PassPoint - Genitourinary Disorders
A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse states that many members of the health care team (including a mental health practitioner) will see the client. A mental health practitioner should be involved in the client's care to:
help the client cope with the anxiety associated with changes in body image.
A client is admitted for a transurethral resection of the prostate (TURP). Preoperative teaching will include which information?
"You will return from surgery with a catheter in your bladder and fluid flowing into and out of it continuously."
A client with marked oliguria is ordered a test dose of 0.2 g/kg of 15% mannitol solution intravenously over 5 minutes. The client weighs 132 lb (60 kg). How many grams would the nurse administer? Record your answer as a whole number.
12
A client has a transurethral resection of the prostate to treat benign prostatic hyperplasia. The client returns to the room with continuous bladder irrigation and reports bladder pain. What is the priority nursing action?
Assess irrigation catheter for patency and drainage.
The nurse teaches a client who had a cystoscopy about the urge to void when the procedure is over. What other information should the nurse tell the client to expect to do?
Increase intake of fluids.
The nurse is developing a community health education program about sexually transmitted infections. Which information about women who acquire gonorrhea should be included?
Women with gonorrhea usually have no symptoms.
The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which snack is most appropriate?
a gelatin dessert
A client is recovering from renal angiography in which a femoral puncture site was used. What is the nurse's priority action during post-procedure care?
Check the client's pedal pulses and extremity appearance every 4 hours.
The nurse is teaching the caregiver of an older adult client about urinary incontinence. What statement should the nurse make to the caregiver about urinary incontinence in the older adult?
Urinary incontinence has many causes and can often be improved with intervention.
The nurse is creating a medication list and notes that the client takes saw palmetto. What should the nurse assess next?
"Tell me about your normal voiding patterns."
The nurse is planning care for a client with pain associated with renal colic. Which nursing action will provide the most relief?
administering morphine
A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction?
"Increase your carbohydrate intake."
The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is a:
condoms
The nurse is assessing a young adult male client who has pain when urinating. The client states they think they have a sexually transmitted infection. When obtaining a health history, the nurse should ask the client if they are experiencing which symptom?
urethral discharge
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation?
urine pH of 3.0
A 20-year-old female client says, "I feel that my vaginal opening constricts whenever I am about to have intercourse. I seem to have no control over it." Which term should the nurse use to document the client's condition?
vaginismus
Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)?
voiding pattern
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:
water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
A nulliparous client tells the nurse that during their last pelvic examination, the health care provider said that their uterus was in a severely retroverted position. The nurse determines that the client may experience which complication?
difficulty conceiving a child
A client reports having difficulty voiding to the nurse. What question(s) will the nurse ask the client? Select all that apply.
"Are you waking up in the middle of the night to void?" "Are you waking up in the middle of the night to void?" "What are your usual voiding patterns?"
A female client with cystitis is to take a 10-day prescription of an antibiotic. The client asks the nurse if they can continue to have sexual intercourse. What should the nurse tell the client?
"As long as you are comfortable, you can have intercourse as often as you wish, but be sure to urinate within 15 minutes after intercourse."
A client who is recovering from transurethral resection of the prostate (TURP) experiences urinary incontinence and has decreased the fluid intake because of the incontinence. What is the nurse's best response to the client?
"Drink eight glasses of water a day, and urinate every 2 hours."
A nurse is teaching a client about prevention of genital herpes. What statement indicates the teaching was successful?
"I'll ask any future partners if they have ever been diagnosed with genital herpes."
A 65-year-old male client with erectile dysfunction (ED) asks the nurse, "Is all this just in my head? Am I crazy?" What should the nurse tell the client?
"More than 50% of the cases are attributed to organic causes."
Which instruction would a nurse include in the discharge teaching for a client who has an ileal conduit?
"Mucous in the pouch is expected."
A client with a urinary tract infection is to take nitrofurantoin four times each day. The client asks the nurse, "What should I do if I forget a dose?" What should the nurse tell the client?
"Take the prescribed dose as soon as you remember it, but if it's very close to the time for the next dose, delay that next dose."
A client who is to have a vaginal radium implant tells the nurse she is concerned about being radioactive. What should the nurse tell the client?
"The radioactive material is controlled and stays with the source; once the material is removed, no radioactivity will remain."
A client with a new ileal conduit asks the nurse when to wear the appliance. What should the nurse tell the client?
"You need to wear your appliance all the time."
A nurse is attending a seminar at the local senior center. The nurse knows the presenter has a good understanding of genitourinary changes in the elderly when the presenter makes which statement?
"You should leave a light on in your bathroom at night."
An older adult client diagnosed with end-stage renal disease (ESRD) presents with fluid volume excess. Which nursing intervention is the priority?
Assess the client's lung sounds.
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?
Assess the color and temperature of the left leg.
A client undergoes a nephrectomy. In the immediate postoperative period, which nursing intervention has the highest priority?
Assess urine output hourly.
A client with end-stage renal failure has an internal arteriovenous fistula in the left arm for vascular access during hemodialysis. What should the nurse instruct the client to do? Select all that apply.
Avoid sleeping on the left arm. Wear a wristwatch on the right arm. Assess fingers on the left arm for warmth.
A client who had undergone an abdominal hysterectomy is in the recovery room. The surgeon has prescribed a 250-mL bolus of normal saline over 1 hour to replace blood loss. The intravenous (IV) solution infusing in the client was 1000 mL normal saline with 40 mEq of potassium chloride at 100 mL per hour. What should the nurse do? Select all that apply.
Connect a 250-mL bag of normal saline to the Y-connector, and calculate to infuse over 1 hour. Contact the health care provider regarding continuation of the primary IV infusion during the bolus infusion. Administer the normal saline bolus via an IV infusion pump.
A postmenopausal woman is worried about pain in the upper outer quadrant of her left breast. The nurse's best course of action is to:
Do a breast examination and report the results to the physician.
When assessing a client prescribed hemodialysis, the nurse notes the client's blood pressure is 140/82 mm Hg, heart rate is 82 beats/min, and respirations are 12 breaths/min. The nurse also notes a continuous vibration over the client's fistula. What is the appropriate action by the nurse?
Document presence of a thrill.
After surgery to create a urinary diversion, the client is at risk for a urinary tract infection. What should the nurse do to prevent a urinary tract infection?
Empty the urinary appliance before it is one-third full.
A client had an intravenous pyelogram (IVP) 1 hour ago. What should the nurse include in the client's plan of care?
Encourage adequate fluid intake.
The nurse warms the dialysis solution before use in peritoneal dialysis. What is the expected outcome of warming the solution?
Encourage the removal of serum urea.
A client has a ureteral catheter in place after renal surgery. What should the nurse do to provide safe care of the ureteral catheter?
Ensure that the catheter is draining freely.
The nurse is planning care for a client with a catheter. What action(s) should the nurse take to prevent a catheter-associated urinary tract infection? Select all that apply.
Provide perineal care at least once a day. Maintain a closed drainage system. Encourage the client to drink 101 oz (3000 mL) fluids daily.
A client comes into the emergency department with severe back pain radiating to the left lower groin. The healthcare provider prescribes morphine sulfate 5-10 mg IV every 2 hours. One hour after receiving 10 mg of morphine, the client is restless and distressed, reporting the pain is still at 8 of 10. What action will the nurse take?
Reassess the client's pain and associated symptoms, and report findings to the healthcare provider to advocate for better pain control.
A client is diagnosed with genital herpes (herpes simplex virus type 2, or HSV-2). What information should the nurse give to the client about managing this health problem?
Reducing stressful life events may decrease the incidence of herpetic outbreaks.
A client tells the nurse that she has had sexual contact with someone whom she suspects has genital herpes. What information should the nurse give to the client?
Report any difficulty urinating.
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.
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?
Scan the client's bladder to determine if residual volumes are present.
A nurse is discharging a client diagnosed with a urinary tract infection. Which information should the nurse include in the discharge teaching? Select all that apply.
Take all antibiotics as prescribed. Avoid coffee, tea, and alcohol.
The nurse is observing an unlicensed assistive personnel (UAP) give care to a client after gynecologic surgery. When should the nurse discuss the care with the UAP?
The UAP massages the client's legs.
A nurse is assessing a client with right flank pain, fever, and chills. A urine culture is obtained, and a diagnosis of suspected right pyelonephritis is documented. When instructing the client on the diagnosis, the nurse uses a diagram of the urinary structures. Identify the area associated with the diagnosis.
anatomical right kidney, (left kidney when looking at picture)
When teaching a client with a urinary tract infection about taking a prescribed antibiotic for 7 days, the nurse should tell the client to report which symptom(s) to the health care provider (HCP)? Select all that apply.
blood in the urine rash fever above 100° F (37.8° C)
A client returns to the intensive care unit after coronary artery bypass graft surgery, which was complicated by a prolonged cardiopulmonary bypass and hypotension. After 3 hours in the unit, the client's condition stabilizes. Which assessment finding indicates a potential complication related to this occurrence?
blood urea nitrogen level (BUN) of 40 mg/dL
A client with acute kidney injury has a serum potassium level of 6.5 mEq/L (6.5 mmol/L). The nurse should monitor the client for which potential complication?
cardiac arrest
A client reports experiencing vulvar pruritus. Which assessment factor may indicate that the client has an infection caused by Candida albicans?
cottage cheese-like discharge
The nurse is teaching an older adult with a urinary tract infection about the importance of increasing fluids in the diet. What puts this client at a risk for not obtaining sufficient fluids?
decreased ability to detect thirst
A nulliparous client says that they and their spouse plan to use a diaphragm with spermicide to prevent conception. Which should the nurse include as the action of spermicides when teaching the client?
destruction of spermatozoa before they enter the cervix
The nurse is caring for a client following a cystocele and rectocele repair. The nurse has just received the client from the post anesthesia care unit (PACU). Which healthcare provider orders would the nurse question? Select all that apply.
discontinue Foley catheter maintain sitting position
A nurse is teaching a client how to prevent a vaginal infection. Which activity puts the client at risk for altering the normal pH of their vagina?
douching unless instructed to do so by the health care provider (HCP)
The nurse is obtaining a history from a client diagnosed with renal calculi. Which finding in a client's history indicates a risk for renal calculi?
drinks one to two glasses of fluid daily.
A female client with gonorrhea informs the nurse that they had sexual intercourse with their male partner and asks the nurse, "Would they have any symptoms?" The nurse can tell the client which symptoms of gonorrhea occur in men?
dysuria
A client is admitted to the recovery room after cystoscopy with biopsy. Before discharging the client, what should the nurse determine?
emptied the bladder.
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
epoetin alfa.
A 50-year-old man has a long history of type 1 diabetes, which is poorly controlled. What does diabetes greatly increase the man's risk of experiencing?
erectile dysfunction
The client is six hours post-open hysterectomy. Intravenous fluids are infusing at 125 mL/hr, urinary catheter has drained 170 mL since surgery, and the client reports pain as a 3 out of 10. What is the nurse's priority concern?
fluid balance
A 28-year-old female client is prescribed danazol for endometriosis. The nurse should instruct the client to report which symptoms to the health care provider?
headaches
The nurse is caring for a client with acute renal failure. Rank in chronological order the phases of acute renal failure. All options must be used.
initial insult oliguric phase diuretic phase recovery phase
A client with acute renal failure is undergoing dialysis for the first time. The nurse monitors the client closely for dialysis disequilibrium syndrome. Which assessment is the priority?
neurological status
The nurse is caring for a client with end-stage kidney disease. What arterial blood gas results are most closely associated with this disorder?
pH 7.20, PaCO2 36, HCO3 14-
A nurse is obtaining a health history from a male senior citizen. The client states that he is having urinary hesitancy, slight dysuria, and dribbling. He denies reports of hematuria. Identify the area where the nurse anticipates the primary cause of the urinary dysfunction.
prostate
The client with acute pyelonephritis wants to know the possibility of developing chronic pyelonephritis. The nurse's response is based on knowledge of which disorder that most commonly leads to chronic pyelonephritis?
recurrent urinary tract infections
A nurse is caring for a client who had an ileal conduit 3 days earlier. Which assessment finding, if made by the nurse, would indicate a need for a further consultation with the enterostomal nurse?
red, sensitive skin around the stoma site
A client receiving total parenteral nutrition is ordered a 24-hour urine test. When initiating a 24-hour urine specimen, the collection time should
start after a known voiding.
A nurse is providing in-service education for staff members about evidence collection after sexual assault. The educational session is successful when staff members focus their initial care on which step?
supporting the client's emotional status
Following surgery, the nurse is assessing a client who had an incisional approach to an abdominal hysterectomy yesterday. Which assessment should the nurse include in the care plan?
thrombophlebitis
Which clinical finding should a nurse look for in a client with chronic renal failure?
uremia
Which information would the nurse include in the teaching plan for a 32-year-old female client requesting information about using a diaphragm for family planning?
Diaphragms should not be used if the client develops acute cervicitis.
The client is at dialysis when the nurse enters the client's room to administer po medications metoprolol and furosemide. What action(s) should the nurse take? Select all that apply.
Go to dialysis and administer the furosemide. Go to dialysis and administer the furosemide.
The client is at dialysis when the nurse enters the client's room to administer po medications metoprolol and furosemide. What action(s) should the nurse take? Select all that apply.
Go to dialysis and administer the furosemide. Wait until the client comes back from dialysis to administer metoprolol.
A client comes to the emergency department reporting 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?
acute pain
A nurse is caring for a client diagnosed with ovarian cancer. Diagnostic testing reveals that the cancer has spread outside the pelvis. The client has previously undergone a right oophorectomy and received chemotherapy. The client now wants palliative care instead of aggressive therapy. The nurse determines that the care plan's priority nursing diagnosis should be:
acute pain.
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?
creatinine, 2.6 mg/dL (230 µmol/L)
To treat a urinary tract infection, a client is ordered sulfamethoxazole-trimethoprim. The nurse should teach the client that sulfamethoxazole-trimethoprim is most likely to cause which adverse effect?
diarrhea
A charge nurse is completing day-shift client care assignments on the genitourinary floor. A new graduate is starting the first day on the unit. An agency nurse and an experienced nurse are also present. The charge nurse should assign the new graduate nurse to the care of which client?
middle-aged stable client with bladder cancer awaiting surgery
When auscultating an arteriovenous (AV) fistula, a bruit is noted. What is the appropriate action by the nurse?
Document the presence of a bruit.
