Renal/GU Prep-U
An appropriate nursing intervention for the client following a nuclear scan of the kidney is to: a) Strain all urine for 48 hours. b) Monitor for hematuria. c) Apply moist heat to the flank area. d) Encourage high fluid intake.
Encourage high fluid intake.
Which of the following substances stimulate the bone marrow to produced red blood cells?
Erythropoietin
Which of the following substances stimulate the bone marrow to produced red blood cells? a) Prostaglandin E b) Prostacyclin c) Erythropoietin d) Renin
Erythropoietin
Which type of incontinency refers to the involuntary loss of urine due to medications? a) Iatrogenic b) Urge c) Reflex d) Overflow
Iatrogenic
Which of the following is accurate regarding sildenafil (Viagra)? a) It can be taken twice daily for increased effect. b) Its side effects include headache, flushing, and dizziness. c) The medication should be taken right before intercourse. d) There does not need to be sexual stimulation to produce an erection.
Its side effects include headache, flushing, and dizziness.
Which finding is an early indicator of bladder cancer? a) Dysuria b) Occasional polyuria c) Painless hematuria d) Nocturia
Painless hematuria
A female client is undergoing a bladder training program as treatment for urinary incontinence. Which of the following techniques would be the most appropriate suggestion? a) Performing Kegel exercises. b) Using the services of a chronic pain center. c) Taking warm sitz baths. d) Instilling dimethyl sulfoxide (DMSO) in the bladder.
Performing Kegel exercises.
A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? a) Cystography b) Bladder ultrasonography c) IV urography d) Nuclear scan
b
After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first? a) Artificial sphincter use b) Kegel exercises c) Self-catheterization d) Fluid restriction
b
The nurse is admitting a client who is to undergo an open renal biopsy. About which of the following comments by the client should the nurse be most concerned? a) "I signed the consent form in the physician's office." b) "I took my usual dose of Coumadin last night." c) "I have not eaten since 8 pm last night." d) "I brought a copy of my living will with me."
"I took my usual dose of Coumadin last night."
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)? a) "I've had trouble getting started when I urinate, often straining to do so." b) "I'm waking up at night to urinate and I've noticed some burning, too." c) "I've had some pain in my lower abdomen lately and felt a bit sick to my stomach." d) "I've had a fever and noticed I've been running to the bathroom more often."
"I've had trouble getting started when I urinate, often straining to do so."
A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is:
"The glomerular filtration rate decreases as we age."
A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is: a) "The glomerular filtration rate decreases as we age." b) "Hypoplasia of the prostate occurs in older men." c) "Contractility of the bladder wall increases with age." d) "Urethral hypertrophy occurs following menopause."
"The glomerular filtration rate decreases as we age."
A client is scheduled for a creatinine clearance test. The nurse should explain that this test is done to assess the kidneys' ability to remove a substance from the plasma in: a) 30 minutes. b) 24 hours. c) 1 minute. d) 1 hour.
1 minute.
When fluid intake is normal, the specific gravity of urine should be
1.010 to 1.025.
When fluid intake is normal, the specific gravity of urine should be a) greater than 1.025. b) 1.000. c) 1.010 to 1.025. d) less than 1.010.
1.010 to 1.025.
Approximately what percentage of blood passing through the glomeruli is filtered into the nephron? a) 10 b) 30 c) 40 d) 20
20
Which hormone causes the kidney to reabsorb sodium? a) ADH b) Prostaglandins c) Growth hormone d) Aldosterone
Aldosterone
A 32-year-old client has been admitted to the renal unit of the hospital with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. What signs and symptoms would you expect the client to exhibit? a) Flank pain b) Elevated temperature c) Malaise d) All options are correct
All options are correct
Which type of medication may be used in the treatment of a patient with incontinence to inhibit contraction of the bladder? a) Over-the-counter decongestant b) Tricyclic antidepressants c) Anticholinergic agent d) Estrogen hormone
Anticholinergic agent
After undergoing renal arteriogram, in which the left groin was accessed, a client complains of left calf pain. Which intervention should the nurse perform first? a) Assess for anaphylaxis. b) Place cool compresses on the calf. c) Exercise the leg and foot. d) Assess peripheral pulses in the left leg.
Assess peripheral pulses in the left leg.
A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? a) IV urography b) Cystography c) Nuclear scan d) Bladder ultrasonography
Bladder ultrasonography
Students preparing for a test are reviewing the structure and function of the male reproductive system. They demonstrate understading of the material when they identify which of the following as the site of spermatogenesis? a) Prostate gland b) Seminal vesicles c) Testes d) Vas deferens
C
The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening? a) Transrectal ultrasound every 5 years after age 50 years b) Annual digital rectal examination (DRE) after age 35 years c) Annual prostate-specific antigen (PSA) testing after age 40 years d) Monthly testicular self-examination (TSE)
D
Which of the following vitamin is necessary for maintenance of normal calcium levels?
D
Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure? a) Increased red blood cell count b) Decreased serum potassium level c) Increased serum creatinine level d) Increased serum calcium level
Increased serum creatinine level
After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an I.V. infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? a) It's a normal finding associated with the client's nothing-by-mouth status. b) It's an abnormal finding that requires further assessment. c) It's a normal finding caused by blood loss during surgery. d) It's an abnormal finding that will correct itself when the client ambulates.
It's an abnormal finding that requires further assessment.
A client undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. Which of the following postoperative procedures should the nurse perform? a) Suggest a visit to a local ostomy group. b) Show photographs and drawings of the placement of the stoma c) Determine the client's ability to manage stoma care. d) Maintain skin and stomal integrity.
Maintain skin and stomal integrity.
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? a) Assess the client's mental changes. b) Evaluate the client for periorbital edema. c) Monitor the client for signs of electrolyte and water imbalance. d) Monitor the client for an allergy to iodine contrast material.
Monitor the client for an allergy to iodine contrast material.
Which of the following is an effect of aging on upper and lower urinary tract function? a) Increased GFR b) Increased blood flow to the kidney c) Acid-base balance d) More prone to develop hypernatremia
More prone to develop hypernatremia
During a routine assessment, the patient states; "I wake up all night long to go the bathroom." The nurse will document this finding as which of the following? a) Oliguria b) Dysuria c) Polyuria d) Nocturia
Nocturia
Which of the following describes awakening at night to urinate?
Nocturia
A client, aged 75, is diagnosed with a renal disease and administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe the client closely for any changes in renal status. Which of the following measures may help a nurse determine a change in renal status? a) Checking for a thrill or a bruit daily. b) Observing the client's urinary output. c) Observing the client's fluid intake. d) Observing the skin color and nail beds.
Observing the client's urinary output.
A creatinine level has been ordered. The nurse prepares to: a) Obtain a clean catch urine. b) Collect the client's urine for 24 hours. c) Obtain a blood specimen. d) Straight cath for a specimen.
Obtain a blood specimen.
Which of the following is a characteristic of a normal stoma? a) Pink color b) Dry in appearance c) No bleeding when cleansing stoma d) Painful
Pink color
Nursing students are reviewing information about the male reproductive system and normal age-related changes. They demonstrate understanding of the topic when they identify which of the following as occurring? a) Testes become heavier in weight. b) Secretions of the prostate gland increase. c) Plasma testosterone levels decrease. d) Spematogenesis drops significantly
Plasma testosterone levels decrease.
Retention of which electrolyte is the most life-threatening effect of renal failure?
Potassium
Which of the following is an age-related change associated with the renal system?
Renal arteries thicken
Which is the correct term for the ability of the kidneys to clear solutes from the plasma? a) Renal clearance b) Tubular secretion c) Glomerular filtration rate (GFR) d) Specific gravity
Renal clearance
The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: a) Protein 15 mg/dL b) Specific gravity 1.035 c) Bright yellow urine d) Creatinine 0.7 mg/dL
Specific gravity 1.035
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? a) Overflow b) Reflex c) Urge d) Stress
Stress
A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make? a) Testicular cancer is a highly curable type of cancer. b) Testicular cancer is more common in older men. c) Testicular cancer is very difficult to diagnose. d) Testicular cancer is the number one cause of cancer deaths in males.
Testicular cancer is a highly curable type of cancer.
A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact?
The left kidney usually is slightly higher than the right one.
A patient undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. Which of the following postoperative procedures should the nurse perform? a) Show photographs and drawings of the placement of the stoma b) Determine the patient's ability to manage stoma care c) Suggest a visit to a local ostomy group d) Maintain skin and stomal integrity
d
The term used to describe total urine output of less than 400 mL in 24 hours is a) dysuria. b) nocturia. c) anuria. d) oliguria.
d
What should a male client older than age 50 do to help ensure early identification of prostate cancer? a) Have a transrectal ultrasound every 5 years. b) Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. c) Perform monthly testicular self-examinations, especially after age 50. d) Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.
d
Which finding is an early indicator of bladder cancer? a) Dysuria b) Nocturia c) Occasional polyuria d) Painless hematuria
d
Which of the following is a cause of a calcium renal stone? a) Gout b) Neurogenic bladder c) Foreign bodies d) Excessive intake of vitamin D
d
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? a) Overflow b) Urge c) Reflex d) Stress
d
Which type of medication may be used in the treatment of a patient with incontinence to inhibit contraction of the bladder? a) Tricyclic antidepressants b) Estrogen hormone c) Over-the-counter decongestant d) Anticholinergic agent
d
The term used to describe total urine output of less than 400 mL in 24 hours is
oliguria
A client asks the nurse what PSA is. The nurse should reply that it stands for: a) Papanicolaou-specific antigen, which is used to screen for cervical cancer. b) protein serum antigen, which is used to determine protein levels. c) prostate-specific antigen, which is used to screen for prostate cancer. d) pneumococcal strep antigen, which is a bacteria that causes pneumonia.
prostate-specific antigen, which is used to screen for prostate cancer.
Testicular cancer risk is highest for adolescents and men younger than age 35. To specifically address testicular cancer risk, a nurse should modify client teaching for male clients to include: a) family history. b) risk factors. c) testicular self-examination. d) physician visits.
testicular self-examination.
The most accurate indicator of fluid loss or gain in an acutely ill patient is a) pulse rate. b) edema. c) weight. d) blood pressure.
weight
Common tests of renal function include which of the following? Select all that apply. a) Creatinine clearance b) Renal concentration test c) Serum creatinine d) Arterial blood gas analysis e) Blood urea nitrogen (BUN)
• Renal concentration test • Creatinine clearance • Serum creatinine • Blood urea nitrogen (BUN)
The client asks the nurse about the functions of the kidney. Which should the nurse include when responding to the client? Select all that apply. a) Secretion of insulin b) Vitamin D synthesis c) Regulation of blood pressure d) Secretion of prostaglandins e) Vitamin B production
• Secretion of prostaglandins • Regulation of blood pressure • Vitamin D synthesis
Which of the following are age-related changes affecting the male reproductive system? a) Testes become soft b) Patency increases c) Decrease plasma testosterone levels d) Prostate secretion increase
c
Which of the following hormones is secreted by the juxtaglomerular apparatus?
renin
Which of the following is accurate regarding sildenafil (Viagra)? a) It can be taken twice daily for increased effect. b) There does not need to be sexual stimulation to produce an erection. c) Its side effects include headache, flushing, and dizziness. d) The medication should be taken right before intercourse.
c
Which of the following is the only definitive way to diagnose testicular cancer? a) Ultrasound b) Computed tomography of abdomen c) Tissue biopsy d) Lactate dehydrogenase levels
c
Which of the following vitamin is necessary for maintenance of normal calcium levels? a) E b) A c) D d) C
c
Which of the following would be included in a teaching plan for a patient diagnosed with a urinary tract infection? a) Void every 4 to 6 hours b) Use tub baths as opposed to showers c) Drink liberal amount of fluids d) Drink coffee or tea to increase diuresis
c
Which type of incontinency refers to the involuntary loss of urine due to medications? a) Urge b) Overflow c) Iatrogenic d) Reflex
c
The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements? a) Take tub baths instead of showers b) Increase intake of coffee, tea, and colas c) Void every 5 hours during the day d) Void immediately after sexual intercourse
Void immediately after sexual intercourse
Which of the following is a strategy to promote urinary continence? a) Void regularly, 5 to 8 times a day b) Use caffeine in moderation c) Take diuretics after 4 PM d) Implement a low fiber diet
Void regularly, 5 to 8 times a day
Which part of the kidney contains the nephrons? a) Glomerulus b) Cortex c) Medulla d) Pelvis
Cortex
The diagnosis of prostate cancer is confirmed by which of the following? a) Histologic exam of tissue b) Bone scan c) Magnetic resonance imaging d) Computed tomography
a
Which of the following is the most common site of a nosocomial infection? a) Urinary tract b) Respiratory tract c) Skin d) Gastrointestinal tract
a
Testicular cancer risk is highest for adolescents and men younger than age 35. To specifically address testicular cancer risk, a nurse should modify client teaching for male clients to include: a) risk factors. b) testicular self-examination. c) physician visits. d) family history.
b
A client asks the nurse what PSA is. The nurse should reply that it stands for: a) pneumococcal strep antigen, which is a bacteria that causes pneumonia. b) prostate-specific antigen, which is used to screen for prostate cancer. c) Papanicolaou-specific antigen, which is used to screen for cervical cancer. d) protein serum antigen, which is used to determine protein levels.
prostate-specific antigen, which is used to screen for prostate cancer.
Which of the following instructions regarding future sexual activity should a nurse give a patient with a vasectomy? a) Expect some bruising and incisional soreness after every sexual activity for the first 2days b) Sexual activity can resume after three weeks c) Use a reliable method of contraception until the physician ensures that sperm no longer are present d) Administer a mild analgesic before any sexual activity
c
A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? a) Creatinine clearance b) Liver function studies c) Therapeutic index d) GI absorption rate
Creatinine clearance
The nurse is caring for the client following surgery for a urinary diversion. The client refuses to look at the stoma or participate in its care. The nurse formulates a nursing diagnosis of: a) Anticipatory grieving b) Deficient knowledge: stoma care c) Situational low self esteem d) Disturbed body image
Disturbed body image
The term used to describe painful or difficult urination is which of the following? a) Nocturia b) Anuria c) Dysuria d) Oliguria
Dysuria
Which of the following is the most common site of a nosocomial infection? a) Urinary tract b) Gastrointestinal tract c) Respiratory tract d) Skin
Urinary tract
A 32-year-old client has a history of neurogenic bladder and presents with fever, burning, and discharge at her catheter insertion site. What would you suspect is the problem? a) Urinary retention b) Urinary incontinence c) Urinary tract infection d) Urethral strictures
Urinary tract infection
Which of the following instructions regarding future sexual activity should a nurse give a client with a vasectomy? a) Sexual activity can only resume after three weeks b) Expect some bruising and incisional soreness after every sexual activity in the first two days c) Use a reliable method of contraception until the physician ensures that sperm no longer are present d) Administer a mild analgesic before any sexual activity
Use a reliable method of contraception until the physician ensures that sperm no longer are present
Which of the following is a characteristic of a normal stoma? a) Dry in appearance b) No bleeding when cleansing stoma c) Pink color d) Painful
c
A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client? a) "You may experience headache and some flushing with this drug." b) "You need to take this medication throughout the day to be effective." c) "Your blood glucose level might increase when you take this drug." d) "The effects of this medication usually last for up to 48 hours."
a
A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is: a) "The glomerular filtration rate decreases as we age." b) "Urethral hypertrophy occurs following menopause." c) "Hypoplasia of the prostate occurs in older men." d) "Contractility of the bladder wall increases with age."
a
The nurse is admitting a client who is to undergo an open renal biopsy. About which of the following comments by the client should the nurse be most concerned? a) "I took my usual dose of Coumadin last night." b) "I have not eaten since 8 pm last night." c) "I signed the consent form in the physician's office." d) "I brought a copy of my living will with me."
a
Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply. a) Risk for impaired skin integrity b) Urinary retention c) Deficient knowledge: management of urinary diversion d) Chronic pain e) Disturbed body image
a, c, e
A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis? a) Impaired urinary elimination b) Acute pain c) Risk for infection d) Imbalanced nutrition: Less than body requirements
b
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction? a) "Apply an antibacterial dressing to the incision daily." b) "Increase your fluid intake to 2 to 3 L per day." c) "Take your temperature every 4 hours." d) "Be aware that your urine will be cherry-red for 5 to 7 days."
b
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? a) The urine in the drainage bag appears red to pink. b) The client reports bladder spasms and the urge to void. c) About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned. d) The normal saline irrigant is infusing at a rate of 50 drops/minute.
b
Bladder retraining following removal of an indwelling catheter begins with a) encouraging the patient to void immediately. b) instructing the patient to follow a 2 to 3 hour timed voiding schedule. c) advising the patient to avoid urinating for at least 6 hours. d) performing straight catheterization after 4 hours.
b
If an indwelling catheter is necessary, the nursing interventions that should be implemented to prevent infection include a) using sterile technique to disconnect the catheter from tubing to obtain urine specimens. b) performing meticulous perineal care daily with soap and water. c) placing the catheter bag on the patient's abdomen when moving the patient. d) using clean technique during insertion.
b
Which of the following is a strategy to promote urinary continence? a) Use caffeine in moderation b) Void regularly, 5 to 8 times a day c) Take diuretics after 4 PM d) Implement a low fiber diet
b
Which of the following medications maybe ordered to relieve discomfort associated with a urinary tract infection? a) Levofloxacin (Levaquin) b) Phenazopyridine (Pyridium) c) Ciprofloxacin (Cipro) d) Nitrofurantoin (Furadantin)
b
A client comes to the emergency department complaining of 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? a) Ureter b) Urethra c) Kidney d) Bladder
c
A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged I.V. pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow? a) Counter-balancing the I.V. pole b) Collecting a urine specimen before beginning irrigation c) Evaluating patency of the drainage lumen d) Attaching the infusion set to an infusion pump
c
A client presents at the testing center for an intravenous pyelogram. What question should the nurse ask to ensure the safety of the client? a) "Who has come with you today?" b) "Do you have a pacemaker?" c) "Do you have any allergies?" d) "Have you any artificial joints?"
c
The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? a) "A catheter will drain urine directly from my kidney." b) "I will not need to worry about being incontinent of urine." c) "My urine will be eliminated through a stoma." d) "My urine will be eliminated with my feces."
c
The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following? a) Light pink with few red streaks b) Reddish-pink with numerous clots c) Light yellow and clear d) Dark amber with copious mucous
c
Which nursing intervention should the nurse caring for the client with pyelonephritis implement? a) Straight catheterize the client every 4 to 6 hours. b) Administer acetaminophen (Tylenol). c) Teach client to increase fluid intake up to 3 liters per day. d) Restrict fluid intake to 1 liter per day.
c
Which of the following is a factor contributing to UTI in older adults? a) Active lifestyle b) Sporadic use of antimicrobial agents c) Immunocompromise d) Low incidence of chronic illness
c
A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? a) Establishing a predetermined fluid intake pattern for the client b) Restricting fluid intake to reduce the need to void c) Encouraging the client to increase the time between voidings d) Assessing present voiding patterns
d
The nurse is reviewing the client's lab results. Which lab result requires follow up by the nurse? Select all that apply. a) Urine specific gravity 1.020 b) Urine: RBC 20 c) BUN 28 mg/dL d) Serum creatinine 0.8 mg/dL e) Urine: WBC 1
• Urine: RBC 20 • BUN 28 mg/dL