Med 3 ch 72, 65, 66
A client has returned from a captopril renal scan. Which teaching does the nurse provide when the client returns? a "Arise slowly and call for assistance when ambulating." b "I must measure your intake and output." c "We must save your urine because it is radioactive." d "I must attach you to this cardiac monitor."
A
A client with these assessment data is preparing to undergo a computed tomography scan with contrast: Physical Assessment Diagnostic Findings Medications Flank pain BUN 54 mg/dL Captopril Dysuria Creatinine 2.4 mg/dL Metformin Bilateral knee pain Calcium 8.5 mg/dL Acetylcysteine Which medication does the nurse plan to administer before the procedure? a Acetylcysteine (Mucosil) b Metformin (Glucophage) c Captopril (Capoten) d Acetaminophen (Tylenol)
A
An older adult woman who reports a change in bladder function says, "I feel like a child who sometimes pees her pants." What is the nurse's best response? a "Have you tried using the toilet at least every couple of hours?" b "How does that make you feel?" c "We can fix that." d "That happens when we get older."
A
Which age-related change can cause nocturia? a Decreased ability to concentrate urine b Decreased production of antidiuretic hormone c Increased production of erythropoietin d Increased secretion of aldosterone
A
Which urinary assessment information for a client indicates the potential need for increased fluids? a Increased blood urea nitrogen b Increased creatinine c Pale-colored urine d Decreased sodium
A
For which clients scheduled for a computed tomography (CT) scan with contrast does the nurse communicate safety concerns to the health care provider? (Select all that apply.) a Client with an allergy to shrimp b Client with a history of asthma c Client who requests morphine sulfate every 3 hours d Client with a blood urea nitrogen of 62 mg/dL and a creatinine of 2.0 mg/dL e Client who took metformin (Glucophage) 4 hours ago
A B C D E
The RN is caring for a client who has just had a kidney biopsy. Which action does the nurse perform first? a Obtain blood urea nitrogen (BUN) and creatinine. b Position the client supine. c Administer pain medications. d Check urine for hematuria.
B
The charge nurse is making client assignments for the day shift. Which client is best to assign to an LPN/LVN? a Client who has just returned from having a kidney artery angioplasty b Client with polycystic kidney disease who is having a kidney ultrasound c Client who is going for a cystoscopy and cystourethroscopy d Client with glomerulonephritis who is having a kidney biopsy
B
Which laboratory test is the best indicator of kidney function? a Blood urea nitrogen (BUN) b Creatinine c Aspartate aminotransferase (AST) d Alkaline phosphatase
B
Which percussion technique does the nurse use to assess a client who reports flank pain? a Place outstretched fingers over the flank area and percuss with the fingertips. b Place one hand with the palm down flat over the flank area and use the other fisted hand to thump the hand on the flank. c Place one hand with the palm up over the flank area and cup the other hand to percuss the hand on the flank. d Quickly tap the flank area with cupped hands.
B
A client is in the emergency department for an inability to void and for bladder distention. What is most important for the nurse to provide to the client? a Increased oral fluids b IV fluids c Privacy d Health history forms
C
The nurse is reviewing the medical record for a client with polycystic kidney disease who is scheduled for computed tomographic angiography with contrast: History and Physical Assessment Medications Diagnostic Findings Polycystic kidney disease Diabetes Hysterectomy Abdomen distended Negative edema Glyburide Metformin Synthroid BUN 26 mg/dL Creatinine 1.0 mg/dL HbA1c 6.9% Glucose 132 mg/dL Which intervention is essential for the nurse to perform? a Obtain a thyroid-stimulating hormone (TSH) level. b Report the blood urea nitrogen (BUN) and creatinine. c Hold the metformin 24 hours before and on the day of the procedure. d Notify the provider regarding blood glucose and glycosylated hemoglobin (HbA1c) values.
C
The nurse is teaching a client how to provide a clean-catch urine specimen. Which statement by the client indicates that teaching was effective? a "I must clean with the wipes and then urinate directly into the cup." b "I will have to drink 2 liters of fluid before providing the sample." c "I'll start to urinate in the toilet, stop, and then urinate into the cup." d "It is best to provide the sample while I am bathing."
C
The nurse visualizes blood clots in a client's urinary catheter after a cystoscopy. What nursing intervention does the nurse perform first? a Administer heparin intravenously. b Remove the urinary catheter. c Notify the health care provider. d Irrigate the catheter with sterile saline.
C
When a client with diabetes returns to the medical unit after a computed tomography (CT) scan with contrast dye, all of these interventions are prescribed. Which intervention does the nurse implement first? a Give lispro (Humalog) insulin, 12 units subcutaneously. b Request a breakfast tray for the client. c Infuse 0.45% normal saline at 125 mL/hr. d Administer captopril (Capoten).
C
When caring for a client with uremia, the nurse assesses for which symptom? a Tenderness at the costovertebral angle (CVA) b Cyanosis of the skin c Nausea and vomiting d Insomnia
C
When performing bladder scanning to detect residual urine in a female client, the nurse must first assess which factor? a Abdominal girth b Presence of urinary infection c History of hysterectomy d Hematuria
C
Which assessment finding alarms the nurse immediately after a client returns from the operating room for cystoscopy performed under conscious sedation? a Pink-tinged urine b Urinary frequency c Temperature of 100.8° F d Lethargy
C
Which instruction does the nurse give a client who needs a clean-catch urine specimen? a "Save all urine for 24 hours." b "Use the sponges to cleanse the urethra, and then initiate voiding directly into the cup." c "Do not touch the inside of the container." d "You will receive an isotope injection, then I will collect your urine."
C
A client had a computed tomography (CT) scan with contrast dye 8 hours ago. Which nursing intervention is the priority for this client? a Maintaining bedrest b Medicating for pain c Monitoring for hematuria d Promoting fluid intake
D
A client is scheduled for a cystoscopy later this morning. The consent form is not signed, and the client has not had any preoperative medication. The nurse notes that the provider visited the client the day before. What action does the nurse take? a Asks the client to sign the informed consent b Cancels the procedure c Asks the client's spouse to sign the form d Notifies the department and the provider
D
One of the nurse's roles is talking to adult clients about urinary and sexual hygiene. Which words does the nurse use when referring to the client's reproductive body parts? a Children's terms that are easily understood b Slang words and terms that are heard "socially" c Technical and medical terminology d Words that the client uses
D
The nurse has these client assignments. Which client does the nurse encourage to consume 2 to 3 liters of fluid each day? a Client with chronic kidney disease b Client with heart failure c Client with complete bowel obstruction d Client with hyperparathyroidism
D
When planning an assessment of the urethra, what does the nurse do first? a Examine the meatus. b Note any unusual discharge. c Record the presence of abnormalities. d Don gloves.
D
Which technique does the nurse use to obtain a sterile urine specimen from a client with a Foley catheter? a Disconnect the Foley catheter from the drainage tube and collect urine directly from the Foley. b Remove the existing catheter and obtain a sample during the process of inserting a new Foley. c Use a sterile syringe to withdraw urine from the urine collection bag. d Clamp the tubing, attach a syringe to the specimen, and withdraw at least 5 mL of urine.
D
A client who is admitted with urolithiasis reports "spasms of intense flank pain, nausea, and severe dizziness." Which intervention does the nurse implement first? a Administer morphine sulfate 4 mg IV. b Begin an infusion of metoclopramide (Reglan) 10 mg IV. c Obtain a urine specimen for urinalysis. d Start an infusion of 0.9% normal saline at 100 mL/hr.
a
A client who was previously diagnosed with a urinary tract infection (UTI) and started on antibiotics returns to the clinic 3 days later with the same symptoms. When asked about the previous UTI and medication regimen, the client states, "I only took the first dose because after that, I felt better." How does the nurse respond? a "Not completing your medication can lead to return of your infection." b "That means your treatment will be prolonged with this new infection." c "This means you will now have to take two drugs instead of one." d "What you did was okay; however, let's get you started on something else."
a
A young adult with testicular cancer is admitted for unilateral orchiectomy and retroperitoneal lymph node dissection. Which nursing action is best for the nurse to delegate to unlicensed assistive personnel (UAP)? a Encourage the client to cough and deep-breathe after surgery. b Discuss reproductive options with the client and significant other. c Teach about the availability of a gel-filled silicone testicular prosthesis. d Evaluate the client's understanding of chemotherapy and radiation treatment.
a
The RN working in the hospital emergency department is assigned to care for these four clients. Which client does the nurse attend to first? a Adolescent with an erection for "10 or 11 hours" who is reporting severe pain b Young adult with a swollen, painful scrotum who has a recent history of mumps infection c Middle-aged adult discharged 2 days ago after a transurethral resection of the prostate who has increased hematuria d Older adult with a history of benign prostatic hyperplasia and palpable bladder distention
a
The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which client statement shows a correct understanding of what the nurse has taught? a "I should be drinking at least 1.5 to 2.5 liters of fluids every day." b "It is a good idea for me to reduce germs by taking a tub bath daily." c "Trying to get to the bathroom to urinate every 6 hours is important for me." d "Urinating 1000 mL on a daily basis is a good amount for me."
a
The nurse is caring for a client with erectile dysfunction who has not had success with other treatment modalities. The nurse anticipates that the health care provider will recommend which treatment for this client? a Penile implants b Penile injections c Transurethral suppository d Vacuum constriction device
a
The nurse is questioning a female client with a urinary tract infection (UTI) about her antibiotic drug regimen. Which statement by the client indicates a need for further instruction? a "I take my medication only when I have symptoms." b "I always wipe front to back." c "I don't use bubble baths and other scented bath products." d "I try to drink 3 liters of fluid a day."
a
When is the best time for the nurse to begin discharge planning and a community-based plan of care for a client with prostate cancer? a Before surgery b After surgery c 2 days before being discharged d The day of discharge
a
A client with benign prostatic hyperplasia is being discharged with alpha-adrenergic blockers. Which information is important for the nurse to include when teaching the client about this type of pharmacologic management? (Select all that apply.) a Avoid drugs used to treat erection problems. b Be careful when changing positions. c Keep all appointments for follow-up laboratory testing. d Hearing tests will need to be conducted periodically. e Take the medication in the afternoon.
a b c
A client with a urinary tract infection is prescribed trimethoprim/sulfamethoxazole (Bactrim). What information does the nurse provide to this client about taking this drug? (Select all that apply.) a "Be certain to wear sunscreen and protective clothing." b "Drink at least 3 liters of fluids every day." c "Take this drug with 8 ounces of water." d "Try to urinate frequently to keep your bladder empty." e "You will need to take all of this drug to get the benefits."
a b c e
What information will the nurse provide to a client who is scheduled for extracorporeal shock wave lithotripsy? (Select all that apply.) a "Your urine will be strained after the procedure." b "Be sure to finish all of your antibiotics." c "Immediately call the health care provider if you notice bruising." d "Remember to drink at least 3 liters of fluid a day to promote urine flow." e "You will need to change the incisional dressing once a day."
a b d
Which clients with long-term urinary problems does the nurse refer to community resources and support groups? (Select all that apply.) a A 32-year-old with a cystectomy b A 44-year-old with a Kock pouch c A 48-year-old with urinary calculi d A 78-year-old with urinary incontinence e An 80-year-old with dementia
a b d
A client with prostate cancer asks the nurse for more information and counseling. Which resources does the nurse suggest? (Select all that apply.) a American Cancer Society's Man to Man program b Us TOO International c American Prostate Cancer Society d National Prostate Cancer Coalition e Client's church, synagogue, or place of worship
a b d e
Which clients with an indwelling urinary catheter does the nurse reassess to determine whether the catheterization needs to be continued or can be discontinued? (Select all that apply.) a Three-day postoperative client b Client in the stepdown unit c Comatose client with careful monitoring of intake and output (I&O) d Incontinent client with perineal skin breakdown Incontinent older adult in long-term care
a b e
An older adult client diagnosed with stress incontinence is prescribed the medication oxybutynin (Ditropan). Which side effects does the nurse tell the client to expect? (Select all that apply.) a Dry mouth b Increased blood pressure c Increased intraocular pressure d Constipation e Reddish-orange urine color
a c d
The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). Which concepts does the nurse explain in the presentation? (Select all that apply.) a Dysuria b Enuresis c Frequency d Nocturia e Urgency f Polyuria
a c d e
After returning from transurethral resection of the prostate, the client's urine in the continuous bladder irrigation system is a burgundy color. Which client needs does the nurse anticipate after the surgeon sees the client? (Select all that apply.) a Antispasmodic drugs b Emergency surgery c Forced fluids d Increased intermittent irrigation e Monitoring for anemia
a e
A client is having a radical prostatectomy. Which preoperative teaching specific to this surgery does the nurse emphasize? a Incentive spirometry b Kegel exercises c Pain control d Penile implants
b
A client with prostate cancer asks why he must have surgery instead of radiation, even if his cancer is the least-invasive type. What is the nurse's best response? a "It is because your cancer growth is large." b "Surgery is the most common intervention to cure the disease." c "Surgery slows the spread of cancer." d "The surgery is to promote urination."
b
A male client being treated for bladder cancer has a live virus compound instilled into his bladder as a treatment. What instruction does the nurse provide for postprocedure home care? a "After 12 hours, your toilet should be cleaned with a 10% solution of bleach." b "Do not share your toilet with family members for the next 24 hours." c "Please be sure to stand when you are urinating." d "Your underwear worn during the procedure and for the first 12 hours afterward should be bagged and discarded."
b
The nurse is teaching a client with a neurogenic bladder to use intermittent self-catheterization for bladder emptying. Which client statement indicates a need for further clarification? a "A small-lumen catheter will help prevent injury to my urethra." b "I will use a new, sterile catheter each time I do the procedure." c "My family members can be taught to help me if I need it." d "Proper handwashing before I start the procedure is very important."
b
The nurse receives the change-of-shift report on four clients. Which client does the nurse decide to assess first? a A 26-year-old admitted 2 days ago with urosepsis with an oral temperature of 99.4° F (37.4° C) b A 28-year-old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours c A 32-year-old admitted with hematuria and possible bladder cancer who is scheduled for cystoscopy d A 40-year-old with noninfectious urethritis who is reporting "burning" and has estrogen cream prescribed
b
Why is prostate cancer screening often emphasized to the African-American population in the United States? a Metastasis of prostate cancer is higher. b Prostate cancer occurs at an earlier age. c Prostate-specific antigen (PSA) is not sensitive to prostate disease. d Clinical presentation is different.
b
The nurse in the urology clinic is providing teaching for a female client with cystitis. Which instructions does the nurse include in the teaching plan? (Select all that apply.) a Cleanse the perineum from back to front after using the bathroom. b Try to take in 64 ounces of fluid each day. c Be sure to complete the full course of antibiotics. d If urine remains cloudy, call the clinic. e Expect some flank discomfort until the antibiotic has worked.
b c d
A client diagnosed with stress incontinence is started on propantheline (Pro-Banthine). What interventions does the nurse suggest to alleviate the side effects of this anticholinergic drug? (Select all that apply.) a Take the drug at bedtime. b Encourage increased fluids. c Increase fiber intake. d Limit the intake of dairy products. e Use hard candy for dry mouth.
b c e
Which interventions are helpful in preventing bladder cancer? (Select all that apply.) a Drinking 2½ liters of fluid a day b Showering after working with or around chemicals c Stopping the use of tobacco d Using pelvic floor muscle exercises e Wearing a lead apron when working with chemicals f Wearing gloves and a mask when working around chemicals and fumes
b c f
A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and some discomfort upon urination. Her vital signs are stable except for a temperature of 100° F. Which drug does the health care provider prescribe? a Nitrofurantoin (Macrodantin) after intercourse b Estrogen (Premarin) c Trimethoprim/sulfamethoxazole (Bactrim) d Phenazopyridine (Pyridium) with intercourse
c
A 53-year-old postmenopausal woman reports "leaking urine" when she laughs, and is diagnosed with stress incontinence. What does the nurse tell the client about how certain drugs may be able to help with her stress incontinence? a "They can relieve your anxiety associated with incontinence." b "They help your bladder to empty." c "They may be used to improve urethral resistance." d "They decrease your bladder's tone."
c
A cognitively impaired client has urge incontinence. Which method for achieving continence does the nurse include in the client's care plan? a Bladder training b Credé method c Habit training d Kegel exercises
c
The certified Wound, Ostomy, and Continence Nurse or enterostomal therapist teaches a client who has had a cystectomy about which care principles for the client's post-discharge activities? a Nutritional and dietary care b Respiratory care c Stoma and pouch care d Wiping from front to back (asepsis)
c
The nurse is educating a female client about hygiene measures to reduce her risk for urinary tract infection. What does the nurse instruct the client to do? a "Douche—but only once a month." b "Use only white toilet paper." c "Wipe from front to back." d "Wipe with the softest toilet paper available."
c
The nurse is instructing an older adult female client about interventions to decrease the risk for cystitis. Which client comment indicates that the teaching was effective? a "I must avoid drinking carbonated beverages." b "I need to douche vaginally once a week." c "I should drink 2½ liters of fluid every day." d "I will not drink fluids after 8 PM each evening."
c
The potential problem of grief is most relevant to a client after which procedure? a Cystoscopy b Transurethral microwave therapy c Radical prostatectomy d Sperm banking
c
Which assessment finding causes the nurse to suspect that a client may have testicular cancer? a Hematuria b Penile discharge c Painless testicular lump d Sudden increase in libido
c
Which method is a common complementary and alternative therapy for benign prostatic hyperplasia (BPH)? a Acupuncture b Calcium supplements c Serenoa repens d Yoga
c
Which nursing activity illustrates proper aseptic technique during catheter care? a Applying Betadine ointment to the perineal area after catheterization b Irrigating the catheter daily c Positioning the collection bag below the height of the bladder d Sending a urine specimen to the laboratory for testing
c
Which type of incontinence benefits from pelvic floor muscle (Kegel) exercise? a Functional b Overflow c Stress d Urge
c
With which male client does the nurse conduct prostate screening and education? a Young adult with a history of urinary tract infections b Client who has sustained an injury to the external genitalia c Adult who is older than 50 years d Sexually active client
c
19. A client has undergone transurethral resection of the prostate (TURP). Which interventions does the nurse incorporate in this client's postoperative care? (Select all that apply.) Administer antispasmodic medications. Encourage the client to urinate around the catheter if pressure is felt. Perform intermittent urinary catheterization every 4 to 6 hours. Place the client in a supine position with his knees flexed. Assist the client to mobilize as soon as permitted.
c e
A client is admitted for extracorporeal shock wave lithotripsy (ESWL). What information obtained on admission is most critical for a nurse to report to the health care provider before the ESWL procedure begins? a "Blood in my urine has become less noticeable, so maybe I don't need this procedure." b "I have been taking cephalexin (Keflex) for an infection." c "I previously had several ESWL procedures performed." d "I take over-the-counter naproxen (Aleve) twice a day for joint pain."
d
A client is referred to a home health agency after being hospitalized with overflow incontinence and a urinary tract infection. Which nursing action can the home health RN delegate to the home health aide (unlicensed assistive personnel [UAP])? a Assisting the client in developing a schedule for when to take prescribed antibiotics b Inserting a straight catheter as necessary if the client is unable to empty the bladder c Teaching the client how to use the Credé maneuver to empty the bladder more fully d Using a bladder scanner (with training) to check residual bladder volume after the client voids
d
A client receiving external beam radiation therapy calls the nurse to report rectal urgency, cramping, and passing of mucus and blood. What is the nurse's best response? a "This is an emergency. Go directly to the emergency department." b "This is normal and will resolve as soon as the treatment stops." c "Avoid caffeine and continue drinking plenty of water and other fluids." d "Limit spicy or fatty foods, caffeine, and dairy products."
d
A client who is 6 months pregnant comes to the prenatal clinic with a suspected urinary tract infection (UTI). What action does the nurse take with this client? a Discharges the client to her home for strict bedrest for the duration of the pregnancy b Instructs the client to drink a minimum of 3 liters of fluids, especially water, every day to "flush out" bacteria c Recommends that the client refrain from having sexual intercourse until after she has delivered her baby d Refers the client to the clinic nurse practitioner for immediate follow-up
d
A client with testicular cancer is worried about sterility and the ability to conceive children later. Which resource does the nurse refer the client to before surgery takes place? a American Cancer Society b American Fertility Society c RESOLVE: The National Infertility Association d Sperm bank
d
An older adult woman confides to the nurse, "I am so embarrassed about buying adult diapers for myself." How does the nurse respond? a "Don't worry about it. You need them." b "Shop at night, when stores are less crowded." c "Tell everyone that they are for your husband." d "That is tough. What do you think might help?"
d
Hormone treatment for prostate cancer works by which action? a Decreases blood flow to the tumor b Destroys the tumor c Shrinks the tumor d Suppresses growth of the tumor
d
The health care provider requests phenazopyridine (Pyridium) for a client with cystitis. What does the nurse tell the client about the drug? a "It will act as an antibacterial drug." b "This drug will treat your infection, not the symptoms of it." c "You need to take the drug on an empty stomach." d "Your urine will turn red or orange while on the drug."
d
The issue that is often foremost in the minds of men who have been diagnosed with prostate cancer and must be addressed by the nurse is the alteration of which factor? a Comfort because of surgical pain b Mobility after treatment c Nutrition because of radiation side effects d Sexual function after treatment
d
The nurse is caring for clients on a renal/kidney medical-surgical unit. Which drug, requested by the health care provider for a client with a urinary tract infection (UTI), does the nurse question? a Bactrim b Cipro c Noroxin d Tegretol
d
The nurse is educating a group of young men about testicular self-examination (TSE). Which statement by a member of the group indicates teaching has been effective? a "I will examine my testicles right before taking a shower." b "I should squeeze each testicle in my hand to feel any lumps." c "I should only report any large lumps to my health care provider." d "I will look and feel for any lumps or changes to my testes."
d
The nurse is teaching a client about pelvic muscle exercises. What information does the nurse include? a "For the best effect, perform all of your exercises while you are seated on the toilet." b "Limit your exercises to 5 minutes twice a day, or you will injure yourself." c "Results should be visible to you within 72 hours." d "You know that you are exercising correct muscles if you can stop urine flow in midstream."
d
The nurse is teaching a client who is scheduled for a neobladder and a Kock pouch. Which client statement indicates a correct understanding of these procedures? a "If I restrict my oral intake of fluids, the adjustment will be easier." b "I must go to the restroom more often because my urine will be excreted through my anus." c "I need to wear loose-fitting pants so the urine can flow into my ostomy bag." d "I will have to drain my pouch with a catheter."
d
The nurse is teaching the importance of a low purine diet to a client admitted with urolithiasis consisting of uric acid. Which statement by the client indicates that teaching was effective? a "I am so relieved that I can continue eating my fried fish meals every week." b "I will quit growing rhubarb in my garden since I'm not supposed to eat it anymore." c "My wife will be happy to know that I can keep enjoying her liver and onions recipe." d "I will no longer be able to have red wine with my dinner."
d
What does the nurse teach a client to do to decrease the risk for urinary tract infection (UTI)? a Limit fluid intake. b Increase caffeine consumption. c Limit sugar intake. d Drink about 3 liters of fluid daily.
d
Which client does the nurse manager on the medical unit assign to an experienced LPN/LVN? a A 42-year-old with painless hematuria who needs an admission assessment b A 46-year-old scheduled for cystectomy who needs help in selecting a stoma site c A 48-year-old receiving intravesical chemotherapy for bladder cancer d A 55-year-old with incontinence who has intermittent catheterization prescribed
d
Which nursing intervention or practice is most effective in helping to prevent urinary tract infection (UTI) in hospitalized clients? a Encouraging them to drink fluids b Irrigating all catheters daily with sterile saline c Recommending that catheters be placed in all clients d Periodically re-evaluating the need for indwelling catheters
d