Test 1 Urinal Remediation: by Phaoron

A 25-year-old woman comes to the emergency department with nonspecific urethritis. Which information is most important for the nurse to obtain? "How many servings of green vegetables do you eat each day? "How often, if any, do you consume alcohol?" "How often do you use bath salts or take bubble baths?" "Do you take a daily multivitamin?"

"How often do you use bath salts or take bubble baths?"

In order to communicate with the patient more effectively, the nurse clarifies the meanings of some urological terms. Match these terms with their correct definitions. Anuria Nocturia

Anuria- little to no urine output, less that 50ml in a 24 hr peroid. Nocturia - Urinating at night.

Which statement(s) accurately describe the functions of the kidneys? (select all that apply.) A.)Regulation of electrolytes B.)Regulation of fluid volume C.)Regulation of blood pressure D.) Secretion of erythropoietin E.) Transportation of urine

B.)Regulation of fluid volume A.)Regulation of electrolytes. C.)Regulation of blood pressure. D.) Secretion of erythropoietin

The nurse is caring for a client with oliguria. When instructing the client on the process of urine formation, place the following in correct sequence. Use all options. Write the letter followed by a space such as A B C D. A) Drains into the bladder then out the urethra B) Moves through the nephrons and is absorbed or excreted C) Filtration of plasma by glomerulus D) Products enter the Bowman's capsule E) Flows into the renal pelvis and down the ureter F) Drains from the collecting tubules

C D B F E A

A patient has been admitted to the medical unit with a diagnosis of ureteral colic secondary to urolithiasis. When planning the patient's admission assessment, the nurse should be aware of the signs and symptoms that are characteristic of this diagnosis? Select all that apply. A) Diarrhea B) High fever C) Hematuria D) Urinary frequency E) Acute pain

C) Hematuria D) Urinary frequency E) Acute pain

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? a.) Acute. b.) glomerulonephritis c.) Ureteral stricture d.) Urinary calculi e.) Renal cell carcinoma

C.) Urinary calculi

A gerontologic nurse is assessing a patient who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply. a.)Food cravings b.) Upper abdominal pain c.) Insatiable thirst d.) Uncharacteristic fatigue e.) New onset of confusion

D) Uncharacteristic fatigue

The nurse is assisting a client who is new to a low-potassium diet to select food items from the menu. Which food item is lowest in potassium and should be recommended to the client on this dietary restriction? a.) Apple b.) Spinach c.) Potatoes d.) Banana e.) Cantaloupe

a.) Apple

The nurse is caring for a patient postoperative day 4 following a kidney transplant. When assessing for potential signs and symptoms of rejection, what assessment should the nurse prioritize? a.) Assessment of the quantity of the patient's urine output b.) Assessment of the patient's incision c.) Assessment of the patient's abdominal girth d.) Assessment for flank or abdominal pain

a.) Assessment of the quantity of the patient's urine output

When the patient asks why he has so many urinary tract infections (UTIs), the nurse informs the patient that his recurrent UTIs most likely result from which causative factor? a.) Bacteria that colonize in the kidney. b.) Viral infections generating debris in the bladder. c.) Carelessness in handwashing. d.)Spicy foods irritating the bladder wall

a.) Bacteria that colonize in the kidney.

When preparing a client for hemodialysis, which of the following would be most important for the nurse to do? a.) Check for thrill or bruit over the access site. b.) When preparing a client for hemodialysis, the nurse would need to check for a thrill or bruit over the vascular access site to ensure patency. c.) Inspect the catheter insertion site for infection. d.) Add the prescribed drug to the dialysate. e.) Warm the solution to body temperature. Hemodialysis

a.) Check for thrill or bruit over the access site.

In order to communicate with the patient more effectively, the nurse clarifies the meanings of some urological terms. Match these terms with their correct definitions. Polyuria Hematuria

Polyura - excessive or an abnormally large production or passage of urine (greater than 2.5 L[1] or 3 L Hematuria- Blood in the urine.

A patient comes to the medical clinic with complaints of urgency, frequency, pain in the area of the symphysis pubis, and dark cloudy urine. What should the nurse suspect that this patient has? a.) Urinary calculi, probably located in the ureter b.) Kidney infection, most likely pyelonephritis c.) Cystitis, probably from bacterial contamination. d.) Acute glomerulonephritis

c.) Cystitis, probably from bacterial contamination.

A nurse is caring for a patient who is in the diuresis phase of AKI. The nurse should closely monitor the patient for what complication during this phase? a.) Hypokalemia b.) Hypocalcemia c.) Dehydration d.) Acute flank pain

c.) Dehydration

A client with end stage kidney disease (ESKD) begins peritoneal dialysis. The nurse observes for which signs/symptoms indicating peritonitis? Select all that apply. a.) Cloudy, straw-colored peritoneal effluent b.) Clear fluid leakage at the catheter exit site c.) Poor dialysate outflow d.) Nausea and vomiting e.) Abdominal tenderness f.) Oral temperature of 38.4 degrees Celsius

Nausea and vomiting Abdominal tenderness Cloudy peritoneal effluent Oral temperature of 38 C

A patient who has cystitis has been told to drink at least 30 mL for each kilogram of body weight. Her weight is 154 lb. How many mL/day should the nurse instruct the patient to drink? 2100

154 lb ÷ 2.2 lb/kg = 70 kg; 70 kg ´ 30 mL = 2100 mL.

The nurse is assessing a patient admitted with renal stones. During the admission assessment, what parameters would be priorities for the nurse to address? Select all that apply. A.) Dietary history B.)Family history of renal stones C.) Medication history D.)Surgical history E.)Vaccination history

A) Dietary history B) Family history of renal stones C) Medication history

A patient with ESKD receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate action? a.) Inform the physician and assess the patient for signs of infection. (Peritonitis is the most common and serious complication of peritoneal dialysis. The first sign of peritonitis is cloudy dialysate drainage fluid, so prompt reporting to the primary care provider and rapid assessment for other signs of infection are warranted. Administration of an IV bolus is not necessary or appropriate and the physician would determine whether removal of the catheter is required. Flushing the catheter does not address the risk for infection.) b.) Flush the peritoneal catheter with normal saline. c.) Remove the catheter promptly and have the catheter tip cultured. d.) Administer a bolus of IV normal saline as ordered.

Inform the physician and assess the patient for signs of infection.

The nurse is caring for clients at a long-term care facility. When considering activities in the summer heat, which physiologic change of renal aging can also result in geriatric dehydration? a.) Decreased ability to concentrate urine. b.) Decreased renal blood flow c.) Thickening of the renal tubules d.) Double voiding e.) Lifespan considerations

a.) Decreased ability to concentrate urine.

A patient with ESKD is scheduled to begin hemodialysis. The nurse is working with the patient to adapt the patient's diet to maximize the therapeutic effect and minimize the risks of complications. The patient's diet should include which of the following modifications? Select all that apply. a.) Decreased protein intake b.) Decreased sodium intake c.) Increased potassium intake d.) Fluid restriction e.) Vitamin D supplementation

a.) Decreased protein intake b.) Decreased sodium intake d.) Fluid restriction

The nurse is caring for a patient who has just returned to the post-surgical unit following renal surgery. When assessing the patient's output from surgical drains, the nurse should assess what parameters? Select all that apply. a.) quantity of output b.) Color of the output c.) Visible characteristics of the output d.) Odor of the output e.) pH of the output

a.) Quantity of output b.) Color of the output c.) Visible characteristics of the output

A patient on the critical care unit is postoperative day 1 following kidney transplantation from a living donor. The nurse's most recent assessments indicate that the patient is producing copious quantities of dilute urine. What is the nurse's most appropriate response? a.) Recognize this as an expected finding. b.) Assess the patient for further signs or symptoms of rejection. c.) Inform the primary care provider of this finding. d.) Administer exogenous antidiuretic hormone as ordered.

a.) Recognize this as an expected finding.

A nurse assesses a Grey Turner sign in a patient who was admitted 2 days earlier after an automobile accident. What does this finding indicate? a.) Retroperitoneal bleeding and bruising over the flank. b.) Hematuria with abdominal bruising. c.) Distended bladder with painful urination. d.) Bladder spasms on palpation of abdomen

a.) Retroperitoneal bleeding and bruising over the flank.

The nurse who is leading a wellness workshop has been asked about actions to reduce the risk of bladder cancer. What health promotion action most directly addresses a major risk factor for bladder cancer? a.) Smoking cessation b.) Reduction of alcohol intake c.) Maintenance of a diet high in vitamins and nutrients d.) Vitamin D supplementation

a.) Smoking cessation

The nurse is attempting to irrigate an indwelling catheter. Which action best indicates that the nurse accurately understands the correct procedure? a.) The nurse irrigates using a steady, gentle stream. b.) When irrigating, use the correct amount of sterile solution (according to agency policy, or the amount of solution that may be determined by physician's order for nephrostomy tubes, ureteral tubes, or catheters). When irrigating, use a steady, gentle stream to irrigate. c.) The nurse forces solution into the catheter to remove the obstruction. d.) The nurse pulls back on the plunger if fluid will not enter the catheter. E.) The nurse counts the amount of irrigation fluid as output.

a.) The nurse irrigates using a steady, gentle stream.

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? a.) edema b.) hypotension c.) weight loss d.) dysuria e.) Renal transplant

a.) edema

A nurse is caring for a patient with a Foley catheter. What actions should the nurse implement to decrease this patient's risk for infection? (Select all that apply.) a.)Keep the bag below the level of the bed. b.)Provide perineal care twice a day. c.)Flushing the tubing as needed. d.)Using standard precautions when handling urine and tubing. e.)Keep the drainage system open.

a.)Keep the bag below the level of the bed. d.)Using standard precautions when handling urine and tubing.

Which age-related change(s) occur(s) in the urinary system? (select all that apply.) a.)Prostate hypertrophy b.) Decreased renin secretion c.) Decreased bladder muscle tone d.) Enlarged bladder. e.) Increased ability to concentrate urine

a.)Prostate hypertrophy b.) Decreased renin secretion c.) Decreased bladder muscle tone

A family member of a patient who has returned to the special unit after renal transplantation is alarmed by blood in the urine of the patient. What is the nurse's best explanation when explaining the reason for hematuria in this patient? a.) "It is related to the immunosuppressant drugs taken before transplantation." b.) "It is a normal postoperative expectation." c.) "It is caused by dye injected during surgery." d.) "It is caused by a small vessel that may be bleeding but will coagulate as urine flow increases."

b.) "It is a normal postoperative expectation."

The nurse is instructing a senior high health class on the function of the kidney. The nurse is correct to highlight which information? Select all that apply. A.)Regulates estrogen and progesterone B.) Excretes waste products c.) Controls blood pressure D.)Regulate calcium and the synthesis of vitamin D E.) Activates growth hormone F.) Regulates red blood cell production

b.) Excretes waste products. c.) Controls blood pressure. d.) Regulate calcium and the synthesis of vitamin D. e.) Activates growth hormone. f.) Regulates red blood cell production.

A patient has a kidney stone lodged in the ureter. He questions why it must be removed. What response is most appropriate? a.) If the stone is not promptly removed, you will continue to have blood in your urine." b.) If the stone is not removed, it could block urine flow from the kidney and cause swelling within the kidney. c.) Keeping the stone in your body may result in a condition called glomerulonephritis." d.) You may experience scarring of the renal structures and a condition known as nephrotic syndrome may result."

b.) If the stone is not removed, it could block urine flow from the kidney and cause swelling within the kidney.

A patient has been successfully treated for kidney stones and is preparing for discharge. The nurse recognizes the risk of recurrence and has planned the patient's discharge education accordingly. What preventative measure should the nurse encourage the patient to adopt? a.) Increasing intake of protein from plant sources b.) Increasing fluid intake c.) Adopting a high-calcium diet e.) Eating several small meals each day

b.) Increasing fluid intake

The nurse is caring for a hemodialysis client who has been receiving treatment for several years and is not a candidate for kidney transplant. The nurse knows that the majority of deaths of hemodialysis clients are related to which causes? Select all that apply. a.) Malignancies b.) Infectious complications c.) Myocardial infarction d.) Trauma e.) Curling's ulcer f.) Cerebrovascular accident g.) Hemodialysis

b.) Infectious complications c.) Myocardial infarction. f.) Cerebrovascular accident

A patient has just returned to the nursing unit after having a renal biopsy. Which intervention is most important to include in the patient's nursing care plan? a.) Keep the patient NPO for the first 4 hours after the procedure. b.) Instruct the patient to avoid laughing and use a pillow to splint when sneezing. c.) Report hematuria immediately. d.) Teach the patient about the importance of limiting fluid intake.

b.) Instruct the patient to avoid laughing and use a pillow to splint when sneezing.

A 25-year-old man comes to the college clinic with fever of 101° F, nausea, and flank pain that radiates into the thigh and genitals. The nurse anticipates that the patient will undergo workup for which infection? a.) Urethritis b.) Pyelonephritis c.) Acute pyelonephritis is an infection of the kidneys. It is thought to occur when bacteria (such as Escherichia coli) from a bladder infection travel up the ureters to infect the kidneys. A frequent cause of pyelonephritis is an obstruction, causing stasis of urine and stones that cause irritation of the tissue. Both situations provide an environment in which bacteria can grow. When bacteria enter the renal pelvis, inflammation and infection occur. Pyelonephritis causes nausea and vomiting, flank pain, temperature elevation with chills, headache, and malaise. d.) Glomerulonephritis e.) Cystitis

b.) Pyelonephritis

A patient with a sacral pressure ulcer has had a urinary catheter inserted. As a result of this new intervention, the nurse should prioritize what nursing diagnosis in the patient's plan of care? a.) Impaired physical mobility related to presence of an indwelling urinary catheter. b.) Risk for infection related to presence of an indwelling urinary catheter. c.) Toileting self-care deficit related to urinary catheterization d.) Disturbed body image related to urinary catheterization

b.) Risk for infection related to presence of an indwelling urinary catheter.

A client tells the nurse she completed an educational program to manage her stress incontinence but is now discouraged. Which information from the client indicates the need for further teaching? Select all that apply. a.) She maintains her fluid intake to 3000 mL of fluid daily. b.) She quit drinking coffee with cream but drinks diet cola. c.) She has decreased her caloric and fat intake to lose weight. d.) She performs the Kegel exercises every other day. e.) She has begun an exercise program that includes lifting weights.

b.) She quit drinking coffee with cream but drinks diet cola d.) She performs the Kegel exercises every other day. e.) She has begun an exercise program that includes lifting weights.

The patient confides that sneezing makes her "wet her pants." The nurse recognizes this cardinal sign of which type of incontinence? a.) Urge incontinence. b.) Stress incontinence. c.) Functional incontinence d.) Overflow incontinence

b.) Stress incontinence.

The nurse is discussing alternative therapies with a patient who has cystitis. The patient asks the nurse if there are any dietary changes that might help. What response is most appropriate? a.) "Drinking lots of water is the only dietary change that would help." b.) "Many rumors exist about dietary prevention of UTIs but none are proven at this time." c.) "Vitamin C may help decrease the frequency of cystitis." d.) "Increase the amount of leafy green vegetables in your daily diet." e.) Leafy green vegetables are not considered a preventative food for UTIs.

c.) "Vitamin C may help decrease the frequency of cystitis."

The nurse is assessing a client's arteriovenous fistula being used for hemodialysis. Which findings would prompt the nurse to notify the primary health care provider immediately? Select all that apply. a.) Dialysis treatment lasting longer than 3 hours b.) Fistula site transparent dressing last changed 8 days ago c.) Absent pulse distal to the arteriovenous fistula d.) No bruit auscultated at the fistula site e.) No thrill palpated at fistula site

c.) Absent pulse distal to the arteriovenous fistula d.) No bruit auscultated at the fistula site e.) No thrill palpated at fistula site

A patient has a nephrostomy tube that has been inserted because of an obstruction in the ureter. What special precautions in the care of the nephrostomy tube should the nurse implement? a.) Clamping every 2 hours to allow expansion of the kidney pelvis. b.) Instilling no more than 50 mL of sterile water if sterile irrigations are ordered c.) Being certain the tube is connected, not kinked, or not clamped to ensure that it continually drains d.) Leaving the nephrostomy site open to air

c.) Being certain the tube is connected, not kinked, or not clamped to ensure that it continually drains

A client is administered dialysate solution through an abdominal catheter. The nurse notices that the return flow rate is slow, so the nurse advises the client to move to the other side. However, even after changing the client's position, the nurse does not observe an increase in return flow. Which of the following actions should the nurse perform to help accelerate the return flow rate? a.) Disconnect the catheter and reapply. b.) Loosen the tubing clamp. c.) Inform the physician that catheter may need repositioning. d.) The nurse instills dialysate solution and clamps the tubing.

c.) Inform the physician that catheter may need repositioning.

The nurse is caring for a patient with deteriorating kidney function. Laboratory work indicates 900 mg of uric acid in 24 hours. In addition to administering prescribed medication, which dietary modification should the nurse address? a.) Increase intake of avocados and liver. b.) Avoid yogurt or skim milk. c.) Limit servings of beef to 3-ounce portions. d.) Limit intake of potatoes and pasta.

c.) Limit servings of beef to 3-ounce portions.

A nurse is caring for a patient with an atrioventricular (AV) fistula in the forearm and assesses that a trill is absent when palpating the venous side of the fistula. What action should the nurse implement? a.) Inject the ordered amount of heparin into the fistula. b.) Apply warm compresses and lower the arm below the heart level. c.) Report to the charge nurse that the fistula is occluded.

c.) Report to the charge nurse that the fistula is occluded.

The nurse is providing a health education workshop to a group of adults focusing on cancer prevention. The nurse should emphasize what action in order to reduce participants' risks of renal carcinoma? a.) Avoiding heavy alcohol use b.) Control of sodium intake c.) Smoking cessation

c.) Smoking cessation

The nurse is caring for a patient receiving hemodialysis three times weekly. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient? a.) Using a stethoscope for auscultating the fistula is contraindicated. b.) The patient feels best immediately after the dialysis treatment. c.) Taking a BP reading on the affected arm can damage the fistula. d.) The patient should not feel pain during initiation of dialysis.

c.) Taking a BP reading on the affected arm can damage the fistula.

A patient who has recently undergone ESWL for the treatment of renal calculi has phoned the urology unit where he was treated, telling the nurse that he has a temperature of 101.1°F (38.4°C). How should the nurse best respond to the patient? a.) Remind the patient that renal calculi have a noninfectious etiology and that a fever is unrelated to their recurrence. b.) Remind the patient that occasional febrile episodes are expected following ESWL. c.) Tell the patient to report to the ED for further assessment. d.) Following ESWL, the development of a fever is abnormal and is suggestive of a UTI; prompt medical assessment and treatment are warranted. It would be inappropriate to delay further treatment. e.) Tell the patient to monitor his temperature for the next 24 hours and then contact his urologist's office.

c.) Tell the patient to report to the ED for further assessment.

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding(s) would lead to the suspicion that the client is experiencing rejection? Select all that apply. a.)Hypotension b.) Weight gain c.) Polyuria d.) Abdominal pain e.) fever f.) increased serum creatinine levels

d.) Abdominal pain e.) fever f.) increased serum creatinine levels

A nurse is caring for a patient after urinary diversion surgery. What postoperative nursing assessment is the priority? a.) Level of fluid intake b.) Position on the left side c.) Keep the bed flat d.) Bowel sounds

d.) Bowel sounds

Which urine test provides the most accurate measurement of renal function? a.) BUN b.) Phosphates c.) Specific gravity d.) Creatinine

d.) Creatinine

The nurse is assessing a patient who is being treated for acute pyelonephritis. When finding best indicates to the nurse that the patient is in the early stages of pyelonephritis? a.) Smoky-colored urine b.) Temperature of 99.4° F c.) Weakness d.) Flank pain

d.) Flank pain

A nurse is performing frequent catheterizations for residual urine. What causes the greatest concern for the nurse? a.) Frequent genital exposure of the patient b.) Presence of the indwelling catheter c.) Causing urethral erosion d.) Introduction of pathogens into the bladder

d.) Introduction of pathogens into the bladder

Which outcome is most necessary for a patient diagnosed with renal calculi? a.) Patient states an awareness of signs and symptoms of kidney stones and knows where to find pain relief. b.) Patient will measure intake and output so that they will be approximately equal. c.) Patient will avoid infections and situations that would increase stress. d.) Patient is able to describe measures to prevent recurrence of calculi.

d.) Patient is able to describe measures to prevent recurrence of calculi.

The nurse is caring for a confused patient who requires bladder training. Which component of the bladder training program can the nurse safely delegate to the nursing assistant? a.) Teaching the patient about a voiding diary b.) Creating a schedule for voiding c.) Creating a schedule for fluids d.) Recording instances of linen changes and fluids offered

d.) Recording instances of linen changes and fluids offered

What discharge teaching is appropriate for the nurse to provide to a patient who has had a lithotripsy? a.) Check for edema of the legs and ankles. b.) Decrease fluid intake to 1000 mL/day. c.) Remain on restricted activity for a week. d.) Activity is resumed the next day. e.) Watch for stone debris in the urine in 1 to 4 weeks.

e.) Watch for stone debris in the urine in 1 to 4 weeks.