Medsurg Final Exam

The nurse is administering calcium acetate (PhosLo) to a patient with ESKD. When is the best time for the nurse to administer this medication? a) 2 hours before meals b) 2 hours after meals c) With food d) At bedtime with 8 ounces of fluid

With food

At the end of five peritoneal exchanges, a patient's fluid loss was 500 mL. How much is this loss equal to? a) 2 lb b) 1.0 lb c) 1.5 lb d) 0.5 lb

1.0 lb

The nurse is reviewing the results of renal function studies of a patient. The nurse understands that which of the following is a normal BUN-to-creatinine ratio? a) 10:1 b) 4:1 c) 6:1 d) 8:1

10:1

A client is diagnosed with polycystic kidney disease and requires teaching on the management of the disorder. Which statement made by the client indicates a need for further teaching? a) "If renal failure develops, I may need to consider dialysis." b) "The cysts can get quite large in size." c) "I inherited this disorder from one of my parents." d) "As long as I have one normal kidney, I should be fine."

"As long as I have one normal kidney, I should be fine."

A female patient presents to the health clinical for a routine physical examination. The nurse observes that the patient's urine is bright yellow in color. Which of the following questions is most appropriate for the nurse to ask the patient? a) "Have you had a recent urinary tract infection?" b) "Have you noticed any vaginal bleeding?" c) "Do you take phenytoin (Dilantin) daily?" d) "Do you take multiple vitamin preparations?"

"Do you take multiple vitamin preparations?"

The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse? a) "I do not have a pacemaker, artificial heart valve, or artificial joints." b) "I had my last cigarette 3 hours ago with my morning coffee." c) "I did not take my multivitamin this morning." d) "I took my blood pressure medication with my morning coffee an hour ago."

"I took my blood pressure medication with my morning coffee an hour ago."

A client is prescribed flavoxate (Urispas) following cystoscopy. Which of the following instructions would the nurse give the client? a) "This medication will relieve your pain." b) "This medication prevents infection in your urinary tract" c) "This medication prevents urinary incontinence." d) "This medication will treat the blood in your urine."

"This medication will relieve your pain."

Which statement by the client with end-stage renal disease indicates teaching by the nurse was effective? a) "Ultrafiltration methods take much longer than hemodialysis." b) "A family member can help me perform hemodialysis in my home." c) "There are few complications with renal replacement therapies." d) "A special access is created in my vein for peritoneal dialysis."

"Ultrafiltration methods take much longer than hemodialysis."

A patient has a history of multiple urinary tract infections. The nurse catheterized the patient and confirmed the presence of residual urine. Select the urine volume that is significantly associated with the risk of infection. a) 25 mL b) 100 mL c) 50 mL d) 150 mL

150 mL

The nurse must obtain surgical consent forms for the scheduled surgery. Which patient would not be able to consent legally to surgery? a. 65 year old patient who cannot read and write b. 30 year old patient who doesn't understand english c. 16 year old patient who has a fractured ankle d. 80 year old patient who is not orientated to the day

16 year old patient who has a fractured ankle

A client has undergone a renal transplant and returns to the healthcare agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? a) Polyuria b) Abdominal pain c) Hypotension d) Weight loss

Abdominal pain

Which of the following is the most effective intravesical agent for recurrent bladder cancer? a) Methotrexate b) Cisplatin c) Vinblastine d) Bacillus Calmette-Guérin (BCG)

Bacillus Calmette-Guérin (BCG)

A client requires hemodialysis. Which type of drug should be withheld before this procedure? a) Cardiac glycosides b) Phosphate binders c) Antibiotics d) Insulin

Cardiac glycosides

The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important? a) Record the volume of urine obtained. b) Check for residual after the client reports the urge to void. c) Catheterize the client immediately after the client voids. d) Set up a routine schedule of every 4 hours to check for residual urine.

Catheterize the client immediately after the client voids

Which of the following patient populations have the highest risk for developing testicular cancer? a) Asian American b) African American c) Mexican American d) Caucasian American

Caucasian American

Which of the following is a major cause of relapsing urinary tract infections in men? a) Urinary retention b) Chronic bacterial prostatitis c) Improper hygiene d) Pyelonephritis

Chronic bacterial prostatitis

A nurse assesses a patient diagnosed in the prerenal stage of ARF. The nurse expects to find the following signs and symptoms. Select all that apply. a) Urine specific gravity of 1.029 b) Increase in urinary sediment c) Urine osmolality of 350 mOsm/Kg d) Urine sodium <20 mEq/L e) Creatinine level of 1.3 mg/dL f) BUN value of <10 mg/dL

Creatinine level of 1.3 mg/dL Urine sodium <20 mEq/L Urine specific gravity of 1.029

A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take? a) Administer a unit of packed red blood cells. b) Increase the rate of the IV fluids. c) Discontinue the irrigations. d) Prepare the patient for an ECG.

Discontinue the irrigations

The nurse caring for a patient with a urinary diversion notices mucus around the stents and in the patient's urine. The appropriate nursing intervention is to do which of the following? a) Document presence of mucus in the urine. b) Remove the urinary stents. c) Document the separation of the mucocutaneous junction. d) Contact the physician.

Document presence of mucus in the urine.

Which of the following causes should the nurse suspect in a client is diagnosed with intrarenal failure? a) Glomerulonephritis b) Hypovolemia c) Ureteral calculus d) Dysrhythmia

Glomerulonephritis

Which of the following is as integumentary manifestation of chronic renal failure? a) Gray-brown skin color b) Tremors c) Seizures d) Asterixis

Gray-brown skin color

The nurse is performing a renal assessment on a client with prostate cancer. Which clinical manifestation suggests prostate cancer? Select all that apply. a) Nocturia b) Dyspnea c) Hesitancy d) Chills e) Palpitations

Hestitancy Nocturia

Which metabolic defects are associated with stone formation? a) Hyperparathyroidism b) Hypouricemia c) Hypoparathyroidism d) Hyperthyroidism

Hyperparathyroidism

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which of the following should the nurse include? a) Avoiding drinking fluids for 6 hours b) Performing straight catheterization every 4 hours c) Implementing a 2- to 3-hour voiding schedule d) Encouraging voiding immediately after catheter removal

Implementing a 2- to 3-hour voiding schedule

Which of the following is a characteristic of the intrarenal category of acute renal failure? a) Decreased creatinine b) Decreased urine sodium c) High specific gravity d) Increased BUN

Increased BUN

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? a) Acute renal failure b) Infection c) Nephrotic syndrome d) Obstruction of the lower urinary tract

Infection

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) Urge her to apply moisture sealants. c) Instruct her to take warm sitz baths. d) Advise her to cleanse her perineum frequently.

Instruct her to take warm sitz baths.

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation? a) Need to urinate after engaging in sexual intercourse b) Need to wear underwear made from synthetic material c) Suggestion to take tub baths instead of showers d) Importance of urinating every 4 to 6 hours while awake

Need to urinate after engaging in sexual intercourse

Select the urinary tract symptom that is associated with a specific disease, yet not caused by infection. a) Nocturia b) Enuresis c) Urgency d) Dysuria

Nocturia

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Select the correct example of how urine concentration is affected from among the following statements. a) When the kidneys are diseased, the ability to concentrate urine may be impaired and the specific gravity may vary widely. b) A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity. c) On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. d) On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

Which of the following occurs late in chronic glomerulonephritis? a) Nosebleed b) Peripheral neuropathy c) Seizure d) Stroke

Peripheral neuropathy

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following? a) Stoma retraction b) Stoma ischemia c) Peritonitis d) Postoperative pneumonia

Peritonitis

The client with a history of kidney disease is admitted to the hospital reporting weakness and lethargy. The client's electrocardiogram shows sinus bradycardia with a prolonged PR interval. Which lab value does the nurse expect to find? a. Potassium 3.0 b. potassium 3.5 c. potassium 5.0 d. potassium 8.5

Potassium 8.5

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal? a) Relieve the pain. b) Prevent nephron destruction. c) Determine the stone type. d) Relieve any obstruction.

Relieve the pain.

Which is the correct term for the ability of the kidneys to clear solutes from the plasma? a) Renal clearance b) Tubular secretion c) Glomerular filtration rate (GFR) d) Specific gravity

Renal Clearance

Which of the following hormones is secreted by the juxtaglomerular apparatus? a) Renin b) Aldosterone c) Antidiuretic hormone (ADH) d) Calcitonin

Renin

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a) Risk for infection b) Activity intolerance c) Impaired urinary elimination d) Toileting self-care deficit

Risk for Infection

Which of the following would a nurse classify as a prerenal cause of acute renal failure? a) Polycystic disease b) Ureteral stricture c) Prostatic hypertrophy d) Septic shock

Septic shock

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: a) Creatinine 0.7 mg/dL b) Specific gravity 1.035 c) Protein 15 mg/dL d) Bright yellow urine

Specific gravity 1.035

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? a) Urge b) Stress c) Reflex d) Overflow

Stress

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) Apply ice to area after scrotal swelling subsides. c) Undertake lifting exercises. d) Resume sexual intercourse.

Take prescribed antibiotics

A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal? a) Transurethral resection of the prostate (TURP) b) Transurethral laser incision of the prostate c) Suprapubic prostatectomy d) Retropubic prostatectomy

Transurethral resection of the prostate (TURP)

Which clinical finding should a nurse look for in a client with chronic renal failure? a) Hypotension b) Uremia c) Metabolic alkalosis d) Polycythemia

Uremia

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) Urge b) Functional c) Overflow d) Stress

Urge

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? a) Blood urea nitrogen (BUN) level of 22 mg/dl b) Serum creatinine level of 1.2 mg/dl c) Temperature of 100.2° F (37.8° C) d) Urine output of 250 ml/24 hours

Urine output of 250 ml/24 hours

Which of the following instructions regarding future sexual activity should a nurse give a patient with a vasectomy? a) Expect some bruising and incisional soreness after every sexual activity for the first 2 days. b) Use a reliable method of contraception until the physician ensures that sperm are no longer present. c) Sexual activity can resume after 3 weeks. d) Administer a mild analgesic before any sexual activity.

Use a reliable method of contraception until the physician ensures that sperm are no longer present.

Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)? a) Voiding pattern b) Creatinine clearance c) Serum testosterone level d) Size of the prostate

Voiding Pattern

The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include: a) RBC 3 b) glucose trace c) proteinuria d) WBC 50

WBC 50

A client presents at the clinic with complaints of urinary retention. What question should the nurse ask to obtain additional information about the client's complaint? a) "When did you last urinate?" b) "Do you get up at night to urinate?" c) "Have you had a fever and chills?" d) "How much fluid are you drinking?"

When did you last urinate?

all of the following are NSAIDs except for: a. naproxen b. ibuprofen c. acetaminophen d. aspirin

acetaminophen

Which of the following may result if prostate cancer invades the urethra or bladder? a) Rectal discomfort b) Hematuria c) Backache d) Hip pain

hematuria

The nurse is caring for a patient in the oliguric phase of AKI. What does the nurse know would be the daily urine output? a) 1.0 L b) Less than 50 mL c) Less than 400 mL d) 1.5 L

less than 400 mL

An investment banker, with chronic renal failure, informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse? a) "Peritoneal dialysis does not work well for every client." b) "This type of dialysis will provide more independence." c) "The risk of peritonitis is greater with this type of dialysis." d) "Peritoneal dialysis will require more work for you."

"This type of dialysis will provide more independence."

The nurse working on the postoperative unit receives a report on the following patients. Based on the information provided, whom should the nurse see first? a) A 55-year-old male patient admitted with orchitis with tenderness in both testicles, unilateral testicular swelling, with a WBC of 114,000 mm3. Vital signs are temperature 100.2°F, pulse 82, respirations 18, and blood pressure 140/80. b) A 67-year-old male patient is recovering from a prostatectomy with a potassium level of 4.0 mEq/L and a serum sodium level of 130 mEq/L. Vital signs are temperature 99.2°F, pulse 88, respirations 22, and blood pressure 156/92. c) A 45-year-old man diagnosed with acute bacterial prostatitis. Vital signs are temperature 101.2°F, pulse 92, respirations 16, blood pressure 148/88, and painful urination. d) A 35-year-old man 1 hour postoperative vasectomy with scrotal swelling, a pain rating of 5, and scrotal ecchymoses. Vital signs are temperature 98.9°F, pulse 72, respirations 16, and blood pressure 140/82.

A 67-year-old male patient is recovering from a prostatectomy with a potassium level of 4.0 mEq/L and a serum sodium level of 130 mEq/L. Vital signs are temperature 99.2°F, pulse 88, respirations 22, and blood pressure 156/92.

Which of the following is the priority nursing diagnosis for the client preparing for a voiding cystourethrography? a) Urinary retention b) Deficient knowledge: procedure c) Risk for infection: urinary tract d) Acute pain

Deficient knowledge: procedure

A patient has demonstrated interest in obtaining a penile implant. What should the patient consider prior to making this decision? (Select all that apply.) a) Expectations of the patient and his partner b) Occupation c) ADLs d) Social activities e) Financial status

ADLs Social activities Expectations of the patient and his partner

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders? a) Acute glomerulonephritis b) Nephrotic syndrome c) Acute renal failure d) Chronic renal failure

Acute glomerulonephritis

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis? a) Imbalanced nutrition: Less than body requirements b) Risk for infection c) Acute pain d) Impaired urinary elimination

Acute pain

Which hormone causes the kidney to reabsorb sodium? a) Growth hormone b) ADH c) Aldosterone d) Prostaglandins

Aldosterone

An 80-year-old client is being seen by the urologist because of erectile dysfunction. This client has a history of hypertension and heart disease. Which of the following would be the most likely cause of his erectile dysfunction? a) Depression b) Atherosclerosis c) All options are correct. d) Hypertension medication

All options are correct.

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? a) Intermittent catheterizations b) Application of an ostomy pouch c) Exercises to promote sphincter control d) Irrigating the urinary diversion

Application of an ostomy pouch

A client comes to the emergency department complaining of moderate to severe testicular pain and tenderness. Both testicles are swollen and a penile discharge is present. The client is diagnosed with viral orchitis. Which of the following would the nurse include in this client's plan of care? a) Administering prescribed antibiotics b) Keeping the scrotum in a dependent position c) Aplying ice to the scrotum d) Preparing the client for incision and drainage

Applying ice to the scrotum

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as: a) Interval voiding b) Voiding at given intervals. c) Bladder retaining d) Prompted voiding

Bladder retaining

The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition? a) Serum creatinine of 1.2 mg/dL. b) Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20. c) BUN of 18 mg/dL. d) Glomerular filtration rate (GFR) of 100 mL/min.

Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20.

During a routine office visit, a client mentions difficulty maintaining an erection. While reviewing the client's medical history, the nurse notes the client's medication history. Which medication would the nurse interpret as a potential cause of erectile dysfunction? Select all that apply. a) Fluoxetine b) Lorazepam c) Clonidine d) Nadolol e) Warfarin

Clonidine Lorazepam Nadolol Fluoxetine

Patient education regarding a fistulae or graft includes which of the following? Select all that apply. a) Check daily for thrill and bruit. b) No IV or blood pressure taken on extremity with dialysis access. c) Cleanse site b.i.d. d) Avoid compression of the site. e) No tight clothing.

Check daily for thrill and bruit. Avoid compression of the site. No IV or blood pressure taken on extremity with dialysis access. No tight clothing.

A 57-year-old client is being seen at the free clinic where you practice nursing. He has an edematous glans penis, pain, and an extremely constricted foreskin. What treatment would you expect the physician to prescribe? a) Circumcision b) Increased hygienic measures c) Scrotal support d) Narcotic analgesics

Circumcision

The nurse is preparing a patient for a nuclear scan of the kidneys. Following the procedure, the nurse will instruct the patient to complete which of the following? a) Carefully handle urine as it is radioactive. b) Drink liberal amounts of fluids. c) Notify the health care team if bloody urine is noted. d) Maintain bed rest for 2 hours.

Drink liberal amounts of fluids

A client has a full bladder. Which sound would the nurse expect to hear on percussion? a) Tympany b) Flatness c) Resonance d) Dullness

Dullness

A major goal when caring for a catheterized patient is to prevent infection. Select all the nursing actions that apply. a) Suspend the drainage bag off the floor. b) Irrigate the catheter every 24 hours. c) Disconnect the tubing to collect urine samples. d) Wash the perineal area with soap and water at least twice daily. e) Empty the collection bag at least every 8 hours to reduce bacterial growth.

Empty the collection bag at least every 8 hours to reduce bacterial growth. Suspend the drainage bag off the floor. Wash the perineal area with soap and water at least twice daily.

A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause? a) Escherichia coli b) Staphylococcus c) Paramyxovirus d) Streptococcus

Escherichia coli

A client newly diagnosed with chronic kidney disease has just been started on peritoneal dialysis. During the infusion of the dialysis, the client complains of abdominal pain. Which action by the nurse is most appropriate? a. stop the dialysis b. slow the infusion c. decrease the amount to be infused d. explain that the pain will subside after the first few exchanges

explain that the pain will subside after the first few exchanges

Which of the following are symptoms of left sided heart failure? Select All That Apply. a. JVD b. lower limb edema c. ascites d. pink frothy sputum e. SOB f. weight gain g. restlessness

pink frothy sputum SOB restlessness

The nurse is obtaining a medication history from a client who is reporting erectile dysfunction. Which medication would the nurse identify as being least likely to contribute to the client's condition? a) Spironolactone b) Ibuprofen c) Cimetidine d) Methyldopa

Ibuprofen

The most common presenting objective symptoms of a UTI in older adults, especially in those with dementia, include which of the following? a) Change in cognitive functioning b) Hematuria c) Back pain d) Incontinence

change in cognitive functioning

The client with acute renal failure progresses through four phases. Which of the following describes the initiation phase? a) The excretion of wastes and electrolytes continues to be impaired despite increased water content of the urine. b) It is accompanied by reduced blood flow to the nephrons. c) Fluid volume excess develops, which leads to edema, hypertension, and cardiopulmonary complications. d) Normal glomerular filtration and tubular function are restored.

It is accompanied by reduced blood flow to the nephrons.

Which of the following is used to decrease potassium level seen in acute renal failure? a) Kayexalate b) Calcium supplements c) IV dextrose 50% d) Sorbitol

Kayexalate

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, reducing swelling and facilitating passage of the stone? a) Aspirin b) Ketoralac (Toradol) c) Meperidine (Demerol) d) Morphine sulfate

Ketoralac (Toradol)

Mr. Jarvis's renal failure has become chronic. You are seeing him in clinic and he discusses the various signs and symptoms he is experiencing. Select all of the following which you know to be associated with chronic renal failure. a) Lethargy b) Bleeding of the oral mucous membranes c) Enhanced cognition d) Muscle cramps

Lethargy Muscle cramps Bleeding of the oral mucous membranes

The nurse caring for a patient after urinary diversion surgery monitors the patient closely for peritonitis by assessing for which of the following? Select all that apply. a) Hyperactive bowel sounds b) Abdominal distention c) Muscle flaccidity d) Leukocytosis

Leukocytosis Abdominal distention

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following? a) Abnormalities in urine b) Location of discomfort c) Structural defects in the kidneys d) Elevated calcium levels

Location of discomfort

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the student have understood the material when they identify which of the following as a cause of stress incontinence? a) Bladder irritation related to urinary tract infections b) Decreased pelvic muscle tone due to multiple pregnancies c) Obstruction due to fecal impaction or enlarged prostate d) Increased urine production due to metabolic conditions

Decreased pelvic muscle tone due to multiple pregnancies

A health care provider prescribes ketoconazole (Nizoral), a second-line hormonal agent for the treatment of prostatic cancer. The nurse explained to the patient that this drug acts by: a) Decreasing the endocrine production of androgen. b) Suppressing androgenic stimuli to the prostate. c) Interrupting the conversion of dihydrotestosterone (DHT). d) Decreasing the level of circulating plasma testosterone.

Decreasing the endocrine production of androgen.

Which of the following is a failure of one or both or both of the testes to descend into the scrotum? a) Varicocele b) Hydrocele c) Phimosis d) Cryptorchidism

Cryptorchidism

A client who is blind is admitted for treatment of gastroenteritis. Which nursing diagnosis takes highest priority for this client? a) Activity intolerance b) Impaired physical mobility c) Deficient fluid volume d) Risk for injury

Deficient fluid volume

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) Diuresis b) Restored glomerular function c) Acute tubular necrosis d) Oliguria

Oliguria

After having transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded? a) The normal saline irrigant is infusing at a rate of 50 drops/minute. b) The urine in the drainage bag appears red to pink. c) About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned. d) The client reports bladder spasms and the urge to void.

The client reports bladder spasms and the urge to void.

A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact? a) The left kidney usually is slightly higher than the right one. b) The kidneys lie between the 10th and 12th thoracic vertebrae. c) The average kidney is approximately 5 cm (2?) long and 2 to 3 cm (¾? to 1??) wide. d) The kidneys are situated just above the adrenal glands.

The left kidney usually is slightly higher than the right one.

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) A skin barrier was applied properly. b) Stoma dilation wasn't performed. c) The pouch faceplate doesn't fit the stoma. d) The skin wasn't lubricated before the pouch was applied.

The pouch faceplate doesn't fit the stoma.

The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated? a) The specific gravity will be inversely proportional b) The specific gravity will equal to one c) The specific gravity will be low d) The specific gravity will be high.

The specific gravity will be high

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest? a) A diet high in calcium b) A diet high in fruits and vegetables c) A low-sodium diet d) A low-purine diet

a low-purine diet

A client has undergone a renal transplant and returns to the healthcare agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? a) Abdominal pain b) Weight loss c) Polyuria d) Hypotension

abdominal pain

The new nurse is completing a neurovascular assessment on a patient with chronic venous insufficency. What should be included in the assessment? Select All That Apply. assess for paresthesia assess for pedal pulses assess for paralysis assess for pallor assess for polar

assess for paresthesia assess for pedal pulses assess for paralysis assess for pallor assess for polar

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? a) Encouraging the client to increase the time between voidings b) Assessing present voiding patterns c) Restricting fluid intake to reduce the need to void d) Establishing a predetermined fluid intake pattern for the client

assessing present voiding patterns

NURS 230 students know that beta-blockers are contraindicated in patient's with a history of: a. HTN b. COPD c. asthma d. hypercalcemia

asthma

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education? a) Brief, hot daily showers b) Pats skin dry after bathing c) Uses moisturizing creams d) Keeps nails trimmed short

brief, hot daily showers

Which assessment data would the nurse expect to assess in a patient diagnosed with chronic venous insufficiency? a. decreased pedal pulses b. cool skin temperature c. intermittent claudication d. brown discolored skin

brown discolored skin

The nurse monitoring a client receiving peritoneal dialysis notes that client's outflow is less than in the inflow. Which actions should the nurse take? Select all that apply. a. check the level of the drainage bag b. repositiion the client to his or her side. c. contact the health care provider (HCP) d. place the client in good body alignment e. check the pertoneal dialysis system for kinks f. increase the flow rate of the peritoneal dialysis solution

check the level of the drainage bag reposition the client to his or her side place the client in good body alignment check the peritoneal dialysis for kinks

A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions? a) Place a bed board under the mattress to add support. b) Check the patient's urine for hematuria. c) Apply moist heat, every 4 hours for the first 48 hours to aid healing. d) Keep the patient on bed rest for 72 hours.

check the patient's urine for hematuria

High oxalate foods may have to be avoided in patients with renal calculi. Which of the following are high oxalate foods? Select all that apply. a. sardines b. chocolate c. tea d. oily fish e. instant coffee f. liver g. kidney

chocolate tea instant coffee

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish? a) Radiography b) Cystoscopy c) Computed tomography with contrast d) Bladder ultrasonography

computed tomography with contrast

A patient has a tranurethral resection of the prostate (TURP). Twenty four hours later, the nurse notices that the patient's urine is bright red. Which of the following nursing actions is most appropriate? a. continue to monitor the patient b. irrigate the catheter c. remove the catheter d. contact the physician

contact the physician

A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client's temperature is 100.2F. Which nursing action is most appropriate? a. encourage fluids b. notify the health care provider c. continue to monitor vitals signs d. monitor the site of the shunt for infection

continue to monitor vital signs

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include: a) continuous inflow and outflow of irrigation solution. b) intermittent flow of irrigation solution and prevention of hemorrhage. c) continuous inflow and intermittent outflow of irrigation solution. d) intermittent inflow and continuous outflow of irrigation solution.

continuous inflow and outflow of irrigation solution.

The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator? a) Creatinine clearance level b) Uric acid level c) Blood urea nitrogen (BUN) d) BUN to creatinine ratio

creatinine clearance level

The nurse is collecting data from a client who has a history of benign prostatic hyperplasia. To determine whether the client currently is experiencing this condition, the nurse should ask the client about the presence of which early symptom? a. nocturia b. urinary retention c. urge incontinence d. decreased force in the stream of urine

decreased force in the stream of urine

the client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for diequilibrium syndrome, the nurse should asess the client during dialysis for which associated manifestations? a. hypertension, tachycarda, and fever b. hypotension, bradycardia, and hypothermia c. restlessness, irritability, and generalized weakness d. headache, deteriotating level of conscious and twitching

headache, deteriotating level of conscious and twitching

A male client age 56 is being assessed for possible cancer of the urinary bladder. Of the client's signs and symptoms, which one is the most significant for cancer of the urinary tract? a. dysuria b. retention c. hesitancy d. hematuria

hematuria

A nurse is working with a patient with suspected cancer of the bladder. Which finding is most common in a patient with cancer of the bladder? a. Potassium 5.9 mEq/dL b. painful urination c. right flank pain d. hematuria

hematuria

Which of the following should nurses teach all men, especially those who have had cryptorchidism? a) How to perform a testicular self-examination. b) Importance of regular monitoring of prostate-specific antigen (PSA) levels. c) Need to undergo a baseline and follow up lymph node biopsies. d) Need for blood tests to measure serum acid phosphatase levels.

how to perform a testicular self-examination

The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk for which complication? a. infection b. hyperglycemia c. hypophosphatemia d. disquilitium syndrome

hyperglycemia

The nurse is caring for a patient admitted for an acute exacerbation of COPD. Which assessment findinds would the nurse expect? a. hypocapnia b. hyperinflated chest noted on the CXR c. decreased oxygen saturation with mild exercise d. a widened diaphragm noted on the CXR

hyperinflated chest noted on the CXR decreased oxygen saturation with mild exercise

A nurse is drawing labs for a patient wiht chronic kidney disease. The nurse would expect which of the following in the results? a. hypercalcemia and hypophosphatemia b. hypokalemia c. hyperthyroidism and hyperinsulinemia d. hypocalcemia and hyperphosphetemia

hypocalcemia and hyperphosphetemia

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? a) Paralytic ileus caused by manipulation of the colon during surgery b) Pneumonia caused by shallow breathing because of severe incisional pain c) Abdominal distention owing to reflex cessation of intestinal peristalsis d) Hypovolemic shock caused by hemorrhage

hypovolemic shock caused by hemorrhage

Which of the following is a factor contributing to UTI in older adults? a) Active lifestyle b) Low incidence of chronic illness c) Immunocompromise d) Sporadic use of antimicrobial agents

immunocompromise

A patuent with a foley catheter complains of discomfort and the nurse notes his mildly distended bladder. For the past hour, the patient has had a urine output of 20 mL. What actions would the nurse take first? a. irrigate the foley catheter b. gently massage the patient's bladder in a proximal direction c. briefly raise the drainage bag above the level of the pt's bladder d. inspect the foley catheter tubing

inspect the foley catheter tubing

A patient diagnosed with DVT is admitted to the med-surg unit. Which nursing interventions should be implemented? Select all that apply. a. place SCDs on the patient b. instruct the patient to stay in bed and not ambulate c. encourage fluids d. monitor IV site q4h and PRN e. assess homan's signs daily

instruct the patient to stay in bed and not ambulate encourage fluids monitor IV site q4h and PRN

Which of the following is accurate regarding sildenafil (Viagra)? a) Its side effects include headache, flushing, and dizziness. b) The medication should be taken right before intercourse. c) It can be taken twice daily for increased effect. d) There does not need to be sexual stimulation to produce an erection.

its side effects include headache, flushing, and dizziness.

The nurse caring for the client with acute renal failure would question which of the following for the treatment of hyperkalemia? a) lanthanum carbonate (Fosrenol) b) albuterol sulfate (Ventolin HFA) c) sodium polysterene sulfonate (Kayexalate) d) hypertonic glucose and insulin infusions

lanthanum carbonate (Fosrenol)

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important? a) Limiting fluid intake b) Encouraging coughing and deep breathing c) Promoting carbohydrate intake d) Providing pain-relief measures

limiting fluid intake

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to: a) Loss of motor control of the detrusor muscle. b) A stricture or tumor in the bladder. c) Uninhibited detrusor contractions. d) Compromised ligament and pelvic floor support of the urethra.

loss of motor control of the detrusor muscle

pH: 7.47 CO2: 35 HCO3: 28 pO2: 88 SaO2: 94 a. respiratory alkalosis b. metabolic alkalosis c. respiratory acidosis d. metabolic acidosis

metabolic alkalosis

A client is admitted for treatment of glomerulonephritis. On initial assessment, the nurse detects one of the classic signs of acute glomerulonephritis of sudden onset. Such signs include: a) green-tinged urine. b) periorbital edema. c) moderate to severe hypotension. d) polyuria.

periorbital edema.

The nurse is preparing to assess a patient's newly created stoma. Which of the following findings would the nurse include in the documentation of a healthy stoma? a) Pink color b) Dry in appearance c) Black color d) Pain

pink color

all of the following are anticoagulants except for: a. coumadin b. lovenox c. plavix d. heparin

plavix

Which of the following is the obstructive and irritative symptom complex caused by benign prostatic hypertrophy? a) Prostaglandin b) Prostatitis c) Prostatectomy d) Prostatism

prostatism

Sympathomimetics have which of the following effects on the body? a) Decrease of heart rate b) Constriction of bronchioles c) Constriction of pupils d) Relaxation of bladder wall

relaxation of bladder wall

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: a) renal calculi. b) interstitial cystitis. c) acute prostatitis. d) an overdistended bladder.

renal calculi

The nephrons are the functional units of the kidney, responsible for the initial formation of urine. The nurse knows that damage to the area of the kidney where the nephrons are located will affect urine formation. Identify that area. a) Renal cortex b) Renal papilla c) Renal pelvis d) Renal medulla

renal cortex

Please interpret the following arterial blood gas values and determine which acid-base imbalance your patient is suffering from: pH 7.32 CO2: 48 HCO3: 24 O2: 95 SaO2: 97 a. respiratory acidosis b. metabolic alkalosis c. respiratory alkalosis d. metabolic acidosis

respiratory acidosis

A client is admitted to the emergency department following a motor vehicle accident. The client was wearing a lap seat belt when the accident occurred and now the client has hematuria and lower abdominal pain. To assess further whetherr the pain is caused by bladder trauma, the nurse should ask the client if the pain is referred to which area? a. hip b. shoulder c. umbilicus d. costovertebral angle

shoulder

Nursing students know that which procedure results in bleeding and urinary draining in the dressing? a. perineal prostatectomy b. suprapubic prostatectomy c. TURP d. retropubic prostacetomy

suprapubic prostatectomy

Nursing students understand that prior to administering nitroglycerin, what intervention must be taken? a. palpate the apical pulse for one full minute b. take a baseline blood pressure c. assess the serum potassium level d. take a STAT EKG

take a baseline blood pressure

A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess wehther the client's problem is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristic of this disorder? a. soft and swollen prostate gland b. reddened, swollen, and boggy prostate gland c. tender and edematous prostate gland with ecchymosis d. tender, indurated prostate gland that is warm to the touch

tender, indurated prostate gland that is warm to the touch

The nurse is interviewing the surgical patient in the pre-op area. Which info should the nurse report to the anesthesiologist? Select all that apply. a. the patient has loose, decayed teeth b. the patient is experiencing anxiety c. the patient smokes two packs of cigarettes per day d. the patient has a chest x-ray that shows no infiltrates e. the patient reports using herbs

the patient has loose, decayed teeth the patient smokes two packs of cigarettes per day the patient reports using herbs

Which data would cause the nurse to question administering Digoxin to a patient diagnosed with heart failure? a. the digoxin level is 1.2 b. the patient denies a yellow haze c. the patient's apical pulse is 64 d. the potassium level is 3.2

the potassium level is 3.2

A client comes to the Emergency Department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? a) Acute glomerulonephritis b) Renal cell carcinoma c) Ureteral stricture d) Urinary calculi

urinary calculi

A 32-year-old client has a history of neurogenic bladder and presents with fever, burning, and suprapubic pain. What would you suspect is the problem? a) Urethral strictures b) Urinary tract infection c) Urinary retention d) Urinary incontinence

urinary tract infection

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? a) Blood urea nitrogen (BUN) level of 22 mg/dl b) Urine output of 250 ml/24 hours c) Temperature of 100.2° F (37.8° C) d) Serum creatinine level of 1.2 mg/dl

urine output of 250ml/24 hours

A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis? a) Wear a mask when performing exchanges. b) Perform deep-breathing exercises vigorously. c) Avoid carrying heavy items. d) Auscultate the lungs frequently.

weak a mask when performing exchanges

A client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, the nurse knows that the client is most likely to experience: a) increased urine output. b) weight loss. c) hematuria. d) increased blood pressure.

weight loss