GU PrepU Adaptive Quizzing

The nurse on a nephrology unit is caring for a diverse group of clients. For which client would a kidney biopsy most likely be contraindicated?

A 42-year-old client with morbid obesity

A client is diagnosed with polycystic kidney disease. Which symptom would the nurse most likely assess?

Hypertension

A client asks the nurse why a creatinine clearance test is accurate. The nurse is most correct to reply which of the following?

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

A client is learning how to perform Kegel exercises. Which statement by the client indicates a need for additional teaching?

"I need to hold the position for at least 15 seconds."

The nurse is giving discharge instructions to the client with uric acid renal calculi. Which statement by the client indicates the client understands the prescribed diet?

"I should limit my intake of meat and fish."

The nurse is caring for several older clients. For which client would the nurse be especially alert for signs and symptoms of pyelonephritis?

A client with urinary obstruction

The nurse is conducting discharge teaching for a client who was admitted with a kidney stone. The nurse includes which instruction as a measure to prevent additional kidney stones?

Avoid drinking tea.

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

Cipro

The nurse is educating a patient who will be performing self-catheterization at home. What information provided by the nurse will help reduce the incidence of infection?

Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.

The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable?

Clients have chronic renal failure.

A creatinine clearance test has been ordered. The nurse prepares to:

Collect the client's urine for 24 hours.

The nurse notes that the client's urine is blood-tinged following cystoscopy. Which nursing action should the nurse take next?

Document the finding in the health record.

A client has a flaccid bladder secondary to a spinal cord injury. The nurse recognizes this client's high risk for urinary retention and should implement what intervention in the client's plan of care?

Double voiding

A gerontologic nurse is assessing a client who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply.

Fever New onset of confusion

The nurse analyzes a urinalysis report. He is aware that the presence of this substance in the urine indicates a blood level that exceeds the kidney's reabsorption capacity. Select the substance.

Glucose

A client on the medical unit has a documented history of polycystic kidney disease (PKD). What principle should guide the nurse's care of this client?

The client's disease is incurable and the nurse's interventions will be supportive.

A client with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?

Ultrasound

The client presents with nausea and vomiting, absent bowel sounds, and colicky flank pain. The nurse interprets these findings as consistent with:

Ureteral colic

Which statement describing urinary incontinence in an older adult client is true?

Urinary incontinence isn't a disease.

The nurse is reviewing the client's lab results. Which lab result requires follow up by the nurse? Select all that apply.

Urine: RBC 20 BUN 28 mg/dL

In a diagnosis of a lower urinary tract infection, which structures could be affected? Select all that apply.

bladder urethra

Which risk factors predispose a client to the development of kidney stones? Select all that apply.

immobilization

A client is reporting hematuria, or the presence of red blood cells in the urine. What is not a cause of hematuria?

lithium toxicity

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:

notify the physician about cloudy or foul-smelling urine.

In a diagnosis of an upper urinary tract infection, which structures could be affected? Select all that apply.

ureter kidney

The nurse is reviewing the results of a urinalysis on a client with acute pyelonephritis. Which of the following would the nurse most likely expect to find?

Pyuria

Which of the following is classified as a upper urinary tract infection (UTI)? Select all that apply.

Acute pyelonephritis Renal abscess

A client is suspected of having interstitial cystitis. Which diagnostic test would the nurse anticipate as being used to confirm the diagnosis?

Bladder biopsy

A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following?

By ascending infection (transurethral)

A client who is blind is admitted for treatment of gastroenteritis. Which nursing diagnosis takes highest priority for this client?

Deficient fluid volume

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?

Diabetes mellitus

A creatinine level has been ordered. The nurse prepares to:

Obtain a blood specimen.

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

"Make sure to eat enough fiber to prevent constipation."

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?

"This medication will relieve your pain."

Which nursing diagnosis is appropriate for a client with renal calculi?

Risk for infection

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.

Secretion of prostaglandins Regulation of blood pressure Vitamin D synthesis

Which of the following is the most sensitive indicator of renal function?

Serum creatinine

As glomerular filtration decreases, which of the following occurs? Select all that apply.

Serum creatinine increases Blood urea nitrogen (BUN) increases Creatinine clearance decreases

A client has been experiencing severe pain and hematuria and is hardly able to ambulate into the physician's office. The physician suspects kidney stones and orders diagnostic tests to confirm. What test would physician order?

KUB

The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?

Ketoralac (Toradol)

A client is scheduled for a diagnostic MRI of the lower urinary system. What preprocedure education should the nurse include?

Relaxation techniques to apply during the test

A patient undergoing a CT scan with contrast has a baseline creatinine level of 3 mg/dL, identifying this patient as at a high risk for developing kidney failure. What is the most effective intervention to reduce the risk of developing radiocontrast-induced nephropathy (CIN)?

Hydrating with saline intravenously before the test

The nurse is preparing an education program on risk factors for kidney disorders. Which of the following risk factors would be inappropriate for the nurse to include in the teaching program?

Hypotension

A nurse caring for a patient with a neurogenic bladder knows to assess for the major complication of:

Infection

Which nursing intervention can help the client prevent urinary incontinence? Select all that apply.

Instruct the client how to perform Kegel exercises. Remind the client to empty the bladder every 2 to 3 hours.

A nurse who provides care in a long-term care facility is aware of the high incidence and prevalence of urinary tract infections among older adults. What action has the greatest potential to prevent UTIs in this population?

Limit the use of indwelling urinary catheters.

A client with a history of chronic cystitis comes to an outpatient clinic with signs and symptoms of this disorder. To prevent cystitis from recurring, the nurse recommends maintaining an acid-ash diet to acidify the urine, thereby decreasing the rate of bacterial multiplication. On an acid-ash diet, the client must restrict which beverage?

Milk

Which type of incontinence refers to involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?

Stress

The nurse and urologist have both been unsuccessful in catheterizing a client with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the health care provider to use to drain the client's bladder?

Insertion of a suprapubic catheter

A patient who complains of a dull, continuous pain in the suprapubic area that occurs with, and at the end of, voiding would most likely be diagnosed with which of the following?

Interstitial cystitis

What is true about extracorporeal shock wave lithotripsy (ESWL)? Select all that apply.

Stones are shattered into smaller particles that are passed from the urinary tract. ESWL is administered with the client in a water bath or surrounded by a soft cushion while under light anesthesia or sedation.