Med-Surg module 2
Which statement reflects the nurse's suspicions regarding a client's cloudy urine noted on a urinalysis report? A) The client has a urinary infection. B) The client has a biliary obstruction. C) The client has diabetic ketoacidosis. D) The client has been on a starvation diet.
A The urine becomes cloudy when an infection is present due to the presence of leukocytes. The nurse concludes the client has a urinary infection. In cases of biliary obstruction, the urine contains bilirubin. The presence of ketones in the urine indicates diabetic ketoacidosis or prolonged starvation.
The nurse prepares a male client with a history of recurrent urinary tract infections (UTIs) for discharge after a ureterolithotomy. Which clinical manifestations of a UTI would the nurse teach this client to recognize? A)Urgency or frequency of urination B) An increase of ketones in the urine C) The inability to maintain an erection D) Pain radiating to the external genitalia
A) Urgency or frequency of urination Urgency or frequency of urination occurs with a urinary tract infection because of bladder irritability; burning on urination and fever are additional signs of a UTI. Increased ketones indicate diabetes mellitus, starvation, or dehydration. A UTI does not affect the ability of a male to maintain an erection. Pain radiating to the external genitalia is a symptom of a urinary calculus, not an infection.
In which components of the nephron unit does furosemide decrease fluid reabsorption? Select all that apply. One, some, or all responses may be correct. A)Glomerulus B)Loop of Henle C)Distal tubules D)Proximal tubules E) Bowman capsule (BC)
A,B,C Furosemide, known as a "loop diuretic," inhibits sodium and chloride reabsorption from the ascending loop of Henle, proximal tubules, and distal tubules. The glomerulus is the site of glomerular filtration. The BC is the site of the collection of glomerular filtrate and contains the glomerulus.
A pathology report states a client's urinary calculus is composed of uric acid. Which food item would the nurse instruct the client to avoid? a) MILK B) LIVER C) CHEESE D) VEGETABLES
B A low-purine diet controls the development of uric acid stones. Clients with uric acid stones should avoid foods high in purine, such as organ meats and extracts. The client should avoid milk if he or she had calcium stones, not uric acid stones. The client should avoid cheese or animal protein if he or she had cysteine stones, not uric acid stones. The client does not need to avoid vegetables when on a low-purine diet.
Which action is promoted by vasopressin? A) Sodium reabsorption B) Reabsorption of water C) Tubular secretion of sodium D) Red blood cell production
B Vasopressin is also known as an antidiuretic hormone. It helps in the reabsorption of water into the capillaries. Aldosterone promotes sodium reabsorption. Natriuretic hormones promote tubular secretion of sodium. Erythropoietin stimulates bone marrow to make red blood cells.
Which statement indicates the nurse has a correct understanding of kidney ultrasonography? A) "Kidney ultrasonography primarily makes use of iodinated B) "Kidney ultrasonography is performed on the client with an empty bladder." C) "Kidney ultrasonography makes use of sound waves and has minimal risk." D) "Kidney ultrasonography provides three-dimensional information regarding kidneys."
C Kidney ultrasonography is a minimal-risk diagnostic procedure. Ultrasonography makes use of sound waves, which when reflected from internal organs of varying densities produce images of the kidneys, bladder, and associated structures on the display screen. Although a dye can be used in computed tomography (CT), it is not the primary method. Generally, when performing a kidney ultrasonography, the client's bladder is full. A CT scan gives three-dimensional information about the kidney and associated structures.
Which urine characteristic is consistent with a urinary tract infection? A)Smoky B) Cloudy C) Orange-amber D) Yellow-brown
C) Orange-amber
The nurse is teaching a birthing/prenatal class about breast-feeding. Which hormone stimulates the production of milk during lactation? A) Inhibin B) Estrogen C) Prolactin D) Progesterone
C) Prolactin Prolactin is the hormone that initiates and produces milk during lactation. Inhibin prevents the secretions of follicle-stimulating hormone and gonadotropin-releasing hormone. Estrogen and progesterone are the sex hormones produced by the ovaries.
The nurse is performing a male reproductive system assessment of an older adult client. The nurse expects which age-related finding? a) Asymmetrical testes b) Reduced size of testes c) Absence of pubic hair d) Foreskin that is difficult to retract
b 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. Pubic hair is normally present. For uncircumcised males, a foreskin will be present and should be easily retractable.
Which condition should the nurse anticipate as a potential problem in a female client with a neurogenic bladder? A.Stress incontinence B.Infection C.Painless gross hematuria D.Peritonitis
b infection is the major complication resulting from stasis of urine and subsequent catheterization. Option A is the involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure. Option C is the most common symptom of bladder cancer. Option D is the most common and serious complication of peritoneal dialysis.
A client, transferred to the postanesthesia care unit after a transurethral resection of the prostate (TURP), has an intravenous (IV) line and a urinary retention catheter. During the immediate postoperative period, for which potentially critical complication would the nurse monitor? a)Sepsis b)Phlebitis c) Hemorrhage d) Leakage around urinary catheter
c 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. The nurse assesses for phlebitis, but phlebitis is not the most important complication. Hemorrhage is more important than phlebitis. Leaking around the IV catheter is not a major complication.
A client diagnosed with invasive cancer of the bladder has brachytherapy scheduled. Which successful therapy outcome would the nurse expect with this client? Decrease in urine output Increase in pulse strength Shrinkage of the tumor when scanned Increase in the quantity of white blood cells (WBCs)
c Brachytherapy involves implanting isotope seeds in, or next to, the tumor. The isotope seeds interfere with cell multiplication, which should control the growth and metastasis of cancerous tumors. Radiation affects healthy as well as abnormal cells; urinary output will increase with successful therapy. With brachytherapy of the bladder, an increase in pulse strength is not a sign of success. The radioactive isotope seeds may affect the client's bone marrow sites, resulting in a reduction of WBCs.
Which substance is released in response to low serum levels of calcium? a) Renin b) Erythropoietin c) Parathyroid hormone d) Atrial natriuretic peptide
c 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.
Which process is a function of the kidney hormones? a) Prostaglandin increases blood flow and vascular permeability. b) Bradykinin regulates intrarenal blood flow via vasodilation or vasoconstriction. c) Renin raises blood pressure because of angiotensin and aldosterone secretion. d) Erythropoietin promotes calcium absorption in the gastrointestinal tract tract.
c Renin is a kidney hormone that raises blood pressure as a result of angiotensin and aldosterone secretion. Prostaglandin is a kidney hormone that regulates intrarenal blood flow via vasodilation or vasoconstriction. Bradykinin is a kidney hormone that increases blood flow and vascular permeability. Erythropoietin is a kidney hormone that stimulates the bone marrow to make red blood cells.
A client recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary health care provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests would the nurse expect the primary health care provider to prescribe to confirm this diagnosis? a) Cystoscopy and bilirubin level b) Specific gravity and pH of the urine c) Urinalysis with a urine culture and sensitivity d) Creatinine clearance and albumin/globulin (A/G) ratio
c 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, white blood cells, or casts in the urine, which are associated with urinary tract infection, it will not identify the causative organism.
Which term is used to describe a client passing air and bubbles during urination? a) Nocturia b) Oliguria c) Pneumaturia d) Stress incontinence
c The occurrence of gas along with urination is called pneumaturia and could result from the formation of a fistula between the bowel and urinary bladder. Frequent urination during the night is called nocturia and is associated with conditions such as heart failure and diabetes mellitus. In medical conditions such as severe dehydration and shock, the urine output is reduced to 100 to 400 mL/day, and this is termed oliguria. Weak sphincter control, urinary retention, and estrogen deficiency are some causes for stress incontinence or involuntary urination during increased pressure situations.
A client arrives at a health clinic reporting a recent onset of hematuria, frequency, urgency, and pain on urination. Which diagnosis will the nurse observe in the client's medical record? a) Chronic glomerulonephritis b) Nephrotic syndrome c) Pyelonephritis d) Cystitis
d 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.
Which finding in a urinalysis indicates a urinary tract infection? a) Crystals b) Bilirubin c) Ketones d) Leukoesterase
d Leukoesterases are released by white blood cells in response to an infection or inflammation. The presence of this chemical in urine indicates a urinary tract infection. The presence of crystals in the urine indicates that the specimen had been allowed to stand. Presence of bilirubin in the urine indicates anorexia nervosa, diabetic ketoacidosis, and prolonged fasting. The presence of ketones indicates diabetic ketoacidosis.
Which medication turns urine reddish-orange in color? a) Amoxicillin b) Ciprofloxacin c) Nitrofurantoin d) Phenazopyridine
d Phenazopyridine is a topical anesthetic that is used to treat pain or burning sensation associated with urination. It also imparts a characteristic orange or red color to urine. Amoxicillin is a penicillin form that could cause pseudomembranous colitis as a complication; it is not associated with reddish-orange colored urine. Ciprofloxacin is a quinolone antibiotic used for treating urinary tract infections (UTIs) and can cause serious cardiac dysrhythmias and sunburns. It is not, however, responsible for reddish-orange colored urine. Nitrofurantoin is an antimicrobial medication prescribed for UTIs. This medication may affect the kidneys but is not associated with reddish-orange colored urine.
The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis report. Which urinary finding indicates the need to notify the primary health care provider? a) Acidic pH b) Glucose negative c) Bacteria negative d) Presence of large proteins
d The glomeruli are not permeable to large proteins such as albumin or red blood cells, and finding them in the urine is abnormal; the nurse would report their presence to the primary health care provider to modify the client's treatment plan. The urine can be acidic; normal pH is 4.0 to 8.0. Glucose and bacteria should be negative and are normal findings.
Which content about self-care should the nurse include in the teaching plan of a female client who has genital herpes? (Select all that apply.) A.Encourage annual physical and Pap smear. B.Take antiviral medication as prescribed. C.Use condoms to avoid transmission to others. D. Warm sitz baths may relieve itching. E.Use Nystatin suppositories to control itching. F.Use a douche with weak vinegar solution to decrease itching.
he nurse should include (A, B, C, and D) in the teaching plan of a female client with genital herpes. (E) is specific for Candida infections, and option (F) is used to treat Trichomonas.