urinary system Final

The nurse is caring for a client who has chronic urinary retention and discussing the options. When discussing care, which intervention is considered first? A) Completing clean intermittent catheterization B) Inserting a cystostomy tube C) Applying a condom catheter D) Using the Credé's maneuver

D) Using the Credé's maneuver

The nurse is caring for several older clients. Which client would the nurse be especially alert for signs and symptoms of pyelonephritis? A)A client with acute renal failure B)A client with a urinary tumor C)A female client with preexisting chronic glomerulonephritis D)A client with urinary obstruction

D)A client with urinary obstruction

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse? A) "Even a perfect match does not guarantee organ rejection." B) "Immunosuppressive drugs guarantee organ success." C) "The doctor may decide to delay the use of immunosuppressant drugs." D) "Let's wait until after the surgery to discuss your treatment plan."

A) "Even a perfect match does not guarantee organ rejection."

The nurse is employed in an urologist office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? A) Anticholinergic B) Diuretics C) Anticonvulsant D) Cholinergic

A) Anticholinergic

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? A) Application of an ostomy pouch B) Intermittent catheterizations C) Exercises to promote sphincter control D) Irrigating the urinary diversion

A) Application of an ostomy pouch

When preparing a client for hemodialysis, which of the following would be most important for the nurse to do? A) Check for thrill or bruit over the access site. B) Inspect the catheter insertion site for infection. C) Add the prescribed drug to the dialysate. D) Warm the solution to body temperature.

A) Check for thrill or bruit over the access site.

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively? A) Client's manual dexterity and vision B) History of allergy to iodine and seafood C) Dietary habits involving cholesterol-laden food D) Menstrual history

A) Client's manual dexterity and vision

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client? A) Coffee in the morning B) Fruit juice midmorning C) Milk at lunch D) Ginger ale at dinner time

A) Coffee in the morning

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication? A) Decrease in the blood flow through the kidneys B) Obstruction of urine flow from the kidneys C) Blood clot formed in the kidneys interfered with the flow D) Structural damage occurred in the nephrons of the kidneys

A) Decrease in the blood flow through the kidneys

The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with temporary pouch. In gathering information for the client, which urinary diversion would the nurse select? A) Ileal conduit B) Kock pouch C) Ureterosigmoidostomy D) Indiana pouch

A) Ileal conduit

The office nurse is providing information to a client who has experienced recurrent renal calculi. Which of the following jobs would place a client at greatest risk for calculi formation? A) Over-the-road truck driver B) Mining engineer C) Nursing instructor D) Rumba instructor

A) Over-the-road truck driver

The hemodialysis client is scheduled to receive weekly injections of epoetin. Which is the most important consideration to be taken by the nurse in the administration of this medication? A) Schedule injection on non-dialysis day. B) Administer immediately after dialysis. C) Monitor complete blood count prior to dose. D) Administer with low-dose aspirin to prevent clot formation.

A) Schedule injection on non-dialysis day.

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure? A) The kidneys can improve over a period of months. B) Once on dialysis, the need will be permanent. C) Kidney function will improve with transplant. D) Acute renal failure tends to turn to end-stage failure.

A) The kidneys can improve over a period of months.

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections? A) The urethra B) The bladder C) The rectum D) The ureters

A) The urethra

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom? A) Azotemia B) Diminished erythropoietin production C) Impaired immunologic response D) Electrolyte imbalances

B) Diminished erythropoietin production

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following? A)Abnormalities in urine B)Location of discomfort C)Elevated calcium levels D)Structural defects in the kidneys

B) Location of discomfort

Which assessment finding is most important in determining nursing care for a client with acute glomerulonephritis? A) Presence of albumin in the urine B) Dark smoky colored urine C) Blurred vision D) Peripheral edema

C) Blurred vision

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder? A) Incontinence B) Dysuria C) Hematuria D) Frequency

C) Hematuria

The nurse is caring for a client with cystitis. Which adjunct therapy is the nurse most correct to suggest to keep bacteria from adhering to the wall of the bladder? A) Douching with a vinegar solution B) Drinking cranberry juice C) Flushing the system with water D) Wiping from the urethra to rectum

B) Drinking cranberry juice

A 176-lb client with pyelonephritis has been instructed to drink at least 30 mL of water for each kilogram of body weight. The client prefers to drink bottled water and asks the nurse to calculate the number of 16-oz bottles needed to fulfill the daily intake required. Fill in the blank with the total number of 16-oz bottles of water that should be consumed each day. __________ bottles

5 Bottles

A client with chronic glomerulonephritis has generalized edema. Which response by the nurse best describes why anasarca occurs with this disorder? A) Fluid shifting occurs due to loss of serum protein. B) Albumin levels increase in the blood dragging fluid inside the vessels. C) Increased intake of sodium in the diet results in anasarca. D) Urinary retention promotes the absorption of fluid into tissue spaces.

A) Fluid shifting occurs due to loss of serum protein.

A child is brought into the clinic with symptoms of periorbital edema and dark brown rusty urine. Which nursing assessment finding would best assist in determining the cause of this problem? A) Sore throat 2 weeks ago B) Red blood cells in the urine C) Elevation of blood pressure D) Protein elevation in the urine

A) Sore throat 2 weeks ago

The nurse is caring for a client diagnosed with bladder stones. The client is scheduled for a litholapaxy. Which nursing action is most important to complete prior to the procedure? A) Strain all urine B) Maintain the intake and output C) Maintain 12 hours of nothing by mouth D) Make sure that the nurse has the consent signed

A) Strain all urine

The nurse is providing instruction in stoma care with temporary bag following an ileal conduit surgery. Which of the following instructions are accurate? Select all that apply. A) Ascorbic acid suppresses urine odors. B) Change temporary ostomy bag when it becomes three-quarters (3/4) full. C) Change the pouch every 4 to 7 days if it is a two-piece pouch. D) Change the pouch daily if it is a one-piece pouch. E) Apply an appliance deodorant to decrease odors.

A)Ascorbic acid suppresses urine odors. C)Change the pouch every 4 to 7 days if it is a two-piece pouch. E)Apply an appliance deodorant to decrease odors.

A client is diagnosed with polycystic kidney disease. Which of the following would the nurse most likely assess? A)Hypertension B)Flank pain C)Fever D)Periorbital edema

A)Hypertension

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching? A) "It is important to use strict aseptic technique." B) "It is appropriate to warm the dialysate in a microwave." C) "The infusion clamp should be open during infusion." D) "The effluent should be allowed to drain by gravity."

B) "It is appropriate to warm the dialysate in a microwave."

An investment banker, with chronic renal failure, informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse? A) "The risk of peritonitis is greater with this type of dialysis." B) "This type of dialysis will provide more independence." C) "Peritoneal dialysis will require more work for you." D) "Peritoneal dialysis does not work well for every client."

B) "This type of dialysis will provide more independence."

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest? A) A low-sodium diet B) A low-purine diet C) A diet high in fruits and vegetables D) A diet high in calcium

B) A low-purine diet

An older adult male client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises him to wear barrier garments, such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity? A) Avoiding the application of moisture sealant B) Exposing the affected area to air C) Using scented sprays or perfumes D) Avoiding using an electric room deodorizer

B) Exposing the affected area to air

The nurse is caring for several clients on a urinary medical unit. Which client is at an increased risk for bladder stones? A) The client with frequent urinary tract infections B) The client who is paraplegic C) The client with difficulty ambulating D) The client with abdominal surgery

B) The client who is paraplegic

When assessing a client with chronic glomerulonephritis, the nurse notes that the client has generalized edema. The nurse documents this as which of the following? A)Periorbital edema B)Anasarca C)Uremic frost D)Hydronephrosis

B)Anasarca

A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands which of the following reasons that this drug is an effective treatment? Select all that apply. A) Increases contraction of the detrusor muscle B) Increases bladder neck resistance C) Reduces bladder spasticity D) Decreases involuntary bladder contractions E) Decrease sphincter control

B)Increases bladder neck resistance D)Decreases involuntary bladder contractions

A client is diagnosed with polycystic kidney disease and requires teaching on the management of the disorder. Which statement made by the client indicates a need for further teaching? A) "I inherited this disorder from one of my parents." B) "The cysts can get quite large in size." C) "As long as I have one normal kidney, I should be fine." D) "If renal failure develops, I may need to consider dialysis."

C) "As long as I have one normal kidney, I should be fine."

A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse? A) "Squamous cell carcinomas do not present with detectable symptoms." B) "You should have sought treatment earlier." C) "Very few symptoms are associated with renal cancer." D) "Painless gross hematuria is the first symptom in renal cancer."

C) "Very few symptoms are associated with renal cancer."

As the nurse comes from morning report, the nurse is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 mL. The client denies any pain on urination. The nurse scans 250 mL of remaining urine in the bladder. Which entry is most correct when documenting the intervention? A) Client voided 300 mL without dysuria B) Client voided 550 mL of urine for the daylight shift C) Client voided 300 mL with 250 mL residual volume D) Bladder scanning resulted in 250 mL

C) Client voided 300 mL with 250 mL residual volume

The client with glomerulonephritis is exhibiting gross periorbital edema. Which is the best nursing intervention to relieve this symptom? A) Administer diuretics. B) Apply warm compresses. C) Elevate the head of the bed. D) Monitor intake and output.

C) Elevate the head of the bed.

A chronic renal failure client complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures? A) Elevated serum creatinine B) Hyperkalemia C) Hyperphosphatemia D) Elevated urea and nitrogen

C) Hyperphosphatemia

The nurse is caring for a male client who has a significant urinary narrowing secondary to an enlarged prostate. Which nursing action is best to relieve his urinary retention? A) Use a 22-French catheter to remove urine from bladder. B) Teach the Credé's maneuver to remove urine from the bladder. C) Insert a coudé catheter to remove urine from the bladder. D) Use a straight-tipped catheter to remove urine from the bladder.

C) Insert a coudé catheter to remove urine from the bladder.

The licensed practical nurse is employed as a charge nurse at a long-term care facility. A resident is ordered a catheterization schedule of every 6 hours due to chronic urinary retention. The LPN reports daily catheterization amounts from the previous day ranging from 450 to 800 mL. Which nursing action is most correct? A) Continue the same order. B) Obtain an order to decrease the frequency of the catheterizations. C) Obtain an order to increase the frequency of the catheterizations. D) Leave the catheter in if obtaining a urine amount over 500 mL.

C) Obtain an order to increase the frequency of the catheterizations.

The nurse evaluates the client as experiencing symptoms of disequilibrium syndrome, following an initial hemodialysis treatment. Which is the best action to be taken by the nurse? A) No action is needed. B) Hold the next scheduled treatment. C) Slow the dialysis process during future treatment. D) Notify the physician and manage the symptoms.

C) Slow the dialysis process during future treatment.

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client? A) Urine output of 35 to 40 mL/hour B) Pain of 3 out of 10, 1 hour after analgesic administration C) SpO2 at 90% with fine crackles in the lung bases D) Blood-tinged drainage in Jackson-Pratt drainage tube

C) SpO2 at 90% with fine crackles in the lung bases

The nurse is assessing a client brought to the emergency department for systemic complications after a traumatic event. Which assessment finding is most suggestive of an intact urinary tract? A) The nurse notes no abnormalities on abdominal inspection. B) The client states diffuse abdominal pain. C) Urine output is pink and noted at 300 mL. D) The physician notes urine leakage upon palpation.

C)Urine output is pink and noted at 300 mL.

The nurse is caring for a client with a cystoscopy tube draining urine from the bladder. When reviewing the client's history prior to administering care, which is of most concern? A) Diagnostic studies reporting bladder stones B) Crusted drainage around the cystoscopy tube C) A white blood count of 12,000 cells/mm3 D) New diagnosis of urosepsis

D) New diagnosis of urosepsis

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom? A) Urinary retention B) Fever C) Frequency D) Painless hematuria

D) Painless hematuria

Following ureteroscopy, for the removal of ureteral calculus, a stent is temporarily left in place. The client asks what purpose the stent provides. Which is the best response from the nurse? A) "The stent is coated with an anti-infective to promote healing." B) "The stent will catch any debris or blood clots left behind." C) "The stent will provide easier passing of future stones." D) "Inflammation from the stone can block the flow of urine."

D) "Inflammation from the stone can block the flow of urine."

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? A) Hypotension B) Weight loss C) Polyuria D) Abdominal pain

D) Abdominal pain

As the home health nurse reviews medications taken by the client with polycystic kidney disease, which medication should be addressed first? A) Lovastatin B) Methylprednisolone C) Furosemide D) Ibuprofen

D) Ibuprofen

The nurse is caring for a client with a urinary tract infection and a urethral stricture. Which complication of the condition is the primary cause of infection? A) The bladder mucosa attracts bacteria. B) There is a backflow of urine causing a diverticulum. C) Urine leakage occurs as urine passes through the stricture. D) Urine production is limited because of the urine remaining in the bladder.

B) There is a backflow of urine causing a diverticulum.

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client? A) Suprapubic cystostomy tube B) Permanent drainage with a urethral catheter C) Clean intermittent catheterization D) Credé voiding procedure

B) Permanent drainage with a urethral catheter

The nurse is caring for four clients on a urinary medical unit. For which client does the nurse need no further medical interventions? A) The client has pain of 7 out of 10 in the midabdomen. B) The client has a residual urine of 90 mL on a bedside ultrasound bladder scan. C) The client has a WBC count of 15,000 on recent lab reports. D) The client is unable to void in the morning hours.

B) The client has a residual urine of 90 mL on a bedside ultrasound bladder scan.

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action, made by the nursing assistant, would require instruction? A) The nursing assistant keeps the catheter and drainage bag together when moving the client. B) The nursing assistant places the drainage bag on the client's abdomen for transport. C) The nursing assistant places the drainage bag on the lower area of the wheelchair for transport. D) The nursing assistant holds the drainage bag while the client moves to the wheelchair.

B) The nursing assistant places the drainage bag on the client's abdomen for transport.

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? A) Stress B) Urge C) Overflow D) Functional

B) Urge

The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document? A) Urinary frequency B) Urinary urgency C) Urinary incontinence D) Urinary stasis

B) Urinary urgency

The nurse is caring for a 37-year-old female client with potential interstitial cystitis. Which question, asked by the nurse, is helpful in suggesting the disease? A) "Have you noticed any unusual vaginal drainage?" B) "Have you experienced hematuria with cramping?" C) "When was your last menstrual period?" D) "Do you drink alcoholic beverages on a frequent basis?"

C) "When was your last menstrual period?"

The nurse is caring for a client with chronic bladder infections and inflammation. The physician has ruled out several medical diagnoses and is considering interstitial cystitis. The nurse is most correct to anticipate which diagnostic test to confirm the disorder? A) A cystoscopy B) A voiding cystourethrogram C) A bladder biopsy D) A potassium sensitivity test

C) A bladder biopsy

The nurse is caring for a client who is following a treatment plan to decrease urinary tract infections. Which of the following indicates the need to change the treatment plan? A) The client has history of repeated antibiotic therapy. B) The client has improved personal hygiene methods. C) The client exhibits continued symptoms. D) The client has diluted urine.

C) The client exhibits continued symptoms.

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education? A) Pats skin dry after bathing B) Uses moisturizing creams C) Keeps nails trimmed short D) Brief, hot daily showers

D) Brief, hot daily showers

The nurse is caring for a 13-year-old female client diagnosed with urethritis. Which of the following assessment answers would indicate that further instruction is needed? Select all that apply. A) "I change my sanitary napkin when it is full." B) "My mom buys just regular toilet paper." C) "I take a bubble bath a couple of times per week." D) "I clean my private area with soap and water." E) "I drink fruit drinks because I do not like water."

A)"I change my sanitary napkin when it is full." C)"I take a bubble bath a couple of times per week." D)"I clean my private area with soap and water."

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation? A) Need to wear underwear made from synthetic material B) Importance of urinating every 4 to 6 hours while awake C) Suggestion to take tub baths instead of showers D) Need to urinate after engaging in sexual intercourse

D) Need to urinate after engaging in sexual intercourse

The nurse is completing a plan of care for a client with chronic urinary incontinence. Which of the following outcomes is a priority? A) The client will decrease fluid intake to 1000 mL/day. B) The client will use the bathroom every 30 minutes while awake. C) The client will maintain perineal skin integrity. D) The client will express feelings of acceptance related to condition.

C) The client will maintain perineal skin integrity.

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? A) Acute glomerulonephritis B) Ureteral stricture C) Urinary calculi D) Renal cell carcinoma

C) Urinary calculi

A client is administered dialysate solution through an abdominal catheter. The nurse notices that the return flow rate is slow, so the nurse advises the client to move to the other side. However, even after changing the client's position, the nurse does not observe an increase in return flow. Which of the following actions should the nurse perform to help accelerate the return flow rate? A)Disconnect the catheter and reapply. B)Loosen the tubing clamp. C)Inform the physician that catheter may need repositioning. D)Stop the process for 5 minutes and resume later.

C)Inform the physician that catheter may need repositioning.

A client in chronic renal failure becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which of the following lab values? A) Elevated urea levels B) Hyperkalemia C) Hypocalcemia D) Elevated white blood cells

B) Hyperkalemia

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? A) Low oxalate B) Low purine C) High protein D) High sodium

B) Low purine

A nephrostomy tube is inserted in a client with a large ureteral calculus. Which is the most important consideration in providing nursing care for this client? A) Clamp the tube for no longer than 2 hours at a time. B) Maintain free, continuous urine drainage. C) Leave nephrostomy site open to the air. D) Use only sterile NSS to irrigate the tube.

B) Maintain free, continuous urine drainage.

A client with several calculi in the ureter is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which teaching statement by the nurse best describes the procedure? A) A scope is passed through the urethra to visualize and destroy the stones with a laser. B) After locating the calculi, a small incision is made to remove the stones. C) The stone is identified via fluoroscopy and then shock waves are used to shatter the stones. D) Once the calculi are located, a fine wire delivers shock waves to pulverize the stones.

C) The stone is identified via fluoroscopy and then shock waves are used to shatter the stones.

The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important? A) Set up a routine schedule of every 4 hours to check for residual urine. B) Check for residual after the client reports the urge to void. C) Record the volume of urine obtained. D) Catheterize the client immediately after the client voids.

D) Catheterize the client immediately after the client voids.

An elderly client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? A) Shows damage to the kidneys B) If risk for chronic pyelonephritis is likely C) Reveals causative microorganisms D) Detects calculi, cysts, or tumors

D) Detects calculi, cysts, or tumors