urinary

A client is diagnosed with polycystic kidney disease and requires teaching on the management of the disorder. Which statement made by the client indicates a need for further teaching?

C) "As long as I have one normal kidney, I should be fine."

Chapter 59 The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?

B) Permanent drainage with a urethral catheter

A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse?

C) "Very few symptoms are associated with renal cancer."

The nurse is caring for a 37-year-old female client with potential interstitial cystitis. Which question, asked by the nurse, is helpful in suggesting the disease?

C) "When was your last menstrual period?"

The nurse is caring for clients on a medical urinary unit. Which client, scheduled for a urinary procedure, will be prescribed antibiotics following the procedure?

D) The client scheduled for a cystometrography

The nurse is caring for a client who has chronic urinary retention and discussing the options. When discussing care, which intervention is considered first?

D) Using the Credé's maneuver

A client who is suspected of urinary tract infection is asked to collect a 24-hour urine specimen for culture. Which of the following measures can the nurse suggest to the client that may help prevent the entire urine specimen from becoming contaminated?

B) Refrigerate the specimen until it is taken to the laboratory.

the summer heat, which physiologic change of renal aging can also result in geriatric dehydration?

A) Decreased ability to concentrate urine

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action, made by the nursing assistant, would require instruction?

B) The nursing assistant

The nurse is caring for a client with a urinary tract infection and a urethral stricture. Which complication of the condition is the primary cause of infection?

B) There is a backflow of urine causing a diverticulum.

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?

B) Urge

The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?

B) Urinary urgency

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

B) "It is appropriate to warm the dialysate in a microwave."

An investment banker, with chronic renal failure, informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?

B) "This type of dialysis will provide more independence."

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?

B) A low-purine diet

When assessing a client with chronic glomerulonephritis, the nurse notes that the client has generalized edema. The nurse documents this as which of the following?

B) Anasarca

Following ureteroscopy, for the removal of ureteral calculus, a stent is temporarily left in place. The client asks what purpose the stent provides. Which is the best response from the nurse?

D) "Inflammation from the stone can block the flow of urine."

The nurse is caring for several older clients. Which client would the nurse be especially alert for signs and symptoms of pyelonephritis?

D) A client with urinary obstruction

A client has undergone a renal transplant and returns to the healthcare agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection?

D) Abdominal pain

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?

D) Brief, hot daily showers

The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important?

D) Catheterize the client immediately after the client voids.

The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable?

D) Clients have chronic renal failure.

The nurse is employed in a urologist office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?

A) Anticholinergic

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

A) Application of an ostomy pouch

The client with glomerulonephritis is exhibiting gross periorbital edema. Which is the best nursing intervention to relieve this symptom?

C) Elevate the head of the bed.

The nurse is instructing a 3-year-old's mother regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as normal finding for this age-group?

B) Enuresis

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish?

B) Computed tomography with contrast

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?

B) Diminished erythropoietin production

The nurse is caring for a client with cystitis. Which adjunct therapy is the nurse most correct to suggest to keep bacteria from adhering to the wall of the bladder?

B) Drinking cranberry juice

A client asks the nurse why a creatinine clearance test is accurate. The nurse is most correct to reply which of the following?

A) "Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse? A) "Even a perfect match does not guarantee organ rejection."

A) "Even a perfect match does not guarantee organ rejection."

The nurse is caring for a 13-year-old female client diagnosed with urethritis. Which of the following assessment answers would indicate that further instruction is needed? Select all that apply.

A) "I change my sanitary napkin when it is full." C) "I take a bubble bath a couple of times per week." D) "I clean my private area with soap and water."

The client tells the nurse of the feeling of always needing to void. The nurse instructs on normal urine elimination. At which amount of urine accumulation in the bladder is the nerve reflex triggered to signal the need to void?

A) 150 mL

The nurse is providing instruction in stoma care with temporary bag following an ileal conduit surgery. Which of the following instructions is accurate? Select all that apply.

A) Ascorbic acid suppresses urine odors C) Change the pouch every 4 to 7 days if it is a two-piece pouch. E) Apply an appliance deodorant to decrease odors.

The nurse is caring for an 84-year-old client who is being admitted for diagnostic studies for a potential renal disorder. The nurse planning care has initiated a care plan of "Knowledge Deficit related to poor understanding of diagnostic studies as manifested by client statements of not understanding diagnostic procedures and elevated anxiety." Which nursing interventions does the nurse include in the plan of care? Select all that apply.

A) Assess client's level of understanding. C) Remain with client and answer questions. D) Administer an ordered sedative. E) Use simple language.

The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following?

A) Bleeding

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.

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively?

A) Client's manual dexterity and vision

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client? A) Coffee in the morning

A) Coffee in the morning

Which of the following urine characteristics would the nurse anticipate when caring for a client whose lab work reveals a high urine specific gravity related to dehydration?

A) Dark amber urine

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?

A) Decrease in the blood flow through the kidneys

A client with chronic glomerulonephritis has generalized edema. Which response by the nurse best describes why anasarca occurs with this disorder?

A) Fluid shifting occurs due to loss of serum protein.

A client is diagnosed with polycystic kidney disease. Which of the following would the nurse most likely assess?

A) Hypertension

The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with temporary pouch. In gathering information for the client, which urinary diversion would the nurse select?

A) Ileal conduit

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?

A) Kidney stones

The client is admitted to the nursing unit for a biopsy of the urinary tract tissue. When planning nursing care for the postoperative period, which nursing intervention documents the prescribed activity level?

A) Maintain the client on bedrest

The office nurse is providing information to a client who has experienced recurrent renal calculi. Which of the following jobs would place a client at greatest risk for calculi formation?

A) Over-the-road truck driver

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.

A) Products enter the Bowman's capsule B) Drains from the collecting tubules C) Filtration of plasma by glomerulus D) Moves through the nephrons and is absorbed or excreted E) Flows into the renal pelvis and down the ureter F) Drains into the bladder then out the urethra

The hemodialysis client is scheduled to receive weekly injections of epoetin (Epogen). Which is the most important consideration to be taken by the nurse in the administration of this medication?

A) Schedule injection on nondialysis day.

A child is brought into the clinic with symptoms of periorbital edema and dark brown rusty urine. Which nursing assessment finding would best assist in determining the cause of this problem?

A) Sore throat 2 weeks ago

The nurse is caring for a client diagnosed with bladder stones. The client is scheduled for a litholapaxy. Which nursing action is most important to complete prior to the procedure?

A) Strain all urine

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure? A) The kidneys can improve over a period of months.

A) The kidneys can improve over a period of months.

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections?

A) The urethra

A client has a full bladder. Which sound would the nurse expect to hear on percussion?

B) Dullness

Chapter 57 Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?

B) Angiography

The nurse is caring for a client prescribed gentamicin 110 mg every 8 hours for 10 days. Which laboratory study is anticipated to monitor medication side effects?

B) BUN and serum creatinine

A client, who has suffered with recurrent renal calculi, has learned that the stones were composed of calcium oxalate. In providing dietary education to this client, which food contains the highest levels of oxalate and should be limited?

B) Chocolate

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.

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

An older adult male client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises him to wear barrier garments such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity?

B) Exposing the affected area to air

A client in chronic renal failure becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which of the following lab values?

B) Hyperkalemia

The nurse discontinues a client's Foley catheter following diagnostic procedure. When assessing the client's voided urine, it is noted to be concentrated with red strings. Which nursing action is best?

B) Instruct the client to increase fluid intake.

Chapter 58 The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following?

B) Location of discomfort

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

B) Low purine

A nephrostomy tube is inserted in a client with a large ureteral calculus. Which is the most important consideration in providing nursing care for this client?

B) Maintain free, continuous urine drainage.

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?

B) Monitor the client for an allergy to iodine contrast material.

The nurse is assisting the physician in completing a cystoscopy. In which position would the nurse place the client when preparing for the procedure?

B) On the client's back with feet in the stirrups

A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?

B) Renal pelvis

The nurse is caring for four clients on a urinary medical unit. For which client does the nurse need no further medical interventions?

B) The client has a residual urine of 90 mL on a bedside ultrasound bladder scan.

The nurse is caring for several clients on a urinary medical unit. Which client is at an increased risk for bladder stones?

B) The client who is paraplegic

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness?

B) The costovertebral angle

The nurse is caring for a client with chronic bladder infections and inflammation. The physician has ruled out several medical diagnoses and is considering interstitial cystitis. The nurse is most correct to anticipate which diagnostic test to confirm the disorder?

C) A bladder biopsy

The nurse is reviewing urine tests to obtain client baseline information. Which of the following urine tests is preferred to identify characteristics of normal and abnormal urine?

C) A clean-catch midstream specimen from the first voiding of the morning

The nurse is completing a full exam of the renal system. Which assessment finding best documents the need to offer the use of the bathroom?

C) A dull sound when percussing over the bladder

Which assessment finding is most important in determining nursing care for a client with acute glomerulonephritis?

C) Blurred vision

As the nurse comes from morning report, the nurse is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 mL. The client denies any pain on urination. The nurse scans 250 mL of remaining urine in the bladder. Which entry is most correct when documenting the intervention?

C) Client voided 300 mL with 250 mL residual volume

A nurse identifies a nursing diagnosis of Risk for Ineffective Breathing Pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?

C) Encourage use of incentive spirometer every 2 hours.

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?

C) Hematuria

A chronic renal failure client complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?

C) Hyperphosphatemia

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?

C) Inform the physician that catheter may need repositioning.

The nurse is caring for a male client who has a significant urinary narrowing secondary to an enlarged prostate. Which nursing action is best to relieve his urinary retention?

C) Insert a coudé catheter to remove urine from the bladder.

The licensed practical nurse is employed as a charge nurse at a long-term care facility. A resident is ordered a catheterization schedule of every 6 hours due to chronic urinary retention. The LPN reports daily catheterization amounts from the previous day ranging from 450 mL to 800 mL. Which nursing action is most correct?

C) Obtain an order to increase the frequency of the catheterizations.

During the physical examination of a client, the nurse monitors for signs that may indicate a urinary tract disorder. Which of the following would suggest that the client may have a urinary tract disorder?

C) Periorbital edema D) Flank pain

The nurse has received morning lab work on a client with chronic renal disease. Which finding indicates renal disease?

C) Protein level of 400 mg/dL

Which nursing action is best to comfort the client prior to urologic testing?

C) Provide for privacy and allow verbalization of concerns.

The nurse evaluates the client as experiencing symptoms of disequilibrium syndrome, following an initial hemodialysis treatment. Which is the best action to be taken by the nurse?

C) Slow the dialysis process during future treatment.

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client?

C) SpO2 at 90% with fine crackles in the lung bases

The nurse is caring for a client who is following a treatment plan to decrease urinary tract infections. Which of the following indicates the need to change the treatment plan?

C) The client exhibits continued symptoms.

The nurse is obtaining a history on a client stating nocturia. When evaluating the client's evening behaviors, which may be the cause of the problem?

C) The client takes a furosemide (Lasix) with the evening medications.

The nurse is completing a plan of care for a client with chronic urinary incontinence. Which of the following outcomes is a priority?

C) The client will maintain perineal skin integrity.

The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated?

C) The specific gravity will be high.

A client with several calculi in the ureter is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which teaching statement by the nurse best describes the procedure?

C) The stone is identified via fluoroscopy and then shock waves are used to shatter the stones.

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract?

C) Ureters

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?

C) Urinary calculi

The nurse is assessing a client brought to the emergency department for systemic complications after a traumatic event. Which assessment finding is most suggestive of an intact urinary tract?

C) Urine output is pink and noted at 300 mL.

The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period?

D) Complete a pulse assessment of the legs and feet.

A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands which of the following reasons that this drug is an effective treatment?

D) Decreases involuntary bladder contractions

An elderly client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?

D) Detects calculi, cysts, or tumors

As the home health nurse reviews medications taken by the client with polycystic kidney disease, which medication should be addressed first?

D) Ibuprofen (Motrin)

When teaching a client about a diagnostic procedure, which teaching philosophy provides the best manner to present the information to the client?

D) Move from general details of the procedure to specifics.

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?

D) Need to urinate after engaging in sexual intercourse

The nurse is caring for a client with a cystoscopy tube draining urine from the bladder. When reviewing the client's history prior to administering care, which is of most concern?

D) New diagnosis of urosepsis

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

D) Painless hematuria

The nurse is caring for a client who has a history of urine reflux. To assess the client for this urinary complication, which nursing action is best?

D) Palpate the client's bladder for distension.

When describing the functions of the kidney to a client, which of the following would the nurse include?

D) Secretion of the enzyme renin