The Client with Cancer of the Bladder

9. The nurse is assessing the urine of a client who has had an ileal conduit and notes that there is a moderate amount of mucus in the urine. The nurse should: 1. change the appliance bag 2. notify the healthcare provider (HCP) 3. obtain a urine specimen for culture 4. encourage a high fluid intake

4. encourage a high fluid intake

10. When teaching the client to care for an ileal conduit, the nurse instructs the client to empty the appliance frequently. Which outcome indicates that the client is following instructions? 1. The skin around the stoma is red 2. The urine is a deep yellow 3. There is no odor present 4. The seal around the stoma is intact

4. The seal around the stoma is intact

20. A nurse is planning care for a client who underwent a percutaneous needle biopsy of the kidney. What should the nurse plan to do immediately after the biopsy? Select all that apply. 1. Assess the biopsy site. 2. Take vital signs every hour. 3. Assess urine for hematuria. 4. Place the client in a prone position. 5. Assess the client for chest pain.

1. Assess the biopsy site. 3. Assess urine for hematuria. 4. Place the client in a prone position.

1. A client has undergone a cystectomy and ileai conduit diversion. What should the nurse include in the discharge instructions? Select all that apply. 1. Drink at least 3,000 mL of fluid each day. 2. Minimize daily activities. 3. Keep urine alkaline to prevent urinary tract infections 4. Avoid odor-producing foods, such as onions, fish, eggs, and cheese. 5. Wear snug clothing over the stoma to encourage urine flow into the drainage bag.

1. Drink at least 3,000 mL of fluid each day 4. Avoid odor-producing foods, such as onions, fish, eggs, and cheese.

31. Which would be the most appropriate measure for preventing the development of a paralytic ileus in a client who has undergone renal surgery? 1. Encourage the client to ambulate every 2 to 4 hours 2. Offer 3 to 4 oz (90 to 120 ml) of a carbonated beverage periodically 3. Encourage use of a stool softener 4. Continue IV fluid therapy

1. Encourage the client to ambulate every 2 to 4 hours

34. Because a client's renal stone was found to be composed of uric acid, a low-purine, alkaline-ash diet was prescribed. Incorporation of which food items into the home diet would indicate that the client understands the necessary diet modifications? 1. milk, apples, tomatoes, and corn 2. eggs, spinach, dried peas, and gravy 3. salmon, chicken, caviar, and asparagus 4. grapes, corn, cereals, and liver

1. milk, apples, tomatoes, and corn

36. A client has been prescribed allopurinol for renal calculi that are caused by high uric acid levels. Which symptoms indicate the client is experiencing adverse effects of this drug? Select all that apply. 1. nausea 2. rash 3. constipation 4. flushed skin 5. bone marrow depression

1. nausea 2. rash 5. bone marrow depression

29. After an intravenous pyelogram (IVP), the nurse should include which measure in the client's plan of care? 1. Maintain bed rest. 2. Encourage adequate fluid intake. 3. Assess for hematuria. 4. Administer a laxative.

2. Encourage adequate fluid intake.

17. The nurse is teaching the client with an ilea conduit how to prevent a urinary tract infection. Which measure would be most effective? 1. Avoid people with respiratory tract infections. 2. Maintain a daily fluid intake of 2,000 to 3,000 mL. 3. Use sterile technique to change the appliance. 4. Irrigate the stoma daily.

2. Maintain a daily fluid intake of 2,000 to 3,000 mL.

27. A client who has been diagnosed with renal calculi reports that the pain is intermittent and less colicky. Which nursing action is most important at this time? 1. Report hematuria to the healthcare provider (HCP). 2. Strain the urine carefully. 3. Administer meperidine every 3 hours. 4. Apply warm compresses to the flank area.

2. Strain the urine carefully.

26. Which is likely to provide the most relief from the pain associated with renal colic? 1. applying moist heat to the flank area 2. administering meperidine 3. encouraging high fluid intake 4 maintaining complete bed rest

2. administering meperidine

5. Which symptom indicates that a client has developed a complication after a cystoscopy? 1. dizziness 2. chills 3. pink-tinged urine 4. bladder spasms

2. chills

12. The nurse should teach the client with an ileal conduit to prevent urine leakage when changing the appliance by: 1. inserting a gauze wick into the stoma 2. closing the opening temporarily with a cellphone seal. 3. suctioning the stoma before changing the appliance 4. avoiding oral fluids for several hours before changing the appliance.

2. closing the opening temporarily with a cellphone seal.

19. A client is scheduled to undergo weekly intravesical chemotherapy for bladder cancer for the next 8 weeks. Which statement indicates that the client understands how to manage the urine as a biohazard? The client will: 1. void into a bedpan and then empty the urine into the toilet. 2. disinfect the urine and toilet with bleach for 6 hours following a treatment. 3. clean the bathroom daily with disinfectant wipes. 4. use a separate bathroom from the rest of the family for the next 8 weeks.

2. disinfect the urine and toilet with bleach for 6 hours following a treatment.

30. A client has a ureteral catheter in place after renal surgery. A priority nursing action for care of the ureteral catheter is to: 1. irrigate the catheter with 30 mL of normal saline every 8 hours. 2. ensure that the catheter is draining freely. 3. clamp the catheter every 2 hours for 30 minutes. 4. ensure that the catheter drains at least 30 mL/h.

2. ensure that the catheter is draining freely.

35. Allopurinol, 200 mg/day, is prescribed for the client with renal calculi to take at home. The nurse should teach the client about which adverse effect of this medication? 1. retinopathy 2. maculopapular rash 3. nasal congestion 4. dizziness

2. maculopapular rash

25. In addition to nausea and severe flank pain, a female client with renal calculi has pain in the groin and bladder. The nurse should assess the client further for signs of: 1. nephritis. 2. referred pain. 3. urine retention. 4. additional stone formation.

2. referred pain.

8. After surgery for an ileal conduit, the nurse should closely assess the client for occurrence of which complication specifically related to this pelvic surgery? 1. peritonitis 2. thrombophlebitis 3. ascites 4. inguinal hernia

2. thrombophlebitis

32. The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. The nurse should report which finding to the healthcare provider (HCP)? 1. temperature, 99.8°F (37.7°C) 2. urine output, 20 mL/h 3. absence of bowel sounds 4. a 2° × 2° (5 cm x 5 cm) area of serosanguine-ous drainage on the flank dressing

2. urine output, 20 mL/h

14. A client has an ileal conduit. Which solutions will useful to help control odor in the urine collecting bag after it has been cleaned? 1. salt water 2. vinegar 3. ammonia 4. bleach

2. vinegar

13. The nurse is evaluating the discharge teaching for a client who has an ileal conduit. Which statements indicate that the client has correctly understood the teaching? Select all that apply. 1. "If I limit my fluid intake, I will not have to empty my ostomy pouch as often." 2. " I can place an aspirin tablet in my pouch to decrease odor." 3. " I can usually keep my ostomy pouch on for 3 to 7 days before changing it." 4. "I must use a skin barrier to protect my skin from urine." 5. "I should empty my ostomy pouch of urine when it is full."

3. " I can usually keep my ostomy pouch on for 3 to 7 days before changing it." 4. "I must use a skin barrier to protect my skin from urine."

28. The client is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi. Which action would be most important for the nurse to include in pretest preparation? 1. Ensure adequate fluid intake on the day of the test. 2. Prepare the client for the possibility of bladder spasms during the test. 3. Check the client's history for allergy to iodine. 4. Determine when the client last had a bowel movement.

3. Check the client's history for allergy to iodine.

23. A client is admitted to the hospital with a diagnosis of renal calculi. The client is experiencing severe flank pain and nausea; the temperature is 100.6°F (38.1°C). Which outcome is a priority for this client? 1. prevention of urinary tract complications 2. alleviation of nausea 3. alleviation of pain 4. maintenance of fluid and electrolyte balance

3. alleviation of pain

7. A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively, the nurse reinforces the client's understanding of the surgical procedure by explaining that an ileal conduit: 1. is temporary procedure that can be reversed later. 2. diverts urine into the sigmoid colon, where it is expelled through the rectum. 3. conveys urine from the ureters to a stoma opening on the abdomen. 4. creates an opening in the bladder that allows urine to drain into an external pouch.

3. conveys urine from the ureters to a stoma opening on the abdomen.

4. The nurse should conduct a focused assessment for the client with suspected bladder cancer for which common sign of the disease? 1.suprapubic pain 2. dysuria 3. painless hematuria 4 urine retention

3. painless hematuria

22. A client has renal colic due to renal lithiasis. What is the nurse's first priority in managing care for this client? 1. Do not allow the client to ingest fluids. 2. Encourage the client to drink at least 500 mL of water each hour. 3. Request the central supply department to send supplies for straining urine. 4. Administer an opioid analgesic as prescribed.

4. Administer an opioid analgesic as prescribed.

6. If the client develops lower abdominal pain after a cystoscopy, what should the nurse instruct the client to do? 1. apply an ice pack to the pubic area 2. Massage the abdomen gently 3. Ambulate as much as possible 4. Sit in a tub of warm water.

4. Sit in a tub of warm water.

18. The nurse evaluates the effectiveness of the client's postoperative plan of care. Which outcome is expected for a client with an ileal conduit? 1. The client verbalizes the understanding that physical activity must be curtailed. 2. The client will place an aspirin in the drainage pouch to help control odor. 3. The client demonstrates how to catheterize the stoma. 4. The client will empty the drainage pouch frequently throughout the day.

4. The client will empty the drainage pouch frequently throughout the day.

15. A female client who has a urinary diversion tells the nurse. "This urinary pouch is embarrassing. Everyone will know that I am not normal . I do not see how I can go out in public anymore." The most appropriate goal for this client is to: 1. manage her anxiety about her health. 2. learn how to care for urinary diversion 3. overcome feelings of worthlessness 4. express fears about the urinary diversion

4. express fears about the urinary diversion

16. The nurse teaches the client with a urinary diversion to attach the appliance to a standard urine collection bag at night. The most important reason for doing this is to prevent: 1. Urine reflux into the stoma 2. appliance separation. 3. urine leakage 4. the need to restrict fluids

1. Urine reflux into the stoma

2. A nurse nurse is caring for a client with an ileal conduit. When assessing the stoma, which outcomes are not desirable? Select all that apply 1. dermatitis 2. bleeding 3. fungal infection 4. use of adhesive solvent on the skin around the stoma 5. placing skin cement on the face plate of the collection bag.

1. dermatitis 2. bleeding 3. fungal infection

11. The nurse should teach the client with an ileal conduit to prevent urine leakage when changing the appliance by: 1. inserting a gauze wick into the stoma 2. closing the opening temporarily with a cellphone seal 3. suctioning the stoma before changing the appliance 4. avoiding oral fluids for several hours before changing the appliance

1. inserting a gauze wick into the stoma

3. A client is admitted to the recovery room after cystoscopy with biopsy. Before the nurse can discharge the client, the nurse should be sure the client: 1. has a bowel movement 2. has received the first dose of pain medication 3. has voided 4. has no blood in the urine

3. has voided

37. The nurse is reviewing laboratory reports for a client who is taking allopurinol. Which finding indicates that the drug has a therapeutic effect? Indicates that the drug has had a therapeutic effect? 1. Decreased urine alkaline phosphatase level 2. Increased urine calcium excretion 3. Increased serum calcium level 4. Decreased serum uric acid level

4. Decreased serum uric acid level

33. A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instruction should the nurse include in the client's discharge teaching plan? 1. Increase daily fluid intake to at least 2 to 3 L. 2. Strain urine at home regularly. 3. Eliminate dairy products from the diet. 4. Follow measures to alkalinize the urine.

1. Increase daily fluid intake to at least 2 to 3 L.

21. A client had a lithotripsy to treat renal calculi. The client is having ureteral spasms and hematuria. What should the nurse do? Select all that apply. 1. Strain all urine. 2. Apply a heating pad to the lower back area. 3. Contact the healthcare provider (HCP) to report hematuria. 4. Encourage fluid intake of 1,000 mL/day. 5. Assess pain level.

1. Strain all urine. 2. Apply a heating pad to the lower back area. 5. Assess pain level.

24. The client is scheduled to have a kidney, ure-ter, and bladder (KUB) radiograph. To prepare the client for this procedure, the nurse should explain to the client that: 1. fluid and food will be withheld the morning of the examination. 2. a tranquilizer will be given before the examination. 3. an enema will be given before the examination. 4. no special preparation is required for the examination.

4. no special preparation is required for the examination.