URINARY DISORDERS (PREVIOUS EXAM)
For a client receiving dialysis for end-stage renal disease, which client statement indicates effective teaching for a prescribed diet restricting protein, sodium, and potassium?
"I should avoid using salt substitutes."
For a male client with a history of recurrent urinary tract infections (UTI), which UTI indicator would the nurse provide as part of the discharge instructions after a ureterolithotomy? -Urgency or frequency of urination -The inability to maintain an erection -Pain radiating to the external genitalia -An increase in the alkalinity of the urine
-Urgency or frequency of urination (Urgency or frequency of urination occur with a urinary tract infection because of bladder irritability.)
Which finding would the nurse expect in a client with a blood pressure of 190/94 and reporting minimal urinary output, despite drinking adequate fluid? Thirst Urinary retention Weight gain Urinary hesitancy
-WEIGHT GAIN
The nurse is caring for a client who had surgery for the formation of a continent urostomy. Which complication would be prevented by early postoperative ambulation? Wound infection Urinary retention Abdominal distention Incisional evisceration
Abdominal distention
Which factor would the nurse determine is the likely cause of renal calculi in clients with paraplegia?
Accelerated bone demineralization (
The nurse would instruct a client prescribed a low sodium diet and furosemide to include which foods in the diet? Liver Apples Cabbage Bananas
Bananas (Furosemide is a loop diuretic that eliminates potassium by preventing renal absorption. Bananas have a significant amount of potassium: 450 mg.)
When prescribed for a client reporting urinary problems, cholinergic medications prevent which physiological response? Bladder spasticity Bladder flaccidity Urinary tract calculi Urinary tract infections
Bladder flaccidity (Cholinergics intensify and prolong the action of acetylcholine, which increases tone in the genitourinary tract and prevents urinary retention.)
When reviewing the laboratory reports for a client with end-stage renal disease, which test result would the nurse anticipate? Arterial pH 7.5 Hematocrit of 54% Creatinine of 1.2 mg/dL Potassium of 6.3 mEq/L
Potassium of 6.3 mEq/L (Clients with end-stage renal disease have impaired potassium excretion so the nurse should anticipate a potassium level more than the expected range of 3.5 to 5 mEq/L.)
Which condition would the nurse suspect for a client reporting dysuria, hesitancy, urinary urgency, and leaking; and whose laboratory reports reveal a serum prostate-specific antigen (PSA) level of 5 ng/mL with an elevated prostatic acid phosphatase (PAP) levels?
Prostate cancer
For a client with glomerulonephritis, the nurse would provide which instruction to prevent recurrent attacks? Take showers instead of tub baths. Continue the same restrictions on fluid intake. Avoid situations that involve physical activity. Seek early treatment for respiratory tract infections.
Seek early treatment for respiratory tract infections. (Hemolytic streptococci are common in throat infections and can initiate an immune reaction that damages the glomeruli.)
Which test would determine whether a client's newly transplanted kidney is working effectively?
Serum creatinine
When the nurse provides a client, who receives dialysis for end- stage renal disease, information about restricting dietary protein, sodium, and potassium, which client statement indicates effective teaching?
"I should avoid using salt substitutes."
After treatment for a bladder infection, a client asks whether there is anything she can do to prevent cystitis in the future. Which response would the nurse give?
"Increase your daily fluid consumption."
When a client asks what to expect after transurethral resection of the prostate (TURP), which response would the nurse give? - "You will have an abdominal incision and a dressing." - "Your urine will be pink and free of clots." - "There will be an incision between your scrotum and rectum." - "There will be an indwelling urinary catheter and a continuous bladder irrigation in place."
"There will be an indwelling urinary catheter and a continuous bladder irrigation in place." (
A client with repeated episodes of cystitis is scheduled for a cystoscopy to determine the possibility of urinary tract abnormalities. The client asks the nurse to describe the procedure. Which response would the nurse give? - "This procedure is a computerized scan that outlines the bladder and surrounding tissue." - "This procedure is an x-ray film of the abdomen, kidneys, ureters, and bladder after administration of dye." - "This procedure is the visualization of the inside of the bladder wit
"This procedure is the visualization of the inside of the bladder with an instrument connected to a source of light." -
Which action would the nurse take upon determining that a client's urine output has progressively diminished and is less than 40 mL/hr over the past three hours, despite the client's having received 2900 mL intake for two days? - Assess breath sounds and obtain vital signs - Decrease the intravenous (IV) flow rate and increase oral fluids - Insert an indwelling catheter to facilitate emptying of the bladder - Check for dependent edema by assessing the lower extremities
Assess breath sounds and obtain vital signs
Which clinical finding would the nurse monitor to best determine the effectiveness of the client's hydrochlorothiazide therapy? Blood pressure Decreasing edema Serum sodium level Urine specific gravity
Blood pressure (Diuretics promote urinary excretion, which reduces the volume of fluid in the intravascular compartment, thus lowering blood pressure.)
A client with acute kidney injury (AKI) has a total 24-hour urine output of 300 mL after intravenous therapy with a nephrotoxic antibiotic. Which condition would the nurse associate with this finding? Pruritus Paresthesia Dehydration Cardiac arrhythmia
Cardiac arrhythmia (Decreasing urinary output found in acute kidney injury (AKI) is associated with hyperkalemia, which can trigger a cardiac arrhythmia.)
Admitted to the hospital in the oliguric phase of acute kidney injury, the client estimates their urinary output was less than 240 mL for the last 12 hours. The nurse reviews the plan of care and notes a prescription for 900 mL of water, orally over the next 24 hours. Which rationale would the nurse associate with this amount of prescribed fluid?
Compensate for both insensible and expected output over the next 24 hours
When a client arrives at a health clinic reporting hematuria, frequency, urgency, and pain on urination, which condition would the nurse suspect? Chronic glomerulonephritis Cystitis Nephrotic syndrome Pyelonephritis
Cystitis (Cystitis is an inflammation of the bladder that causes frequency and urgency of urination, pain on micturition, and hematuria.)
When preparing a client for a discharge home after lithotripsy for a renal calculus, the nurse would include which instruction during the discharge process? -Drink at least 3 L of fluid daily for 4 weeks -Eliminate organ meats from the diet for 6 weeks -Increase the intake of dairy products for 5 days -Restrict movement for 3 days before resuming usual activities
Drink at least 3 L of fluid daily for 4 weeks (Increasing fluid intake aids in the passage of fragments of the calculus remaining after the lithotripsy.)
Which factor likely contributed to the development of renal calculi in a client?
Excess ingestion of antacids
When noting a client's medication history includes a cholinergic medication, the nurse recalls the medication treats which type of urinary condition? Kidney stones Flaccid bladder Spastic bladder Urinary tract infections
Flaccid bladder (Cholinergics intensify and prolong the action of acetylcholine. This increases the tone in the genitourinary tract and prevents urinary retention.)
For which symptom would the nurse assess in a client recently admitted with renal colic?
Flank discomfort
Which initial finding would the nurse anticipate when providing care for a client with glomerulonephritis? Anuria Dysuria Polyuria Hematuria
HEMATURIA (Blood in the urine (hematuria) and red blood cell casts are classic manifestations of the onset of glomerulonephritis because of the increased permeability of the vascular bed in the kidneys
Which finding would the nurse identify as an early sign common to cancer of the urinary system? Dysuria Retention Hesitancy Hematuria
Hematuria
While providing immediate postoperative care for a client after a transurethral resection of the prostate, the client has an IV and a urinary retention catheter? For which serious complication would the nurse monitor potential development? Sepsis Hemorrhage Leakage around the catheter Urinary retention with overflow
Hemorrhage
For which complication would the nurse monitor a client receiving hemodialysis for chronic kidney disease?
Hepatitis B
Which factor would the nurse suspect contributed to a client's development of urinary calculi?
History of hyperparathyroidism
To prevent future development of renal calculi for a client with ureteral colic, which action would the nurse include in the plan of care?
Instructing the client to drink 8 to 10 glasses of water daily
Before discharging a child who is being treated for acute poststreptococcal glomerulonephritis (APSGN), which information would the nurse plan to give the parents?
Instructions about which high-sodium foods to avoid
The nurse would assess the client with a long history of hypertension for which complication? Cataracts Esophagitis Kidney failure
Kidney failure (Some renal impairment usually is present even with mild hypertension and is attributed to the ischemia resulting from narrowed renal blood vessels and increased intravascular pressure; decreased blood flow causes atrophy of renal structures, such as tubules, glomeruli, and nephrons, leading to kidney failure.)
To prevent futher stone formation for a client diagnosed with renal calculi secondary to hyperuricemia, which food item, if selected by the client, would indicate that the nurse and dietician need to plan further client education regarding necessary dietary modifications? Strawberries Spinach salad Liver and onions Peanut butter sandwich
Liver and onions (Uric acid stones occur from too much purine in the diet. This is found in organ meats, gravies, red wines, and sardines.)
Which intervention would the nurse use to help a client, recovering from an exploratory laparotomy, avoid a urinary tract infection? -Limit the client's fluid intake to 32 oz (946 mL) per day -Encourage the client to use a sitz bath twice per day -Maintain a closed indwelling urinary catheter system and secure the catheter to the leg -Encourage the client to douche once a day after removal of the indwelling urinary catheter
Maintain a closed indwelling urinary catheter system and secure the catheter to the leg
A client, injured in a motor vehicle accident and admitted for observation, has obvious bladder damage. Which finding would lead the nurse to conclude the client is at increased risk of bladder rupture?
Not having voided for six hours
urinary stream has a cystoscopy and biopsy of the prostate gland scheduled. After the procedure, the client reports an inability to void. Which action would the nurse take?
PALPATE ABOVE THE PUBIS SYMPHYSIS
A 9-year-old child is found to have acute glomerulonephritis after a recent infection. Which microorganism would the nurse suspect as the cause of the child's current health problem?
Streptococcus
Which action would the nurse recommend a client take the day before a scheduled intravenous pyelogram (IVP)? Avoid fats and proteins Drink a large amount of fluids Omit dinner and limit beverages Take a laxative before going to bed
Take a laxative before going to bed (Laxatives remove feces and flatus which provides better visualization.)
For the older adult population, which genitourinary factor contributes to urinary incontinence? Sensory deprivation Urinary tract infection Frequent use of diuretics Inaccessibility of a bathroom
Urinary tract infection
For a client scheduled for a transurethral resection of the prostate, which information would the nurse provide regarding post-surgical expectations? -"Urinary control may be permanently lost to some degree." -"An indwelling urinary catheter is required for at least a day." -"Your ability to perform sexually will be impaired permanently." -"Burning on urination will last while the cystotomy tube is in place."
-"An indwelling urinary catheter is required for at least a day." (An indwelling urethral catheter is used because surgical trauma can cause edema and urinary retention. This can lead to additional complications such as bleeding.)
The nurse is providing care to a client being treated for bacterial cystitis. Which goal would need to be met before discharge for this client? -Understand the need to drink 4 L of water per day. -Be able to identify dietary restrictions and plan menus. -Achieve relief of symptoms and maintain kidney function. -Recognize signs of bleeding as a complication of treatment.
-Achieve relief of symptoms and maintain kidney function.
Which outcome must be achieved prior to discharge of a client treated for bacterial cystitis? -Understands need to drink 4 L of water per day -Able to identify dietary restrictions and plan menus -Achieves relief of symptoms and maintains kidney function -Recognizes signs of bleeding as a complication of treatment
-Achieves relief of symptoms and maintains kidney function (To have relief of symptoms and continued urine output are measurable responses to therapy and are the desired outcomes.)
Which symptom indicates to the nurse that the client has an inadequate fluid volume? Select all that apply. Decreased urine Hypotension Dyspnea Dry mucous membranes Pulmonary edema Poor skin turgor
Decreased urine Hypotension Dry mucous membranes Poor skin turgor
Which discharge instruction would the nurse give the client with limited mobility to prevent urinary stasis and formation of renal calculi?
Increase oral fluid intake to 2 to 3 L per day.
When providing care for a client with chronic renal disease, which post-hemodialysis manifestation would the nurse expect?
Weight loss
Which nursing intervention would help prevent sepsis in an older adult client who has an indwelling urinary catheter? Select all that apply. One, some, or all responses may be correct. (4)
-Empty the urinary drainage bag when it is one-half full. -Wash hands and wear clean gloves when performing catheter care. -Use alcohol to clean the drainage port before reconnecting it to the bag. -Consult the health care provider to have the catheter removed as soon as possible.
For a client admitted with a ureteral calculus, which finding would the nurse anticipate identifying? -Urgency and mild aching pain -Foul odor and dark urine -Hematuria with sharp pain when voiding -Frequency with small amounts of urine
-Hematuria with sharp pain when voiding (RationaleHematuria and pain may result from damage to the ureteral lining as the calculus moves down the urinary tract and the urine may become cloudy or pink tinged.)
Which nurse's action is a priority when the adult child of an 87- year-old client reports the parent has recently become confused and has painful urination? -Evaluate oxygen saturation. -Continue to monitor urinary symptoms. -Obtain a urine sample. -Monitor for indications of respiratory distress.
-Obtain a urine sample.
Which assessment finding would the nurse report to the health care provider when caring for a client 8 hours after a surgical repair of an upper urinary tract obstruction? Incisional pain Decreased bowel sounds Urine output of 20 mL per hour Serosanguineous drainage on the dressing
Urine output of 20 mL per hour
