL c. 20 mL d. 50 mL

B

19. A patient with glomerulonephritis asks, "How could I have gotten this?" How should the nurse respond? a. "Has anyone in your family had glomerulonephritis?" b. "Have you had a sore throat or skin infection recently?" c. "Glomerulonephritis almost always follows a bladder infection." d. "Glomerulonephritis often results from having unprotected sex."

B

19. The nurse is caring for a patient with kidney disease. How should the nurse end a 24-hour urine test at the end of the 24 hours? a. The final voiding before 24 hours is discarded. b. The patient voids at the end of 24 hours, adding it to the collection container. c. One hundred milliliters of collected urine is placed into a specimen cup and sent to the laboratory. d. The patient voids, and the first and last specimens from 24 hours are sent to the laboratory.

B

2. The nurse is caring for a patient with a kidney infection. When providing prescribed medications, the nurse should recall that which structure is the capillary network in each nephron? a. Corpuscles b. Glomerulus c. Renal tubules d. Bowman's capsule

B

20. The nurse is helping to prepare a patient for a renal biopsy. In which position should the nurse help the patient assume? a. Sims' b. Prone c. Supine d. Fowler's

B

21. The nurse is caring for a patient recovering from a renal biopsy. For which complication should the nurse monitor the patient during the 24 hours after the procedure? a. Polyuria b. Bleeding c. Infection d. Urinary obstruction

B

23. The nurse is contributing to the plan of care for a patient who is having an intravenous pyelogram (IVP) done to diagnose possible bladder cancer. Which intervention should the nurse recommend be included for the patient after the procedure? a. Document heart rhythm. b. Monitor creatinine level. c. Monitor arterial blood gases (ABGs). d. Review thyroid-stimulating hormone (TSH) and T4 levels.

B

27. During an assessment, the nurse notes that a patient has crystals deposited on the skin. What should this finding indicate to the nurse? a. Gout b. Uremic frost c. Poor hygiene d. Metabolic alkalosis

B

5. The nurse is collecting data for a patient with kidney disease. When reviewing a urinalysis report, which range should the nurse recognize as normal specific gravity of urine? a. 0.080 to 0.100 b. 1.002 to 1.035 c. 2.600 to 3.000 d. 4.612 to 5.030

B

5. The nurse is collecting data from a patient with suspected cancer of the bladder. What finding should the nurse recognize as the most common symptom of cancer of the bladder? a. Pain b. Hematuria c. Urine retention d. Burning on urination

B

25. A patient is diagnosed with end-stage kidney disease. The nurse realizes that what percentage of functioning nephrons have been lost in this patient? a. 25% b. 50% c. 75% d. 90%

D

1. A patient hospitalized for orthopedic surgery had a urinary catheter inserted. The patient later develops a urinary tract infection (UTI) and asks the nurse what caused it. What is the appropriate response by the nurse? a. "There was a change in the pH of your urine." b. "You probably did not void frequently enough." c. "Bacteria probably ascended the catheter, causing the infection." d. "There are always bacteria on your perineum that enter your urine."

C

10. The nurse is to obtain orthostatic blood pressure measurements for a patient on dialysis for end-stage renal disease. What should the nurse do when measuring this patient's blood pressure? a. Take blood pressure before and after dialysis treatments. b. Check blood pressure every minute three times for four readings. c. Obtain blood pressure while the patient is lying, sitting, and standing. d. Monitor blood pressure before and after an antihypertensive medication is given.

C

12. A patient is scheduled for an intravenous pyelogram (IVP). What care should the nurse provide before the patient has this procedure? a. IV antibiotics b. Opioid pain medication c. Enema evening before the test d. Bedrest for 16 hours before the test

C

14. The nurse contributes to the plan of care for a patient with edema. Which action should the nurse take as the best indicator of this patient's fluid volume status? a. Vital signs b. Skin turgor c. Daily weight d. Intake and output

C

14. The nurse is caring for a patient with chronic kidney disease. Which data collection technique is the best one for the nurse to use to determine this patient's fluid volume status? a. Vital signs b. Skin turgor c. Daily weight d. Intake and output

C

17. The nurse is reinforcing teaching provided to a patient with chronic kidney disease. Which patient statement indicates the need for further teaching? a. "I do not use salt substitute." b. "My fluid intake is restricted." c. "As long as I don't eat protein, I'll be okay." d. "Since I'm on dialysis, I cannot eat just anything I want."

C

2. The nurse is reinforcing 24-hour fluid intake teaching for a patient to prevent further UTIs. Which amount should the patient state that indicates that teaching has been effective? a. "1000 mL." b. "1500 mL." c. "3000 mL." d. "5000 mL."

C

20. A patient with glomerulonephritis develops acute kidney injury. Which form of kidney injury should the nurse realize has occurred with this patient? a. Prerenal b. Postrenal c. Intrarenal d. Suprabladder

C

23. The nurse is instructing a patient on the use of Kegel exercises. How many times a day should the nurse recommend that these exercises be performed? a. 10 to 20 b. 15 to 30 c. 30 to 80 d. 85 to 100

C

26. A patient has a glomerular filtration rate of 20 mL/min. For which stage of renal failure should the nurse plan care for this patient? a. Mild b. Slight c. Severe d. Moderate

C

4. The nurse is reinforcing teaching provided to a patient about antibiotics prescribed for a UTI. Which patient statement indicates teaching has been effective? a. "I will take the antibiotics until my urine is no longer cloudy." b. "I will take the antibiotics whenever I feel discomfort from urinating." c. "I will take the antibiotics until they are gone regardless of symptoms." d. "I will take the antibiotics until my temperature has been normal for 3 days."

C

6. The nurse is reviewing a urinalysis report. What should the nurse recognize as the normal average pH of urine? a. 2 b. 4.2 c. 6 d. 7.4

C

22. The nurse is reinforcing teaching provided to a patient about risk factors for prerenal injury. Which risk factor should the patient state that indicates understanding of this teaching? a. "Kidney stones." b. "Enlarged prostate." c. "Exposure to nephrotoxins agents." d. "Use of nonsteroidal anti-inflammatory drugs."

D

30. The nurse is reviewing the results of a patient's urinalysis. Which components should the nurse identify as being abnormal in urine? (Select all that apply.) a. Urea b. Water c. Protein d. Ammonia e. Hormones f. Red blood cells

C, F

1. The nurse is reviewing the anatomy of the kidney with a patient scheduled for renal surgery. What should the nurse explain as being the structural and functional unit of the kidney? a. Cortex b. Medulla c. Pyramid d. Nephron

D

11. The nurse is caring for a patient who has an acute kidney injury. Which diagnostic test result should the nurse identify as most supporting this diagnosis? a. Hematocrit 20% (normal 38% to 47%) b. Uric acid 8 ng/dL (normal 2.5 to 5.5 ng/dL) c. 24-hour creatinine clearance 5 mL/min (normal 100 mL/min) d. Blood urea nitrogen 20 mg/100 mL (normal 8 to 25 mg/100 mL)

D

12. A patient who has diabetic nephropathy asks the nurse, "Why am I using smaller doses of insulin than I used to?" What would be the best explanation by the nurse? a. "Insulin is now more potent than it used to be." b. "It would be best if you spoke with your physician about this." c. "You have probably decreased the amount of food you are eating." d. "Your kidneys are no longer breaking down the insulin as much as before."

D

15. A patient who is on hemodialysis for chronic kidney disease is prescribed sevelamer hydrochloride (Renagel) with meals. What explanation should be provided to the patient as the primary reason the medication is being given? a. To prevent metabolic acidosis b. To prevent gastrointestinal ulcer formation c. To relieve gastric irritation from excess acid production d. To prevent damage to bones from high phosphorus levels

D

15. The nurse is collecting data from a patient with stress incontinence. Which finding should the nurse document? a. The patient is unable to tell when there is the need to urinate. b. The patient is unable to hold urine when under emotional stress. c. The patient is unable to reach the bathroom and urinates in underwear. d. The patient loses small amounts of urine when he or she coughs or sneezes.

D

21. A 19-year-old patient reports flank pain and scanty urination. The nurse notices periorbital edema, and the urinalysis reveals white blood cells, red blood cells, albumin, and casts. What question would be most important for the nurse to include in data collection? a. "Is your vision blurred?" b. "Are you sexually active?" c. "Have you had any gastrointestinal problems lately?" d. "Have you had a strep infection of the throat or skin recently?"

D

4. The nurse is caring for a patient with an acid-base imbalance from kidney disease. How should the nurse explain the role of the kidneys to maintain acid-base balance in the body to the patient? a. Promoting retention of proteins b. Promoting excretion of carbon dioxide c. Conserving or excreting potassium ions d. Conserving or excreting bicarbonate ions

D

6. The nurse notes that the urine from a patient with an ileal conduit has mucus strands. What action should the nurse take? a. Notify the physician. b. Send a urine sample to the laboratory for culture. c. Ask the patient about a history of UTIs. d. Nothing, as the nurse understands that this is a normal finding.

D