HESI EAQs - Renal, Urinary, and Reproductive Systems

Which actions should the nurse perform while collecting subjective data from a client during a focused urinary assessment? Inquire about painful urination Ask the client about changes in characteristics of urination Assess the levels of blood urea nitrogen and creatinine Palpate the abdomen for bladder distention or masses Inspect the urinary meatus for inflammation or discharge

Inquire about painful urination Ask the client about changes in characteristics of urination While collecting subjective data from a client during the focused urinary assessment, the nurse should ask the client about painful urination and also about any changes in the characteristics of urination (diminished, excessive). This information indicates the presence or absence of urinary disorders. The nurse should palpate the abdomen for bladder distention or masses while collecting objective data during the physical examination. The blood, urea, nitrogen, and creatinine values are included in the objective diagnostic data. The nurse inspects the client's urinary meatus for inflammation or discharge while collecting objective data during the physical examination.

Which part of the female external genital protects inner vulval structures and enhances sexual arousal? Clitoris Mons pubis Labia majora Bartholin glands

Labia majora The labia majora are two vertical folds of adipose tissue that protects the inner vulval structures and enhances sexual arousal. The clitoris is a small, cylindrical organ that becomes larger and increases sexual sensation. The mons pubis is a fat pad that covers and protects the symphysis pubis during coitus. The Bartholin glands are located near the vaginal opening; they secrete lubricating fluid during sexual excitement.

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

Swab the drainage directly from the urethra to obtain a specimen. Swabbing the drainage directly from the urethra obtains a specimen uncontaminated by environmental organisms. Instructing the client to provide a semen specimen is not as accurate as obtaining the purulent discharge from the site of origin. Swabbing the discharge when it appears on the prepuce will contaminate the specimen with organisms external to the body. Teaching the client how to obtain a clean catch specimen of urine will dilute and possibly contaminate the specimen.

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

The length of the urethra The length of the urethra is shorter in women than in men; therefore, microorganisms have a shorter distance to travel to reach the bladder. The proximity of the meatus to the anus in women also increases the incidence of urinary tract infections. Fluid intake may or may not be adequate in both men and women and does not account for the difference. Hygienic practices can be inadequate in men or women. Mucous membranes are continuous in both men and women.

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

Moist, fleshy projections on the penis Moist, fleshy projections on the penis with single or multiple projections is a clinical manifestation of condyloma acuminatum. Macules on the penis or scrotum are clinical manifestations of penile erythema. Chancroid is manifested by pus-filled ulcers on the penis. A swollen penis with tight foreskin is a clinical manifestation of paraphimosis.

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

Accelerated bone demineralization Calcium that has left the bones as a response to prolonged inactivity enters the blood and may precipitate in the kidneys, forming calculi. Increased fluid intake is helpful in preventing this condition by preventing urinary stasis. Calcium intake usually is limited to prevent the increased risk for calculi. Calculi may develop despite adequate kidney function; kidney function may be impaired by the presence of calculi and urinary tract infections associated with urinary stasis or repeated catheterizations.

A client has returned from pelvic surgery. Which action should the nurse include in the plan of care? Encouraging the client to ambulate in the hallway Elevating the client's legs by raising the bed's knee support Assisting the client to center self securely in the middle of the bed Maintaining the client on bed rest until the bandages are removed

Encouraging the client to ambulate in the hallway Muscle contraction during ambulation improves venous return, preventing venous stasis and thrombus formation[1][2]. Elevating the client's legs by raising the bed's knee support places pressure on popliteal spaces, limiting venous return and increasing the risk for thrombus formation. Assisting the client to center self securely will not promote circulation. Bed rest is associated with venous stasis, which increases the risk for thrombus formation.

When assessing a client during peritoneal dialysis, a nurse observes that drainage of the dialysate from the peritoneal cavity has ceased before the required volume has returned. What should the nurse instruct the client to do? Drink a glass of water Turn from side to side Deep breathe and cough Rotate the catheter periodically

Turn from side to side Turning from side to side will change the position of the catheter, thereby freeing the drainage holes of the tubing, which may be obstructed. Drinking a glass of water and deep breathing and coughing do not influence drainage of dialysate from the peritoneal cavity. The position of the catheter should be changed only by the primary healthcare provider.

The nurse provides discharge instructions to a male client who had an ureterolithotomy. The client has a history of recurrent urinary tract infections (UTIs). For which indicators of a UTI should the nurse instruct the client? Urgency or frequency of urination An increase of ketones in the urine The inability to maintain an erection Pain radiating to the external genitalia

Urgency or frequency of urination Urgency or frequency of urination occur with a urinary tract infection[1][2] because of bladder irritability; burning on urination and fever are additional signs of a UTI. Increase of ketones is associated with diabetes mellitus, starvation, or dehydration. The inability to maintain an erection is not related to a UTI. Pain radiating to the external genitalia is a symptom of a urinary calculus, not infection.

The nurse is providing education to a client with calculi in the calyces of the right kidney. The client is scheduled to have the calculi removed. Which information should the nurse include in the teaching? The calculi are too large for transurethral removal. During the surgery, the right ureter will be removed. After surgery, a suprapubic catheter will be in place. After surgery, there will be a small incision in the right flank area.

After surgery, there will be a small incision in the right flank area. If the calculi are in the renal pelvis, a percutaneous pyelolithotomy is performed. The calculi are removed via a small flank incision which will be evident in the right flank area. The calculi can be removed without damage to the ureter. Transurethral removal of large ureteral and renal calculi can be performed using ureteroscopic ultrasonic lithotripsy. Placement of a suprapubic catheter usually is unnecessary unless there is damage to the ureter during the procedure.

The nurse is performing an assessment of a female client's reproductive system. Which action should the nurse take? Maintain friendly demeanor with the client during assessment Ask about sexual practices at the beginning of assessment Ask about menstrual history at the beginning of assessment Maintain gender-specific terms while questioning during assessment

Ask about menstrual history at the beginning of assessment It is necessary to gather health information as part of an assessment of the reproductive system. The nurse should always start the questioning with minimally sensitive information such as menstrual history. This will help the client adjust gradually. The nurse should maintain a professional demeanor while assessing or taking a reproductive health history. Sensitive information, such as client's sexual practices, should be asked after basic and less-sensitive topics. The nurse should make use of gender-neutral terms while questioning the client regarding their sexual partners.

Which medication used to treat urinary incontinence strengthens the urinary sphincters and has anticholinergic action? Midorine Duloxetine Oxybutynin Mirabegron

Duloxetine Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that strengthens urinary sphincters and has anticholinergic action. Midorine is an alpha-adrenergic-agonist, which increases the contractile force of the urethral sphincter. Oxybutynin is an antispasmodic that causes bladder muscle relaxation. Mirabegron is a beta-3 blocker that relaxes the detrusor smooth muscle, which increases bladder capacity and urinary storage.

A client has been diagnosed with anemia. Which decreased hormone level may be the cause? Bradykinin Prostaglandin Erythropoietin Activated vitamin D

Erythropoietin Erythropoietin stimulates the production of red blood cells (RBCs) in the bone marrow. Deficiency of erythropoietin causes a decrease in RBCs, thereby resulting in anemia. Bradykinin increases blood flow and vascular permeability. Prostaglandins regulate kidney perfusion. Activated vitamin D promotes the absorption of calcium in the gastrointestinal (GI) tract.

A client fears pregnancy despite the use of oral contraceptives. Which blood test would the primary healthcare provider order for the client? Prolactin test Testosterone test Progesterone test Human chorionic gonadotropin (hCG) test

Human chorionic gonadotropin (hCG) test A human chorionic gonadotropin (hCG) test is used to detect pregnancy; therefore, the primary healthcare provider orders an hCG test for the client. A prolactin test is used to detect amenorrhea. A testosterone test is used to determine ovarian dysfunction. A progesterone test is used to determine the occurrence of ovulation.

The registered nurse is preparing to assess a client's renal system. Which statement by the nurse indicates effective technique? "I must first palpate the client if a tumor is suspected." "I must first listen for normal pulse at the client's wrist region." "I must first auscultate the client and then proceed to percussion and palpation." "I must first examine tender abdominal areas and then proceed to nontender areas."

"I must first auscultate the client and then proceed to percussion and palpation." Palpation and percussion can cause an increase in normal bowel sounds and hide abdominal vascular sounds. Therefore it is wise to perform auscultation prior to percussion and palpation during clinical assessment of the renal system. Palpation should be avoided if a client is suspected of having a tumor because it could harm the client. It is more important as part of clinical assessment of the renal system to listen for bruit by auscultating over the renal artery. Bruit indicates renal artery stenosis. The nontender areas should be examined prior to tender areas to avoid confusion regarding radiating pain from the tender area being percussed.

Which part of the female reproductive organ is engorged during the excitation phase of sexual intercourse? Mons Pubis Clitoris Skene gland Hymen

Clitoris The clitoris, which is engorged with blood during the excitation phase of sexual intercourse. The mons pubis, which is a fatty layer covering the pubic bone. The Skene gland, which lubricates the urinary meatus. The hymen, which surrounds the vaginal introitus.

A client arrives at a health clinic reporting hematuria, frequency, urgency, and pain on urination. Which diagnosis will the nurse most likely observe written in the client's medical record? Chronic glomerulonephritis Nephrotic syndrome Pyelonephritis Cystitis

Cystitis Cystitis is an inflammation of the bladder that causes frequency and urgency of urination, pain on micturition, and hematuria. Chronic glomerulonephritis is a disease of the kidney that is associated with manifestations of systemic circulatory overload. Nephrotic syndrome is a condition of increased glomerular permeability characterized by severe proteinuria. Pyelonephritis is a diffuse, pyogenic infection of the pelvis and parenchyma of the kidney that causes flank pain, chills, fever, and weakness.

What is the action of the vasopressin hormone released from the client's posterior pituitary? Helps produce concentrated urine Causes tubular secretion of sodium Promotes potassium secretion in the collecting duct Enhances sodium reabsorption in the distal convoluted tubule

Helps produce concentrated urine The action of the hormone vasopressin released from the posterior pituitary is to make the distal convoluted tubule and collecting duct permeable to water so as to maximize reabsorption and produce concentrated urine. The natriuretic hormones produced from cardiac ventricles cause tubular secretion of sodium. Aldosterone released from the adrenal cortex promotes potassium secretion and sodium reabsorption in the distal convoluted tubules and collecting duct.

A client reports swelling of the scrotum with no pain. Which condition does the nurse anticipate in the client? Chancroid Hydrocele Spermatocele Incarcerated hernia

Hydrocele Unilateral or bilateral swelling of the scrotum without pain is a clinical manifestation of a hydrocele; therefore, this is what the nurse anticipates the client to have. Chancroid is manifested by papular or irregularly shaped nonindurated, pus-filled ulcers on the penis. A translucent, wormlike appearance of the scrotum is a characteristic of spermatocele. Swelling and pain in the scrotum are the clinical manifestations of incarcerated hernia.

What are the functions of antidiuretic hormone (ADH)? Controlling calcium balance Increasing arteriole constriction Increasing tubular permeability to water Stimulating the bone marrow to make red blood cells Promoting the reabsorption of sodium in the distal convoluted tubule (DCT)

Increasing arteriole constriction Increasing tubular permeability to water Antidiuretic hormone (ADH), also known as vasopressin, is a hormone released from the posterior pituitary gland. ADH increases arteriole constriction and tubular permeability to water. Calcium balance is controlled by blood levels of calcitonin and the parathyroid hormone (PTH). Erythropoietin stimulates the bone marrow to make red blood cells. Aldosterone promotes the reabsorption of sodium in the distal convoluted tubule (DCT).

Which part of the kidney produces the hormone bradykinin? Kidney tissues Kidney parenchyma Renin-producing granular cells Juxtaglomerular cells of the arterioles

Juxtaglomerular cells of the arterioles The juxtaglomerular cells of the arterioles produce the hormone bradykinin, which increases blood flow and vascular permeability. The kidney tissues produce prostaglandins that regulate internal blood flow by vasodilation or vasoconstriction. The kidney parenchyma produces erythropoietin that stimulates the bone marrow to make red blood cells. The renin-producing granular cells produce the renin hormone that raises blood pressure as a result of angiotensin and aldosterone secretion.

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

Liver Uric acid stones are controlled by a low-purine diet. Foods high in purine, such as organ meats and extracts, should be avoided. Milk should be avoided with calcium, not uric acid, stones. Cheese or animal protein should be avoided with cystine, not uric acid, stones. Vegetables do not have to be avoided.

A nurse is caring for a client with a ureteral calculus. Which are the most important nursing actions? . Limiting fluid intake at night Monitoring intake and output Straining the urine at each voiding Recording the client's blood pressure Administering the prescribed analgesic

Monitoring intake and output Straining the urine at each voiding Administering the prescribed analgesic A urinary calculus may obstruct urine flow, which will be reflected in a decreased output; obstruction may result in hydronephrosis[1][2]. Urine is strained to determine whether any calculi or calcium gravel is passed. Reduction of pain is a priority. A calculus obstructing a ureter causes flank pain that extends toward the abdomen, scrotum and testes, or vulva; the pain begins suddenly and is severe (renal colic). Fluids should be encouraged to promote dilute urine and facilitate passage of the calculi. Recording the blood pressure is not critical.

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

Phenazopyridine (Pyridium) is a topical anesthetic that is used to treat pain or burning sensation associated with urination. It also imparts a characteristic orange or red color to urine. Amoxicillin is a penicillin form that could cause pseudomembranous colitis as a complication; it is not associated with reddish-orange colored urine. Ciprofloxacin is a quinolone antibiotic used for treating UTIs and can cause serious cardiac dysrhythmias and sunburns. It is not, however, responsible for reddish-orange colored urine. Nitrofurantoin is an antimicrobial medication prescribed for UTIs. This drug may affect the kidneys but is not associated with reddish-orange colored urine.