Renal System
Bethanechol chloride is prescribed for a client with urinary retention. Which disorder should be a contraindication to the administration of this medication? 1. Gastric atony 2. Urinary strictures 3. Neurogenic atony 4. Gastroesophageal reflux
2 Bethanechol chloride can be harmful to clients with urinary tract obstruction or weakness of the bladder wall. The medication has the ability to contract the bladder and thereby increase pressure within the urinary tract. Elevation of pressure within the urinary tract could rupture the bladder in clients with these conditions.
The nurse is reinforcing discharge instructions to a client receiving sulfadiazine. Which should be included in the list of instructions? 1. Restrict fluid intake. 2. Maintain a high fluid intake. 3. Decrease the dosage when symptoms are improving to prevent an allergic response. 4. If the urine turns dark brown, call the primary health care provider (PHCP) immediately.
2 Each dose of sulfadiazine should be administered with a full glass of water, and the client should maintain a high fluid intake. The medication is more soluble in alkaline urine. The client should not be instructed to taper or discontinue the dose. Some forms of sulfadiazine cause urine to turn dark brown or red. This does not indicate the need to notify the PHCP.
The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record should the nurse identify as a risk factor for this diagnosis? 1. Hypoglycemia 2. Diabetes mellitus 3. Coronary artery disease 4. Orthostatic hypotension
2 Risk factors associated with pyelonephritis include diabetes mellitus, hypertension, chronic renal calculi, chronic cystitis, structural abnormalities of the urinary tract, presence of urinary stones, and indwelling or frequent urinary catheterization.
A sulfonamide is prescribed for a client with a urinary tract infection. During review of the client's record, the nurse notes that the client is taking warfarin sodium daily. Which prescription should the nurse anticipate for this client? 1. Discontinuation of warfarin sodium 2. A decrease in the warfarin sodium dosage 3. An increase in the warfarin sodium dosage 4. A decrease in the usual dose of the sulfonamide
2 Sulfonamides can potentiate the effects of warfarin sodium, phenytoin, and orally administered hypoglycemics such as tolbutamide. When an oral anticoagulant is combined with a sulfonamide, a decrease in the anticoagulant dosage may be needed.
The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of infection. Which sign/symptom is likely to present first? 1. Fever 2. Urgency 3. Confusion 4. Frequency
3 In an older client, the only symptom of a UTI may be something as vague as increasing mental confusion or frequent unexplained falls. Frequency and urgency may commonly occur in an older client, and fever can be associated with a variety of conditions.
A patient with CRF has a BUN of 120 mg/dL, creatinine of 9 mg/dL, and potassium of 6.9 mEq/L. What is the primary significance of these laboratory values? 1. They are expected laboratory results for a patient with CRF. 2. The values signify renal insufficiency. 3. The results, in conjunction with uremic signs, indicates a need for dialysis. 4. The patient should be referred as a good candidate for peritoneal dialysis.
3. the results, in conjunction with uremic signs, indicates a need for dialysis (3) Uremia signs generally appear when BUN concentration passes 100 mg/dL. The presence of uremic signs is the absolute indicator for initiating dialysis, and the goal is to maintain BUN below 100 mg/dL and to keep creatinine below 8 mg/dL. (1) The result is high, but (2) without further information it is not possible to determine the cause. (4) Other information is needed to determine candidacy for peritoneal dialysis.
The nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine whether the client is currently experiencing exacerbation of BPH, the nurse should ask the client about the presence of which early symptom? 1. Nocturia 2. Urinary retention 3. Urge incontinence 4. Decreased force in the stream of urine
4 Decreased force in the stream of urine is an early sign of BPH. The stream later becomes weak and dribbling. The client may then develop hematuria, frequency, urgency, urge incontinence, and nocturia. If untreated, complete obstruction and urinary retention can occur.
A patient prescribed oxybutynin (Ditropan) asks you why his mouth and eyes are dry. What is your best response? A. "These are common side effects of drugs used to treat overactive bladder (OAB)." B. "I will notify your prescriber because you may need to be prescribed a different drug." C. "These are signs of an allergic reaction and you must avoid taking this drug again." D. "Let me check your vital signs and then I will notify your prescriber."
A. "These are common side effects of drugs used to treat overactive bladder (OAB)."
A patient with glomerulonephritis requests a snack. Which is most appropriate? A. Applesauce B. Warm broth C. Orange juice D. Gelatin (Jello)
A. applesauce Applesauce will provide additional vitamins and carbohydrates needed for healing. Orange juice, broth, and gelatin contain liquids, which should be restricted. Broth is a liquid and is high in sodium content, which should also be restricted.
When obtaining a history on a patient with suspected kidney disease, the most significant information would be a personal or family history of which condition(s)? (Select all that apply.) A. Diabetes B. Gastric ulcers C. Hypertension D. Lactose intolerance E. Cardiovascular disease
A. diabetes C. hypertension E. cardiovascular disease Diabetes, hypertension, and cardiovascular disease are all known causes of kidney disease. Gastric ulcers and lactose intolerance do not impact functioning of the urinary system.
Which side effect is common when a patient is prescribed a drug for overactive bladder? A. Dry mouth B. Confusion C. Nausea D. Blurred vision
A. dry mouth
Which drug is a potassium-sparing diuretic? A. Spironolactone B. Bumetanide C. Metolazone D. Torsemide
A. spironolactone
When collecting a 24-hour urine specimen, nursing responsibilities include which action? A. Starting the timing of the collection after the first voided urine B. Beginning urine sample collection with the first voided specimen C. Collecting a urine sample from the patient every hour for 24 hours D. Encouraging sufficient patient fluid intake to ensure 2 L of urine production
A. starting the timing of the collection after the first voided urine Unless otherwise ordered, the first void should be discarded; the collection should then be timed and begun for all urine voided for the next 24 hours. Collecting a urine sample every hour is not correct procedure for maintaining a 24-hour urine specimen. It is not necessary to encourage fluid intake in order to ensure 2 L of urine production.
The nurse notes the patient's urine is dark orange in color. What question is most appropriate for the nurse to ask the patient? A. "Are you currently menstruating?" B. "Are you currently on antibiotics?" C. "How much fluid intake have you had recently?" D. "How much protein have you eaten in the past 2 days?"
B. "are you currently on antibiotics" Dark amber or orange urine is associated with dehydration or increased metabolic state (e.g., fever), urobilinogen (a by-product of bilirubin normally excreted through stool and urine), or bilirubin (a component of bile normally metabolized and excreted via stool and urine). Foods that may result in this color of urine include carrots. Menstrual blood in the urine may result in pink- or red-tinged urine. Antibiotics and protein do not change the color of the urine.
Which class of drugs would you instruct a patient taking an ED drug to avoid? A. Calcium channel blockers B. Nitrates C. Angiotensin-converting enzyme inhibitors D. Beta blockers
B. Nitrates
Which consideration applies to older adults prescribed loop diuretic therapy? A. Depression B. Increased risk for falls C. Dosage varies with patient weight D. Risk for increased potassium level
B. increased risk for falls
The tiny, funnel-shaped microscopic structure of the kidney responsible for producing urine is the A. glomeruli. B. nephron. C. renal corpuscle. D. renal tubule
B. nephron
The capillary network that is tucked into Bowman's capsule is the A. nephron. B. renal corpuscle. C. proximal convoluted tubule. D. glomerulus.
D. glomerulus
The nurse is caring for the client with epididymitis. Which treatment modalities should be implemented? Select all that apply. 1. Bed rest 2. Sitz bath 3. Antibiotics 4. Heating pad 5. Scrotal elevation
1,2,3,5 Common interventions used in the treatment of epididymitis include bed rest, elevation of the scrotum, ice packs, sitz baths, analgesics, and antibiotics. A heating pad should not be used because direct application of heat could increase blood flow to the area and increase the swelling.
________ is the inflammation of the bladder
cystitis Cystitis is the inflammation of the bladder and is a common urinary tract infection.
The nurse is reviewing the client's record and notes that the primary health care provider (PHCP) has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal function? Select all that apply. 1. Elevated serum creatinine level 2. Elevated thrombocyte cell count 3. Decreased red blood cell (RBC) count 4. Decreased white blood cell (WBC) count 5. Elevated blood urea nitrogen (BUN) level
1,3,5 BUN testing is a frequently used laboratory test to determine renal function. The BUN and serum creatinine levels start to rise when the glomerular filtration rate falls below 40% to 60%. A decreased RBC count may be noted if erythropoietic function by the kidney is impaired. An increased WBC is most likely to be noted in renal disease. Thrombocyte cell counts do not indicate decreased renal function.
Which patient statement indicates that your female patient needs additional teaching on the discharge instructions for urinary tract infection? 1. "I will always wipe from back to front after a bowel movement." 2. "I should avoid wearing tight slacks." 3. "I won't wash my underclothing with strong detergents." 4. "I will take a shower instead of a tub bath."
1. "I will always wipe from back to front after a bowel movement" (1) Female patients should wipe front to back after a bowel movement. (3-5) The other statements are correct information to prevent future urinary infections.
When writing a nursing care plan for a patient with stress incontinence, what interventions should you include? (Select all that apply.) 1. Instruct patient to keep a voiding diary. 2. Teach patient Kegel exercises. 3. Offer patient assistance every 3 to 4 hours. 4. Obtain bedside commode as needed. 5. Teach patient to avoid bladder irritants, such as coffee and nicotine.
1. instruct patient to keep a voiding diary 2. teach patient Kegal exercises 5. Teach patient to avoid bladder irritants, such as coffee and nicotine (1) Keeping a voiding diary helps patients to link activities, foods, and situations to episodes of incontinence. Also, noting the frequency of voiding will help patients to establish a regular schedule to empty the bladder. (2) For stress incontinence, the goal is to help strength the sphincters and to help the patient avoid bladder irritants; Kegel exercises are appropriate. (5) Teaching the patient to avoid bladder irritants is most important for patients with urge incontinence but can help other types of incontinence as well. (3, 4) Assisting the patient to the bathroom every 3 to 4 hours or obtaining a bedside commode is more appropriate for patients with functional incontinence;
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 of which complication? 1. Peritonitis 2. Hyperglycemia 3. Hyperphosphatemia 4. Disequilibrium syndrome
2 An extended dwell time increases the risk of hyperglycemia in the client with diabetes mellitus as a result of absorption of glucose from the dialysate and electrolyte changes. Diabetic clients may require extra insulin when receiving peritoneal dialysis. Peritonitis is a risk associated with breaks in aseptic technique. Hyperphosphatemia is an electrolyte imbalance that occurs with renal dysfunction. Disequilibrium syndrome is a complication associated with hemodialysis.
A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome? 1. Tachycardia and diarrhea 2. Bradycardia and confusion 3. Increased urinary output and anemia 4. Decreased urinary output and bladder spasms
2 TUR syndrome is caused by increased absorption of nonelectrolyte irrigating fluid used during surgery. The client may show signs of cerebral edema and increased intracranial pressure, such as increased blood pressure, bradycardia, confusion, disorientation, muscle twitching, visual disturbances, and nausea and vomiting.
A patient with nephrotic syndrome is admitted with severe generalized edema, ascites, and cloudy urine. The patient is irritable and tired. What is the priority nursing problem? 1. Potential for infection 2. Altered fluid volume 3. Pain 4. Fatigue
2. altered fluid volume (2) Patients with nephritic syndrome have problems as fluid shifts into the body tissues and results in severe edema. Urinary retention is not the issue. (3) Patient will have discomfort related to ascites and will (4) experience fatigue, but these are not the priorities at this point.
What is the first action you should take to assist a patient to develop a toileting schedule? 1. Encourage use of condom catheters or incontinence pads 2. Assess pattern of incontinence 3. Schedule trips to the bathroom 4. Provide positive reinforcement for small successes
2. assess pattern of incontinence (2) First assess the pattern of incontinence. (1, 3, 4) The other three options may be appropriate based on the assessment findings.
When starting a 24-hour urine collection, what is essential to ensure correct results? 1. Include the first void of the 24-hour period. 2. Record the time of initial void as the start time of the test. 3. Discard the last void of the 24-hour period. 4. Encourage fluid intake before starting the test.
2. record the time of initial void as the start time of the test (2) The nurse should note the time of the initial void as the start of the 24-hour period. (1) The first void is not saved; it is discarded. (3) The last void is not discarded; it is saved. (4) The patient may need to fast the night before but does not need to drink additional fluids.
A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse take? 1. Restrict fluids. 2. Administer a sedative. 3. Determine if there is a history of allergies. 4. Administer an oral preparation of radiopaque dye.
3 An iodine-based dye may be used during the IVP and can cause allergic reactions such as itching, hives, rash, tight feeling in the throat, shortness of breath, and bronchospasm. Checking for allergies is the priority. Options 1, 2, and 4 are unnecessary.
The nurse who is administering bethanechol chloride is monitoring for acute toxicity associated with the medication. The nurse should check the client for which sign of toxicity? 1. Dry skin 2. Dry mouth 3. Bradycardia 4. Signs of dehydration
3 Toxicity (overdose) produces manifestations of excessive muscarinic stimulation such as salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. Treatment includes supportive measures and the administration of atropine sulfate subcutaneously or intravenously.
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder? 1. Hematuria and pyuria 2. Dysuria and proteinuria 3. Hematuria and urgency 4. Dysuria and penile discharge
4 Urethritis in the male client often results from chlamydial infection and is characterized by dysuria, which is accompanied by a clear to mucopurulent discharge. Because this disorder often coexists with gonorrhea, diagnostic tests are done for both and include culture and rapid assays. Hematuria is not associated with urethritis. Proteinuria is associated with kidney dysfunction.
A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which does this data indicate? 1. Advancing uremia 2. Phosphate overdose 3. Folic acid deficiency 4. Aluminum intoxication
4 Aluminum intoxication may occur when there is accumulation of aluminum, an ingredient in many phosphate-binding antacids. It results in mental cloudiness, dementia, and bone pain from infiltration of the bone with aluminum. This condition was formerly known as dialysis dementia. It may be treated with aluminum-chelating agents, which make aluminum available to be dialyzed from the body. It can be prevented by avoiding or limiting the use of phosphate-binding agents that contain aluminum.
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which signs/symptoms of this disorder? 1. Edema and purpura of the left arm 2. Warmth, redness, and pain in the left hand 3. Aching pain, pallor, and edema of the left arm 4. Pallor, diminished pulse, and pain in the left hand
4 Arterial steal syndrome results from vascular insufficiency after creation of a fistula. The client exhibits pallor and diminished pulse distal to the fistula and complains of pain distal to the fistula, which is caused by tissue ischemia. Warmth, redness, and pain should more likely characterize a problem with infection. Options 2 and 3 are not characteristics of steal syndrome.
Oxybutynin chloride is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication? 1. Pallor 2. Drowsiness 3. Bradycardia 4. Restlessness
4 Toxicity (overdose) of this medication produces central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not indicate overdose.
A patient with ESRD is on dialysis and waiting for a kidney transplant. The patient says, "I am never going to be at the top of the list for a kidney. I wish I could just die and get it over with." What is the most therapeutic response? 1. "I am sure you are going to get a kidney. A lot of people donate these days." 2. "Are you thinking about hurting or killing yourself?" 3. "I would be discouraged too, but I have never been very good at waiting." 4. "You seem really down today. What's going on?"
4. "you seem really down today. what's going on?" (4) Reflecting feelings is a way of telling that the patient that you are listening and acknowledging the feelings. Asking a broad question allows the patient to take the lead in disclosing more information. (1) False reassurance is not therapeutic. (2) It may be appropriate to directly ask the patient about suicidal or self-harm thoughts; however, you should gather more data first to determine what the patient is thinking about. (3) It is not therapeutic to shift the focus of the conversation toward yourself and your own feelings.
_________ has a central role in the regulation of urine volume. A. ADH B. Aldosterone C. TSH D. Plasma
A. ADH
The condition that occurs when waste products in the blood quickly accumulate to toxic levels is A. uremia. B. cystitis. C. interstitial cystitis. D. anemia.
A. uremia
Which action is most important before administering tamsulosin (Flomax) to a patient? A. Check the patient's blood pressure lying, sitting, and standing. B. Elevate the head of the bed to at least 45 degrees. C. Check the patient's baseline weight and height. D. Warn the patient that side effects may include hair loss from the scalp.
A.Check the patient's blood pressure lying, sitting, and standing.
What is the most common side effect of drugs prescribed to treat BPH? A. Decreased libido B. Hypotension C. Angina D. Hair loss
A.Decreased libido
A 50-year-old patient prescribed furosemide (Lasix) is preparing for discharge. Which teaching points will you include with discharge teaching? (Select all that apply.) A. Urine output can increase dramatically. B. There is no need to limit alcohol intake. C. You may develop skin sensitivity, so wear protective clothing and stay out of direct sunlight. D. Avoid potassium-rich foods such as bananas, avocadoes, and dried apricots. E. Report any decrease in hearing or ringing in the ears. F. This drug can cause you to have a very high blood potassium level.
A.urine output can increase dramatically C. you may develop skin sensitivity, so wear protective clothing and stay out of direct sunlight E.report any decrease in hearing or ringing in the ears
A 52-year-old man is prescribed testosterone gel (AndroGel) for low serum testosterone. What must you teach his wife about this drug? A. "Be sure to provide your husband with high carbohydrate meals." B. "Avoid touching linen or clothing that has been in contact with the drug." C. "Your husband may experience impotence as a result of this drug." D. "If your husband experiences hair loss, be sure to contact the prescriber."
B."Avoid touching linen or clothing that has been in contact with the drug."
An older adult male is prescribed finasteride (Proscar) for BPH. Which age-related teaching point will you be sure to include during discharge teaching? A. Take acetaminophen if you experience a headache. B. Be sure to have your annual screening for prostate cancer. C. You may experience an increase in urine output. D. You may experience a rash, but it will improve over a couple of weeks.
B.Be sure to have your annual screening for prostate cancer.
A patient prescribed sildenafil (Viagra) for erectile dysfunction is also prescribed isosorbide dinitrate. What is your best action? A. Administer the drugs if blood pressure is within normal range. B. Contact the prescriber. C. Hold both drugs if the heart rate is high. D. Administer the sildenafil at night and isosorbide in the morning.
B.Contact the prescriber.
Which finding, if present in a patient's history, is most closely related to the patient's developing acute glomerulonephritis? A. "I use bubble bath in the tub." B. "I've used a diuretic for about a month." C. "I had strep throat about 2 or 3 weeks ago." D. "I usually have allergies at this time of the year."
C. "I had strep throat about 2 or 3 weeks ago" Glomerulonephritis is primarily seen in children and young adults, and it affects males more than females. It most commonly occurs about 2 to 3 weeks after a group A beta-hemolytic streptococcal infection, such as "strep throat" or impetigo; however, it can occur in response to bacterial, viral, or parasitic infections elsewhere in the body. It is an immunologic problem caused by an antigen-antibody reaction. It is not caused by use of bubble bath, a diuretic, or seasonal allergies
Which foods would you teach a patient prescribed hydrochlorothiazide (Oretic) to consume? A. Grapefruit and carrots B. Corn and squash C. Bananas and broccoli D. Chicken and beef
C. bananas and broccoli
The patient prescribed tamsulosin (Flomax) asks you how this drug will help his benign prostate hyperplasia (BPH). What is your best response? A. "It works directly on the prostate gland to shrink it." B. "It works with testosterone by converting it to its most powerful form." C. "It relaxes smooth muscle tissue in the prostate, neck of the bladder, and urethra." D. "It increases pressure inside the bladder to help increase the urine stream."
C."It relaxes smooth muscle tissue in the prostate, neck of the bladder, and urethra."
Which precaution is most important to teach a patient prescribed tamsulosin (Flomax) for treatment of BPH? A. Avoid donating blood. B. Be sure to have annual prostate cancer screenings. C. Do not take this drug if you are allergic to "sulfa" drugs. D. Do not drink alcoholic beverages while taking this drug.
C.Do not take this drug if you are allergic to "sulfa" drugs.
Which patient should not receive testosterone replacement? A. Older male with history of tuberculosis B. Younger male with history of 20% body surface burns C. Middle-aged male with history of prostate cancer D. Older male with history of gastroesophageal reflux disease
C.Middle-aged male with history of prostate cancer
The nurse is caring for a patient who has a urinary catheter. Which nursing intervention should be done to help prevent infection? A. Keep the drainage bag above the level of the catheter or insertion site. B. Keep the drainage bag above the level of the catheter hanging on the side rail of the patient's bed. C. Perform perineal care once with bathing, cleaning the urinary meatus and catheter with soap and water. D. Perform perineal care at least twice daily, cleaning the urinary meatus and catheter with soap and water.
D. perform perineal care at least twice daily, cleaning the urinary meatus and catheter with soap and water When a patient has a urinary catheter, the nursing intervention to help prevent infection is to perform perineal care at least twice daily, cleaning the urinary meatus and catheter with soap and water. Cleaning the perineal area once with bathing is not enough to help prevent infection. The drainage bag should always be kept below the level of the catheter or insertion site, not above and never on the patient's side rail.
Which two blood electrolyte levels must you check before giving a patient a loop diuretic such as furosemide (Lasix)? A. Potassium and calcium B. Calcium and sodium C. Magnesium and potassium D. Sodium and potassium
D. sodium and potassium
The patient is prescribed tadalafil (Cialis) for erectile dysfunction. For which adverse effect should you monitor after administering this drug? A. Flushing of the skin B. Nasal congestion with itching C. Indigestion with acid reflux D. Prolonged painful erection
D.Prolonged painful erection
A 50-year-old man is prescribed sildenafil (Viagra) for erectile dysfunction. For which herbal preparation in use by the patient will you need to notify the prescriber or pharmacist? A. Black cohosh B. Echinacea 491 C. Feverfew D. St. John's wort
D.St. John's wort
What must you teach an older adult being discharged with a prescription for a loop diuretic? (Select all that apply.) A. "Be sure to get up slowly." B. "You are at less risk for falls with these drugs than with thiazide diuretics." C. "Be sure to eat foods that are rich in potassium, like broccoli and bananas." D. "If you experience any new muscle weakness, make sure to report it to your prescriber." E. "You may need to set the volume of your radio or television at a higher level." F. "If you are to take the drug once a day, be sure to take it in the evening before bedtime."
A. "Be sure to get up slowly." C."Be sure to eat foods that are rich in potassium, like broccoli and bananas." D."If you experience any new muscle weakness, make sure to report it to your prescriber." E."You may need to set the volume of your radio or television at a higher level."
A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication? 1. Hematocrit of 33% (0.33) 2. Platelet count of 400,000 mm3 (400 × 109/L) 3. White blood cell count of 6000 mm3 (6.0 × 109/L) 4. Blood urea nitrogen level of 15 mg/dL (5.25 mmol/L)
1 Epoetin alfa is synthetic erythropoietin, which the kidneys produce to stimulate red blood cell production in the bone marrow. It is used to treat anemia associated with chronic kidney disease. The normal hematocrit level is Male: 42% to 52% (0.42 to 0.52); Female: 37% to 47% (0.37 to 0.47). Therapeutic effect is seen when the hematocrit reaches between 30% and 33% (0.30 and 0.33). The normal platelet count is 150,000 to 400,000 mm3 (150 to 400 × 109/L). The normal blood urea nitrogen level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). The normal white blood cell count is 5000 to 10,000 mm3 (5-10 × 109/L). Platelet production, white blood cell production, and blood urea nitrogen do not respond to erythropoietin.
You are trying to console an older adult who is embarrassed about wetting the bed. Which patient comment is consistent with functional incontinence? 1. "I knew that I needed to go, but I couldn't get out of bed by myself." 2. "Every time I laugh, cough, or sneeze I pass a little bit of urine." 3. "When I need to pee, I really have to go right away!" 4. "My doctor says that my enlarged prostate is causing the problem."
1. "I knew that I needed to go, but I couldn't get out of bed by myself." Inability to reach the toilet due to physical disability or immobility is an example of functional incontinence. (2) Losing urine during laughing, coughing, sneezing, or aerobic exercise is associated with stress incontinence. (3) Needing to go immediately upon sensing the urge to urinate is urge incontinence. (4) Prostate problems or other types of obstructions such as a vaginal prolapse can cause overflow incontinence.
What is included in the nursing care of a patient undergoing peritoneal dialysis? (Select all that apply.) 1. Maintain aseptic technique when accessing a peritoneal catheter. 2. Instruct the patient to remain supine until the dialysate is drained. 3. Weigh the patient before and after dialysis. 4. Monitor vital signs. 5. Check color and volume of effluent.
1. Maintain aseptic technique when accessing a peritoneal catheter. 3. Weigh the patient before and after dialysis. 4. Monitor vital signs. 5. Check color and volume of effluent. (2) Patient can get up and ambulate after dialysate is instilled. (Dwell time varies from 4 to 8 hours. Others may have the dwell time at night or have continuous ambulatory peritoneal dialysis [CAPD], which goes on for 24 hours a day. (1, 3, 4, 5) All other answers are correct.
While caring for a patient who has received SWL (lithotripsy) for renal calculi, you would anticipate what possible actions that may be taken to help the patient increase the rate of stone passage? (Select all that apply.) 1. Follow orders for MET. 2. Increase oral fluid intake. 3. Administer Vicodin for pain. 4. Cystoscopy to retrieve the stones. 5. Strain all urine. 6. Low-salt and low-fat diet.
1. follow orders for MET 4. cystoscopy to retrieve the stones (1, 4) Several different approaches may be taken to help pass the renal calculi after ESWL. (3) Pain relief is important but may not help in passage of the stones.
A patient with a history of throat infection becomes suddenly ill with fever, chills, flank pain, widespread edema, puffiness around the eyes, visual disturbances, and marked hypertension. You would anticipate which diagnostic test? 1. Urinalysis 2. CT of the abdomen 3. Serum amylase 4. Prothrombin time
1. urinalysis (1) Patient has symptoms of glomerulonephritis. Diagnostic tests include urinalysis, creatinine, blood urea nitrogen (BUN), and complete blood count (CBC). (3-5) The health care provider may opt to order other tests, but they are less specific to the initial diagnosis of glomerulonephritis. (2) An intravenous pyelogram is more likely to be ordered if stones, tumors, or other anatomical obstructions are suspected.
A patient is scheduled to have a renal biopsy. What is included in the preoperative care for this patient? (Select all that apply.) 1. Administer bowel preparation. 2. Report abnormal coagulation studies. 3. Enforce nothing by mouth (NPO) for 6 to 8 hours before the procedure. 4. Check for allergy to contrast media. 5. Insert indwelling urinary catheter.
2. report abnormal coagulation studies 3. enforce noting by mouth (NPO) for 6 to 8 hours before the procedure Hemorrhage is a potential complication of renal biopsy; therefore, reporting abnormalities in coagulation studies is essential. Keeping the patient NPO for 6 to 8 hours before the procedure is not uncommon. (1) A bowel preparation is not needed, because the biopsy will not approach or interfere with the bowel. (4, 5) Contrast media and indwelling catheters are not necessary for the biopsy procedure.
A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client instructions to prevent recurrence. The nurse determines that the client needs further teaching if the client states the intention to do which action? 1. Drink an increased amount of fluids. 2. Limit the force of the stream during voiding. 3. Continue to take antibiotics until all symptoms are gone. 4. Use condoms to eliminate risk associated with chlamydia and gonorrhea.
3 The client who experiences epididymitis from UTI should increase intake of fluids to flush the urinary system. Because organisms can be forced into the vas deferens and epididymis from strain or pressure during voiding, the client should limit the force of the stream. Condom use can help prevent urethritis and epididymitis from STIs. Antibiotics are always taken until the full course of therapy is completed.
A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instructions? 1. Stop antibiotic therapy when pain subsides. 2. Exercise as much as possible to stimulate circulation. 3. Use warm sitz baths and analgesics to increase comfort. 4. Keep fluid intake to a minimum to decrease the need to void.
3 Treatment of prostatitis includes medication with antibiotics, analgesics, and stool softeners. The client is also taught to rest, increase fluid intake, and use sitz baths for comfort. Antimicrobial therapy is always continued until the prescription is completely finished.
You are planning care for four patients on the night shift. Which patient is most likely to have nocturia related to a decreased ability to concentrate urine? 1. A patient with a high BUN 2. A pregnant patient 3. An older adult 4. A patient who had a bladder scan
3. an older adult (2) The kidneys of an older adult are less able to concentrate urine as efficiently as it once did. (1) The patient with a high amount of blood urea nitrogen (BUN) could be dehydrated or have kidney failure. (2) Pregnancy is associated with urinary frequency, but it is related to the pressure of the uterus on the bladder and to increased fluid volume. (4) Bladder scan is a noninvasive procedure that should not precipitate nocturia.
You are assisting in administering BCG intravesically to a patient with bladder cancer. Place the steps in the correct order to accomplish this procedure. 1. Clamp the urethral catheter for 2 hours. 2. Change position every 15 to 30 minutes. 3. Aseptically insert a urinary catheter. 4. Drain urinary bladder. 5. Instill the BCG fluid.
3. aseptically insert a urinary catheter 5. instill the BCG fluid 1. clamp the urethral catheter for 2 hours 2. change position every 15 to 30 minutes 4. drain urinary bladder The solution is instilled into the bladder via a urinary catheter. The catheter is clamped for 2 hours and the patient's position is changed every 15 to 30 minutes. Then the bladder is drained.
Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. Which should the nurse reinforce to the client? 1. Take the medication at bedtime. 2. Take the medication before meals. 3. Discontinue the medication if a headache occurs. 4. A reddish-orange discoloration of the urine may occur.
4 The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse also should instruct the client that this discoloration can stain fabric. The medication should be taken after meals to reduce the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not warrant discontinuation of the medication.
In determining the presence of stress urinary incontinence, what signs are characteristic? 1. Involuntary loss of urine when the urge to urinate occurs 2. Discomfort and burning frequently when urinating 3. Inability to recognize the urge to urinate because of cognitive impairment 4. Loss of urine when coughing, sneezing, or laughing or during aerobic exercise
4. loss of urine when coughing, sneezing, or laughing or during aerobic exercise (4) Coughing, laughing, sneezing, or aerobic exercise can all cause stress incontinence loss of urine. (1) Urgency, accompanied by dribbling and leaking are symptoms of urge incontinence. (2) Discomfort and burning upon urination are signs of bladder irritation and infection. (3) Inability to recognize the urge to urinate can be due to cognitive impairment and is functional incontinence.
A nurse should notify the physician if: A. 24-hour urine output is 700 mL. B. 24-hour urine output is 800 mL. C. 24-hour urine output is 720 mL. D. 24-hour urine output is 1000 mL.
A. 24-hour urine output is 700mL Average hourly urine output is 30 mL, therefore 700 mL in a 24 hour period is abnormal because it averages to less than 30 mL/hour. The remaining options reflect urine output within normal range for a 24-hour period.
The ureter of each kidney conducts urine from the kidney to the A. urethra. B. bladder. C. prostate gland. D. calyx
B. bladder
A nurse is collecting a voided specimen for urinalysis. The nurse should: A. Tell the patient it is necessary to fill the container. B. Send the urine to the laboratory within 20 minutes. C. Tell the patient to use sterile technique. D. Tell the patient that only about 1.5 inches of urine is needed.
D. tell the patient that only about 1.5 inches of urine is needed When collecting a voided specimen for urinalysis, it is not necessary to fill the container with urine; only about 1.5 inches of urine is needed. Send the urine within 5 to 10 minutes. Sterile technique is not needed.
You are sending a patient to the dialysis clinic. What predialysis nursing interventions should be included? (Select all that apply.) 1. Withholding anticoagulants 2. Administering antihypertensives 3. Assessing dialysis access site 4. Checking vital signs 5. Monitoring laboratory values
1. withholding anticoagulants 3. assessing dialysis access site 4. checking vital signs 5. monitoring laboratory values (2) Antihypertensive medications are held because they can cause hypotension during the treatment. Nitroglycerin (NTG) patches, digitalis, and anticoagulants also are held. (1, 3-5) Physical assessment, checking for bruit and thrill at the access site, vital signs, weight and laboratory results are done and compared with post-treatment results.
The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which class of medications? 1. Diuretics 2. Antibiotics 3. Antitussives 4. Decongestants
4 Episodes of urinary retention can be triggered by certain medications such as decongestants, anticholinergics, and antidepressants. Diuretics, antibiotics, and antitussives generally do not trigger urinary retention. Retention also can be precipitated by other factors such as alcoholic beverages, infection, bed rest, and becoming chilled.
The LPN/LVN should understand that invasive procedures are postponed for 4 to 6 hours after hemodialysis for which reason? A. The procedure is very tiring. B. Heparin is used during the procedure. C. The patient is disoriented immediately after the procedure. D. The chance of infection is heightened immediately after the procedure.
B. heparin is used during the procedure Invasive procedures are postponed for 4 to 6 hours after dialysis because the clotting time is extended from the heparin used during dialysis and prolonged bleeding could occur. Disorientation of the patient after the procedure is not anticipated. Although the patient may be fatigued after the procedure, this is not the most important reason for avoiding invasive procedures in the period of time immediately after hemodialysis. Infection risk is not increased after dialysis.
A patient prescribed furosemide (Lasix) has a potassium level of 3.4 mEq/L. What is your best action? A. Document the finding as a normal level. B. Hold the drug and notify the prescriber. C. Instruct the patient to eat a banana and orange. D. Repeat the lab test to ensure that it is correct.
B. hold the drug and notify the prescriber
Attacks of renal colic are caused by A. gallstones. B. kidney stones. C. ANH. D. sodium stones.
B. kidney stones
The central, "blood balancing" organ of the urinary system is the A. liver. B. bladder. C. kidney. D. urethra.
C. kidney
How much water is reabsorbed from the proximal tubules? A. 25% B. 50% C. 75% D. 99%
D. 99%
The cells of the juxtaglomerular apparatus function to regulate A. urine production. B. water absorption. C. salt absorption. D. blood pressure.
D. blood pressure
The female patient presents to the clinic complaining of urinary frequency and burning. The nurse suspects a urinary tract infection (UTI) that was most likely caused by which organism? A. Escherichia coli B. Staphylococcus aureus C. Streptococcus pyogenes D. Herpes simplex virus 1 (HSV-1)
A. escherichia coli E. coli causes 80% of UTIs in females. HSV-1, S. aureus, and S. pyogenes are much less likely to cause UTIs.
After a renal biopsy, the client complains of pain at the biopsy site that radiates to the front of the abdomen. Which would this indicate? 1. Bleeding 2. Infection 3. Renal colic 4. Normal, expected pain
1 If pain originates at the biopsy site and begins to radiate to the flank area and around the front of the abdomen, bleeding should be suspected. Hypotension, a decreasing hematocrit, and gross or microscopic hematuria should also indicate bleeding. Signs of infection should not appear immediately after a biopsy. Pain of this nature is not normal. There are no data to support the presence of renal colic.
After placing an indwelling urinary catheter, you perform several interventions. Place the interventions in order of priority. 1. Secure the drainage bag below the level of the bladder so that it hangs freely. 2. Secure the catheter to the patient's leg. 3. Check that the catheter tubing is unimpeded and is looped above the drainage bag. 4. Use aseptic technique when emptying the drainage bag. 5. Observe the amount of urine drainage in the bag whenever you are in the patient's room.
1.Secure the drainage bag below the level of the bladder so that it hangs freely. 3.Check that the catheter tubing is unimpeded and is looped above the drainage bag. 2.Secure the catheter to the patient's leg. 5.Observe the amount of urine drainage in the bag whenever you are in the patient's room. 4.Use aseptic technique when emptying the drainage bag. (1) Securing the drainage bag to the bed frame below the level of the bladder is the priority step. (3) Making certain that the tubing is not kinked or that the patient is lying on it is the 2nd priority. (2) Securing the catheter to the patient's leg is next. (5) Observing the amount of urine in the drainage bag should be done every time you are in the patient's room. (4) Using aseptic technique when emptying the drainage bag is very important.
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply. 1. Contact the nephrologist. 2. Check the level of the drainage bag. 3. Reposition the client to his or her side. 4. Place the client in good body alignment. 5. Check the peritoneal dialysis system for kinks. 6. Increase the flow rate of the peritoneal dialysis solution.
2,3,4,5 If outflow drainage is inadequate, the nurse attempts to stimulate outflow by changing the client's position. Turning the client to the other side or making sure that the client is in good body alignment may assist with outflow drainage. The drainage bag needs to be lower than the client's abdomen to enhance gravity drainage. The connecting tubing on the peritoneal dialysis system is also checked for kinks or twisting, and the clamps on the system are checked to ensure that they are open. There is no reason to contact the nephrologist. Increasing the flow rate is an inappropriate action and is unassociated with the amount of outflow solution.
Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication? 1. Hemoglobin level of 14.0 g/dL (140 g/L) 2. Creatinine level of 0.6 mg/dL (53 mcmol/L) 3. Blood urea nitrogen level of 25 mg/dL (8.8 mmol/L) 4. Fasting blood glucose level of 99 mg/dL (5.5 mmol/L)
3 Cyclosporine is an immunosuppressant. Nephrotoxicity can occur from the use of cyclosporine. Nephrotoxicity is evaluated by monitoring for elevated blood urea nitrogen and serum creatinine levels. The normal blood urea nitrogen level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). The normal creatinine level for a male is 0.6 to 1.2 mg/dL (53 to 106 mcmol/L) and for a female 0.5 to1.1 mg/dL (44 to 97 mcmol/L). Cyclosporine can lower complete blood cell count levels. A normal hemoglobin is Male: 14 to 18 g/dL (140 to 180 mmol/L); Female: 12 to 16 g/dL (120 to 160 mmol/L). A normal hemoglobin is not an adverse effect. Cyclosporine does affect the glucose level. The normal fasting glucose is 70 to 110 mg/dL (4 to 6 mmol/L).
What information should you give to a community group about prevention of urologic problems? 1. Drinking orange juice every morning prevents urinary tract infection. 2. Drinking several glasses of fluid a day helps preserve kidney function. 3. Emptying the bladder prevents prolonged exposure to toxins. 4. Eating spinach, chocolate, or strawberries may cause kidney stones.
3. emptying the bladder prevents prolonged exposure to toxins (3) Emptying the bladder is a good health practice because prolonged exposure to toxins is thought to increase chances of bladder cancer. In addition, repetitive bladder distention places strain on urinary sphincters and will contribute to incontinence later in life. (1) Orange juice does not prevent urinary tract infection; although orange juice in itself is acidic, when consumed it turns alkaline and does not provide acidic urine which helps prevent urinary tract infections. (2) "Several glasses" is a vague recommendation that could be misinterpreted as two or three. Minimal fluid intake for good kidney health is 2000 to 2500 mL/day (i.e., 8 to 10 glasses). (4) Spinach and strawberries can be eaten by most people but are to be avoided by people who have calcium oxalate stones.
A 45-year-old man has a history of calcium oxalate stones, which can result in further renal calculi. What should you include about diet in this patient's education? 1. He should increase his protein intake but restrict dietary calcium and sodium. 2. He should increase intake of spinach and nuts. 3. He should increase fluids and dietary calcium. 4. He should increase sodium but decrease protein intake.
3. he should increase fluids and dietary calcium (3) In the past, patients with calcium oxalate stones were encouraged to decrease dietary calcium; however, evidence-based practice now indicates that these patients should actually be encouraged to increase fluids and dietary calcium, but (1-2) decrease protein and (4) sodium intake.
Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it developed during the course of this medication therapy? 1. Nausea 2. Diarrhea 3. Headache 4. Sore throat
4 Clients taking trimethoprim-sulfamethoxazole should be informed about early signs of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the PHCP if these symptoms occur. The other options do not require PHCP notification.
The nursing assessment of a patient with a suspected disorder of the urinary system should include which data? (Select all that apply.) A. Initiation of voiding B. Urine specific gravity C. Abdominal distention D. Volume of urine voided E. Frequency of headaches
A. initiation of voiding B. urine specific gravity C. abdominal distention D. volume of urine voided Initiation and volume of voiding, urine specific gravity, and abdominal distention are related to bladder and kidney function. Frequency of headaches is not related to kidney and bladder function.
A female patient has had a knee replacement and is experiencing difficulty voiding. What should the nurse recommend? A. Pour warm water over the perineum while patient attempts to void. B. Catheterize the patient to avoid problems. C. Use Crede's maneuver per nursing order. D. Use a sitz bath per nursing order.
A. pour warm water over the perineum while patient attempts to void Warm water may help patients to initiate the voiding reflex. Catheterization is used after other techniques have been unsuccessful. A physician order is needed for use of Crede's maneuver and/or a sitz bath.
After urologic surgery, nursing interventions should focus of which patient need? A. Promoting unimpeded urine flow B. Decreasing environmental stimuli C. Reporting dressings that have blood-tinged drainage D. Maintaining patients in one position for 24 to 48 hours
A. promoting unimpeded urine flow The patient who has had urologic surgery is at risk for inflammation and other complications. The most important thing is to avoid damage to the kidney, which would be caused by impeding urine flow. Dressings may be blood tinged. This is an expectation. The nurse must monitor for blood loss that may reflect hemorrhage or excessive blood loss. To avoid pulmonary and circulatory complications, it is important that the patient turn, cough, and breathe deeply. Environmental stimuli are not a danger to the patient recovering from urologic surgery.
The nurse is caring for the patient with end-stage renal disease (ESRD). The patient's serum calcium level is critically low, which places the patient at risk for which complication? A. Seizures B. Increased edema C. Cardiac problems D. Respiratory depression
A. seizures During ESRD, calcium is not absorbed from the intestinal tract, and this leads to the loss of calcium from the body and a corresponding drop in serum calcium. If the hypocalcemia is not corrected, the patient will eventually suffer from muscle cramps, twitching, and possibly seizures. Increased edema, cardiac problems, and respiratory depression are not signs of hypocalcemia.
The patient presents to the clinic with urinary frequency, burning, and dysuria and is diagnosed with a UTI. The nurse should recommend which nonpharmacologic interventions to help treat the infection and control symptoms? (Select all that apply.) A. Sitz baths B. Cranberry juice C. Vaginal douche twice a day D. One glass of red wine each night E. Consumption of 64 to 96 ounces of water daily
A. sitz baths B. cranberry juice E. consumption of 64 to 96 ounces of water daily Nonpharmacologic interventions for UTIs include sitz baths, cranberry juice, and increased fluid intake. Vaginal douches are not recommended because they alter the vaginal pH and destroy healthy flora. Alcohol is not helpful for UTIs.
A patient with cystitis is given a urinary antiseptic, phenazopyridine. Which statement, if made by the patient, indicates that the patient understood the instructions regarding the drug? A. "I should stay out of the sunlight." B. "It's likely that my urine will turn orange." C. "I need to take this medication with milk." D. "It's likely that I will experience a little dizziness."
B. "it's likely that my urine will turn orange." The use of phenazopyridine will turn urine orange. It is not necessary to avoid sunlight or take the medication with milk, and the patient is not expected to experience dizziness.
Which are the two main groups of drugs used to treat BPH? A. Phosphodiesterace-5 inhibitors B. DHT inhibitors C. Testosterone replacement drugs D. Selective alpha-1 blockers E. Non-selective alpha-1 blockers
B. DHT inhibitors
A patient has been admitted to the unit with a urinary tract obstruction and has been scheduled for an intravenous pyelogram (IVP). Nursing responsibilities for this patient will include which action? A. Keeping the patient in the fasting state B. Asking about allergies to contrast media C. Preparing the patient for nausea and vomiting to occur after the test D. Holding all aspirin and nonsteroidal anti-inflammatory drug (NSAID) medication
B. asking about allergies to contrast media The IVP is used to visualize the kidneys, ureters, and bladder. It is used to detect obstructions related to stones or tumors. Because the contrast medium generally used contains iodine, allergies to shellfish or iodine-containing substances are significant. The patient having an IVP does not have to be NPO (nothing by mouth). The use of aspirin and NSAID medications will not significantly alter the ability of the diagnostic test to be performed. Nausea and vomiting are not routine occurrences after the test.
When a urine culture is ordered, nursing responsibilities include which action? A. Keeping the specimen warm B. Collecting at least 200 mL of urine C. Obtaining the first voided urine in the morning D. Maintaining sterility of the specimen collection container
B. collecting at least 200mL of urine A urine culture is used to determine pathogens in voided urine. The specimen container should be sterile to avoid contamination. It is not necessary to collect the first voided urine. The specimen should not be kept warm. There is no need to collect 200 mL of urine to perform the test.
A patient's blood urea nitrogen (BUN) is found to be elevated. This finding is most suggestive of the fact that the patient has which condition? A. An infection B. Dehydration C. Liver damage D. Protein deficiency
B. dehydration BUN is the most common test used to evaluate kidney function and hydration status. High BUN levels can indicate poor kidney function, dehydration, or increased breakdown of body protein as caused by severe burns or excessive exercise.
Which bacterium is most often responsible for cystitis? A. Proteus B. Escherichia coli C. Pseudomonas D. Enterococcus
B. escherichia coli Escherichia coli is often the bacterium responsible for cystitis, especially in females. Proteus, Pseudomonas, and Enterococcus may cause cystitis but are not considered the most common causes.
Before giving a thiazide diuretic such as hydrochlorothiazide (Hydrodiuril), the patient's potassium level is 3.2 mEq/L. Which assessment takes priority at this time? A. Blood pressure B. Heart rate and rhythm C. Respiratory rate D. Body temperature
B. heart rate and rhythm
The passage of urine from the body or the emptying of the bladder is referred to as A. incontinence. B. micturition. C. urinary suppression. D. urinary retention.
B. micturition
When intermittently catheterizing an elderly female patient, the nurse may: A. position the patient prone. B. position the patient on her side. C. approach the meatus only from the front. D. pre-medicate elderly patients for relaxation purposes.
B. position the patient on her side In the elderly female, the urinary meatus is sometimes found just inside the opening of the vagina. If the patient has difficulty with the dorsal recumbent position, place her on her side with the knees flexed and upper leg supported by pillows, then approach the meatus from the rear. Prone position is not appropriate for catheterization. Pre-medication is not an appropriate intervention unless there is significant discomfort with the procedure.
Which measure is usually included in the care of a patient with stress incontinence? A. Encouraging the patient to drink caffeinated fluids B. Teaching the patient pelvic floor strengthening exercises C. Suggesting that the patient have a glass of water before bedtime D. Discouraging the patient from voiding more frequently than every 4 hours
B. teaching the patient pelvic floor strengthening exercises The use of strengthening exercises (such as Kegel exercises) is helpful in the management of stress incontinence. Caffeinated fluids, water before bedtime, and voiding less frequently than every 4 hours increase the patient's risk for incontinence.
What are the functions of the urinary structures for elimination? (Select all that apply.) A. The urethra carries urine from the kidneys to the bladder. B. Urine output is related to the amount of fluid intake. C. Waste products are diluted with water and excreted as urine. D. A bladder can hold 2500 mL of urine.
B. urine output is related to the amount of fluid intake C. waste products are diluted with water and excreted as urine Urine output is related to fluid intake and can vary considerably. Waste products are excreted as urine. Ureters carry urine from the kidneys to the bladder. A bladder can hold 1000 to 1800 mL of urine.
Urine is formed by the nephron by means of which three processes? A. filtration, secretion, and excretion B. filtration, reabsorption, and excretion C. filtration, reabsorption, and secretion D. reabsorption, secretion, and excretion
C. filtration, reabsorption, and secretion
A patient is prescribed a daily IV dose of furosemide (Lasix). To ensure the safety of the patient, what action do you take before and after administering this drug? A. Ensure that the IV flow rate is set for at least 125 mL/hr. B. Check to be sure that the serum potassium level is 5 or higher. C. Assess the IV site for patency. D. Instruct the patient to call for help before getting out of bed.
C. assess the IV site for latency
Catheterization is an appropriate intervention in which situation? A. Hematuria noted on urinalysis B. Urinary tract infection (UTI) C. Dilation of urethral stricture D. Bladder scan reveals 150 mL of residual urine
C. dilation of urethral stricture Catheterization is an appropriate intervention for dilation of a urethral stricture. Catheterization is not an appropriate intervention for hematuria, for UTI, or for 150 mL of residual urine in the bladder.
The mechanism for voiding urine begins with the voluntary relaxation of the A. internal sphincter muscle of the bladder. B. urethra. C. external sphincter muscle of the bladder. D. detrusor muscle.
C. external sphincter muscle of the bladder
The patient presents to the clinic complaining of urinary urgency, frequency, dysuria, and low back pain. The nurse suspects cystitis and prepares to educate the patient on taking which medications? (Select all that apply.) A. Metronidazole B. Spironolactone C. Phenazopyridine D. Hydrochlorothiazide E. Hydrocodone/acetaminophen F. Trimethoprim-sulfamethoxazole
C. phenazopyridine F. trimethoprim-sulfamethoxazole The patient with cystitis would be prescribed an antibiotic such as trimethoprim-sulfamethoxazole as well as phenazopyridine, which is a urinary analgesic. Metronidazole is usually prescribed to treat vaginitis. Spironolactone is a potassium-sparing diuretic. Hydrochlorothiazide is used as a diuretic. Hydrocodone/acetaminophen is a narcotic pain reliever, not usually prescribed for cystitis.
One of the earliest signs of renal impairment is which symptom? A. Oliguria B. Pruritus C. Polyuria D. Dark-colored urine
C. polyuria There are three stages of chronic renal failure. In stage 1, there is diminished renal reserve but no accumulation of metabolic wastes. The healthier kidney works harder. Urine concentration is decreased, and polyuria and nocturia occur. In later stages, oliguria, dark-colored urine, and pruritus occur.
The movement of substances out of the renal tubules into the peritubular capillaries is called A. secretion. B. filtration. C. reabsorption. D. absorption.
C. reabsorption
Which of the following is the triangular division of the medulla of the kidney? A. calyx B. renal medulla C. renal pyramid D. renal pelvis
C. renal pyramid
Regarding long-term care, patients who have kidney transplants should be given which instruction? A. They need to limit their intake of sodium. B. They have to be on a protein-restricted diet. C. They have increased susceptibility to infection. D. They have to have their DNA checked periodically.
C. they have increased susceptibility to infection Transplant patients will be placed on antirejection medications. These medications reduce the patients' immunity and increase their risk for the development of infection. It is not necessary to restrict protein and sodium or to have their DNA checked.
A nurse is educating a group of elderly patients in an assisted-living facility about urinary incontinence. Information offered during the encounter may include: A. avoidance of Kegel exercises. B. wear adult diapers day and night to prevent leakage. C. condom catheters may be used by males. D. indwelling Foley catheters are recommended for management of all types of incontinence.
D. indwelling Foley catheters are recommended for management of all types of incontinence Condom catheters are appropriate for males if used correctly. Kegel exercises are recommended and may greatly reduce or stop incontinence. Adult diapers are not to be worn 24 hours a day as a result of an increased risk of skin breakdown. Indwelling Foley catheters are not appropriate for all types of incontinence, and the risks associated with trauma and infection may outweigh the benefits.
Which age-related change in the urinary system should a nurse expect? A. Increased bladder tone B. Episodes of incontinence C. Increased red blood cells (RBCs) in the urine D. Reduced rate of renal filtration
D. reduced rate of renal filtration Reduced rate of renal filtration occurs with aging and may lead to a decrease in renal function. The bladder tone decreases with aging. Incontinence is not a normal part of aging. Increased RBCs is not an age-related change.
