EAQ Practice Questions: Renal, Urinary, and Reproductive Systems

Which statement regarding erythropoietin is true? 1. Erythropoietin is released by the pancreas. 2. An erythropoietin deficiency causes diabetes. 3. An erythropoietin deficiency is associated with renal failure. 4. erythropoietin is released only when there is adequate blood flow.

An erythropoietin deficiency is associated with renal failure Erythropoietin is produced by the kidneys; its deficiency occurs in renal failure. Erythropoietin is released by the kidneys, not the pancreas. Erythropoietin deficiency causes anemia. Erythropoietin is secreted in response to hypoxia, which results in decreased oxygenated blood flow to the tissues.

What does the presence of ketones in the urine of a client with renal dysfunction indicate?

Anorexia nervosa The body of a client with anorexia nervosa produces ketones as an alternate source of fuel for muscles and organs. Increased red blood cells (RBCs) in the urine indicate cystitis. Increased specific gravity of the urine indicates heart failure. The presence of casts in the urine indicates urinary calculi.

Which is a primary glomerular disease? 1. Diabetic glomerulopathy 2. Chronic glomerulonephritis 3. Hemolytic-uremic syndrome 4. Systemic lupus erythematosus (SLE)

Chronic glomerulonephritis Chronic glomerulonephritis is a primary glomerular disease. Diabetic glomerulopathy, hemolytic-uremic syndrome, and systemic lupus erythematosus (SLE) are secondary glomerular diseases.

A nurse evaluates that a client with chronic kidney disease understands an adequate source of high biologic-value (HBV) protein when the client selects which food from the menu? 1. Apple juice 2. Raw carrots 3. Cottage cheese 4. Whole wheat bread

Cottage cheese contains more protein than the other choices. Apple juice is a source of vitamins A and C, not protein. Raw carrots are a carbohydrate source and contain beta-carotene. Whole wheat bread is a source of carbohydrates and fiber.

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? 1. Chronic glomerulonephritis 2. Nephrotic syndrome 3. Pyelonephritis 4. 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.

A client who had a transurethral resection of the prostate is transferred to the postanesthesia care unit with an intravenous (IV) line and a urinary retention catheter. For which major complication is it most important for the nurse to assess during the immediate postoperative period? 1. Sepsis 2. Phlebitis 3. Hemorrhage 4. Leakage around the IV catheter

Hemorrhage After transurethral surgery hemorrhage is common because of venous oozing and bleeding from many small arteries in the area. Sepsis is unusual, and if it occurs it will manifest later in the postoperative course. Phlebitis is assessed for, but it is not the most important complication. Hemorrhage is more important than phlebitis. Leaking around the IV catheter is not a major complication.

Which test helps to identify fibroids, tumors, and fistulas while performing a reproductive tract examination? 1. Mammography 2. Ultrasonography 3. Hysterosalpingography 4. Computed tomography

Hysterosalpingography A hysterosalpingogram is an X-ray used to evaluate tubal anatomy and patency and used to identify uterine problems such as fibroids, tumors, and fistulas. A mammography is an X-ray of the soft tissue of the breast. An ultrasonography (US) is a technique used to assess fibroids, cysts, and masses. Computer tomography is used to detect and evaluate masses and identify lymphatic enlargement from metastasis.

What are the functions of antidiuretic hormone (ADH)? Select all that apply. 1. Controlling calcium balance 2. Increasing arteriole constriction 3. increasing tubular permeability to water 4. Stimulating the bone marrow to make red blood cells 5. 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).

A nurse educates the client about the relationship between the kidneys and blood pressure. Which term should the nurse use to describe the part of the kidney that senses changes in blood pressure? 1. Calices 2. Glomerulus 3. Macula densa 4. Juxtaglomerular cells

Macula densa The macula densa, a part of the distal convoluted tubule, consists of cells that sense changes in the volume and pressure of blood. Calices are cup-like structures, present at the end of each papilla that collect urine. The glomerulus is the initial part of the nephron, which filters blood to make urine. Juxtaglomerular cells secrete renin. Renin is produced when sensing cells in the macula densa sense changes in blood volume and pressure.

A client in a nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating antibiotic therapy prescribed by the primary healthcare provider? 1. Start a 24-hour urine collection. 2. Prepare for urinary catheterization. 3. Teach the client how to perform perineal care. 4. Obtain a urine specimen for culture and sensitivity.

Obtain a urine specimen for culture and sensitivity. The causative organism should be isolated before starting antibiotic therapy; a culture and sensitivity [1] [2] should be obtained before starting the antibiotic. A 24-hour urine test will not determine the infective organism causing the problem. Catheterization is not a routine intervention for urethritis. Although client teaching is important, it is not the priority at this time.

Which structures are included in the external genitalia in males? Select all that apply. 1. Penis 2. Testes 3. Scrotum 4. Urethra 5. Seminal vesicles

Penis Scrotum The male reproductive system is divided into primary reproductive organs and secondary reproductive organs. Secondary reproductive organs include ducts, sex glands, and external genitalia. The external genitalia consists of the penis and the scrotum. Testes are the primary reproductive organs. The urethra is the duct, and the seminal vesicles are sex glands.

Which structure is removed during circumcision of an infant?

Prepuce

Which hormone is crucial in maintaining the implanted egg at its site? 1. Inhibin 2. Estrogen 3. Progesterone 4. Testosterone

Progesterone Progesterone is necessary to maintain an implanted egg. Inhibin regulates the release of follicle-stimulating hormone (FSH) and gonadotropin-releasing hormone (GnRH). Estrogen plays a vital role in the development and maintenance of secondary sexual characteristics. Testosterone is important for bone strength and development of muscle mass.

Which part of the nephron secretes creatinine required for elimination? 1. Glomerulus 2. Loop of Henle 3. Collecting duct 4. Proximal tubule

Proximal tubule The proximal tubule of the nephron secretes creatinine and hydrogen ions. It also reabsorbs water and electrolytes. The glomerulus filters the blood selectively. The ascending loop of Henle reabsorbs sodium and chloride, whereas the descending loop of Henle concentrates the filtrate. The collecting duct reabsorbs water.

A nurse is counseling a woman who had recurrent urinary tract infections. Which factor should the nurse explain is the reason why women are at a greater risk than men for contracting a urinary tract infection?

Proximity of the urethra to the anus Because a woman's urethra is closer to the anus than a man's, it is at greater risk for becoming contaminated. Urinary pH is within the same range in both men and women. Hormonal secretions have no effect on the development of bladder infections. The position of the bladder is the same in men and women.

Which retrograde procedure involves the examination of the ureters and the renal pelvises? 1. Cystogram 2. Pyelogram 3. Urethrogram 4. Voiding cystourethrogram

Pyelogram A pyelogram is a retrograde examination of the ureters and the pelvis of both kidneys. A cystogram is a retrograde examination of the bladder. An urethrogram is a retrograde examination of the urethra. A voiding cystourethrogram is used to determine whether urine is flowing backward into the urethra.

The nurse is assessing an elderly male. Which finding is seen with aging? 1. Symmetrical testes 2. Reduced size of testes 3. Presence of pubic hair 4. Presence of foreskin on the penis

Reduced size of testes A reduction in the size of the testes is a characteristic of aging. The testes are symmetrical in shape and length; any change in their symmetry denotes an abnormality. Presence of pubic hair is normal. The penis is covered with foreskin; however, circumcised men do not have foreskin. An easily retractable foreskin is an age-related finding.

A male client has discharge from the penis. Gonorrhea is suspected. To obtain a specimen for a culture, what should the nurse do?

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 dischargefrom 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.

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? 1. Drink a glass of water 2. Turn from side to side 3. Deep breathe and cough 4. 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

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 to be on the alert?

Urgency or frequency of urination Urgency or frequency of urination occur with a urinary tract infection 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.

A client who is recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary healthcare provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests should the nurse expect the primary healthcare provider to prescribe to confirm this diagnosis?

Urinalysis and urine culture and sensitivity The client's manifestations may indicate a urinary tract infection; a culture of the urine will identify the microorganism, and sensitivity will identify the most appropriate antibiotic. A cystoscopy is too invasive as a screening procedure; altered bilirubin results indicate liver or biliary problems, not urinary signs and symptoms. Creatinine clearance reflects renal function; A/G ratio reflects liver function. Although an increased urine specific gravity may indicate red blood cells (RBCs), white blood cells (WBCs), or casts in the urine, which are associated with urinary tract infection, it will not identify the causative organism.

What instruction regarding sample collection should the nurse give a client who is ordered a clean-catch urine specimen? 1. Urinate small amount, stop flow, fill half of cup 2. Collect the last urine sample voided in the night 3. Keep the urine sample in dry warm area if delay is anticipated 4. Send the urine sample to the laboratory within 6 hours of collection

Urinate small amount, stop flow, fill half of cup The nurse instructs the client to always collect the midstream urine to send as a test specimen. The client should be instructed to cleanse the perineum with the wipe provided, urinate a small amount, and then stop the flow. The client should then position the specimen cup a few inches from the urethra and resume urination, filling the cup at least half way. The client is asked to collect the first sample voided in the morning because the urine is highly concentrated in the morning. Keeping the urine sample in the refrigerator helps reduce bacterial growth due to alkaline environment. The cells in the urine sample begin to break down in alkalinity, and therefore the client is instructed to send the sample to the laboratory as soon as collected.

A client has a kidney transplant. The nurse should monitor for which assessment findings associated with rejection of the transplant? Select all that apply. 1. Fever 2. Oliguria 3. jaundice 4. Polydipsia 5. Weight gain

fever oliguria weight gain Fever is a characteristic of the systemic inflammatory response to the antigen (transplanted kidney). Oliguria or anuria occurs when the transplanted kidney is rejected and fails to function. Weight gain can occur from fluid retention when the transplanted kidney fails to function or as a result of steroid therapy; this response must be assessed further. Jaundice is unrelated to rejection. Polydipsia is associated with diabetes mellitus; it is not a clinical manifestation of rejection.

which hormone is released in response to low serum levels of calcium?

parathyroid hormone If serum calcium levels decline, the parathyroid gland releases parathyroid hormone to maintain calcium homeostasis. Renin is a hormone released in response to decreased renal perfusion; this hormone is responsible for regulating blood pressure. Erythropoietin is released by the kidneys in response to poor blood flow to the kidneys; it stimulates the production of red blood cells. Atrial natriuretic peptide is produced by the right atrium of the heart in response to increased blood volume. This hormone then acts on the kidneys to promote sodium excretion, which decreases the blood volume.