Genitourinary Disorders
A nurse is planning to administer a sodium polystyrene sulfonate enema to a client with a potassium level of 6.2 mEq/L. Correct administration and the effects of this enema should include having the client retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea. retain the enema for 30 minutes to allow for glucose exchange; afterward, the client should have diarrhea. retain the enema for 60 minutes to allow for sodium exchange; diarrhea isn't necessary to reduce the potassium level. retain the enema for 60 minutes to allow for glucose exchange; diarrhea isn't necessary to reduce the potassium level.
retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.
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 ferrous sulfate. epoetin alfa. filgrastim. enoxaparin.
epoetin alfa.
The nurse is instructing an unlicensed assistive personnel (UAP) to collect a urine specimen from an indwelling catheter. Which statement indicates that the UAP understands the instructions? "I should collect urine from the catheter drainage bag at the end of the shift and place it in the specimen container." "I'll disconnect the drainage tube from the catheter and let urine run from the catheter into the specimen container." "I'll empty the catheter drainage bag, have the client drink some water, and an hour later collect the urine that drains into the bag." "I'll get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container."
"I'll get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container."
Which laboratory value supports a diagnosis of pyelonephritis? myoglobinuria ketonuria pyuria low white blood cell (WBC) count
pyuria
A male client enters the oncology clinic for an evaluation. The nurse explains that the healthcare provider has ordered a prostate-specific antigen (PSA) test. The client asks the nurse, "How will this test tell if I have prostate cancer?" What is the nurse's best response? "If your level is between is between 6 and 8 ng/mL, you have nothing to worry about." "Individuals who have a PSA higher than 10 have a 60-70% chance of having prostate cancer." "The evidence shows that individuals who have levels under 4 ng/mL need yearly follow-up." "Individuals with a 2.5 ng/mL PSA and a mother who had breast cancer need to have a biopsy of the prostate gland."
"Individuals who have a PSA higher than 10 have a 60-70% chance of having prostate cancer."
After trying for a year to conceive, a couple consults a fertility specialist. When obtaining a history from the husband, which question should the nurse ask? "What are your dietary practices?" "What childhood immunizations and illnesses did you have?" "What are your hobbies?" "Have you traveled outside of the continental United States?"
"What childhood immunizations and illnesses did you have?"
A client with chronic renal failure receives hemodialysis treatments through a mature arteriovenous (AV) fistula. What intervention will the nurse include in the care plan? Apply lotion to the AV fistula daily. Clean the AV fistula with sterile saline. Palpate the AV fistula for a bruit. Auscultate the AV fistula for a bruit.
Auscultate the AV fistula for a bruit.
The nurse assesses a client's outflow is less than the inflow during a peritoneal dialysis exchange. What actions will the nurse use to increase peritoneal dialysis outflow? Select all that apply. Increase the inflow. Check the level of the drainage bag. Contact the health care provider. Check the peritoneal dialysis system for kinks. Reposition the client to a side lying.
Check the level of the drainage bag. Check the peritoneal dialysis system for kinks. Reposition the client to a side lying.
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? Explain that a high dose of the pain medication has been administered and that taking more too soon can lead to respiratory depression. Tell the client that the order is for every 2 hours, and explain that an additional dose cannot be given for at least one more hour. Reassess the client's pain and associated symptoms, and report findings to the healthcare provider to advocate for better pain control. Review the client's medical record for evidence of past opioid misuse or drug-seeking behavior to help direct the best course of action.
Reassess the client's pain and associated symptoms, and report findings to the healthcare provider to advocate for better pain control.
A client had a cystoscopy to remove a renal stone. Which laboratory data warrants immediate intervention by the nurse? a creatinine level of 0.7 mg/dL (61.88 µmol/L) a serum calcium level of 9.0 mg/dl (2.25 mmol/L) a white blood cell count of 14,000 mm/dL (14.00 x 109/L) a urinalysis that shows microscopic hematuria
a white blood cell count of 14,000 mm/dL (14.00 x 109/L)
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. impaired home maintenance. noncompliance. knowledge deficit: chemotherapy.
acute pain.
A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis? nulliparity menopause corticosteroids use spermicidal jelly use
corticosteroids use
The nurse is caring for a client with polydipsia and large amounts of urine with a specific gravity of 1.003. Which disorder is anticipated? diabetes mellitus diabetes insipidus diabetic ketoacidosis SIADH secretion
diabetes insipidus
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? anxiety headache diarrhea dizziness
diarrhea
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 sexually transmitted infections retarded ejaculation premature ejaculation
erectile dysfuction
A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department? bacterial vaginitis gonorrhea genital herpes human papillomavirus (HPV)
gonorrhea
When providing discharge teaching for a client with uric acid calculi, the nurse would include an instruction to avoid which type of diet? low calcium low oxalate high oxalate high purine
high purine
To reduce urethral irritation, where should the nurse tape the female client's Foley catheter? inner thigh groin area lower abdomen lower thigh
inner thigh
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? client who had an ileal conduit 3 days ago middle-aged stable client with bladder cancer awaiting surgery middle-aged client who had a kidney transplant 3 days ago elderly client just admitted for an acute stroke
middle-aged stable client with bladder cancer awaiting surgery
A client is scheduled to undergo transurethral resection of the prostate. The procedure is to be done under spinal anesthesia. What should the nurse assess the client for after surgery? seizures cardiac arrest renal shutdown respiratory paralysis
respiratory paralysis
A female client reports to a nurse that she experiences a loss of urine when she jogs. The nurse's assessment reveals no nocturia, burning, discomfort when voiding, or urine leakage before reaching the bathroom. The nurse explains to the client that this type of problem is called: functional incontinence. reflex incontinence. stress incontinence. total incontinence.
stress incontinence.
A client believes they are experiencing premenstrual syndrome (PMS). The nurse should next ask the client about what symptom? menstrual cycle irregularity with increased menstrual flow mood swings immediately after menses tension and fatigue before menses and through the second day of the menstrual cycle midcycle spotting and abdominal pain at the time of ovulation
tension and fatigue before menses and through the second day of the menstrual cycle
After a client has surgery for an ileal conduit, the nurse should assess the client for the occurrence of which complication? peritonitis thrombophlebitis ascites inguinal hernia
thrombophlebitis
The nurse is obtaining a health history from an adult female client with vulvovaginal candidiasis. Which health problem(s) would put this client at risk for increased severity of the vulvovaginal candidiasis?Select all that apply. uncontrolled diabetes immunosuppression due to cancer human immunodeficiency virus (HIV) infection hypertension asthma
uncontrolled diabetes immunosuppression due to cancer human immunodeficiency virus (HIV) infection
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? "Avoid intercourse until you have completed the antibiotic therapy, and then limit intercourse to once a week." "Limit intercourse to once a day in the early morning after your bladder has rested." "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." "You can have intercourse as often as you wish, but be sure your partner uses a condom."
"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 with a urinary tract infection is ordered co-trimoxazole. The nurse should provide which medication instruction? "Take the medication with food." "Drink at least eight 8-oz (240 mL) glasses of fluid daily." "Avoid taking antacids during co-trimoxazole therapy." "Don't be afraid to go out in the sun."
"Drink at least eight 8-oz (240 mL) glasses of fluid daily."
The nurse is planning care for a client with stress incontinence. What goal is realistic for the nurse to establish with the client? Help the client adjust to the frequent episodes of incontinence. Eliminate all episodes of incontinence. Prevent the development of urinary tract infections. Decrease the number of incontinence episodes.
Decrease the number of incontinence episodes.
Which nursing action is most appropriate for a client who has urge incontinence? Have the client urinate on a timed schedule. Provide a bedside commode. Administer prophylactic antibiotics. Teach the client intermittent self-catheterization technique.
Have the client urinate on a timed schedule.
During dialysis, a client has disequilibrium syndrome. What should the nurse do first? Administer oxygen per nasal cannula. Slow the rate of dialysis. Reassure the client that the symptoms are normal. Place the client in a modified Trendelenburg position.
Slow the rate of dialysis.
Two weeks after being diagnosed with a streptococcal infection, a client develops fatigue, a low-grade fever, and shortness of breath. The nurse auscultates bilateral crackles and observes jugular vein distention. Urinalysis reveals red and white blood cells and protein. After the physician diagnoses poststreptococcal glomerulonephritis, the client is admitted to the medical-surgical unit. Which immediate action should the nurse take? Encourage activity as tolerated. Provide a high-protein, fluid-monitored diet. Monitor patient blood pressure. Place the client on a sheepskin, and monitor for increasing edema.
Monitor patient blood pressure.
Prior to initiating hemodialysis therapy on a client, the nurse notes that the client's heart rate is 50 beats/min, blood pressure is 110/78 mm Hg, and respirations are 14 breaths/min. What is the best action by the nurse? Notify the healthcare provider. Hold the client's cardiac medications. Document the findings. Assess for orthostatic hypotension.
Notify the healthcare provider.
A client is receiving peritoneal dialysis. What should the nurse assess while the dialysis solution is dwelling in the client's abdomen? Assess for urticaria. Observe respiratory status. Check capillary refill time. Monitor electrolyte status.
Observe respiratory status.
A client is admitted with a diagnosis of chronic hydronephrosis. Which assessment finding requires immediate action or will assist the nurse in planning care? Client's calcium level is 9.2 mg/dL (2.3 mmol/L). Client's blood urea nitrogen (BUN) is 32 mg/dL. Client's potassium level is 4.9 mEq/L. Client's urinary output is 40 mL/hour.
Client's blood urea nitrogen (BUN) is 32 mg/dL.
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. Explain that pain is caused by hormonal fluctuations. Reassure the client that pain is not a symptom of breast cancer. Teach the client the correct procedure for breast self-examination (BSE).
Do a breast examination and report the results to the physician.
Two days after a herniorrhaphy, the client reports that their scrotum is swollen and painful. What should the nurse instruct the client to do? Apply a snug binder to the abdomen. Wear a truss to support the scrotum. Elevate the scrotum and place ice bags on the area intermittently. Lie on the side and place a pillow between the legs.
Elevate the scrotum and place ice bags on the area intermittently.
A client experienced urinary incontinence and participated in a bladder management program. The client has experienced some success in this program but continues to experience intermittent urinary incontinence, especially at night. The client presents to the clinic reporting skin irritation and is diagnosed with incontinence-associated dermatitis. Which intervention does the nurse expect the health care provider to order as a result? Discontinue bladder management program interventions. Have a chronic indwelling urinary catheter inserted. Use an external urine collection device. Reduce daily fluid intake by half.
Use an external urine collection device.
A middle-aged male client comes to the clinic for an evaluation of difficulty urinating and nocturia. His father died from prostate cancer. He asks the nurse what he can do to ensure early detection of this disease. What question will the nurse ask next? "Do you perform monthly testicular self-examinations?" "Do you have a digital rectal examination and prostate-specific antigen tests yearly?" "Have you had a transrectal ultrasound within the last 10 years?" "How many times a night do you get up to void?"
"Do you have a digital rectal examination and prostate-specific antigen tests yearly?"
The nurse gives a pamphlet that describes pelvic floor muscle exercises (Kegel exercises) to a client with stress incontinence. Which statement indicates that the client has understood the instructions contained in the pamphlet? "I should perform these exercises every evening." "It will probably take a year before the exercises are effective." "I can do these exercises sitting up, lying down, or standing." "I need to tighten my abdominal muscles to do these exercises correctly."
"I can do these exercises sitting up, lying down, or standing."
A client is to take sulfamethoxazole-trimethoprim for a urinary tract infection. Which statement indicates that the client knows how to correctly take the medication? "I'll take the pills until my symptoms disappear." "I'll need to get a urine culture when I am finished taking the pills." "I should decrease my fluid intake to increase the concentration of the drug in my urine." "I should take all the pills and then have the prescription renewed if I still have symptoms."
"I'll need to get a urine culture when I am finished taking the pills."
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction? "Take your temperature every 4 hours." "Increase your fluid intake to 2 to 3 L per day." "Apply an antibacterial dressing to the incision daily." "Be aware that your urine will be cherry-red for 5 to 7 days."
"Increase your fluid intake to 2 to 3 L per day."
The nurse is caring for a client diagnosed with genitourinary tuberculosis (TB). Which statement, made by the client, about genitourinary TB demonstrates an understanding? "It isn't infectious, and I can't pass it from one person to another." "I can't pass it sexually to my partner." "It's a late manifestation of respiratory tuberculosis." "It's an early manifestation of an autoimmune disorder."
"It's a late manifestation of respiratory tuberculosis."
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? "ED is believed to be psychogenic in most cases." "More than 50% of the cases are attributed to organic causes." "Evaluation of nocturnal erections does not help differentiate psychogenic or organic causes." "ED is an uncommon problem among men older than age 65."
"More than 50% of the cases are attributed to organic causes."
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." "Describe your joint pain." "Are you doing anything to lower your cholesterol level?" "Tell me about your sleep patterns."
"Tell me about your normal voiding patterns."
A client is admitted with a diagnosis of viral gastroenteritis. The client has an elevated blood urea nitrogen and creatinine and is oliguric with a blood pressure of 74/30 mmHg. Which order from the healthcare provider should the nurse carry out first? Administer an antiemetic. Administer an antipyretic. Collect stool samples. Administer intravenous fluids.
Administer intravenous fluids.
A client with acute pyelonephritis receives a prescription for co-trimoxazole P.O. twice daily for 10 days. Which finding best demonstrates that the client has followed the ordered regimen? Urine output increases to 2,000 ml/day. Flank and abdominal discomfort decreases. Bacteria are absent on urine culture. The red blood cell (RBC) count is normal.
Bacteria are absent on urine culture.
The nurse is caring for a client with an indwelling urinary catheter. The client has a temperature of 101.2°F (38.4°C) and is reporting abdominal pain and the urge to urinate. The nurse palpates the client's abdomen and finds it to be flat and soft, and the nurse notes that the client has had appropriate urine output for the past several hours. The nurse notifies the health care provider (HCP). What should the nurse expect the HCP to order? Flush the urinary catheter with 20 mL of sterile water. Encourage the client to drink at least 100 mL of fluid per hour. Replace the urinary catheter and collect a urine culture. Reposition the urinary catheter.
Replace the urinary catheter and collect a urine culture.
The nurse notes that the dialysate drainage of a client receiving peritoneal dialysis is cloudy. Which action should the nurse take? Flush the catheter with saline solution. Report the finding to the healthcare provider. Encourage the client to increase the intake of oral fluids. Instill an additional liter of dialysate solution.
Report the finding to the healthcare provider.
A client undergoes extracorporeal shock wave lithotripsy (ESWL) to break up and remove renal calculi. Which nursing measure is appropriate for the postoperative care of this client? Maintain the client on strict bed rest for 48 hours after the procedure. Instruct the client to anticipate a decrease in urine output. Instruct the client to anticipate hematuria for about 24 hours after the procedure. Limit fluid intake to 1000 mL/day (about 4 cups) until all stone fragments have been passed.
Instruct the client to anticipate hematuria for about 24 hours after the procedure.
Which action has the highest priority in the care of a client with chronic renal failure? Apply corticosteroid creams to relieve itching. Achieve pain control with analgesics. Maintain a low-sodium diet. Measure abdominal girth daily.
Maintain a low-sodium diet.
A client is prescribed alfuzosin for benign prostatic hyperplasia (BPH). What should the nurse teach the client? Rise slowly from a supine position. Contact the healthcare provider if the pulse rate falls below 70/bpm. Restrict fluid intake while taking this medication. A dry cough is an expected side effect.
Rise slowly from a supine position.
The nurse collects a urine specimen from a client for a culture and sensitivity analysis. What should the nurse do to preserve the specimen? Send it to the laboratory immediately. Place it on counter for the next specimen pickup. Assign an unlicensed assistive personnel to take it to the laboratory as soon as possible. Store it in the refrigerator until it can be sent to the laboratory.
Send it to the laboratory immediately.
A client who has been diagnosed with renal calculi reports that the pain is intermittent and less colicky. Which nursing action is most important at this time? Report hematuria to the health care provider. Strain the urine carefully. Administer morphine every 3 hours. Apply warm compresses to the flank area.
Strain the urine carefully.
An older adult male client has been taking doxazosin 2 mg daily for 4 weeks for treatment of benign prostatic hypertrophy. The client reports feeling dizzy. What should the nurse do first? Take the client's blood pressure lying, standing, and sitting. Test the client's urine for ketones. Review the client's other medications. Report the symptoms to the health care provider.
Take the client's blood pressure lying, standing, and sitting.
A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? establishing a predetermined fluid intake pattern for the client encouraging the client to increase the time between voidings restricting fluid intake to reduce the need to void assessing present voiding patterns
assessing present voiding patterns
A client has had their urinary catheter removed after having one for 7 days after a mild cerebrovascular accident. Which action should the nurse prioritize to evaluate the client's ability to empty their bladder after voiding? bladder scanning intermittent catheterization palpation of the bladder asking the client if they feel the bladder has emptied
bladder scanning
A client with renal insufficiency is admitted to the hospital with pneumonia. The client is being treated with gentamicin. Which laboratory value should be closely monitored? blood urea nitrogen (BUN) sodium level alkaline phosphatase white blood cell (WBC) count
blood urea nitrogen (BUN)
The nurse implements interventions for decreasing fluid retention in a child with nephrotic syndrome. Which finding indicates that the interventions have been effective? decreased abdominal girth increased caloric intake increased respiratory rate decreased heart rate
decreased abdominal girth
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should assess the client for which alteration in fluid and electrolyte balance? increased osmolality of the plasma decreased serum sodium level increased urine output decreased blood pressure
decreased serum sodium level
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: assess whether the client is a good candidate for surgery. help the client cope with the anxiety associated with changes in body image. assess suicidal risk postoperatively. evaluate the client's need for mental health intervention.
help the client cope with the anxiety associated with changes in body image.
A client comes to the emergency department reporting sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site? kidney ureter bladder urethra
kidney
The correct procedure for collecting a urine specimen from an indwelling catheter is to: open the spigot on the collecting bag and allow urine to empty into the specimen container. disconnect the drainage tube from the collecting bag and allow urine to flow from the tubing into the specimen container. disconnect the drainage tube from the indwelling catheter and allow urine to flow from the tubing into the specimen container. remove urine from the drainage tube with a sterile needle and syringe and place urine from the syringe into the specimen container.
remove urine from the drainage tube with a sterile needle and syringe and place urine from the syringe into the specimen container.
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? impaired urinary elimination toileting self-care deficit risk for infection activity intolerance
risk for infection
A 28-year-old client is diagnosed with acute epididymitis. What should the nurse assess the client for when conducting a focused assessment? burning and pain during urination severe tenderness and swelling in the scrotum foul-smelling ejaculate foul-smelling urine
severe tenderness and swelling in the scrotum
A nurse preceptor is observing a new graduate nurse during care of a client in contact isolation. What action by the new graduate indicates the need for further teaching about handling the client's soiled linens? wears gloves when handling the client's soiled linen disposes of soiled linen before exiting the client's room places blood-soaked linen in the room's biohazard container uses alcohol gel to clean hands after removing gloves
uses alcohol gel to clean hands after removing gloves
A client who weighs 207 lb (94.1 kg) is to receive 1.5 mg/kg of gentamicin sulfate intravenously three times each day. How many milligrams of medication should the nurse administer for each dose? Round to the nearest whole number.
141 mg
A client with chronic renal failure is receiving hemodialysis three times a week. What should the nurse do to protect the fistula? Take the blood pressure in the arm with the fistula. Report the loss of a thrill or bruit on the arm with the fistula. Maintain a pressure dressing on the shunt. Start a second intravenous (IV) in the arm with the fistula.
Report the loss of a thrill or bruit on the arm with the fistula.
A client is at risk for acute pyelonephritis. The nurse should instruct the client about which health promotion behavior that will be most effective in preventing pyelonephritis? Wash the perineum with warm water and soap, cleaning from front to back. Treat fungal infections such as athlete's foot immediately. Have a pneumonia immunization to prevent streptococcal infection. Treat skin lesions with antibiotics, and cover any open lesions.
Wash the perineum with warm water and soap, cleaning from front to back.
The nurse is assessing a client with kidney failure. Which finding is concerning? elevated body temperature increased blood pressure decreased urine output increased urine specific gravity
decreased urine output
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? transurethral resection of the prostate (TURP) suprapubic prostatectomy retropubic prostatectomy transurethral laser incision of the prostate
transurethral resection of the prostate (TURP)
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? specific gravity of 1.03 urine pH of 3.0 absence of protein absence of glucose
urine pH of 3.0
A woman is using progestin injections for contraception. When does the nurse instruct the client to return for the next injection? 1 month 3 months 4 months 6 months
3 months
Six hours after undergoing an abdominal hysterectomy, a client has a strong urge to void and voids 25 mL into the bedpan. Based on these data, what should the nurse determine the client is experiencing? dehydration urine retention urgency a urinary tract infection
urine retention
A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs) about prevention. What statement indicates the client understands the teaching? "I should wipe from back to front." "I should take a tub bath at least 3 times per week." "I should take at least 1,000 mg of vitamin C each day." "I should empty my bladder after eating a meal."
"I should take at least 1,000 mg of vitamin C each day."
During a clinic visit, the parent of an infant with hydrocele states that the infant's scrotum is smaller now than when born. After teaching the parent about the infant's condition, which statement by the parent indicates that the teaching has been effective? "I guess keeping their bottom elevated has helped." "Massaging the groin area is working." "It seems like the fluid is being reabsorbed." "Keeping my child quiet and in an infant seat has helped."
"It seems like the fluid is being reabsorbed."
A client is admitted to the hospital with a diagnosis of renal calculi. The client is experiencing severe flank pain and nausea; their temperature is 100.6°F (38.1°C). Which goal is a priority for this client? Prevent urinary tract complications. Manage nausea. Relieve pain. Maintain fluid and electrolyte balance.
Relieve pain.
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 should be accepted as a relatively normal part of aging. Urinary incontinence has many causes and can often be improved with intervention. Among older adults, urinary incontinence is most often a sign of depression. Being incontinent can increase the client's risk for dehydration and confusion.
Urinary incontinence has many causes and can often be improved with intervention.
The nurse is working the night shift and needs to collect urine from four clients for routine urinalysis. Which client collection can be delegated to the unlicensed assistive personnel (UAP)? the client ordered a urinary catheter insertion the client ordered a voided urine the client ordered a urine for culture the client ordered to self-catheterize at home and requiring education on the technique
the client ordered a voided urine
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? Administer pain medication. Assess for edema in the left leg. Assess the color and temperature of the left leg. Encourage the client to change their position.
Assess the color and temperature of the left leg.
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. Change the catheter daily. Provide perineal care at least once a day. Maintain a closed drainage system. Encourage the client to drink 101 oz (3000 mL) fluids daily. Recommend the health care provider prescribe antibiotics.
Provide perineal care at least once a day. Maintain a closed drainage system. Encourage the client to drink 101 oz (3000 mL) fluids daily.
The nurse is caring for a client with an indwelling urinary catheter. The nurse has noted that there has been no urine output for the past 2 hours. There has been no change in vital signs during that time period. What should the nurse do to determine if there is a problem with the urinary catheter? Press firmly on the abdomen, and note if urine appears in the catheter. Disconnect the catheter from the drainage tubing to release pressure. Use a bladder scanner to determine if there is urine in the bladder. Flush the urinary catheter with at least 30 mL of sterile water.
Use a bladder scanner to determine if there is urine in the bladder.
A client underwent a transurethral resection of the prostate gland 24 hours ago and is prescribed continuous bladder irrigation. What nursing intervention is appropriate? Decrease the rate of irrigation when output is increasingly red in color. Restrict fluids to prevent the client's bladder from becoming distended. Prepare to remove the catheter when urine appears amber in color. Use sterile technique if manual irrigation of the catheter is required.
Use sterile technique if manual irrigation of the catheter is required.
On the second day following an abdominal hysterectomy, a client reports they have had three brown, loose stools of a moderate amount. The morning medications include a prescription for 100 mg of docusate sodium daily or as needed. What should the nurse do next? Administer the docusate sodium according to the prescription. Ask the client if they are having gas pains or hunger. Withhold the medication, and document the client's report of loose stools. Administer the docusate sodium, and instruct the client to avoid high-fiber foods.
Withhold the medication, and document the client's report of loose stools.
The nurse is teaching a female client to manage urinary incontinence. Which outcome indicates that the nurse's instructions have been successful? continence for 24 hours a day improvement in bladder control self-monitoring for urine retention compliance with drinking and voiding schedule
continence for 24 hours a day
A client has urge incontinence. When obtaining the health history, the nurse should ask the client about which factor that could precipitate incontinence? inability to empty the bladder loss of urine when coughing involuntary urination frequent dribbling of urine
involuntary urination
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? increased pH with decreased hydrogen ions increased serum levels of potassium, magnesium, and calcium blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75%
blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl
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: continuous inflow and outflow of irrigation solution. intermittent inflow and continuous outflow of irrigation solution. continuous inflow and intermittent outflow of irrigation solution. intermittent flow of irrigation solution and prevention of hemorrhage.
continuous inflow and outflow of irrigation solution.
A client with type 2 diabetes mellitus who is taking metformin is scheduled for a computed tomography (CT) with contrast of the abdomen tomorrow. Which priority nursing assessment is done before the procedure? ensuring that client has taken nothing by mouth for 24 hours administering polyethylene glycol electrolyte solution over 12 hours until stools are clear and liquid ensuring that the metformin has been withheld for 48 hours prior to the scan administering a sodium biphosphate and sodium phosphate enema until clear the evening before
ensuring that the metformin has been withheld for 48 hours prior to the scan
The client is on a fluid restriction of 500 mL (about 2 cups) per day plus replacement for urine output. Because the client's 24-hour urine output yesterday was 150 mL, the total fluid allotment for the next 24 hours is 650 mL (about 2¾ cups). How should the nurses distribute this fluid over the next 24 hours? supplemented with gelatin and ice cream given with meals, divided equally between breakfast and lunch given in small amounts throughout each shift given in its entirety in the morning to minimize the client's thirst during the rest of the 24 hour period
given in small amounts throughout each shift
A young adult client tells the nurse they have a slight yellow vaginal discharge. The nurse should tell the client to contact their health care provider (HCP) if they have which additional symptom(s)? Select all that apply. vaginal discharge that has a fishy odor starting their menstrual period abdominal pain a temperature above 101ºF (38.3ºC) loss of appetite
vaginal discharge that has a fishy odor abdominal pain a temperature above 101ºF (38.3ºC)
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?" "Do you have a history of hemorrhoids?" "How much fluids are you drinking in the late evenings?" "When is the last time you had a colonoscopy?" "What are your usual voiding patterns?"
"Are you waking up in the middle of the night to void?" "How much fluids are you drinking in the late evenings?" "What are your usual voiding patterns?"
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." "The radioactivity will gradually decrease, and you will be discharged when the radioactive material reaches its half-life." "The radiation is necessary to treat your tumor." "Careful shielding prevents the area above your waist from radioactivity."
"The radioactive material is controlled and stays with the source; once the material is removed, no radioactivity will remain."
After transurethral resection of the prostate, the nurse notices that the urine draining from the catheter is bright red, has numerous clots, and is viscous. Which nursing action is most appropriate? Irrigate the catheter to remove clots. Milk the catheter tube vigorously. Increase the client's fluid intake. Assess vital signs and notify the surgeon.
Assess vital signs and notify the surgeon.
During rounds, a client admitted with gross hematuria asks the nurse about the physician's diagnosis. To facilitate effective communication, what should the nurse do? Ask why the client is concerned about the diagnosis. Change the subject to something more pleasant. Provide privacy for the conversation. Give the client some good advice.
Provide privacy for the conversation.
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? The urine in the drainage bag appears red to pink. The client reports bladder spasms and the urge to void. The normal saline irrigant is infusing at a rate of 50 drops/minute. About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned.
The client reports bladder spasms and the urge to void.
The nurse is developing a community health education program about sexually transmitted infections. Which information about women who acquire gonorrhea should be included? Women are more reluctant than men to seek medical treatment. Gonorrhea is not easily transmitted to women who are menopausal. Women with gonorrhea usually have no symptoms. Gonorrhea is usually a mild disease for women.
Women with gonorrhea usually have no symptoms.
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? The client: runs 5 miles three times a week. takes large doses of vitamin E. eats a diet that meets the daily requirements for calcium. drinks one to two glasses of fluid daily.
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? impotence scrotal swelling urine retention dysuria
dysuria
The nurse is administering a high dose of furosemide to a client with nephrotic syndrome. What potential complication is the nurse most concerned with for the client? electrolyte imbalance visual disturbances altered level of consciousness increased urination
electrolyte imbalance
A client is admitted to the recovery room after cystoscopy with biopsy. Before discharging the client, what should the nurse determine? The client has: had a bowel movement. no pain. emptied the bladder. no blood in the urine.
emptied the bladder.
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? consuming over four cups of coffee per day having sexual intercourse during the menstrual cycle douching unless instructed to do so by the health care provider (HCP) using tampons during the menstrual cycle
douching unless instructed to do so by the health care provider (HCP)
A client recovering from an abdominal hysterectomy has pain in the right calf. What should the nurse do next? Palpate the calf to note pain. Measure the circumference of both calves, and note the difference. Have the client flex and extend the leg and note the presence of pain. Raise the right leg and lower it to detect changes in skin color.
Measure the circumference of both calves, and note the difference.
A menopausal woman with an intact uterus is taking a combined estrogen and progesterone replacement medication, conjugated estrogens/medroxyprogesterone acetate 0.625 mg/2.5 mg, for severe hot flashes. Combined hormonal therapy is given because estrogen alone: Would not be effective for hot flashes. Could be a risk factor for endometrial cancer. Would not be sufficient to maintain libido. Could be a risk factor for ovarian cancer.
Could be a risk factor for endometrial cancer.
A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to: limit oral fluid intake for 1 to 2 weeks. report the presence of fine, sandlike particles through the nephrostomy tube. notify the physician about cloudy or foul-smelling urine. report bright pink urine within 24 hours after the procedure.
notify the physician about cloudy or foul-smelling urine.
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- pH 7.31, PaCO2 48, HCO3 24- pH 7.47, PaCO2 45, HCO3 33- pH 7.50, PaCO2 29, HCO3 22-
pH 7.20, PaCO2 36, HCO3 14-
