Medical- Surgical Nursing - Genitourinary Disorders

A middle-aged male client comes to the clinic for an evaluation of difficulty urinating and nocturia. His father died from prostate cancer. He asks the nurse what he can do to ensure early detection of this disease. What question will the nurse ask next? "Do you perform monthly testicular self-examinations?" "Do you have a digital rectal examination and prostate-specific antigen tests yearly?" "Have you had a transrectal ultrasound within the last 10 years?" "How many times a night do you get up to void?"

"Do you have a digital rectal examination and prostate-specific antigen tests yearly?"

A 45-year-old client had a complete abdominal hysterectomy with bilateral salpingo-oophorectomy 2 days ago. The client's abdominal dressing is dry and intact. While sitting up in the chair, the client has severe pain and numbness in her left leg. What should the nurse do first? Administer pain medication. Assess for edema in the left leg. Assess color and temperature of the left leg. Encourage the client to change her position.

Assess color and temperature of the left leg.

The nurse receives a report of a serum potassium level on an infant of 5.4 mEq/L (5.4 mmol/L). What should the nurse do first? Notify the health care provider (HCP) of the abnormal level. Call the laboratory to see how the specimen was obtained. Connect the infant to a cardiac monitor. Check the infant's last 24-hour output.

Call the laboratory to see how the specimen was obtained. If the specimen was from a fingerstick and not a venous sample, the potassium level can be falsely elevated. Because the finger is squeezed to obtain the sample, cells may have been broken from the pressure of squeezing. When the cells break, they release potassium, which will falsely elevate the potassium level in the result. Calling the HCP without first checking the source of the sample would not give the HCP accurate and complete information. A cardiac monitor would not be necessary if the potassium level is falsely elevated. The last 24-hour output would only indicate that the infant is voiding in an adequate amount. This may or may not have an influence on the infant's potassium level.

A client is voiding small amounts of urine every 30 to 60 minutes. What should the nurse do first? Palpate for a distended bladder. Catheterize the client for residual urine. Obtain a urine specimen for culture. Encourage an increased fluid intake.

Palpate for a distended bladder.

A school nurse is teaching a class about sexually transmitted infections (STIs). Which statement is correct regarding STIs? STIs are most prevalent among teenagers and young adults. The incidence of STIs is decreasing due to limited sex partners. The signs and symptoms of an STI are obvious. STIs disproportionately affect people with a lower socioeconomic status and education.

STIs are most prevalent among teenagers and young adults.

A nurse is caring for a client diagnosed with acute kidney injury with an indwelling urinary catheter. The nurse notes that the total urine output for the previous 24 hours is 35 ml. What action should the nurse perform first? Insert an intravenous catheter, and encourage the client to increase oral intake. Teach the client about what to expect during hemodialysis treatments. Scan the client's bladder to determine if residual volumes are present. Notify the healthcare provider that the client meets the criteria for anuria.

Scan the client's bladder to determine if residual volumes are present

A client who has cervical cancer is scheduled to undergo internal radiation. In teaching the client about the procedure, the nurse should tell the client that: she will be in a private room with unrestricted activities. a bowel-cleansing procedure will precede radioactive implantation. she will be expected to use a bedpan for urination. the preferred position in bed will be semi-Fowler's.

a bowel-cleansing procedure will precede radioactive implantation.

A client with benign prostatic hypertrophy (BPH) is being treated with terazosin 2 mg at bedtime. What should the nurse tell the client to monitor on a regular basis? glucosuria glucose restlessness blood pressure pulse

blood pressure

A client with acute renal failure is undergoing dialysis for the first time. The nurse monitors the client closely for dialysis disequilibrium syndrome, a complication that's most common during the first few dialysis sessions. Typically, dialysis disequilibrium syndrome causes: confusion, headache, and seizures. acute bone pain and confusion. weakness, tingling, and cardiac arrhythmias. hypotension, tachycardia, and tachypnea.

confusion, headache, and seizures.

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? GI absorption rate therapeutic index creatinine clearance liver function studies

creatinine clearance

The nurse receives the preoperative blood work report for a client who is scheduled to undergo surgery. Which laboratory finding should the nurse report to the surgeon and anesthesiologist? red blood cells, 4.5 million/mm3 (4.5 X 1012/L) creatinine, 2.6 mg/dL (230 µmol/L) hemoglobin, 12.2 g/dL (122 g/L) blood urea nitrogen, 15 mg/dL (5.4 mmol/L)

creatinine, 2.6 mg/dL (230 µmol/L)

A client has prostatic hypertrophy. What should the nurse assess when conducting a focused assessment of the client's ability to urinate? voiding at less frequent intervals difficulty starting the flow of urine painful urination increased force of the urine stream

difficulty starting the flow of urine

The nurse is administering a high dose of furosemide to a client with nephrotic syndrome. What potential complication is the nurse most concerned with for the client? electrolyte imbalance visual disturbances altered level of consciousness increased urination

electrolyte imbalance

A client is admitted to the recovery room after cystoscopy with biopsy. Before the nurse can discharge the client, what should the nurse assess? The client has: had a bowel movement. no pain. emptied the bladder. no blood in the urine.

emptied the bladder.

A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged I.V. pole. The nurse then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow? evaluating patency of the drainage lumen counter-balancing the I.V. pole attaching the infusion set to an infusion pump collecting a urine specimen before beginning irrigation

evaluating patency of the drainage lumen

A nurse is planning to administer a sodium polystyrene sulfonate enema to a client with a potassium level of 6.2 mEq/L. Correct administration and the effects of this enema should include having the client retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea. retain the enema for 30 minutes to allow for glucose exchange; afterward, the client should have diarrhea. retain the enema for 60 minutes to allow for sodium exchange; diarrhea isn't necessary to reduce the potassium level. retain the enema for 60 minutes to allow for glucose exchange; diarrhea isn't necessary to reduce the potassium level.

retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.

A female client reports to a nurse that she experiences a loss of urine when she jogs. The nurse's assessment reveals no nocturia, burning, discomfort when voiding, or urine leakage before reaching the bathroom. The nurse explains to the client that this type of problem is called: functional incontinence. reflex incontinence. stress incontinence. total incontinence.

stress incontinence.

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem? blood glucose level of 200 mg/dl (11.1 mmol/L) white blood cell (WBC) count of 20,000/mm3 (0.02 L) potassium level of 3.5 mEq/L (3.5 mmol/L) hematocrit (HCT) of 35%

white blood cell (WBC) count of 20,000/mm3 (0.02 L)

A nurse is instructing a client with an ileal conduit about skin care around the stoma. What should the nurse tell the client about stoma care? Select all that apply. "The stoma will shrink to a normal size in 4 to 6 weeks." "You can take a shower or a bath with the appliance on or off." "You should wash around the stoma with an antibacterial soap." "You can use an electric razor to remove the hair around the stoma." "You should remove the collection bag every day to inspect the stoma for infection"

"The stoma will shrink to a normal size in 4 to 6 weeks." "You can take a shower or a bath with the appliance on or off." "You can use an electric razor to remove the hair around the stoma."

A client is diagnosed with pyelonephritis. Which nursing action is a priority for care now? Monitor hemoglobin levels. Insert a urinary catheter. Stress the importance of the use of long-term antibiotics. Ensure sufficient hydration.

Ensure sufficient hydration.

After an intravenous pyelogram (IVP), the nurse should include which measure in the client's plan of care? Maintain bed rest. Encourage adequate fluid intake. Assess for hematuria. Administer a laxative.

Encourage adequate fluid intake.

A client with chronic renal failure who receives hemodialysis three times weekly has a hemoglobin (Hb) level of 7 g/dl (70mmol/L). The most therapeutic pharmacologic intervention would be to administer ferrous sulfate. epoetin alfa. filgrastim. enoxaparin.

epoetin alfa.

A male client enters the oncology clinic for an evaluation. The nurse explains that the healthcare provider has ordered a prostate-specific antigen (PSA) test. The client asks the nurse, "How will this test tell if I have prostate cancer?" What is the nurse's best response? "If your level is between is between 6 and 8 ng/mL, you have nothing to worry about." "Individuals who have a PSA higher than 10 have a 60-70% chance of having prostate cancer." "The evidence shows that individuals who have levels under 4 ng/mL need yearly follow-up." "Individuals with a 2.5 ng/mL PSA and a mother who had breast cancer need to have a biopsy of the prostate gland."

"Individuals who have a PSA higher than 10 have a 60-70% chance of having prostate cancer." Most men have PSA levels under 4 ng/mL, which has traditionally been used as the cutoff for concern about the risk of prostate cancer. Men with prostate cancer often have PSA levels higher than 4. Those with a PSA between 4 and 10 have a 25% chance of having prostate cancer and if the PSA is higher than 10, the risk increases to 67%.