NCLEX Renal, Urinary, and Reproductive Systems

A client with an indwelling catheter is prescribed a urinalysis test. Arrange the steps involved in the collection of the urine sample in correct order. 1. Aspirate the urine 2. Remove the clamp 3. Attach a sterile syringe 4. Clamp drainage tubing

4. Clamp drainage tubing 3. Attach a sterile syringe 1. Aspirate the urine 2. Remove the clamp

A 76 year old female is admitted due to a recent fall. The patient is confused and agitated. The family members report that this is not normal behavior for the patient. They explain that the patient is very active in the community and cares for herself. Based on the information you have gathered about the patient, which physician's order takes priority? A. "Collect a urinalysis" B. "Collect a T3 and T4 level" C. "Insert a Foley Catheter" D. "Keep patient NPO"

A. "Collect a urinalysis"

On your nursing care plan for a patient with a urinary tract infection, which of the following would be appropriate nursing interventions? SELECT-ALL-THAT-APPLY: A. Encourage voiding every 2-3 hours while awake. B. Restrict fluid intake to 1-2 liters per day. C. Monitor intake and output daily. D. The patient verbalizes the importance of using vaginal sprays to decrease reoccurrence of urinary tract infections prior to discharge home.

A. Encourage voiding every 2-3 hours while awake. C. Monitor intake and output daily.

You're caring for a patient with an indwelling catheter. The patient complains of spasm like pain at the catheter insertion site. Which of the following options below are other signs and symptoms the patient could experience or the nurse could observe if a urinary tract infection was present? SELECT-ALL-THAT-APPLY: A. Increased WBC B. Crystalluria C. Positive McBurney's Sign D. Feeling the need to void even though a catheter is present E. Dark and cloudy urine F. Cramping

A. Increased WBC D. Feeling the need to void even though a catheter is present E. Dark and cloudy urine F. Cramping

The nurse is caring for a client with ureteral colic. To prevent the development of renal calculi in the future, which strategy should be included in the client's plan of care? A. Instructing the client to drink at least 3L of fluid daily B. Interventions to decrease the serum creatinine level C. A urinary output goal of 2000 mL per 24 hours D. Excluding milk products from the diet

A. Instructing the client to drink at least 3L of fluid daily

Which hormone is crucial for ovulation and complete maturation of a client's ovarian follicles? A. Luteinizing hormone B. Follicle stimulating hormone C. Gonadotropin releasing hormone D. Human chorionic gonadotropin hormone

A. Luteinizing hormone

Which hormone elevations indicate Turner syndrome? Select all that apply. A. Lutropin B. Prolactin C. Follitropin D. Testosterone E. Progesterone

A. Lutropin C. Follitropin

Which structures are included in the external genitalia in males? Select all that apply. A. Penis B. Testes C. Scrotum D. Urethra E. Seminal vesicles

A. Penis C. Scrotum

The urinalysis report of a client reveals cloudy urine. What does a nurse infer from the client's report? A. The client has a urinary infection. B. The client has a biliary obstruction. C. The client has diabetic ketoacidosis. D. The client has been on a starvation diet.

A. The client has a urinary infection.

What instruction regarding sample collection should the nurse give a client who is ordered a clean-catch urine specimen? A. Urinate small amount, stop flow, fill half of cup B. Collect the last urine sample voided in the night C. Keep the urine sample in dry warm area if delay is anticipated D. Send the urine sample to the laboratory within 6 hours of collection

A. Urinate small amount, stop flow, fill half of cup

A couple approaches the primary healthcare provider to seek guidance on permanent contraception. Which surgeries are suggested to the couple? Select all that apply. A. Vasectomy B. Cryosurgery C. Mastectomy D. Varicocelectomy E. Tubal ligation

A. Vasectomy E. Tubal ligation

A client begins therapy with a new medication. One month later the client notices blood in the urine. Which drug does the nurse anticipate as the cause? A. Warfarin B. Nifedipine C. Nitrofurantoin D. Phenazopyridine

A. Warfarin

During a head-to-toe assessment on a patient with a possible urinary tract infection, you perform costovertebral angle percussion. The costovertebral angle is found? A. between the bottom of the 12th rib and spine B. between the right upper quadrant and umbilicus C. between the sternal notch and angle of Louis D. between the ischial spine and umbilicus

A. between the bottom of the 12th rib and spine

A nurse is assessing the urine of a client with a urinary tract infection. Which assessment finding is consistent with a urinary tract infection? A. Smoky B. Cloudy C. Orange-amber D. Yellow-brown

B. Cloudy

A patient with a urinary tract infection is taking Bactrim (Sulfamethoxazole/Trimethoprim). As the nurse you know it is important that the patient consumes 2.5 to 3 L of fluid per day to prevent which of the following complications? A. Brown urine B. Crystalluria C. Renal Stenosis D. Renal Calculi

B. Crystalluria

A pathology report states that a client's urinary calculus is composed of uric acid. Which food item should the nurse instruct the client to avoid? A. Milk B. Liver C. Cheese D. Vegetables

B. Liver

Which parts of the nephron are the sites of action for furosemide? Select all that apply. A. Glomerulus B. Loop of Henle C. Distal tubule D. Proximal tubule E. Bowman capsule

B. Loop of Henle C. Distal tubule D. Proximal tubule

A nurse is caring for a client with a diagnosis of renal calculi secondary to hyperparathyroidism. Which type of diet should the nurse explore with the client when providing discharge information? A. Low purine B. Low calcium C. High phosphorus D. High alkaline ash

B. Low calcium

Which part of the female reproductive system produces testosterone in females? A. Uterus B. Ovary C. Fallopian tube D. Ovarian follicle

B. Ovary

Which structure is removed during circumcision of an infant? A. Glans B. Prepuce C. Epididymis D. Vas deferens

B. Prepuce

The primary healthcare provider suspects pituitary gland dysfunction in a female client. Which diagnostic test would the primary healthcare provider suggest to the client? A. Estradiol test B. Prolactin test C. Sims-Huhner test D. Papanicolaou (Pap) test

B. Prolactin test

The nurse is assessing an elderly male. Which finding is seen with aging? A. Symmetrical testes B. Reduced size of testes C. Presence of pubic hair D. Presence of foreskin on the penis

B. Reduced size of testes

A 36 year old female, who is 29 weeks pregnant, reports she is experiencing burning when voiding. The physician orders a urinalysis. Which statement by the patient demonstrates she understands how to collect the specimen? A. "I'll hold the cup firmly against the urethra while collecting the sample." B. "I will cleanse back to front with the antiseptic wipe before peeing in the cup." C. "First, I will pee a small amount of urine in the toilet and then collect the rest in the cup." D. "I will be sure to drink a lot of fluids to keep the urine diluted before peeing into the cup."

C. "First, I will pee a small amount of urine in the toilet and then collect the rest in the cup."

A client with chronic renal failure has been on hemodialysis for 2 years. The client communicates with the nurse in the dialysis unit in an angry, critical manner and is frequently noncompliant with medications and diet. The nurse can best intervene by first considering that the client's behavior is most likely for which reason? A. An attempt to punish the nursing staff B. A constructive method of accepting reality C. A defense against underlying depression and fear D. An effort to maintain life and to live it as fully as possible

C. A defense against underlying depression and fear

Which hormone influences kidney function? A. Renin B. Bradykinin C. Aldosterone D. Erythropoietin

C. Aldosterone

A nurse evaluates that a client with chronic kidney disease understands an adequate source of high biologic-value (HBV) protein when the client selects which food from the menu? A. Apple juice B. Raw carrots C. Cottage cheese D. Whole wheat bread

C. Cottage cheese

The physician orders a urine culture on your patient in room 5505 with a urinary tract infection. In addition, the patient is ordered to start IV Bactrim (Sulfamethoxazole/Trimethoprim). How will you proceed with following this order? A. First, hang the antibiotic, and then collect the urine culture. B. First, hang the antibiotic and when the antibiotic is finished infusing collect the urine culture. C. First, collect the urine culture, and then hang the antibiotic. D. First, collect the urine culture and then hold the dose of the antibiotic until the urine culture is back from the lab.

C. First, collect the urine culture, and then hang the antibiotic.

A client who had a transurethral resection of the prostate is transferred to the postanesthesia care unit with an intravenous (IV) line and a urinary retention catheter. For which major complication is it most important for the nurse to assess during the immediate postoperative period? A. Sepsis B. Phlebitis C. Hemorrhage D. Leakage around the IV catheter

C. Hemorrhage

Which test helps to identify fibroids, tumors, and fistulas while performing a reproductive tract examination? A. Mammography B. Ultrasonography C. Hysterosalpingography D. Computed tomography

C. Hysterosalpingography

Which hormone is released in response to low serum levels of calcium? A. Renin B. Erythropoietin C. Parathyroid hormone D. Atrial natriuretic peptide

C. Parathyroid hormone

The nurse is caring for a client in the postanesthesia care unit. The client had a suprapubic prostatectomy for cancer of the prostate and has a continuous bladder irrigation (CBI) in place. Which primary goal is the nurse trying to achieve with the CBI? A. Stimulate continuous formation of urine. B. Facilitate the measurement of urinary output. C. Prevent the development of clots in the bladder. D. Provide continuous pressure on the prostatic fossa.

C. Prevent the development of clots in the bladder.

Which diagnostic tests are used to measure the kidney size of a client with kidney dysfunction? Select all that apply. A. Cystoscopy B. Cystography C. Radiography D. Cystourethrography E. Computed tomography (CT)

C. Radiography E. Computed tomography (CT)

Which intervention would be most beneficial in preventing a catheter-associated urinary tract infection in a postoperative client? A. Pouring warm water over the perineum B. Ensuring the patency of the catheter C. Removing the catheter within 24 hours D. Cleaning the catheter insertion site

C. Removing the catheter within 24 hours

Which statement is true regarding the functions of kidney hormones? A. Prostaglandin increases blood flow and vascular permeability. B. Bradykinin regulates intrarenal blood flow via vasodilation or vasoconstriction. C. Renin raises blood pressure because of angiotensin and aldosterone secretion. D. Erythropoietin promotes the absorption of calcium in the gastrointestinal tract (GI) tract.

C. Renin raises blood pressure because of angiotensin and aldosterone secretion.

A nurse is notified that the latest potassium level for a client in acute kidney injury is 6.2 mEq (6.2 mmol/L). Which action should the nurse take first? A. Alert the cardiac arrest team. B. Call the laboratory to repeat the test. C. Take vital signs and notify the primary healthcare provider. D. Obtain an electrocardiogram (ECG) strip and obtain an antiarrhythmic medication.

C. Take vital signs and notify the primary healthcare provider.

A nurse is providing client teaching to a woman who has recurrent urinary tract infections. Which information should the nurse include concerning the reason why women are more susceptible to urinary tract infections than men? A. Inadequate fluid intake B. Poor hygienic practices C. The length of the urethra D. The continuity of mucous membranes

C. The length of the urethra

A client who is recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary healthcare provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests should the nurse expect the primary healthcare provider to prescribe to confirm this diagnosis? A. Cystoscopy and bilirubin level B. Specific gravity and pH of the urine C. Urinalysis and urine culture and sensitivity D. Creatinine clearance and albumin/globulin (A/G) ratio

C. Urinalysis and urine culture and sensitivity

A student nurse is caring for a client with chronic kidney failure who is to be treated with continuous ambulatory peritoneal dialysis (CAPD). Which statement by the student nurse indicates to the primary nurse that the student nurse understands the purpose of this therapy? A. "It provides continuous contact of dialyzer and blood to clear toxins by ultrafiltration." B. "It exchanges and cleanses blood by correction of electrolytes and excretion of creatinine." C. "It decreases the need for immobility, because it clears toxins in short and intermittent periods." D. "It uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion."

D. "It uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion."

You're providing discharge teaching to a female patient on how to prevent urinary tract infections. Which statement is INCORRECT? A. "Void immediately after sexual intercourse." B. "Avoid wearing tight fitting underwear." C. "Try to void every 2-3 hours." D. "Use scented sanitary napkins or tampons during menstruation."

D. "Use scented sanitary napkins or tampons during menstruation."

Which client's urine specific gravity level is abnormal? A. 1.006 B. 1.012 C. 1.028 D. 1.041

D. 1.041 (normal is 1.005-1.030)

You're assessing your patients during morning rounding. Which patient below is at MOST risk for developing a urinary tract infection? A. A 25 year old patient who finished a regime of antibiotics for strep throat 10 weeks ago. B. A 55 year old female who is post-opt day 7 from hip surgery. C. A 68 year old male who is experiencing nausea and vomiting. D. A 87 year old female with Alzheimer's disease who is experiencing bowel incontinence.

D. A 87 year old female with Alzheimer's disease who is experiencing bowel incontinence.

A nurse writes a goal of preventing renal calculi in a care plan for a client with paraplegia. Which information most likely caused the nurse to write this goal? A. High fluid intake B. Increased intake of calcium C. Inadequate kidney function D. Accelerated bone demineralization

D. Accelerated bone demineralization

A client is admitted to the hospital with severe flank pain, nausea, and hematuria caused by a ureteral calculus. What should be the nurse's initial intervention? A. Strain all urine output. B. Increase oral fluid intake. C. Obtain a urine specimen for culture. D. Administer the prescribed analgesic.

D. Administer the prescribed analgesic.

The nurse is teaching a client receiving peritoneal dialysis about the reason dialysis solution is warmed before it is instilled into the peritoneal cavity. Which information will the nurse share with the client? A. Because it forces potassium back into the cells, thereby decreasing serum levels B. Because it adds extra warmth to the body because metabolic processes are disturbed C. Because it helps prevent cardiac dysrhythmias by speeding up removal of excess potassium D. Because it encourages removal of serum urea by preventing constriction of peritoneal blood vessels

D. Because it encourages removal of serum urea by preventing constriction of peritoneal blood vessels

The nurse observes a client with kidney failure has increased rate and depth of breathing. Which laboratory parameter does the nurse suspect is associated with this client's condition? A. Potassium 8 mEq/L B. Hemoglobin 10 g/dL C. Phosphorous 7 mg/dL D. Bicarbonate 15 mEq/L

D. Bicarbonate 15 mEq/L

Which urodynamic study provides information on bladder capacity, bladder pressure, and voiding reflexes? A. Radiography B. Renal arteriography C. Electromyography (EMG) D. Cystometrography (CMG)

D. Cystometrography (CMG)

A client who has been told she needs a hysterectomy for cervical cancer is upset about being unable to have a third child. Which action should the nurse take next? A.Evaluate her willingness to pursue adoption. B. Encourage her to focus on her own recovery. C. Emphasize that she does have two children already. D. Ensure that other treatment options for her will be explored.

D. Ensure that other treatment options for her will be explored.

The nurse is educating a couple concerning the process of fertilization. The nurse explains to the couple that which component stimulates the release of estrogen and progesterone after fertilization? A. Inhibin B. Testosterone C. Follicle-stimulating hormone (FSH) D. Human chorionic gonadotropin (hCG)

D. Human chorionic gonadotropin (hCG)

Which part of the kidney produces the hormone bradykinin? A. Kidney tissues B. Kidney parenchyma C. Renin-producing granular cells D. Juxtaglomerular cells of the arterioles

D. Juxtaglomerular cells of the arterioles

A client is diagnosed with condyloma acuminatum. Which finding in the client supports the diagnosis? A. Macules on the penis B. Pus-filled ulcers on the penis C. Swollen penis with tight foreskin D. Moist, fleshy projections on the penis

D. Moist, fleshy projections on the penis

A client in a nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating antibiotic therapy prescribed by the primary healthcare provider? A. Start a 24-hour urine collection. B. Prepare for urinary catheterization. C. Teach the client how to perform perineal care. D. Obtain a urine specimen for culture and sensitivity.

D. Obtain a urine specimen for culture and sensitivity.

A patient, who is having spasms and burning while urinating due to a UTI, is prescribed "Pyridium" (Phenazopyridine). Which option below is a normal side effect of this drug? A. Hematuria B. Crystalluria C. Urethra mucous D. Orange colored urine

D. Orange colored urine

Which drug prescribed to a client with a urinary tract infection (UTI) turns urine reddish-orange in color? A. Amoxicillin B. Ciprofloxacin C. Nitrofurantoin D. Phenazopyridine

D. Phenazopyridine

The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis results. Which urinary finding should the nurse conclude needs to be reported to the primary healthcare provider? A. Acidic pH B. Glucose negative C. Bacteria negative D. Presence of large proteins

D. Presence of large proteins

A nurse is caring for a client with a diagnosis of cancer of the prostate. The nurse should teach the client that which serum level will be monitored throughout the course of the disease? A. Albumin B. Creatinine C. Blood urea nitrogen (BUN) D. Prostate-specific antigen (PSA)

D. Prostate-specific antigen (PSA)

A nurse is counseling a woman who had recurrent urinary tract infections. Which factor should the nurse explain is the reason why women are at a greater risk than men for contracting a urinary tract infection? A. Altered urinary pH B. Hormonal secretions C. Juxtaposition of the bladder D. Proximity of the urethra to the anus

D. Proximity of the urethra to the anus

A male client has discharge from the penis. Gonorrhea is suspected. To obtain a specimen for a culture, what should the nurse do? A. Instruct the client to provide a semen specimen. B. Swab the discharge when it appears on the prepuce. C. Instruct the client how to obtain a clean catch specimen of urine. D. Swab the drainage directly from the urethra to obtain a specimen.

D. Swab the drainage directly from the urethra to obtain a specimen.