assessment of urinary system/ elimination

A patient is scheduled for a test with contrast to determine kidney function. What statement made by the patient should the nurse inform the physician about prior to testing? a) "I don't like needles." b) "I am allergic to shrimp." c) "I take medication to help me sleep at night." d) "I have had a test similar to this one in the past."

" I am allergic to shrimp."

A female patient presents to the health clinical for a routine physical examination. The nurse observes that the patient's urine is bright yellow in color. Which of the following questions is most appropriate for the nurse to ask the patient? a) "Have you had a recent urinary tract infection?" b) "Do you take phenytoin (Dilantin) daily?" c) "Have you noticed any vaginal bleeding?" d) "Do you take multiple vitamin preparations?"

"Do you take multiple vitamin preparations?"

A client is diagnosed with frequent urinary tract infections. Which of the following would be an appropriate question for the nurse to ask the client? a) "Are you on any type of special diet at home?" b) "How often do you have a bowel movement?" c) "How frequently do you urinate each day?" d) "Are you on any blood pressure medications?"

"How often do you have a bowel movement?"

The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective? a) "I should remove all jewelry before the test." b) "I should let the staff know if I feel claustrophobic." c) "I will need to drink all of the dye as quickly as possible." d) "I will feel a warm sensation as the dye is injected."

"I will feel a warm sensation as the dye is injected."

Several of the patients on a geriatric subacute medicine unit are experiencing urinary incontinence from differing causes. Which of the following statements suggests that the patient requires further teaching? a) "I've made a point of scheduling when I drink water instead of waiting until I'm thirsty." b) "I make sure to limit how much I drink so that I don't have accidents." c) "At home, I take my water pill in the morning so that I don't have to use the bathroom as much during the night." d) "I know it's hard to get there, but I want to try to use the commode instead of wearing an adult diaper."

"I've made a point of scheduling when I drink water instead of waiting until I'm thirsty."

The nurse is catheterizing a male urinary bladder, and urine leaks out of the meatus around the catheter. What actions would the nurse perform next? (Select all that apply.) a) If under fill is suspected, attempt to push the catheter further into the bladder. b) Increase the size of the indwelling catheter. c) Ensure that the correct amount of solution was used to inflate the balloon. d) Assess the patient for diarrhea. e) Consider an evaluation for urinary tract infection. f) Make sure the smallest sized catheter with a 10-mL balloon is used.

-make sure the smallest sized catheter with a 10 mL balloon is used -ensure that the correct amount of solution was used to inflate the balloon -consider an evaluation for urinary tract infection

The nurse is preparing to assess a client's postvoid residual using a bladder scanner. Arrange the following steps in the correct order. Press scanner head onto the skin 1 to 1.5 inches above the symphysis pubis. Aim scanner head toward coccyx and activate scan. Verify that screen crossbars fall within bladder image. Position scanner head with directional arrow pointing to the head. Observe and record the volume measurement on the screen. Press the appropriate gender button.

1. Press the appropriate gender button 2. Position scanner head with directional arrow pointing to the head 3. Press scanner head onto the skin 1 to 1.5 inches about the symphysis pubis. 4. Aim scanner head toward coccyx and activate scan 5. Verify that screen crossbars fall within bladder image. 6. Observe and record the volume measurement on the screen

Which hormone causes the kidney to reabsorb sodium? a) Growth hormone b) Prostaglandins c) ADH d) Aldosterone

Aldosterone

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? a) Cystoscopy b) Computed tomography (CT scan) c) Angiography d) Radiography

Angiography

Your client is having a blood urea nitrogen (BUN) test run. What do you recall from your studies that is true about BUN levels? a) BUN is decreased in nephrotic syndrome. b) BUN is decreased in renal disease and urinary obstruction. c) BUN is unchanged in renal disease. d) BUN is increased in renal disease and urinary obstruction.

BUN is increased in renal disease and urinary obstruction

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish? a) Cystoscopy b) Computed tomography with contrast c) Bladder ultrasonography d) Radiography

Computed tomography with contrast

Which of the following terms refers to casts in the urine? a) Crystalluria b) Pyuria c) Cylindruria d) Bacteriuria

Cylindruria

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which of the following? a) Increased fluid intake b) Diabetes insipidus c) Glomerulonephritis d) Decreased fluid intake

Decreased fluid intake

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? a) Enuresis b) Anuria c) Dysuria d) Hematuria

Enuresis

In starting your new job as a nurse with a group of renal specialists, you begin your orientation with a thorough review of renal function. Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which of the following is NOT a function of the kidneys? a) Regulating blood pressure b) Stimulating RBC production c) Excreting nitrogen waste products d) Excreting protein

Excreting protein

a catheter is to remain in place for continuous drainage.

Foley catheters.

The nurse is preparing a client for a cystoscopy procedure. Which intervention would be part of the preparation for this? a) Having the client sign a consent form for the procedure b) Maintaining the client without liquids before the procedure c) Inserting a Foley catheter the morning of the procedure d) Explaining to the client that the procedure will be painful

Having the client sign a consent form for the procedure

A male patient is being transferred to the hospital from a long-term care facility with a diagnosis of dehydration and urinary bladder infection. His skin is also excoriated from urinary incontinence. Which nursing diagnosis is most appropriate for this patient? a) Urinary Incontinence related to urinary tract infection b) Risk for Urinary Tract Infection related to dehydration c) Impaired Skin Integrity related to urinary bladder infection and dehydration d) Impaired Skin Integrity related to functional incontinence

Impaired skin integrity related to urinary bladder infection and dehydration

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? a) Increased serum albumin b) Increased serum creatinine c) Decreased potassium d) Decreased blood urea nitrogen (BUN)

Increased serum albumin

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? a) Ambulate the client in the hall. b) Wait to see the next voided specimen. c) Call the physician for further instructions. d) Instruct the client to increase fluid intake.

Instruct the client to increase fluid intake

The nurse observes the patient's urine to be orange. Which additional assessment would be important for this patient? a) Intake of multiple vitamin preparations b) Intake of medication such as phenytoin (Dilantin) c) Bleeding d) Infection

Intake of medication such as phenytoin (Dilantin)

A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance? a) Intermittent urethral catheter b) Indwelling urethral catheter c) Retention catheter d) Foley catheter

Intermittent urethral catheter

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) Fistula b) Chronic renal failure c) Kidney stones d) Neurogenic bladder

Kidney stones

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? a) Assess the client's mental changes. b) Evaluate the client for periorbital edema. c) Monitor the client for an allergy to iodine contrast material. d) Monitor the client for signs of electrolyte and water imbalance.

Monitor the client for an allergy to iodine contrast material

A patient is suspected of having a disease process affecting the functional unit of the kidney. The nurse correctly recognizes which of the following structures is most likely involved? a) Nephron b) Loop of Henle c) Bowman's capsule d) Glomerulus

Nephron

Which term best describes a total urine output of less than 500 mL in 24 hours? a) Dysuria b) Oliguria c) Polyuria d) Nocturia

Oliguria

Retention of which electrolyte is the most life-threatening effect of renal failure? a) Sodium b) Calcium c) Potassium d) Phosphorous

Potassium

Which intervention would the nurse expect to implement following urologic endoscopy? Select all that apply. a) Provide privacy to promote bladder emptying. b) Administer an antispasmodic agent. c) Assist with coughing and deep breathing. d) Teach leg and range-of-motion exercises. e) Verify the client's understanding about procedure.

Provide privacy to promote bladder emptying administer an antispasmodic agent

pus in the urine; urine appears cloudy

Pyuria

Which of the following hormones is secreted by the juxtaglomerular apparatus? a) Calcitonin b) Renin c) Antidiuretic hormone (ADH) d) Aldosterone

Renin

The physician orders an indwelling urinary catheter to be inserted into a woman who has had a total hip replacement and is on strict bed rest. When inserting the catheter, the nurse would place the client in which position? a) Semi-Fowler position b) Supine position c) Dorsal recumbent position d) Sims (side) position

Sim's (side) position

The nurse is providing teaching to a client who is being discharged to home with an indwelling urinary catheter in place. What information is important for the nurse to discuss with the client? a) Clamp the catheter tubing daily for two hours and then release the clamp at night. b) Restrict daily fluid intake. c) Empty the catheter bag every few days when it is full. d) The catheter can be connected to a smaller leg bag for ambulation.

The catheter bag can be connected to a smaller leg bag for ambulation

Which of the following statements about suprapubic catheters is true? a) They drain urine directly from the ureters. b) They are often preferred over an indwelling urethral catheter for long-term urinary drainage. c) They are surgically inserted through a small incision above the umbilicus. d) Accidental dislodgement can permanently damage the urethra.

They are often preferred over an indwelling urethral catheter for long-term drainage

The most frequent reason for admission to skilled care facilities includes which of the following? a) Myocardial infarction b) Congestive heart failure c) Urinary incontinence d) Stroke

Urinary incontinence

A sterile urine specimen for culture and sensitivity has been ordered for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? a) Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle. b) Discontinue the indwelling catheter and insert an intermittent catheter to obtain the sterile specimen. c) Empty the collection bag, wait 30 minutes, and then collect the contents of the collection bag. d) Collect a urine specimen from the collection bag first thing in the morning, or a few hours after the client receives a diuretic.

Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle

A nurse is caring for an elderly client at his home. The client has had a condom catheter applied. Which of the following describes a condom catheter? a) A urine drainage tube inserted but not left in place b) A flexible sheath that is rolled around the penis c) A bag attached by adhesive backing to the skin around the genitals d) A urine drainage tube that is left in place over a period of time

a flexible sheath that is rolled around the penis

A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? a) 6 hours after the urine is discarded b) At 8:00 am, with or without a specimen c) With the first specimen voided after 8:00 am d) After discarding the 8:00 am specimen

after discarding the 8:00 am specimen

A 32-year-old client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography and you are in the midst of completing client education about the procedure and postprocedural assessments. What postprocedural assessment will you perform on the client? a) Monitor site condition. b) Palpate pedal pulses. c) Hypersensitivity response d) All options are correct.

all options are correct

24 hour urine output is less than 50 mL; Kindey shutdown or renal failure

anuria

A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient complains of severe pain in the back, arms, and shoulders. Which of the following appropriate nursing interventions should be offered by the nurse? a) Provide analgesics to the patient. b) Distract the patient's attention from the pain. c) Enable the patient to sit up and ambulate. d) Asses the patient's back and shoulder areas for signs of internal bleeding.

assess the patient's back and shoulder areas for signs of internal bleeding.

A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? a) Nuclear scan b) Bladder ultrasonography c) IV urography d) Cystography

bladder ultrasonography

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) Dehydration b) Allergic reaction c) Infection d) Bleeding

bleeding

The nurse is caring for a patient following a cystoscopic examination. Following the procedure, the nurse informs the patient that which of the following may occur? a) Nausea and emesis b) Severe abdominal pain c) Diarrhea d) Blood-tinged urine

blood-tinged urine

A home care nurse visits a client diagnosed with depression who informs the nurse that he has been prescribed amitriptyline. Which of the following would the nurse include when teaching the client about the effects of this mediation? a) Causes urinary retention b) Decreases sensation of bladder fullness c) Decreases glomerular filtrate rate d) Causes urine to turn blue-green

causes urine to turn blue-green

A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should: a) keep the client's knee on the affected side bent for 6 hours. b) check the client's pedal pulses frequently. c) apply pressure to the puncture site for 30 minutes. d) remove the dressing on the puncture site after vital signs stabilize.

check the client's pedal pulses frequently

normal finding: pale yellow special consideration: darker than normal when it is scantly and concentrated lighter than normal when it is excessive and diluted

color of urine

organic-urea, uric acid , creatinine, hippuric acid, indicant, urene pigment. inorganic- ammonia, Na,Cl,Fe, Phosphorus, sulfur, potassium, Ca Abnormal-blood, pus, albumin, glucose, ketone bodies, casts, gross bacteria, and bile

constituents

Which of the following does the nurse recognize is the best clinical measure of renal function? a) Creatinine clearance b) Volume of urine output c) Urine-specific gravity d) Circulating ADH levels

creatinine clearance

A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? a) Blood urea nitrogen level b) Uric acid level c) Creatinine clearance level d) Serum potassium level

creatinine clearance level

A client has undergone diagnostic testing that involved the insertion of a lighted tube with a telescopic lens. The nurse identifies this test as which of the following? a) Excretory urogram b) Intravenous pyelography c) Cystoscopy d) Renal angiography

cystoscopy

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Select the correct example of how urine concentration is affected from among the following statements. a) When the kidneys are diseased, the ability to concentrate urine may be impaired and the specific gravity may vary widely. b) A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity. c) On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. d) On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity

d) On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity

The nurse is preparing a patient for a nuclear scan of the kidneys. Following the procedure, the nurse will instruct the patient to complete which of the following? a) Drink liberal amounts of fluids. b) Carefully handle urine as it is radioactive. c) Notify the health care team if bloody urine is noted. d) Maintain bed rest for 2 hours.

drink liberal amounts of fluids

painful or difficult urination

dysuria

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to: a) Encourage high fluid intake. b) Apply moist heat to the flank area. c) Strain all urine for 48 hours. d) Monitor for hematuria

encourage high fluid intake

increased incidence of voiding

frequency

When the bladder contains 350 mL or more of urine, this is referred to as which of the following? a) Functional capacity b) Renal clearance c) Anuria d) Specific gravity

functional capacity

A 42-year-old client is being seen by a urologist in the group where you practice nursing. She is experiencing some secretion abnormalities, for which diagnostics are being performed. Which of the following substances are typically reabsorbed and not secreted in urine? a) Potassium b) Glucose c) Creatinine d) Chloride

glucose

presence of sugar in the urine

glycosuria

The nurse is preparing an education program on risk factors for kidney disorders. Which of the following risk factors would be inappropriate for the nurse to include in the teaching program? a) Hypotension b) Pregnancy c) Neuromuscular disorders d) Diabetes mellitus

hypotension

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? a) Acute renal failure b) Infection c) Nephrotic syndrome d) Obstruction of the lower urinary tract

infection

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) Fistula b) Kidney stones c) Chronic renal failure d) Neurogenic bladder

kidney stones

A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 ml. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of: a) microorganism transfer. b) client discomfort. c) prostate irritation. d) incorrect urine output values.

microorganism transfer

awakening at night to urinate

nocturia

normal finding: aromatic, develops ammonia odor as it stands special consideration: sweet odor-high glucose fetid odor- infected

odor of urine

scantly or greatly diminished amount of urine voided in a given time; 24 hour urine output is less than 400 ml

oliguria

A client is scheduled for a creatinine clearance test. The nurse should explain that this test is done to assess the kidneys' ability to remove a substance from the plasma in: a) 30 minutes. b) 24 hours. c) 1 hour. d) 1 minute.

one minute

A client at a health care facility is being treated for cancer of the bladder. The physician uses a urinary diversion to help the client with urinary elimination. Which of the following describes a urinary diversion? a) Use of a catheter to collect urine in a sterile environment b) One or both of the ureters are surgically implanted elsewhere c) Inability to control either urinary or bowel elimination d) Hygiene measures used to keep meatus and adjacent area of the catheter clean.

one or both of the ureters are surgically implanted elsewhere

range 4.6-8, normal-6.o

pH

excessive output of urine

polyuria (diuresis)

protein I the urine; indication of kidney disease

proteinuria

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? a) Increased alertness b) Pruritus c) Unusually smooth skin d) Hypoventilation

pruritus

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: a) acute prostatitis. b) renal calculi. c) an overdistended bladder. d) interstitial cystitis.

renal calculi

a measure of concentration of dissolved solids in the urine. normal range is 1.015 to 1.025 concentrated- higher, dehydration /diluted-lower, overhydration

specific gravity

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: a) Specific gravity 1.035 b) Creatinine 0.7 mg/dL c) Protein 15 mg/dL d) Bright yellow urine

specific gravity 1.035

What catheter would the nurse use to drain a patient's bladder for short periods (5 to 10 minutes)? a) Straight catheter b) Indwelling urethral catheter c) Suprapubic catheter d) Foley catheter

straight catheter

are used to drain the bladder for shorter periods.

straight catheters

A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing? a) Reflex incontinence b) Functional incontinence c) Stress incontinence d) Urge incontinence

stress incontinence

stoppage of urine production; normally, the adult kidney produce urine continuously at the rate of 60-120 ml/h

suppression

used for long-term continuous drainage. This type of catheter is inserted surgically through a small incision above the pubic area

suprapubic catheter

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? a) Above the symphysis pubis b) The upper abdominal quadrants on the left and right side c) Around the umbilicus d) The cost vertebral angle

the cost vertebral angle

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? a) Around the umbilicus b) The upper abdominal quadrants on the left and right side c) The cost vertebral angle d) Above the symphysis pubis

the cost vertebral angle

The nurse mentor is observing a novice nurse prepare to insert an indwelling catheter for a female client with urinary retention. The mentor would intervene, if which action by the novice nurse is noted? a) The novice asked the client to take a deep breath when resistance was met during insertion of the catheter. b) The novice selected an 18 French Foley catheter to insert. c) The novice assisted the client to a dorsal recumbent position with knees flexed, feet about 2 feet apart. d) The novice placed a trash receptacle within easy reach.

the novice selected an 18 French Foley catheter to insert

You are inserting a urinary catheter into a 63-year-old male patient and encounter resistance. Which of the following is the most likely cause of the resistance? a) The diameter of the catheter is too large. b) The patient has an occult abscess in the urethra. c) The patient has an enlarged prostate. d) You failed to deflate the retention balloon after pretesting it for integrity.

the patient has an enlarged prostate

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? a) The specific gravity will be high. b) The specific gravity will equal to one c) The specific gravity will be inversely proportional d) The specific gravity will be low

the specific gravity will be high

fresh urine -clear/ translucent. becomes cloudy as it stands

turbidity of urine

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? a) Pelvic floor muscles b) Urethra c) Bladder d) Ureters

ureters

strong desire to void

urgency

involuntary loss of urine

urinary incontinence

The nurse measures a patient's residual urine by catheterization after the patient voids. What condition would this test verify? a) Urinary suppression b) Urinary tract infection c) Urinary retention d) Urinary incontinence

urinary retention

The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present? a) When the urine output is between 300 and 500 mL/h b) When the urine output is less than 30 mL/h c) When the urine output is about 100 mL/h d) When the urine output is between 500 and 1,000 mL/h

when urine output is less than 30 mL/h