Renal and Urology ?s
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)? a) "I've had trouble getting started when I urinate, often straining to do so." b) "I've had a fever and noticed I've been running to the bathroom more often." c) "I'm waking up at night to urinate and I've noticed some burning, too." d) "I've had some pain in my lower abdomen lately and felt a bit sick to my stomach."
"I've had trouble getting started when I urinate, often straining to do so." Correct Explanation: Symptoms that might alert the nurse to BPH include difficulty initiating urination and abdominal straining with urination. Although fever, urinary frequency, nocturia, pelvic pain, nausea, vomiting, and fatigue may be noted, they also may suggest other conditions such as urinary tract infection. Fever, nausea, vomiting, and fatigue are general symptoms that can accompany many conditions.
A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal? a) 2.7 nanograms/milliliter b) 4.6 nanograms/milliliter c) 3.2 nanograms/milliliter d) 3.8 nanograms/milliliter
4.6 nanograms/milliliter Correct Explanation: Normal prostate-specific antigen (PSA) levels are less than 4.0 nanograms/milliliter (ng/mL). A level of 4.6 ng/mL would be considered abnormal
Which of the following is accurate regarding sildenafil (Viagra)? a) The medication should be taken right before intercourse. b) It can be taken twice daily for increased effect. c) There does not need to be sexual stimulation to produce an erection. d) Its side effects include headache, flushing, and dizziness.
Its side effects include headache, flushing, and dizziness. Correct Explanation: Side effects of Viagra include headache, flushing, and dizziness. Is should be taken 30 minutes to 4 hours prior to intercourse. Taking this medication more than once a day will not have an increased effect. The patient will have no erection if there is no stimulation
The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following? a) Light yellow and clear b) Light pink with few red streaks c) Reddish-pink with numerous clots d) Dark amber with copious mucous
Light yellow and clear Correct Explanation: Typically a three-way catheter drainage system is removed when the urine appears clear and amber (light yellow). Reddish-pink urine with clots usually occurs in the immediate postoperative period. Eventually the urine becomes light pink within 24 hours after surgery. Dark amber urine suggests concentrated urine commonly associated with dehydration
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? a) High sodium b) Low purine c) Low oxalate d) High protein
Low purine Explanation: A low-purine diet is used for uric acid stones; although, the benefits are unknown. Clients with a history of calcium oxalate stone formation need a diet that is adequate in calcium and low in oxalate. Only clients who have type II absorptive hypercalciuria—approximately half of the clients—need to limit calcium intake. Usually, clients are told to increase their fluid intake significantly, consume a moderate protein intake, and limit sodium. Avoiding excessive protein intake is associated with lower urinary oxalate and lower uric acid levels. Reducing sodium intake can lower urinary calcium levels.
A group of students are reviewing the phases of acute renal failure. The students demonstrate understanding of the material when they identify which of the following as occurring during the second phase? a) Oliguria b) Restored glomerular function c) Acute tubular necrosis d) Diuresis
Oliguria Correct Explanation: During the second phase, the oliguric phase, oliguria occurs. Diuresis occurs during the third or diuretic phase. Acute tubular necrosis (ATN) occurs during the first, or initiation, phase in which reduced blood flow to the nephrons leads to ATN. Restoration of glomerular function, if it occurs, occurs during the fourth, or recovery, phase
The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include? a) Waiting to urinate for 5 to 10 minutes after feeling the initial urge b) Using a bearing down motion to promote complete bladder emptying when voiding c) Engaging in strenuous exercise to strengthen abdominal muscles d) Performing perineal exercises frequently throughout the da
Performing perineal exercises frequently throughout the day Explanation: After a prostatectomy, the client should be instructed in how to perform perineal exercises and to perform them hourly throughout the day, each day. In addition, the client should avoid bearing down (straining) to urinate because of the increased risk for hematuria. He should also avoid strenuous exercise, which increases the tendency to rebleed. The client should be instructed to urinate as soon as he feels the first urge to do so
Which of the following are age-related changes affecting the male reproductive system? a) Testes become soft. b) Patency increases. c) Plasma testosterone levels decrease. d) Prostate secretion increases.
Plasma testosterone levels decrease. Correct Explanation: Changes in gonadal function include a decline in plasma testosterone levels and reduced production of progesterone. The testes become smaller and more firm.
Which of the following terms is used to refer to inflammation of the renal pelvis? a) Pyelonephritis b) Cystitis c) Urethritis d) Interstitial nephritis
Pyelonephritis Explanation: Pyelonephritis is an upper urinary tract inflammation, which may be acute or chronic. Cystitis is inflammation of the urinary bladder. Urethritis is inflammation of the urethra. Interstitial nephritis is inflammation of the kidney
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? a) Stress b) Overflow c) Reflex d) Urge
Stress Correct Explanation: Stress incontinence is the involuntary loss of urine through an intact urethra as a result of sneezing, coughing, or changing position. Reflex incontinence is their involuntary loss of urine due to hyperreflexia in the absence of normal sensations usually associated with voiding. Urge incontinence is the involuntary loss of urine associated with a strong urge to void that cannot be suppressed. Overflow incontinence is the involuntary loss of urine associated with overdistention of the bladder.
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? a) Functional b) Stress c) Overflow d) Urge
Urge Correct Explanation: Urge incontinence occurs when the client experiences the sensation to void but cannot control voiding in time to reach a toilet. Stress incontinence occurs when the client has an involuntary loss of urine that results from a sudden increase in intra-abdominal pressure. Overflow incontinence occurs when the client experiences an involuntary loss of urine related to an overdistended bladder; the client voids small amounts frequently and dribbles. Functional incontinence occurs when the client has function of the lower urinary tract but cannot identify the need to void or ambulate to the toilet.
The nurse is educating a patient about performing testicular self-examination (TSE). The nurse informs the patient that the best time to perform the exam is when? a) After exercise b) At bedtime c) In the morning when arising d) After a warm bath or shower
After a warm bath or shower Correct Explanation: Testicular self-examination is to be performed once a month. The test is neither difficult nor time-consuming. A convenient time is usually after a warm bath or shower when the scrotum is more relaxed
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction? a) "Be aware that your urine will be cherry-red for 5 to 7 days." b) "Apply an antibacterial dressing to the incision daily." c) "Take your temperature every 4 hours." d) "Increase your fluid intake to 2 to 3 L per day.
Take a deep breath and exhale when the physician inserts a gloved finger into the rectum. Correct Explanation: To minimize discomfort and relax the anal sphincter during the rectal examination, the patient is instructed to take a deep breath and exhale slowly as the practitioner inserts a finger. If possible, he should turn his feet inward so his toes are touching
Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis? a) Take prescribed antibiotics. b) Resume sexual intercourse. c) Undertake lifting exercises. d) Apply ice to area after scrotal swelling subsides.
Take prescribed antibiotics. Correct Explanation: Home care for a patient with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics, and to take sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and refrain from sexual intercourse until symptoms are relieved.
Which of the following is the most immediate danger after prostate surgery? a) Obstructed urine flow b) Deep vein thrombosis c) Infection d) Bleeding
Bleeding Correct Explanation: The immediate danger after prostate surgery is bleeding and hemorrhagic shock. If, after 20 minutes, the bleeding is not controlled, surgical exploration may be considered. Since bleeding is increased in the sitting position, which increases bladder and venous pressure, the patient is encouraged to rest in bed with the head of the bed slightly elevated.
Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys? a) Oliguria b) Initiation c) Diuresis d) Recover
Oliguria Correct Explanation: The oliguria period is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys, such as urea and creatinine. The initiation periods begins with the initial insult and ends when oliguria develops. The diuresis period is marked by a gradual increase in urine output. The recovery period signals the improvement of renal function and may take 6 to 12 months.
