Chapter 89
A 37-year-old male client presents at the emergency department with excruciating pain that comes in waves, nausea, vomiting, and chills. The nurse suspects the client has kidney stones. What test would be ordered to confirm or rule out this condition? A) KUB flat plate of the abdomen B) Uric acid studies C) Cystogram D) Renal arteriogram
A
A client is diagnosed with hydronephrosis. What occurs in this condition? A) Urine forms, but the flow of urine from the kidney is obstructed. B) Calculi and lithiasis form primarily in the kidneys. C) Fibrous bands form along the ureters or the urethra, thereby narrowing it. D) Multiple clusters of benign tumors form on the kidneys.
A
A nurse is caring for a client receiving peritoneal dialysis following kidney failure. What measure should the nurse employ for this client? A) Encourage the client to breathe deeply. B) Cool the dialysate solution before use. C) Allow the client to drink water before dialysis. D) Leave the solution in the peritoneum for only 30 minutes.
A
A nurse is caring for a client with urge incontinence. What should the nurse include in the client education? A) Tell the client to perform Kegel exercises daily. B) Ask the client to decrease fluid intake. C) Ask the client to void small amounts frequently. D) Tell the client to perform Credé maneuvers.
A
The nurse is preparing a client for a cystoscope. What is the meaning of the prefix "cysto"? A) Pertaining to the bladder B) Pertaining to the kidney C) Pertaining to the renal pelvis D) Pertaining to the ureter
A
The nurse is preparing a client for urodynamic tests. Which of the following of this series is a noninvasive assessment of the status of micturition and generally the first test done in a urodynamic evaluation? A) Uroflowmetry B) Residual urine volume C) Cystometrogram D) Urethral pressure profile
A
The nurse monitoring clients for symptoms of renal failure knows that oliguria is common in the early phases of renal failure. How would the nurse describe this condition? A) Urinary output is <400 mL in a 24-hour period. B) Urinary output is >400 mL in a 24-hour period. C) Urinary output has stopped altogether. D) Urinary output is <100 mL/day.
A
A 28-year-old female client presents at the emergency department with a rapid onset of fever and chills, with flank pain, pyuria, nausea, vomiting, and headache. Laboratory results indicate bacteriuria, WBCs, and casts. What condition should the nurse suspect? A) Chronic cystitis B) Acute pyelonephritis C) Interstitial cystitis D) Glomerulonephritis
B
A client is prescribed morphine to control pain related to knee replacement. The medication causes the client to be confused and agitated with attempts to get out of bed on her own. Restraints are ordered, which cause the client to be incontinent. What type of incontinence is this client experiencing? A) True incontinence B) Iatrogenic incontinence C) Stress incontinence D) Urge incontinence
B
A client is scheduled for cystoscopy to determine which of her kidneys is diseased. Which of the following is a nursing consideration when caring for this client? A) Obtain a urine culture immediately after the test. B) Help the client with sitz baths to ease voiding. C) Report any blood-tinged urine following the procedure. D) Keep the client NPO for 24 hours following the procedure.
B
A nurse is caring for a client with renal calculi. What measure should the nurse employ for this client? A) Encourage the client to drink at least 1 liter of fluids daily. B) Strain all urine through a piece of gauze, cheesecloth, or strainer. C) Ask the client to try to avoid ambulating, if possible. D) Encourage the client to consume plenty of dairy products.
B
A routine urinalysis is performed on a 59-year-old female client who has kidney disease and electrolyte imbalances. Which of the following abnormality would the nurse suspect to be documented? A) Abnormal pH B) Abnormal specific gravity C) Glycosuria D) Ketonuria
B
The nurse caring for clients in a healthcare facility discusses the risk factors of bladder cancer with a client who is being tested for the disease. Which of the following is one of these risk factors? A) Drinking alcohol B) Having lung cancer C) Exposure to UV rays D) Frequent urinary tract infections
B
The nurse is caring for an elderly client in a nursing home who has a urinary diversion in which the ureters are brought to the abdominal wall as a stoma. This is known as what type of diversion? A) Ileal conduit urinary diversion B) Cutaneous ureterostomy C) Continent cutaneous diversion D) Neobladder to urethra diversion
B
The nurse is checking the laboratory results of a 76-year-old woman who had a urinalysis performed. The nurse notes that there is calcium in her urine. What condition does this abnormal substance in the urine signify? A) Infection B) Bone degeneration C) Kidney disease D) Hypertension
B
The nurse is assessing the urinary functioning of a client. Which of the following conditions are most likely to result in urinary alterations? Select all that apply. A) Staphylococcus infection B) Uncontrolled hypertension C) Diabetes mellitus D) Collagen/vascular disease E) Hypothyroidism F) Bronchitis
B,C,D
A 60-year-old female client who is experiencing stress urinary incontinence is not considered a good candidate for surgical repair of the problem. Her healthcare provider recommends a pessary. Which of the following describes this treatment? A) A small electrode connected to a generator is placed in the vagina or rectum. B) The healthcare provider applies firm, gentle pressure above the bladder. C) A device is inserted into the vagina to support the organs of the pelvis. D) A computer is used to monitor how well the client does Kegel exercises.
C
A client has to undergo a cystoscopy for removal of a kidney polyp. What nursing measure should the nurse undertake when caring for this client? A) Ask the client to reduce salt intake for 2 weeks after the cystoscopy. B) Make sure the client is not allergic to iodine dye before the cystoscopy. C) Report any darkening urine after the cystoscopy. D) Ask the client not to drink fluids immediately after the cystoscopy.
C
A nurse is caring for a client who is receiving dialysis. An order on the client's chart reads "Guaiac all stools." What should the nurse do? A) Monitor all stools for consistency and color. B) Measure all stools to monitor the output. C) Send all stools for occult blood test. D) Send all stools for a culture and sensitivity test.
C
A nurse is caring for a client with an ileal conduit for urinary diversion following bladder removal. What measure should the nurse employ when caring for this client? A) Change the conduit appliance daily. B) Use a synthetic barrier cream that contains karaya. C) Use a solvent to loosen the appliance during removal. D) Wet the skin before applying the new appliance.
C
A nurse is caring for a client with complaints of frequent urination. When assessing the urinalysis report, the nurse should look for what component to confirm a normal urinalysis? A) A specific gravity of 1.030 to 1.050 B) A pH level ranging from 12 to 16 C) Absence of glucose in the urine D) Presence of red blood cells (RBCs)
C
The nurse is reading the laboratory results of a client being evaluated for urinary functioning and notes that bilirubin is present in the urine. What condition would the nurse suspect? A) Gout B) Diabetes C) Hepatitis D) Calculi
C
The nurse is teaching a student nurse about the incidence and etiology of nephromas. Which of the following accurately describes this condition? A) Kidney tumors are almost always benign. B) Kidney tumors occur more frequently in women. C) Kidney tumors are rare in people under 30 years of age. D) Some nephromas have a hereditary risk factor.
C,D
A 48-year-old client is undergoing testing to confirm kidney disease. Which of the following tests uses a collected urine specimen to indicate glomerular filtration rate and renal insufficiency? A) Urinalysis B) Blood urea nitrogen (BUN) C) Uric acid studies D) Creatinine clearance test
D
A nurse is caring for a client who is receiving hemodialysis. During dialysis, what measure should the nurse or the dialysis nurse employ when caring for this client? A) Check the shunt every 20 to 30 minutes for vibration. B) Measure blood pressure on the nondominant hand. C) Encourage the client to drink enough orange juice. D) Keep two clamps on the dressing over the cannula.
D
A nurse is caring for a female client with recurrent urinary tract infection (UTI). What measure should the nurse employ with this client? A) Instruct the client to take a bath with mild soap. B) Tell the client to take vitamin D tablets daily. C) Instruct the client to wipe the perineal area from back to front. D) Instruct the client to void before and after intercourse.
D
A nurse is preparing a client for an intravenous pyelogram (IVP). What measure should the nurse employ? A) Keep the client NPO (nothing by mouth) for at least 4 hours. B) Avoid the use of laxatives before the procedure. C) Provide the client with only a few sips of water if thirsty. D) Determine whether the client is allergic to shellfish.
D
Following identification of a mass by imaging studies, a client undergoes a needle biopsy of the kidney for a specific diagnosis. Which of the following is a nursing consideration for this procedure? A) Prepare the client for general anesthesia. B) Place the client in a side-lying position. C) Place a soft pillow under the client's abdomen. D) Apply pressure to the site to minimize bleeding.
D
The nurse is caring for a client who has renal failure. Which of the following is a characteristic of this disease? A) Waste products are removed from the blood into the kidneys. B) Azotemia occurs and potassium is retained in the blood. C) The phases of renal failure are always characterized by overproduction of urine. D) Abnormal levels of potassium, calcium, and phosphate are found in the blood.
D
The student nurse studying the urinary system learns the functions of the upper and lower urinary tract. Which of the following is a function of the lower urinary tract? A) Filter by-products of metabolism. B) Adjust fluid and electrolyte balance. C) Deliver urine to the bladder. D) Store urine until micturition occurs.
D