NURS 309 Acute Renal 1
A young female patient reports burning with urination. What question does the nurse ask to differentiate between a vaginal infection and a urinary infection? A. "Have you noticed any blood in the urine?" B. "Have you recently had sexual intercourse?" C. "Have you noticed any vaginal discharge?" D. "Have you had fever or chills?"
C. "Have you noticed any vaginal discharge?"
A lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the health care provider? A. Passage of pink-tinged urine B. Pink drainage on the dressing C. Intake of 1750 mL in 24 hours D. Urine output of 20 to 30 mL/hr
D. Urine output of 20 to 30 mL/hr
A patient with urinary incontinence is prescribed oxybutynin. What precautions or instructions does the nurse provide related to this therapy? A. Avoid aspirin or aspirin-containing products B. Increase fluids and dietary fiber intake C. Report any unusual vaginal bleeding D. Change positions slowly, especially in the morning
B. Increase fluids and dietary fiber intake
The nursing student sees an order for a urinalysis for a patient with frequency, urgency, and dysuria. In order to collect the specimen, what does the student do? A. Use sterile technique to insert a small-diameter (6 Fr) catheter B. Instruct the patient on how to collect a clean-catch specimen C. Tell the patient to urinate approximately 10 mL into a specimen cup D. Take the urine from a bedpan and transfer it into a specimen cup
B. Instruct the patient on how to collect a clean-catch specimen
Which factor is the strongest predictor for a patient to develop a catheter-associated urinary tract infection? A. Previous history of urinary tract infections B. Length of time that catheter dwells in patient C. Qualification of health care worker inserting the catheter D. Lack of daily perineal hygiene and daily bathing
B. Length of time that catheter dwells in patient
A pathology report states that a client's urinary calculus is composed of uric acid. Which should the nurse instruct the client to avoid? A. Milk B. Liver C. Cheese D. Vegetables
B. Liver
A nurse is caring for a client with a diagnosis of renal calculi of calcium phosphate composition. Which type of diet should the nurse explore with the client when providing discharge information? A. Low purine B. Low calcium C. High phosphorus D. High alkaline ash
B. Low calcium
A patient is diagnosed with urethral stricture. What is the priority assessment? A. Monitor for pain during urination B. Monitor urinary output C. Assess for swelling at meatus D. Observe for hematuria
B. Monitor urinary output
A nurse is caring for a client with urethral calculus. Which are the most important nursing actions? SATA A. Limiting fluid intake at night B. Monitoring intake and output C. Straining the urine at each voiding D. Recording the client's blood pressure E. Administering the prescribed analgesic
B. Monitoring intake and output C. Straining the urine at each voiding E. Administering the prescribed analgesic
Several attempts to obtain a clean-catch urine specimen from an older patient are unsuccessful because the patient has poor manual dexterity and poor control over stopping and starting the stream. What is the nurse's best action? A. Assist the patient to void directly into a container and label as "voided but not midstream" B. Obtain an order for straight catheterization and use a small-diameter (6 Fr) catheter C. Obtain an order to insert an indwelling catheter and us an 18 Fr catheter with a bag D. Call the health care provider and report that the patient is unable to produce the specimen
B. Obtain an order for straight catheterization and use a small-diameter (6 Fr) catheter
For a patient who needs an indwelling catheter for at least 2 weeks, which intervention would help reduce the bacterial colonization along the catheter? A. Secure the catheter to the female patient's thigh B. Obtain an order to insert an antiseptic catheter C. Wash the urine bag and outflow tube everyday D. Apply antiseptic ointment to the catheter tubing
B. Obtain an order to insert an antiseptic catheter
Which group has the highest prevalence of urinary tract infections? A. Postpartum women B. Older women C. Older men D. Adolescent girls
B. Older women
A client in a nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating antibiotic therapy prescribed by the health care provider? A. Prepare for urinary catheterization B. Teach how to perform perineal care C. Start a 24-hour urine collection D. Obtain a urine specimen for culture and sensitivity
D. Obtain a urine specimen for culture and sensitivity
The nurse is caring for a patient with urolithiasis. Which type of mediation is likely to be given in the acute phase to relieve the patient's severe pain? A. Nonsteroidal anti-inflammatory drugs B. Spasmolytic drugs C. Antibiotics D. Opioid analgesics
D. Opioid analgesics
A patient has been performing Kegel exercises for 2 months. Which outcome statement indicates that the goal of therapy has been met? A. Incontinence is still present, but there is a decrease in frequency B. Patient is able to voluntarily stop the urinary stream C. Patient states that there are no problems with dysuria D. The patient is using fewer absorbent undergarments for protection
B. Patient is able to voluntarily stop the urinary stream
Which clinical manifestations indicates to the nurse that interventions for the patient's renal colic are effective? A. Urine is pink-tinged B. Patient reports that pain is relieved C. Urine output is 50 mL/min D. Bladder scan shows no residual urine
B. Patient reports that pain is relieved
A routine urinalysis is ordered for a client. What should the nurse do if the specimen cannot be sent immediately to the laboratory? A. Take no special action B. Refrigerate the specimen C. Store it in the dirty utility room and send it later D. Discard the specimen and collect another specimen later
B. Refrigerate the specimen
A patient's recurrent cystitis appears to be related to sexual intercourse. The patient seems uncomfortable talking about the situation. What communication technique does the nurse use to assist the patient? A. Have an open and sensitive discussion with the patient B. Give the patient reading material with instructions to call with any questions C. Call the patient's partner and invite the partner to discuss the problem D. Talk about other topics until the patient feels more comfortable disclosing
A. Have an open and sensitive discussion with the patient
The home health nurse is assessing an older adult patient who refuses to leave the house to see friends or participate in usual activities. She reports taking a bath several times a day and becomes very upset when she has an incontinent episode. What is the priority problem for this patient? A. Negative self-image B. Stress urinary incontinence C. Decreased opportunity to socialize D. Potential for skin breakdown
A. Negative self-image
A nurse is caring for a client who is admitted with urethral colic and hematuria. The client also has stage 1 hypertension and is overweight. The decrease of which clinical indicator associated with this client's status should the nurse be most concerned about at this time? A. Pain B. Weight C. Hematuria D. Hypertension
A. Pain
A patient has urolithiasis and is passing the stones into the lower urinary tract. What is the priority nursing concern for the patient at this time? A. Pain B. Infection C. Injury D. Anxiety
A. Pain
The nurse is teaching a patient with urge incontinence about dietary modifications. What is the best information for the nurse to give about fluid intake? A. Drink at least 2000 mL of water every day unless you have heart problems B. Drink 120 mL every hour or 240 mL every 2 hours and limit fluids after dinner C. Drink fluid freely in the morning hours but limit intake before going to bed D. Drinking water is especially good for bladder health; drink as much as you can
B. Drink 120 mL every hour or 240 mL every 2 hours and limit fluids after dinner
Which patient with incontinence is most likely to benefit from a surgical sling or bladder suspension procedure? A. Has stress incontinence and altered urethral competency B. Has reflex (overflow) incontinence caused by obstruction C. Has functional incontinence related to musculoskeletal weakness D. Has overactive bladder and declines bladder training program
A. Has stress incontinence and altered urethral competency
The nurse is admitting a 66-year-old male patient suspected of having a urinary tract infection (UTI). Which part of the patient's medical history supports this diagnosis? A. Patient's wife had a UTI 1 month ago B. Followed for prostate disease for 2 years C. Intermittent catheterization 6 months ago D. Kidney stone removal 1 year ago
B. Followed for prostate disease for 2 years
The nurse hears in report that the patient is being treated for a fungal urinary tract infection (UTI). In addition to performing routine care and assessments, the nurse is extra-vigilant for signs/symptoms of which systemic disorder that may underlie the fungal UTI? A. Chronic cardiac disease B. Immune system compromise C. Chronic skin conditions D. Connective tissue disorder
B. Immune system compromise
A young woman tells the nurse that she gets frequent urinary tract infections that seem to follow sexual intercourse. Which questions would the nurse ask? SATA A. "Do you use a diaphragm or spermicide for contraception?" B. "Do you feel guilty or embarrassed about your sexual activities?" C. "Have you considered abstaining from intercourse?" D. "Do you and your partner(s) wash the perineal area before intercourse?" E. "Some positions cause more irritation during sex. Have you noticed that?" F. "Do you and your partner(s) ever engage in anal intercourse?"
A. "Do you use a diaphragm or spermicide for contraception?" D. "Do you and your partner(s) wash the perineal area before intercourse?" E. "Some positions cause more irritation during sex. Have you noticed that?" F. "Do you and your partner(s) ever engage in anal intercourse?"
The nurse is teaching a patient about self-care measures to prevent urinary tract infections. Which daily fluid intake does the nurse recommend to the patient to prevent a bladder infection? A. 2-3 L of water B. 3-6 glasses of iced tea C. 4-6 cups of electrolyte fluid D. 3-4 glasses of juice
A. 2-3 L of water
Teaching intermittent self-catheterization for incontinence is appropriate for which patient? A. 25-year-old male patient with paraplegia B. 35-year-old female patient with stress incontinence C. 70-year-old patient who wears absorbent briefs D. 18-year-old patient with a severe head injury
A. 25-year-old male patient with paraplegia
Which patient is most likely to have mixed incontinence? A. 62-year-old woman who had four full-term pregnancies B. 40-year-old man who had a stroke with neurological deficits C. 76-year-old man with benign prostatic hyperplasia D. 25-year-old woman who has a pelvic fracture
A. 62-year-old woman who had four full-term pregnancies
The charge nurse would assign the nursing care of which patient to an LPN/LVN, working under the supervision of an RN? A. A 48-year-old patient with cystitis who is taking oral antibiotics B. A 64-year-old patient with kidney stones who has a new order for lithotripsy C. A 72-year-old patient with urinary incontinence who needs bladder training D. A 52-year-old patient with pyelonephritis who has severe acute flank pain
A. A 48-year-old patient with cystitis who is taking oral antibiotics
The nurse is caring for a patient with an indwelling catheter. What intervention does the nurse use to minimize catheter-related infections? A. Assess the patient daily to determine need for catheter B. Irrigate the catheter daily with sterile solution to remove debris C. Use sterile technique to open the system to obtain urine samples D. Apply antiseptic solutions or antibiotic ointments to the perineal area
A. Assess the patient daily to determine need for catheter
The urine output of a patient with a kidney stone has decreased from 40 mL/hr to 5 mL/hr. What is the nurse's priority action? A. Check patency of IV access and notify the health care provider B. Perform the Crede maneuver on the patient's bladder C. Test the urine for ketone bodies D. Document the finding and continue monitoring
A. Check patency of IV access and notify the health care provider
A nurse is assessing the urine of a client with a urinary tract infection. For which characteristic should the nurse assess each specimen of urine? A. Clarity B. Viscosity C. Glucose level D. Specific gravity
A. Clarity
The nurse is teaching a woman how to prevent urinary tract infections. What information does the nurse include? A. Clean the perineal area from front to back B. Douche before and after sexual intercourse C. Take oral estrogen to decrease vaginal dryness D. Avoid urinary stasis by urinating every 6 to 8 hours
A. Clean the perineal area from front to back
Patients who have central nervous system lesions from stroke, multiple sclerosis, or parasacral spinal cord lesions may develop which type of urinary incontinence? A. Detrusor hyperreflexia B. Mixed C. Stress D. Functional
A. Detrusor hyperreflexia
The nurse is counseling a patient with recurrent symptomatic urinary tract infections (UTIs) about diet therapy. What information does the nurse give to the patient? A. Drink cranberry juice but avoid products with high fructose B. Low consumption of protein may prevent recurrent UTIs C. Caffeine, carbonated beverages, and tomato products cause UTI D. Cranberry tablets are more effective than juice or fluids
A. Drink cranberry juice but avoid products with high fructose
A patient with incontinence will be taking oxybutynin chloride 5 mg by mouth three times a day after discharge. Which information would a nurse be sure to teach this patient before discharge? A. Drink fluids or use hard candy when you experience a dry mouth B. Be sure to notify your health care provider (HCP) if you experience a dry mouth C. If necessary, your HCP can increase your dose up to 40 mg/day D. You should take this medication with meals to avoid stomach ulcers
A. Drink fluids or use hard candy when you experience a dry mouth
The nurse is teaching self-care measures to a patient who had shock wave lithotripsy for kidney stones. What information does the nurse include? SATA A. Finish the entire prescription of antibiotics to prevent infections B. Balance regular exercise with sleep and rest C. Drink at least 3 L of fluid a day D. Watch for and immediately report bruising after lithotripsy E. Urine may be bloody for several days F. Pain in the region of the kidneys or bladder is expected
A. Finish the entire prescription of antibiotics to prevent infections B. Balance regular exercise with sleep and rest C. Drink at least 3 L of fluid a day E. Urine may be bloody for several days
The health care provider has recommended intermittent self-catheterization for a patient with long-term problems of incomplete bladder emptying. Which information does the nurse give the patient about he procedure? A. Perform proper hand-washing and cleaning of the catheter to reduce the risk for infection B. Use a large-lumen catheter and good lubrication for rapid emptying of the bladder C. Catheterize yourself when you are incontinent or when the bladder gets distended D. Use sterile technique, especially if catheterization is done by a family member
A. Perform proper hand-washing and cleaning of the catheter to reduce the risk for infection
A patient reports symptoms indicating a urinary tract infection (UTI). Which urine test results most strongly indicates a UTI? A. Presence of leukocyte esterase and nitrate B. Presence of glucose and ketones C. Presence of epithelial cells and red blood cells D. Low urine specific gravity and low urine pH
A. Presence of leukocyte esterase and nitrate
The nurse is reviewing a care plan for a patient who has functional incontinence. There is a note that containment is recommended, especially at night. What is the major concern with this approach? A. Skin integrity B. Cost of materials C. Self-esteem of patient D. Risk for falls
A. Skin integrity
A patient returns to the medical-surgical unit after having shock wave lithotripsy. What is an appropriate nursing intervention for the postprocedural care of this patient? A. Strain the urine to monitor the passage of stone fragments B. Report bruising that occurs on the flank of the affected side C. Continuously monitor electrocardiogram for dysrhythmias D. Apply a local anesthetic cream to the skin of the affected side
A. Strain the urine to monitor the passage of stone fragments
A middle-aged woman has urinary stress incontinence relate to weak pelvic muscles. Which interventions does the nurse include in the treatment plan? SATA A. Suggest keeping a detailed diary of urine leakage, activities, and foods eaten B. Suggests wearing an absorbent undergarment during the assessment process C. tech pelvic floor (Kegel) exercise therapy D. Teach about vaginal cone therapy E. Encourage drinking orange juice every day for 4-6 weeks F. Refer to a nutritionist for diet therapy for weight reduction
A. Suggest keeping a detailed diary of urine leakage, activities, and foods eaten B. Suggests wearing an absorbent undergarment during the assessment process C. tech pelvic floor (Kegel) exercise therapy D. Teach about vaginal cone therapy F. Refer to a nutritionist for diet therapy for weight reduction
The nurse is designing a habit training bladder program for an older adult patient who is alert but mildly confused. What task associated with the training program is delegated to unlicensed assistive personnel? A. Tell the patient it is time to go to the toilet and assist him to go on a regular schedule B. Help the patient record the incidents of incontinence in a bladder diary C. Change the patients incontinence pants (or pad) every 4 hours D. Gradually encourage independence and increase the intervals between voiding
A. Tell the patient it is time to go to the toilet and assist him to go on a regular schedule
A patient reports intense urgency, frequency, and bladder pain. Urinalysis results show now white blood cells and no red blood cells and urine culture results are negative for infection. How does the nurse interpret these findings? A. These findings are associated with a diagnosis of interstitial cystitis B. Patient could have urethritis due to sexually transmitted disease C. Signs and symptoms suggest kidney stones; pain is likely to intensify D. Findings suggest bacterial cystitis that is partially treated by antibiotics
A. These findings are associated with a diagnosis of interstitial cystitis
Which task related to care of patients who have indwelling catheters can be delegated to unlicensed assistive personnel? A. Wash the perineum daily and frequently empty the drainage bag using a separate, clean container for each patient B. Use sterile technique when cleaning urinary catheters or when helping the patients with genital or rectal hygiene C. Determine whether use of condom catheters is appropriate for male patients and apply devices accordingly D. Keep urine collection bag in a place that is readily visible to the patient so that the patient is reassured of kidney function
A. Wash the perineum daily and frequently empty the drainage bag using a separate, clean container for each patient
A male college student comes to the clinic reporting burning or difficulty with urination and a discharge from the urethral meatus. Based on the patient's report, what is the most logical question for the nurse to ask? A. "Do you have a history of a narrow urethra or a stricture?" B. "Could you have been exposed to a sexually transmitted disease?" C. "Do you have a history of kidney stones?" D. "Have you been drinking an adequate amount of fluids?"
B. "Could you have been exposed to a sexually transmitted disease?"
Which patient has the highest risk for developing a complicated urinary tract infection? A. 26-year-old man who is sexually active but inconsistently uses condoms B. 22-year-old man who has a neurogenic bladder due to spinal cord injury C. 35-year-old woman who had 3 full-term pregnancies and a miscarriage D. 53-year-old woman who is having some menstrual irregularities
B. 22-year-old man who has a neurogenic bladder due to spinal cord injury
A client is admitted to the hospital from the emergency department with a diagnosis of urolithiasis. The nurse reviews the client's record and performs an admission assessment. What is the priority nursing action? A. Strain the client's urine B. Administer the prescribed morphine C. Position in the high-Fowler's position D. Collect a urine specimen for culture and sensitivity
B. Administer the prescribed morphine
The nurse reads in the documentation that the advanced practice nurse performed a digital rectal examination and found that the rectal sphincter did not contract on digital insertion. Based on this information, which assessment is the nurse most likely to perform? A. Monitor the urinary output every 4 hours B. Assess for bowel and bladder incontinence C. Palpate the bladder and monitor for distension D. Check the stool and urine for occult blood
B. Assess for bowel and bladder incontinence
A patient is admitted for an elective orthopedic surgical procedure. The patient also has a personal and family history for urolithiasis. Which circumstance creates the greatest risk for recurrent urolithiasis? A. Giving the patient milk with every meal tray B. Restricting food and fluids for extended periods C. Giving the patient an opioid narcotic for pain D. Inserting an indwelling catheter for the procedure
B. Restricting food and fluids for extended periods
A patient received an antibiotic prescription several hours ago and has started the medication but requests "some relief from the burning." What comfort measures does the nurse suggest to the patient? A. Take over-the-counter acetaminophen B. Sit in a sitz bath and urinate into the warm water C. Place a cold pack over the perineal area D. Rest in a recumbent position with legs elevated
B. Sit in a sitz bath and urinate into the warm water
A patient has agreed to try a bladder training program. What is the priority nursing intervention in starting this therapy? A. Advise the patient to plan and start a schedule for voiding every 2-3 hours B. Teach the patient how to be alert, aware, and able to resist the urge to urinate C. Convince the patient that the bladder issues are controlling his/her lifestyle D. Give a thorough explanation of the problem of stress incontinence
B. Teach the patient how to be alert, aware, and able to resist the urge to urinate
The nurse is caring for a patient who had a mid-urethral sling procedure. What instructions would the nurse give to unlicensed assistive personnel to prevent postoperative complications? A. Bedrest with bathroom privileges must be maintained for 2-3 days B. Urethral catheter must be secured in place with a tube holder C. Food and fluid restriction must be maintained for 24 hours D. Watch for an report any drainage on the urethral catheter dressing
B. Urethral catheter must be secured in place with a tube holder
The nurse is reviewing the laboratory results for an older adult patient with an indwelling catheter. The urine culture is pending, but the urinalysis shows greater than 10^5 colony-forming units, and the differential white blood cell count shows a "left shift." The nurse will monitor for additional signs and symptoms associated with which condition? A. Interstitial cystitis B. Urosepsis C. Complicated cystitis D. Bladder cancer
B. Urosepsis
The employee health nurse is conducting a presentation for employees who work in a paint manufacturing plant. In order to protect against bladder cancer, what advice does the nurse give to personnel who directly work with chemicals? A. Shower with mild soap and rinse well before coming to work B. Use personal protective equipment such as gloves and masks C. Limit exposure to chemicals and fumes at all times D. Avoid hobbies such as oil painting that increase exposure to chemicals
B. Use personal protective equipment such as gloves and masks
Which statement by a patient indicates effective coping with a Kock's pouch? A. "I don't have any discomfort, but the pouch frequently overflows" B. "My wife has been irrigating the pich daily. She likes to do it" C. "I check the pouch every 2 to 3 hours and use a catheter as needed" D. "I never undress in front of anyone anymore, but I guess that's okay"
C. "I check the pouch every 2 to 3 hours and use a catheter as needed"
The nurse is evaluating outcome criteria for a patient being treated for urge incontinence. Which statement indicates the treatment has been successful? A. "I'm doing the exercises, but I think surgery is my best choice." B. "I lose a little urine when I sneeze, but I wear a thin pad." C. "I had trouble at first, but now I go to the toilet every 3 hours." D. "I have been using the bladder compression technique and it works."
C. "I had trouble at first, but now I go to the toilet every 3 hours."
The RN is supervising a nurse orienting to the acute care unit who is discharging a patient admitted with kidney stones and who underwent lithotripsy. Which statement by the orienting nurse to the patient requires that the supervising RN intervene? A. "You should finish all of your antibiotics to make sure that you don't get a urinary tract infection" B. "Remember to drink at least 3 L of fluids every day to prevent another stone from forming" C. "Report any signs of bruising to your health care provider immediately because this indicates bleeding" D. "You can return to work in 2 days to 6 weeks, depending on what your HCP prescribes"
C. "Report any signs of bruising to your health care provider immediately because this indicates bleeding"
The RN is supervising a new graduate nurse who is orienting to the unit. The new nurse asks why the patient with uncomplicated cystitis is being discharged with a prescription for ciprofloxacin 250 mg twice a day for only 3 days. What is the RN's best response? A. "We should check with the health care provider because the patient should take this drug for 10 to 14 days" B. "A 3-day course of ciprofloxacin is no the appropriate treatment for a patient with uncomplicated cystitis" C. "Research has shown that a 3-day course of ciprofloxacin is effective for uncomplicated cystitis and there is increased patient adherence to the plan of care" D. "Longer courses of antibiotic therapy are required for hospitalized patients to prevent nosocomial infections"
C. "Research has shown that a 3-day course of ciprofloxacin is effective for uncomplicated cystitis and there is increased patient adherence to the plan of care"
A patient with stress incontinence has been attempting vaginal cone therapy for several weeks but is discouraged. She says, "It isn't working. I want to try something else." What is the nurse's best response? A. "Don't give up yet. Let's review the process and you can try for a few more weeks" B. "The cones are hard to use. I'll ask the healthcare provider to write you a prescription" C. "Tell me about our experience with the cones and how you are tracking your progress" D. "Let me give you some more information about exercises to strengthen the pelvic floor muscles"
C. "Tell me about our experience with the cones and how you are tracking your progress"
Which patient has the highest risk for bladder cancer? A. 60-year-old female patient with malnutrition secondary to chronic alcoholism and self-neglect B. 25-year-old male patient with type 1 diabetes mellitus who is noncompliant with therapeutic regimen C. 60-year-old male patient who smokes two packs of cigarettes per day and works in a chemical factory D. 25-year-old female patient who had three episodes of bacterial cystitis in the past year
C. 60-year-old male patient who smokes two packs of cigarettes per day and works in a chemical factory
The nurse is working in a long-term care facility. Which circumstance is cause for greatest concern, because the facility has a large number of residents who are developing urinary tract infections? A. Residents who are not drinking enough fluids with meals B. Unlicensed personnel are not assisting with toileting in a timely fashion C. A large percentage of residents have indwelling urinary catheters D. Many residents have severe dementia and functional incontinence
C. A large percentage of residents have indwelling urinary catheters
Which dietary changes does the nurse suggest to a patient with urge incontinence? A. Limit fluid intake to no more than 2L/day B. Peel all fruit before consuming C. Avoid alcohol and caffeine D. Avoid smoked or salted foods
C. Avoid alcohol and caffeine
The nurse is caring for a patient who has an indwelling catheter and subsequently developed a urinary tract infection. The patient has been receiving antibiotics for several days but develops hypotension, a rapid pulse, and confusion. The nurse suspects urosepsis and alerts the health care provider. Which diagnostic test is the provider most likely to order to confirm sepsis? A. Culture of urinary meatus B. Culture of the catheter tip C. Blood cultures D. Repeat urinalysis
C. Blood cultures
The home health nurse reads in the patient's chart that the patient has asymptomatic bacterial urinary infection (ABUTI). Which intervention will the nurse perform? A. Obtain an order for urinalysis and urine culture for sensitivity B. Check the patient's medication list for appropriate medication order C. Closely monitor for condition that cause progression to acute infection D. Ask the patient when the ABUTI first started and when it was diagnosed
C. Closely monitor for condition that cause progression to acute infection
Several patients at the clinic have just been diagnosed with urinary tract infections. Which patients may need longer antibiotic treatment (7-21 days) or different agents than the typical first-line medications? SATA A. Postmenopausal female patient B. Female patient with urethritis C. Diabetic female patient D. Immunosuppressed male patient E. Pregnant female patient F. Older male patient who engages in anal intercourse
C. Diabetic female patient D. Immunosuppressed male patient E. Pregnant female patient F. Older male patient who engages in anal intercourse
A patient is diagnosed with a fungal urinary tract infection. Which drug does the nurse anticipate the patient will be treated with? A. Trimethoprim/sulfamethoxazole B. Ciprofloxacin C. Fluconazole D. Amoxicillin
C. Fluconazole
An older adult patient with a coughing impairment is living in an extended-care facility. The patient is incontinent, but as the family points out, "he will urinate in the toilet if somebody helps him." Which type of incontinence does the nurse suspect in this patient? A. Urge B. Overflow C. Functional D. Stress
C. Functional
The nurse is caring for an older adult patient with urinary incontinence. The patient is alert and oriented but refuses to use the call bell and has fallen several times while trying to get to the bathroom. What is the nurse's priority concern for this patient? A. Managing noncompliance B. Accurately measuring urinary output C. Initiating fall prevention measures D. Managing urinary incontinence
C. Initiating fall prevention measures
A client experiences difficulty in voiding after an indwelling urinary catheter is removed. To waht does the nurse determine that this is most probably related? A. Fluid imbalance B. Sedentary lifestyle C. Interruption in previous voiding habits D. Nervous tension following the procedure
C. Interruption in previous voiding habits
The nurse is caring for an obese older adult patient with dementia. The patient is alert and ambulatory but has functional incontinence. Which nursing intervention is best for this patient? A. Help the patient to loss weight B. Help the patient apply an estrogen cream C. Offer assistance with toileting every 2 hours D. Intermittently catheterize the patient
C. Offer assistance with toileting every 2 hours
The pathology reports states that a client's urinary calculus is composed of uric acid. Which nutrients should the nurse instruct the client to avoid? SATA A. Eggs B. Fruit C. Organ meats D. Meat extracts E. Raw vegetables
C. Organ meats D. Meat extracts
The nurse is talking to a 68-year-old male patient who has lifestyle choices and occupational exposure that put him at high risk for bladder cancer. The nurse is most concerned about which urinary characteristic? A. Frequency B. Nocturia C. Painless hematuria D. Incontinence
C. Painless hematuria
The nurse is creating a care plan for older adult patients with incontinence. For which patient will a bladder training program be an appropriate intervention? A. Patient with functional incontinence caused by mental status change B. Patient with stress incontinence due to weakened bladder neck support C. Patient with urge incontinence and abnormal detrusor muscle contractions D. Patient with transient incontinence related to loss of cognitive function
C. Patient with urge incontinence and abnormal detrusor muscle contractions
Which laboratory results is of most concern to the nurse for an adult patient with cystitis? A. Serum white blood cell (WBC) count of 9000 B. Urinalysis results showing 1 or 2 WBCs present C. Urine bacteria count of 100,000 colonies per milliliter D. Serum hematocrit of 36%
C. Urine bacteria count of 100,000 colonies per milliliter
A patient reports severe flank pain. The report indicates that urine is turbid, malodorous, and rust-colored; red blood cells, white blood cells, and bacteria are present; and microscopic analysis shows crystals. What does the nurse suggest? A. Pyuria and cystitis B. Staghorn calculus with infection C. Urolithiasis and infection D. Dysuria and urinary retention
C. Urolithiasis and infection
The health care provider verbally informs the nurse that the patient needs a fluoroquinolone antibiotic to treat a urinary tract infection. The pharmacy delivers gabapentin. What should the nurse do first? A. Administer the medication as ordered B. Call the pharmacist and ask for a read back of the order C. Call the health care provider for clarification of the order D. Look at the written order and take steps to correct the error
D. Look at the written order and take steps to correct the error
The nurse sees that the patient was recently started on oxybutynin. Which question is the nurse most likely to ask to evaluate whether or not the medication is having the desired effect? A. "Are you still losing small amounts of urine during your daily jogging activity?" B. "Have you had any episodes of flank pain or difficult passing your urine?" C. "Have you had any problems with fever or noticed any burnigning when you urinate?" D. "Are you still having a sudden strong urge to void and leaking large amounts of urine?"
D. "Are you still having a sudden strong urge to void and leaking large amounts of urine?"
The nurse is teaching a man about how to prevent urinary tract infections? What information does the nurse include? A. "Drink adequate fluid before and after intercourse" B. "Empty your bladder before and after intercourse" C. "Make sure that spermicides are used with condoms" D. "Gently wash the genital area before intercourse"
D. "Gently wash the genital area before intercourse"
A patient has had a bladder suspension and suprapubic catheter is in place. The patient wants to know how long the catheter will remain in place. What is the nurse's best response? A. "For most patients, it remains for 24 hours postoperatively" B. "It will be removed at your first clinic visit, unless there are complications" C. "When you have the urge and can void on your own, it will be removed" D. "It is removed when you void and residual urine is less than 50 mL"
D. "It is removed when you void and residual urine is less than 50 mL"
A 28-year-old married female patient with cystitis requires instruction about how to prevent future urinary tract infections (UTIs). The supervising RN has assigned this teaching to a newly graduated nurse. Which statement by the new graduate nurse requires that the supervising RN intervene? A. "You should always drink 2 to 3 L of fluid every day" B. "Empty your bladder regularly even if you don't feel the urge to urinate" C. "Drinking cranberry juice daily will decrease the number of bacteria in your bladder" D. "It's okay to soak in the tub with bubble bath because it will keep you clean"
D. "It's okay to soak in the tub with bubble bath because it will keep you clean"
Which patient should not be advised to take cranberry juice? A. 26-year-old pregnant woman with an uncomplicated urinary tract infection B. 23-year-old man with history of recurrent kidney stones C. 65-year-old man with urinary retention secondary to enlarged prostate D. 33-year-old woman with dysuria associated with interstitial cystitis
D. 33-year-old woman with dysuria associated with interstitial cystitis
The nurse is teaching a patient a behavioral intervention for bladder compression. In order to correctly perform the Crede method, what does the nurse teach the patient to do? A. Insert the fingers into the vagina and gently push against the vaginal wall B. Breathe deeply and direct the pressure towards the bladder during exhalation C. Empty the bladder, wait a few minutes, and attempt a second bladder emptying D. Apply firm and steady pressure over the bladder area with the palm of the hand
D. Apply firm and steady pressure over the bladder area with the palm of the hand
The nurse is performing an assessment on a patient with probably stress incontinence. Which assessment technique does the nurse use to validate stress incontinence? A. Assess the abdomen to estimate bladder fullness B. Check for residual urine using a portable ultrasound C. Catheterize the patient immediately after voiding D. Ask the patient to cough while wearing a perineal pad
D. Ask the patient to cough while wearing a perineal pad
The nurse is caring for a patient with functional incontinence. The unlicensed assistive personnel (UAP) reports that "the linens have been changed four times within the past 6 hours, but the patient refuse to wear a diaper." What does the nurse do next? A. Thank the UAP for the hard work and advise to continue to change the linens B. Call the health care provider to obtain an order for an indwelling catheter C. Instruct the UAP to stop using the term "diaper" and instead use "incontinence pants" D. Assess the patient for an new urinary problems and ask about toileting preferences
D. Assess the patient for an new urinary problems and ask about toileting preferences
A patient with reflex (overflow) urinary incontinence had surgery to relieve an obstruction. Postoperatively the nurse observes and reports that the patient is having urinary retention. Which drug has a role in addressing this problem? A. Captopril is given to lower urine cystine levels B. Levofloxacin is given to prevent infection due to retention C. Mirabegron is given to increase bladder capacity D. Bethanechol chloride may be used short-term after surgery
D. Bethanechol chloride may be used short-term after surgery
Which nursing action can best prevent infection from a urinary retention catheter? A. Cleansing the perineum B. Encouraging adequate fluids C. Irrigating the catheter once daily D. Cleansing around the meatus routinely
D. Cleansing around the meatus routinely
A patient has urinary tract infection symptoms but there are no bacteria in the urine. The health care provider suspects interstitial cystitis. The nurse prepares patient teaching material for which diagnostic test? A. Voiding cystourethrography B. Ultrasonography C. Computed tomography D. Cystoscopy
D. Cystoscopy
A patient comes to the clinic and reports severe flank pain, bladder distension, and nausea and vomiting with increasingly smaller amounts of urine with frank blood. The patient states, "I have kidney stones and I just need a prescription for pain medication." What is the priority concern n the interdisciplinary care of this patient? A. Controlling the patient's pain B. Checking the quantity of blood in urine C. Flushing the kidneys with oral fluids D. Determining if there is an obstruction
D. Determining if there is an obstruction
To prevent recurrence of superficial bladder cancer, the patient received intravesical instillation of bacille Calmette-Guerin at the outpatient cancer clinic. What home care instructions should be given to this patient? A. Flush the toilet after every voiding and remind all family members about hand hygiene B. Drink a lot of extra fluid to flush your bladder, but otherwise there are no special instructions C. Your urine will be radioactive for 24 hours so avoid exposing children and pregnant women D. For 24 hours, others should not share your toilet; afterward clean the toilet with 10% bleach
D. For 24 hours, others should not share your toilet; afterward clean the toilet with 10% bleach
A patient is returning from the postanesthesia care unit after surgery for bladder cancer and has a cutaneous ureterostomy. Where does the nurse expect the stoma to be located? A. On the perineum B. At the beltline C. On the posterior flank D. In the mid abdominal area
D. In the mid abdominal area
In which patient circumstance would the nurse question the order for the insertion of an indwelling catheter? A. Patient is critically ill and at risk for hypovolemic shock B. Patient has urinary retention with beginnings of hydronephrosis C. Patient was in a car accident and has a possible spinal cord injury D. Patient has functional incontinence related to Alzheimer's disease
D. Patient has functional incontinence related to Alzheimer's disease
The nurse is providing nursing care for a 24-year-old female patient admitted to the acute care unit with a diagnosis of cystitis. Which intervention should the nurse delegate to the unlicensed assistive personnel (UAP)? A. Teaching the patient how to secure a clean-catch urine sample B. Assessing the patient's urine for color, odor, and sediment C. Reviewing the nursing care plan and add nursing interventions D. Providing the patient with a clean-catch urine sample container
D. Providing the patient with a clean-catch urine sample container
A nurse is counseling a woman who had recurrent urinary tract infections. What factor should the nurse explain is the reason why women are at a greater risk than men for contracting a urinary tract infection? A. Altered urinary pH B. Hormonal secretions C. Juxtaposition of the bladder D. Proximity of the urethra to the anus
D. Proximity of the urethra to the anus
The nurse is providing care for a patient with reflex urinary incontinence. Which action could be appropriately assigned to a new LPN/LVN? A. Teaching the patient bladder emptying by the Crede method B. Demonstrating how to perform intermittent self-catheterization C. Discussing when to report side effects of bethanechol chloride to the health care provider D. Reinforcing the importance of proper hand washing to prevent infection
D. Reinforcing the importance of proper hand washing to prevent infection
A patient with a history of kidney stones presents with severe flank pain, nausea, vomiting, pallor, and diaphoresis. He reports freely passing urine, but it is bloody. What is the priority concern? A. Possible hemorrhage B. Impaired tissue perfusion C. Impaired urinary elimination D. Severe pain
D. Severe pain
A patient reports the loss of small amounts of urine during coughing, sneezing, jogging, or lifting. Which type of incontinence is the patient describing? A. Urge B. Overflow C. Functional D. Stress
D. Stress
A patient is being admitted to rule out interstitial cystitis. What should the nurse's plan of care for this patient include specific to this diagnosis? A. Take daily urine samples for urinalysis B. Maintain accurate intake and output records C. Obtain an admission urine sample to determine electrolyte level D. Teach the patient about the cystoscopy procedure
D. Teach the patient about the cystoscopy procedure
Which urine characteristic suggests that the patient is drinking a sufficient amount of fluid? A. Urine pH is between 6 to 6.5 B. Urine has a high specific gravity C. Urine has a faint ammonia odor D. Urine is a pale yellow color
D. Urine is a pale yellow color
