Med Surg Chapter 28: Nursing Management: Patients With Urinary Disorders: PREPU

A 30-year-old woman has presented for care, stating, "I'm pretty sure that I've got a UTI, so I think I'll need some antibiotics." In the presence of a UTI, the nurse would expect the woman to have which of the following signs and symptoms? Select all that apply. A. Urinary frequency B. Copper-colored urine C. Excessively dilute urine D. Urgency E. Pain on urination

A, D, E,

A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude? A. The pouch faceplate doesn't fit the stoma. B. Stoma dilation wasn't performed. C. A skin barrier was applied properly. D . The skin wasn't lubricated before the pouch was applied.

A

A patient informs the nurse that every time she sneezes or coughs, she urinates in her pants. What type of incontinence does the nurse recognize the patient is experiencing? A. Stress incontinence B. Functional incontinence C. Iatrogenic incontinence D. Urge incontinence

A

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following? A. Location of discomfort B. Structural defects in the kidneys C. Elevated calcium levels D. Abnormalities in urine

A

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively? A. Client's manual dexterity and vision B. History of allergy to iodine and seafood C. Menstrual history D. Dietary habits involving cholesterol-laden food

A It is essential to assess manual dexterity, vision, and level of understanding of a client who undergoes a urinary diversion procedure, because this information will determine the client's ability to manage stoma care and self-catheterization following the urinary diversion procedure.

A female client who suffers from urethral strictures undergoes a dilation procedure. Following the procedure, she experiences a burning sensation while voiding. Which of the following instructions would be most helpful? A. Encourage her to visit a local ostomy support group. B. Instruct her to take warm sitz baths. C. Advise her to cleanse her perineum frequently. D. Urge her to apply moisture sealants.

B

Which statement describing urinary incontinence in an older adult client is true? A. Urinary incontinence is a normal part of aging. B. Urinary incontinence isn't a disease. C. Urinary incontinence in the elderly population can't be treated. D. Urinary incontinence is a disease.

B Urinary incontinence isn't a normal part of aging nor is it a disease. It may be caused by confusion, dehydration, fecal impaction, restricted mobility, or other causes.

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? A. Pancreatitis B. Hyperparathyroidism C. Diabetes mellitus D. Hyperuricemia

C

Which of the following accounts for the majority of ureteral injuries? A. Unintentional injuries B. Knife wounds C. Sports injuries D. Gunshot wounds

D. Gunshot wounds account for 95% of ureteral injuries

A nurse is assessing a client with suspected bladder cancer. Which finding would the nurse most likely expect to assess? A. dysuria B. urgency C. pelvic pain D. painless hematuria

D

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: A. report the presence of fine, sandlike particles through the nephrostomy tube. B. notify the physician about cloudy or foul-smelling urine. C. limit oral fluid intake for 1 to 2 weeks. D. report bright pink urine within 24 hours after the procedure.

B Sandlike debris is normal because of residual stone products. Hematuria is common after lithotripsy.

The nurse is planning the care of a male patient who has been admitted to the medical unit with an exacerbation of chronic pyelonephritis. Which of the following goals should the nurse prioritize in the planning of this patient's nursing care? A. The patient will void every 3 hours. B. The patient will express an understanding of the pathophysiology of pyelonephritis. C. The patient will consume 3 to 4 L of fluid each day. D. The patient will maintain his preadmission activities of daily living (ADLs).

C High fluid intake is important in the treatment of chronic pyelonephritis

The nurse is assessing a patient admitted to the unit with kidney stones. What assessment parameters would be priorities for the nurse to address? Select all that apply. A. Surgical history B. Vaccination history C. Family history of renal stones D. Dietary history E. Medication history

C, D, E,

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease? A. Incomplete bladder emptying B. Urgency C. Urinary retention D Incontinence

D

Select the most common fluid and electrolyte problem in the elderly that can cause urinary incontinence by masking the urge sensation. A. Hernatremia B. Dehydration C. Fluid retention D. Hypokalemia

B

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 an abnormal finding that requires further assessment. B. It's a normal finding associated with the client's nothing-by-mouth status. C. It's a normal finding caused by blood loss during surgery. D. It's an abnormal finding that will correct itself when the client ambulates.

A

Which metabolic defects are associated with stone formation? A. Hypoparathyroidism B. Hyperparathyroidism C. Hyperthyroidism D. Hypouricemia

B

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? A. Septra B. Cipro C. Macrodantin D. Bactrim

B Ciprofloxacin (Cipro) is a fluoroquinolone used to treat UTIs

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor? A. Client with a history of untreated gonorrhea B. Client with a history of cigarette smoking C. Client with a history of bladder inflammation D. Client with a history of a sexually transmitted disease

B

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia? A. Incontinence B. Change in cognitive functioning C. Hematuria D. Back pain

B

A 67-year-old woman whose medical history includes obesity, type 2 diabetes, and hypertension has admitted to her care provider that she has often been incontinent of urine over the past several months. In an effort to control her problem, she has been using absorbent pads but is motivated to find a solution to her overactive bladder. What goal should the patient and the nurse emphasize to restore the patient's urinary continence? A. Changing the woman's diet to reduce her sodium intake B. Making lifestyle changes that will result in weight loss C. Monitoring the patient's blood pressure more closely D. Increasing the frequency of glucometer checks and improving her glycemic control

B Obesity is associated with overactive bladder and urinary incontinence thus weight control should be considered as a first-line intervention, particularly when the body mass index (BMI) is greater than 27.

The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms? A. Urinary analgesics B. Antispasmodic agents C. Anticholinergic agents D Antibiotics

C

Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor? A. Avoid pouches with carbon filters. B. Avoid foods such as buttermilk or yogurt. C. Eat plenty of cheese and eggs. D. Add a few drops of diluted white vinegar to the pouch.

C

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? A. Morphine sulfate B. Meperidine (Demerol) C. Ketoralac (Toradol) D. Aspirin

C.

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? A. Due to a fistula (direct extension) B. Through the bloodstream (hematogenous spread) C. The result of urethra abrasion (sexual intercourse) D. By ascending infection (transurethral)

D

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client? A. Credé voiding procedure B. Suprapubic cystostomy tube C. Clean intermittent catheterization D. Permanent drainage with a urethral catheter

D

Which client is at highest risk for developing a hospital-acquired infection? A. A client with Crohn's disease B. A client who's taking prednisone (Deltasone) C. A client with a laceration to the left hand D. A client with an indwelling urinary catheter

D