Urinary Adaptive Quizzing

Elderly pt complains of involuntary passage of urine, leakage of urine in small amounts, and more frequent when they cough. Which info. does the nurse provide to the pt about the disorder?

- This is called stress incontinence - This is caused by weakness of the muscles around the urethtra - This occurs when intra-abdominal pressure exceeds urethtral resistance Rationale: Involuntary voiding of urine upon coughing is called called stress incontinence. It occurs as a result of weakness of the muscle around the urethtra.

Nurse teaches a group of nursing students about the risk for bladder cancer within various groups of the population. Which group does the nurse expect to have the highest rick?

Black men who smoke Rationale: Blacks are 35% more likely to develop bladder cancer compared with whites, and men are more likely to develop bladder cancer compared to women.

Pt has been prescribed Phenazopyridine(Pyridium) for UTI. What's a common side effect?

Bright orange urine Rationale: It's a urinary analgesic that caused bright orange urine.

Nurse is teaching about transurethral needle ablation (TUNA) to treat benign prostate hypertrophy (BPH). Which statement from the pt regarding TUNA indicates that the pt needs further education?

"A specially designed urinary catheter is inserted into the bladder." Rationale: In TUNA, an interstitial radiofrequency needle is inserted through the urethra and into the lateral lobes of the prostate.

Nurse is providing education to a group of women on how to prevent UTI. Which instruction is best?

"Drink at least 2000 mL of water daily" Rationale: Helps dilute urine.

A 55 year old man is admitted to the hospital with urinary retention. The pt is catheterized to relieve retention. Which actions are necessary to prevent infection in the patient?

- Ensure a closed drainage system - Monitor patency of the catheter - Follow good hand hygiene - Ensue that spigot does not touch any contaminated surfaces Rationale: Closed system drainage prevents microorganisms from entering the system - Maintaining patency ensures that the urine does not pool. - Hand hygiene helps prevent spread of infection

A nursing instructor would share with the students which statements regarding the effects of aging on the renal system? Select all that apply.

- Older men are at risk for urinary retention because of prostatic hypertrophy - Older women are at risk for stress incontinence because of weakened pelvic musculature - Urinary tract infections in older adults are often associated w/ diabetes, neurologic disorders, and procedures (catheterization) Rationale: EXPLANATORY

An elderly male pt has been admitted to the hospital for a urinary tract infection. Which physiologic changes in the urinary system does the nurse teach the pt about?

- Prostate enlargement may lead to urinary retention - Urinary retention increases the risk of urinary retention - Ineffective bladder contraction leads to urinary retention. Rationale:

Nurse is caring for four pt of different age groups and different health complications. Which pt is at increased risk of urinary retention?

65 year old w/ back pain Rationale: Urinary retention is predominant in older men as result of benign prostate hypertrophy

Nurse is caring for a pt with a UTI. Using the urometer connected to a drainage system, the nurse monitors the pt urinary output and finds it is 25 mL/hr. Which action should be the immediate response by the nurse?

Check the placement and function of the drainage system. Rationale: The nurse should first check the position of the drainage system to ensure it is properly placed.

A nurse knows that the pt with urinary incontinence is at risk for which conplication?

Dehydration Rationale: Pt with urinary incontinence are likely to have decreased fluid intake, which leads to dehydration.

Pt has been prescribed methenamine (Mandelamine) to prevent recurrence of chronic urinary tract infections. Which instruction would the nurse provide to maximize the effectiveness of this medication?

Drink cranberry juice daily to acidify the urine Rationale: Pt should be instructed to eat and drink foods that acidify the urine to maximize the effectiveness of Mandelamine.

Nurse is caring for pt with polycystic kidney disease (PKD). Nurse knows this pt is at risk for which fatal disease?

End-Stage Renal Disease Rationale: PKD can progress to end-stage renal disease

A nurse obtains a urine culture specimen from a pt who acquired a urinary tract infection form frequent straight catheterization. The nurse anticipates the culture will grow which organism?

Escherichia Coli Rationale: E. coli is the most common cause of hospital-acquired urinary tract infections.

A 70 year old pt arrives at the clinic w/ complaints of dysuria, nocturia, difficulty starting urination, and oliguria. The provider performs a rectal exam and describes the prostate as enlarged and boggy. The nurse anticipates which medication to shrink the prostate?

Finasteride (Proscar) Rationale: Finasteride (Proscar) is a 5-alpha-reductase inhibitor that shrinks the prostate.

Nurse reports: - Loss of appetite - Severe headache - Lethargy - Dry mucous membranes - Urinary output of 400 mL/hr - Elevated BUN and creatinine Which med will be prescribed?

Flurosemide (Lasix) Rationale: These are all symptoms of acute respiratory failure. This med is prescribed for acute renal failure

Nurse is providing discharge education for pt who has been recently prescribed a potassium-sparing diuretic. Which statement if made by pt indicated need fir further education?

I should reduce my sodium intake by using a potassium chloride salt substitute. Rationale: Potassium-containing salt supplements can lead to hyperkalemia in pt taking potassium-sparing diuretics and should be avoided.

A PT visits the clinic complaining of urinary frequency and dysuria. Which test will be done?

Urine Culture Rationale: PT symptoms shows a possible UTI.

A nurse is providing education to a patient on self-catheterization. Which statement indicates the pt's understanding of the home self-catheterization technique.

I will use a clean technique when catheterizing at home. Rationale: - Clean technique= = used at home. - Sterile technique = hospital setting

The urinalysis of a pt with gastric ulcers shows the presence of gonococcal infection. Which med will the nurse expect in the pt's prescription?

Levofloxacin (Levaquin) Rationale: Levofloxacin is a broad-spectrum fluoroquinolone antibiotic. It is used to treat gonococcal infection in pts w/ gastric ulcers.

Nurse is observing care provided by an UAP of a patient with indwelling catheter. Which action by the UAP would prompt nurse to take immediate action.

Lifting the bag above the pt in bed to drain the collection bag. Rationale: Should not do this to prevent back up of urine into the urinary tract.

Nurse is caring for pt who is taking digoxin once a day for treatment of congestive heart failure. He now has a new prescription for spironolactone(Aldactone). Which nursing intervention is most likely appropriate for this patient?

Monitor pt for S&S of digoxin toxicity. Rationale: As a diuretic takes effect, there may be a resultant increase in the serum concentration of other meds that pt it currently taking.

Which catheter is used to drain urine from the renal pelvis of the kidney?

Mushroom catheter Rationale: -Mushroom catheter: used to drain urine form renel pelvis of the kidney - Coude catheter: used when enlargement of prostate gland is suspected. - Robinson catheter: used when intermittent drainage is required.

A pt with renal impairment with fluid overload is catheterized. The HCP instructs the nurse to perform bladder irrigation. Which herb does the nurse refrain from using in the patient with renal impairment?

Nettle (Urtica dioica) Rationale: Nettle is used to treat benign prostatic hypertrophy (BPH) It is also used to perform bladder irrigation. But contraindicated in pt with renal or cardiac impairment.

A nurse is preparing to care for a pt who sustained a high thoracic spinal cord injury. The nurse knows the pt will have which condition?

Neurogenic bladder Rationale: PT with the spinal cord injuries are likely to have neurogenic bladder.

Nurse is caring for a pt who returned from surgery 8 hrs ago and has yet to void. Which action should nurse do first?

Palpate for bladder distention Rationale: Before calling a HCP the nurse should determine if the pt has bladder distention.

Nurse is caring for pt with incontinence. Which intervention should the nurse include in plan of care?

Pelvic muscle (kegel) exercises Rationale: Helps tighten pelvic muscles

PT complains about stress incontinence after giving birth to 2 baby. Which suggestion would the nurse make first?

Perform Kegel exercises four times a day Rationale: Helps strengthen the pelvic floor muscles to prevent stress incontinence.

Elderly male pt arrives complaining if urinary incontinence. Nurse should ensure which exam is performed?

Prostate Rationale: Urinary incontinence in men is often caused by benign prostatic hyperplasia.

Pt has been diagnosed with a urinary tract infection. Pt is acutely ill, temp. of 102.5 and chills. She is grabbing her left side and has severe pain. Urine specimen appears concentrated with cloudy appearance. These symptoms are most associated with which type of UTI?

Pyelonephritis Rationale: Inflammation of the structures of the kidneys (renal pelvis, renal tubules, and interstitial tissue) usually caused by Escherichia coli.

Nurse is caring for pt ho has nephritis. Which instructions would the nurse include while educating the pt about health promotion?

Report any incidents of hematuria and edema Rationale: Nephritis is characterized by inflammation of the kidneys and manifests as edema over the face especially eye, anorexia, dysuria, and sanguineous urine.

A pt is instructed to provide a composite urine sample. Which instruction would the nurse include in teaching the patient the correct way to obtain the sample?

Save all the urine samples in a container for a designated period after discarding the first urine specimen. Rationale: The pt should be instructed to urinate and discard the first urine specimen. Time should be noted at the start of the test. Pt should than save all urine samples from subsequent urinations in a container for a designated period. At the end of the designated period, the pt should be asked to urinate and add that urine to the container. Pt should be reminded to save all urine during the study period.

Which blood test is done to evaluate for impaired renal function, which is affected very little by dehydration, malnutrition, or hepatic function.

Serum Creatinine Rationale: This test measures the amount of creatinine - a catabolic product of creatine, which is used in skeletal muscle contraction - in blood.

The nurse is teaching a 60-year-old female pt about the changes that occur in the urinary system as a result of aging. Which condition would the nurse stress during the teaching session?

Stress incontinence Rationale: Stress incontinence is the involuntary passing of urine in association with coughing, laughing, and any activity that increases the intra-abdominal pressure. In aging, the bladder loses tone and the perineal muscles relax.

Pt reports the nurse that urination is painful. Which clinical finding does the nurse expect to see in report.

Trauma to urethra Rationale: Painful urination is called dysuria and is caused by infection or trauma to the urethra and bladder.

PT complains of incontinence and states they never have enough time between when I first feel I need to void and when i'm incontinent. The nurse documents which type of incontinence?

Urge Rationale: - Urge: occurs when the urge to void happens w/o much warning immediately before an episode of incontinence. - Stress: Occurs with an increase in intra-abdominal pressure - Overflow: Occurs when the pt is unable to fully empty bladder, causing it to leak. - Functional: Occurs bc the pt doesn't realize he or she needs to urinate or is unable to get to the bathroom in time.

Elderly pt has decreased bladder and muscle tone. Which physical effect does nurse expect in pt?

Urinary Incontinence Rationale: Decreased bladder muscle tone interferes with the external urinary sphincter, which leads to urinary incontinence.

Nurse notices a note that pt is impaired urinary elimination along w/ needed to be reminded to perform kegel exercises and assisting to toilet every 2 hours. What condition is the pt most like experiencing?

Urinary Incontinence Rationale: UI is involuntary loss of urine from the bladder. Kegel exercising and toilet scheduling are two interven tion that might help a patient achieve continence.

PT reports the frequent urge to need to urinate but can't do it completely. Upon palpation, the HCP observes an egg-shaped urinary bladder arising suprapubically. Which prescription will the nurse expect from the HCP?

Urinary catheterization Rationale: Frequent urge to urinate and the inability to void completely indicated urinary retention. Immediate order from HCP should be to surgically release the obstruction or urinary catheterization. Catheterization facilitates the emptying of the bladder and relieves comfort.

An older adult presents with urinary frequency caused by cystitis

- Recommend drinking cranberry juice - Encourage to increase fluid intake - Discourage coffee, tea, cola, and alcohol Rationale: Cranberry juice decreases bacterial infections of the bladder and urinary frequency caused by cystitis. Fluid intake should be at least 8-8 glasses a day. These defect and may increase urinary frequency. inks should be restricted because they have a diuretic effect and may increase urinary frequency.

In caring for a pt with hydronephrosis, which nursing interventions would be appropriate?

- Strict intake and output recording - Assessment and management of pain - Observing for signs and symptoms of infection Rationale: It is important to determine output is adequate and proportional to fluid intake because this disorder is caused by obstructions in the urinary tract. Pain my be present in a pt with hydronephrosis.

Pt tells the nurse they are worried that their urine is a different color. Which questions will the nuse ask the pt to determine the cause of the color changes. Select all that apply.

- Tell me more about your diet - What meds have you been taking? - How much glasses of water do you drink daily? Rationale: Urine color changes if pt consumes food containing water-soluble dyes or consumes medications. Urine also darkens if more concentrated.

Pt arrives at clinic w/ edema of face, anorexia, nocturia, and general malaise. Nurse notes crackles on auscultation of lungs, jugular vein distention, and cola-colored urine. Pt also had a beta-hemolytic streptococcal infection 2 weeks ago. Nurse anticipates which diagnosis?

Acute glomerulonephritis Rationale: Acute glomerulonephritis is characterized by general malaise, fluid overload, and decreased urine output.

a patient diagnosed with an uncomplicated urinary tract infection. The nurse anticipates the provider will prescribe which medication regimen

3 days of sulfamethoxazole-trimethoprim (Bactrim) Rationale: Most common treatment

Nurse is caring for a pt who is taking spironolactone (Aldactone). What food does nurse instruct the pt to include in diet plan?

Apple Juice Rationale: Has low potassium levels. Because the pt is on this med, a potassium-sparing diuretic, the nurse should restrict the potassium content of the diet.

A nurse is caring for a pt immediately after a transurethral resection of the prostate (TURP). The nurse is assessing the pt's output from the continuous bladder irrigation system and notes blood-tinged drainage in the fluid. Which action should the nurse perform first?

Assess pt vital signs Rationale: Nurse should assess vital signs every 2 hours when assessing irrigation fluid for blood.

Pt has been diagnosed with a urinary tract infection caused by gram-positive microbes. Which med, if prescribed by the HCP, would the nurse question?

Nalidixic acid (NegGram) Rationale: Nalidixic acid is effective against only gram-negative bacteria.

Transrectal ultrasonography is used to view which structure?

Prostate Rationale: With this test, a HCP can differentiate between prostate enlargement and prostate cancer.

A nurse is performing patient teaching for a pt who has urolithiasis. This pt has been determined to be a "calcium stone former." On which current research recommendation will the nurse base the answer to the patient's dietary questions?

Restricted animal protein Rationale: Restricted consumption of animal protein with normal calcium intake better educes the risk of kidney stones.

A nurse is caring for a patient with an acute renal failure (oliguric phase). Which finding would the nurse expect to assess in the pt with this diagnosis?

Anorexia, nausea, vomiting, and decreased urine output Rationale: In pt with acute renal failure (oliguria), typical clinal manifestation include anorexia, nausea, vomiting, and decreased urine output.

Nurse has received an order to obtain a urine culture for a pt with indwelling catheter. Nurse uses two pt identifiers to determine correct pt, performs hand hygiene, and dons gloves, What's next?

Clean the drainage port w/ alcohol, and use a sterile adapter and syringe to withdraw urine specimen. Rationale: The urine culture specimen should be withdrawn from a clean port w/ sterile adapter and syringe.

A 50-year-old pt has a prostate-specific antigen (PSA) level of 6 ng/mL. The nurse knows this pt should be evaluated for which condition?

Prostate Cancer Rationale: An elevated level of PSA indicates prostate cancer. Normal range: 0.6-0.7

Nurse is preparing a male pt with a urinary incontinence for bed. Which type of catheter is best option to prevent skin breakdown in this pt?

Texas catheter Rationale: The Texas, or condom, catheter is noninvasive option for the male pt with urinary incontinence for prevention of skin breakdown caused by moisture.