Genitourinary

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction? a. Bladder stones b. Cystitis c. Urinary retention d. Urethral stricture

c. Urinary retention

A point on the right side of the abdomen, about two-thirds of the distance between the umbilicus and the anterior bony prominence of the hip

McBurney's Point

will turn urine orange

Phenazopyridine

Which intervention would be most beneficial in preventing a catheter-associated urinary tract infection in a postoperative client? Pouring warm water over the perineum Ensuring the patency of the catheter Removing the catheter within 24 hours Cleaning the catheter insertion site

Removing the catheter within 24 hours

This drug is mixed with the patient's immune cells and administered by IV infusion to attack tumor

Sipuleucel-T

small incision made to split the gland & reduce pressure on the urethra

TUIP

uses heat produced by radio-frequency to destroy excess prostate tissue

TUNA

Obstructing prostate tissue removed using the wire loop of a resectoscope and electrocautery, inserted through urethra

TURP

Degarelix MOA

GnRH receptor antagonist

high residual urine

100ml

normal urine flow rate

14ml/sec

Uric Acid levels

3.5-7.5 mg/dL

preconditional age for BPH dx

48

After a prostatectomy the client reports that the urinary catheter tubing is pulling too tightly on the leg. The nurse observes that the indwelling catheter tubing is taut and is taped properly to the thigh. Which action should the nurse take? Explain that the traction helps control bleeding. Adjust tension on the catheter to relieve pressure. Untape the catheter and retape it closer to the urinary meatus. Assess the degree of tension on the catheter and contact the primary healthcare provider.

Explain that traction helps control the bleeding

dutasteride

DHT blockers

Phenazopyridine

Urinary Tract Analgesic

Which of the following hormones is secreted by the juxtaglomerular apparatus? a. Renin b. Calcitonin c. Aldosterone d. Antidiuretic hormone (ADH)

a. Renin

Alfuzosin doxazosin

alph-a blockers

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? a. Unusually smooth skin b. Pruritus c. Increased alertness d. Hypoventilation

b. Pruritus

A client asks the nurse why a creatinine clearance test is accurate. The nurse is most correct to reply which of the following? a. "Creatinine is a stress-related response that is excreted by the kidney." b. "Creatinine is found in the urine to make the urine acidic and can be measured." c. "Creatinine is metabolized in the liver and excreted by the kidney at a regular rate." d. "Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."

d. "Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."

Which nursing assessment finding indicates the client has not met expected outcomes? a. The client has blood-tinged urine following brush biopsy. b. The client reports a pain rating of 3 two hours post-kidney biopsy. c. The client consumes 75% of lunch following an intravenous pyelogram. d. The client voids 75 cc four hours post cystoscopy.

d. The client voids 75 cc four hours post cystoscopy.

ciprofloxacin ofoxacin nofloxacin gatiflaxosin

flouroquinolone

reduce voiding symptoms of prostatitis

anticholinergenics

The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure? a. Albumin b. Cortisol c. Renin d. Vasopressin

c. Renin

impotence gynocomastia low labido

DHT blockers

Headache flushing dyspepsia nasal congestion

ED med side effects

sildenafil vardenafil tandalafil

ED meds

goserelin

GnRH agonist

leuprolide

GnRH agonist

nitrofurantoin cephalexin

anti-infective UT bactricidals

fiasteride, dutasteride inhibit conversion of testosterone to DHT

antiandrogens

may cause impotence, decreased libido, decreased ejaculate volume

antiandrogens

The nurse is caring for a client scheduled for urodynamic testing. Following the procedure, which information does the nurse provide to the client? a. "Contact the primary provider if you experience fever, chills, or lower back pain." b. "You can stop taking the prescribed antibiotic." c. "You will be sent home with a urinary catheter." d. "You may resume consuming caffeinated, carbonated, and alcoholic beverages."

a. "Contact the primary provider if you experience fever, chills, or lower back pain."

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? a. Angiography b. Radiography c. Cystoscopy d. Computed tomography (CT scan)

a. Angiography

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? a. Assessing present voiding patterns b. Restricting fluid intake to reduce the need to void c. Encouraging the client to increase the time between voidings d. Establishing a predetermined fluid intake pattern for the client

a. Assessing present voiding patterns

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? a. Client reports increasing fatigue. b. Urine output is 100 ml/hr. c. Client denies frequency and urgency. d. Client rates pain at a 3 on a scale of 0 to 10.

a. Client reports increasing fatigue.

A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? a. Creatinine b. Blood urea nitrogen c. Hemoglobin d. Osmolality

a. Creatinine

An older client is experiencing an increasingly troublesome need to urinate several times through the night. The client's prostate is within normal limits, and the physician prescribes limiting fluid intake after the evening meal. What is another important intervention to keep the client safe? a. Increase fluid intake throughout the day. b. Decrease salt intake. c. Decrease overall fluid intake. d. Increase protein intake.

a. Increase fluid intake throughout the day.

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? a. Low purine b. Low oxalate c. High protein d. High sodium

a. Low purine

A client is being treated for renal calculi and suspected hydronephrosis. Which measure should the nurse take to help maintain a record of the kidneys' function? a. Monitor the client's intake and output. b. Note the nailbeds and mobility of the fingers. c. Palpate for a thrill over the vascular access. d. Inspect the skin over the fistula or graft for signs of infection.

a. Monitor the client's intake and output.

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply. a. Perform hand hygiene prior to patient care. b. Provide careful perineal care. c. For those patients who are incontinent, insert indwelling catheters. d. Encourage patients to wear briefs. e. Assist the patients with frequent toileting.

a. Perform hand hygiene prior to patient care. b. Provide careful perineal care. e. Assist the patients with frequent toileting.

A nurse is preparing an education program about renal disease. Which risk factor should the nurse include when teaching? Select all that apply. a. Spinal cord injury b. Sickle-cell anemia c. Immobility d. Seizures e. Hypotension

a. Spinal cord injury b. Sickle-cell anemia c. Immobility

Which is an effect of aging on upper and lower urinary tract function? a. Susceptibility to develop hypernatremia b. Increased blood flow to the kidney c. Increased glomerular filtration rate d. Acid-base balance

a. Susceptibility to develop hypernatremia

A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact? a. The left kidney usually is slightly higher than the right one. b. The kidneys lie between the 10th and 12th thoracic vertebrae. c. The kidneys are situated just above the adrenal glands. d. The average kidney is approximately 5 cm (2 in.) long and 2 to 3 cm (0.8 to 1.2 in.) wide.

a. The left kidney usually is slightly higher than the right one.

A patient taking an alpha-adrenergic medication for the treatment of hypertension is having a problem with incontinence. What does the nurse tell the patient? a. When the medication is discontinued or changed, the incontinence will resolve. b. The patient will require a medication regimen to decrease the overactivity of the bladder. c. The medication has caused permanent damage to the bladder sphincter and will require surgical correction. d. Relaxation of the supporting ligaments has occurred and the patient will need to perform pelvic floor exercises to strengthen them.

a. When the medication is discontinued or changed, the incontinence will resolve.

The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present? a. When the urine output is less than 30 mL/h b. When the urine output is between 500 and 1,000 mL/h c. When the urine output is between 300 and 500 mL/h d. When the urine output is about 100 mL/h

a. When the urine output is less than 30 mL/h

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: a. renal calculi. b. acute prostatitis. c. interstitial cystitis. d. an overdistended bladder.

a. renal calculi.

terazosin, doxazosin, transulsin, alfuzosin may cause orthostatic hypotension

alpha-andrenergic antagonists

A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is: a. "Contractility of the bladder wall increases with age." b. "The glomerular filtration rate decreases as we age." c. "Hypoplasia of the prostate occurs in older men." d. "Urethral hypertrophy occurs following menopause."

b. "The glomerular filtration rate decreases as we age."

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? a. Anticonvulsant b. Anticholinergic c. Cholinergic d. Diuretics

b. Anticholinergic

As the nurse comes from morning report, she 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 300 mL with 250 mL residual volume c. Client voided 550 mL of urine for the daylight shift d. Bladder scanning resulted in 250 mL

b. Client voided 300 mL with 250 mL residual volume

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? a. Rebound tenderness at McBurney's point b. Cloudy urine c. An output of 200mL with each voiding d. Urine with a specific gravity of 1.005-1.022

b. Cloudy urine

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? a. It's a normal finding associated with the client's nothing-by-mouth status. b. It's an abnormal finding that requires further assessment. c. It's an abnormal finding that will correct itself when the client ambulates. d. It's a normal finding caused by blood loss during surgery.

b. It's an abnormal finding that requires further assessment.

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Which is an example of how urine concentration is affected? a. A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity. b. On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity. c. When the kidneys are diseased, the ability to concentrate urine may be impaired and the specific gravity may vary widely. d. On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity.

b. On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

Which term refers to inflammation of the renal pelvis? a. Urethritis b. Pyelonephritis c. Cystitis d. Interstitial nephritis

b. Pyelonephritis

Sympathomimetics have which of the following effects on the body? a. Decrease of heart rate b. Relaxation of bladder wall c. Constriction of bronchioles d. Constriction of pupils

b. Relaxation of bladder wall

A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters? a. Glomerulus b. Renal pelvis c. Parenchyma d. Nephron

b. Renal pelvis

The most frequent reason for admission to skilled care facilities includes which of the following? a. Myocardial infarction b. Urinary incontinence c. Stroke d. Congestive heart failure

b. Urinary incontinence

A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should: a. keep the client's knee on the affected side bent for 6 hours. b. check the client's pedal pulses frequently. c. remove the dressing on the puncture site after vital signs stabilize. d. apply pressure to the puncture site for 30 minutes.

b. check the client's pedal pulses frequently.

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 diet high in calcium b. A low-sodium diet c. A low-purine diet d. A diet high in fruits and vegetables

c. A low-purine diet

Which hormone causes the kidneys to reabsorb sodium? a. Antidiuretic hormone b. Growth hormone c. Aldosterone d. Prostaglandins

c. Aldosterone

The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator? a. Uric acid level b. Blood urea nitrogen (BUN) c. Creatinine clearance level d. BUN to creatinine ratio

c. Creatinine clearance level

To assess circulating oxygen concentration, the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which diagnostic test? a. Serum iron concentration b. Hematocrit c. Hemoglobin d. Arterial blood gases

c. Hemoglobin

Which term best describes a total urine output less than 500 mL in 24 hours? a. Polyuria b. Dysuria c. Oliguria d. Nocturia

c. Oliguria

Which of the following is the most common symptom of bladder cancer? a. Back pain b. Pelvic pain c. Painless gross hematuria d. Altered voiding

c. Painless gross hematuria

Retention of which electrolyte is the most life-threatening effect of renal failure? a. Sodium b. Calcium c. Potassium d. Phosphorous

c. Potassium

The client asks the nurse about the functions of the kidney. Which should the nurse include when responding to the client? Select all that apply. a. Secretion of insulin b. Vitamin B production c. Regulation of blood pressure d. Secretion of prostaglandins e. Vitamin D synthesis

c. Regulation of blood pressure d. Secretion of prostaglandins e. Vitamin D synthesis

An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: a. palpate the client's bladder before and after voiding. b. confirm which beverages the client normally consumes. c. confirm all of the medications and supplements normally taken. d. assess the client's usual intake of sodium.

c. confirm all of the medications and supplements normally taken.

The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to a. maintain bed rest for 2 hours. b. carefully handle urine because it is radioactive. c. drink liberal amounts of fluids. d. notify the health care team if bloody urine is noted.

c. drink liberal amounts of fluids.

cefadoxril

cephalosporin

nephrotoxicity and super infections are adverse effects

cephalosporins

no thiazide diuretics kemectursis photosensitivity hematuria protienuria

co-trimoxazole

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? a. "Have you had a recent urinary tract infection?" b. "Have you noticed any vaginal bleeding?" c. "Do you take phenytoin daily?" d. "Do you take multiple vitamin preparations?"

d. "Do you take multiple vitamin preparations?"

While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? a. "Is it painful when you urinate?" b. "Do you have a strong desire to void?" c. "Does it burn when you urinate?" d. "Do you urinate while sleeping?"

d. "Do you urinate while sleeping?"

The nurse is admitting a client who is to undergo an open renal biopsy. About which of the following comments by the client should the nurse be most concerned? a. "I brought a copy of my living will with me." b. "I signed the consent form in the physician's office." c. "I have not eaten since 8 pm last night." d. "I took my usual dose of Coumadin last night."

d. "I took my usual dose of Coumadin last night."

The nurse is reviewing the results of a client's renal function study. The nurse understands that which value represent a normal BUN-to-creatinine ratio? a. 4:1 b. 6:1 c. 8:1 d. 10:1

d. 10:1

A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? a. At 8:00 am, with or without a specimen b. With the first specimen voided after 8:00 am c. 6 hours after the urine is discarded d. After discarding the 8:00 am specimen

d. After discarding the 8:00 am specimen

The nurse is caring for a patient who has been NPO for 2 days pending a diagnostic procedure that has been repeated cancelled. When evaluating this patient's urinalysis, what would the nurse anticipate? a. A fixed urine specific gravity b. A fluctuating urine specific gravity c. A decreased urine specific gravity d. An increased urine specific gravity

d. An increased urine specific gravity

As women age, many experience an increased sense of urgency to void, as well as an increased risk of incontinence. This is usually the result of age-related changes in which part of the renal system? a.Tubule system b. Nephron c. Kidney d. Bladder

d. Bladder

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish? a. Radiography b. Cystoscopy c. Bladder ultrasonography d. Computed tomography with contrast

d. Computed tomography with contrast

The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find? a. Suprapubic pain b. Pain after voiding c. Perineal pain d. Costovertebal angle tenderness

d. Costovertebal angle tenderness

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? a. Therapeutic index b. GI absorption rate c. Liver function studies d. Creatinine clearance

d. Creatinine clearance

Which value does the nurse recognize as the best clinical measure of renal function? a. Volume of urine output b. Circulating ADH concentration c. Urine-specific gravity d. Creatinine clearance

d. Creatinine clearance

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? a. Glomerulonephritis b. Increased fluid intake c. Diabetes insipidus d. Decreased fluid intake

d. Decreased fluid intake

The nurse is educating a patient with urolithiasis about preventive measures to avoid another occurrence. What should the patient be encouraged to do? a. Add calcium supplements to the diet to replace losses to renal calculi. b. Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. c. Limit voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system. d. Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation.

d. Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation.

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? a. Chronic renal failure b. Fistula c. Neurogenic bladder d. Kidney stones

d. Kidney stones

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to: a. Compromised ligament and pelvic floor support of the urethra. b. Uninhibited detrusor contractions. c. A stricture or tumor in the bladder. d. Loss of motor control of the detrusor muscle.

d. Loss of motor control of the detrusor muscle.

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 urgency b. Urinary incontinence c. Urinary frequency d. Urinary stasis

d. Urinary urgency

Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys? a. regulating blood pressure b. excreting nitrogen waste products c. stimulating RBC production d. excreting protein

d. excreting protein

A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 mL. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of: a. prostate irritation. b. client discomfort. c. incorrect urine output values. d. microorganism transfer.

d. microorganism transfer.

Advise clients to take ________________ & _______________ medications with a full glass of water and to increase fluid intake

fluoroquinoles & sulfonamides

the distention of the ureter with urine that cannot flow because the ureter is blocked

hydroureter

an antibacterial medication where therapeutic levels are achieved in the urine only

nitrofurantoin

removal of testes

orchiectomy

obtained to rule out prostate cancer

prostate specific androgen

produced only in the cytoplasm of prostate cells

prostate specific androgen

a condition in which the patient experiences symptoms of prostatitis but shows no evidence of inflammation or infection

prostatodynia

severe itching

pruritus

advise clients taking fluoroquinoles or sulfonamides that ________________ is increased.

sun-sensitivity

microwaves used to heat and destroy excess prostate tissue reduces urinary manifestations

transurethral microwave theotherapy

levaquin is used to treat:

uncomplicated UTIs