Urinary Unit exam
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? a) Uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75% b) Increased serum levels of potassium, magnesium, and calcium c) Increased pH with decreased hydrogen ions d) Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl
Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl
Susan Hopkins, a 32-year-old administrative assistant, is being seen by a physician with the urology practice where you practice nursing. She has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What can Mrs. Hopkins consume to decrease the likelihood of bladder infection? a) Prune juice b) Red meat c) Increased protein d) Cranberry juice
Cranberry juice
The patient is taking Spirinolactone (Aldactone). What response determines successful teaching? a) "I should take the medicine around dinnertime for the best effect." b) "I need to make sure I don't eat too many high potassium foods." c) "I can still use my salt substitute if I want to." d) "I need to take the drug on an empty stomach."
"I need to make sure I don't eat too many high potassium foods."
The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is: a) "As the disease progresses, you will most likely require renal replacement therapy." b) "Dietary changes can reverse the damage that has occurred in your kidneys." c) "Draining of the cysts and antibiotic therapy will cure your disease." d) "Genetic testing will determine the best treatment for your condition."
"As the disease progresses, you will most likely require renal replacement therapy."
A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? a) "An x-ray will be done to view your kidneys, ureters, and bladder." b) "A contrast medium will be used to help see the structures better." c) "You don't need to do any fasting before this noninvasive test." d) "You'll have a pressure dressing on your groin after the test."
"You don't need to do any fasting before this noninvasive test."
A 10-year-old child has edema caused by a heart defect. The patient is taking furosemide (Lasix). The dosage is 6 mg/kg per day. The child weighs 76 pounds. How many mg does the child receive in each dose? a) 50 mg b) 105 mg c) 210 mg d) 20 mg
210 mg
Ron Davidson, a 45-year-old editor, is a client on the rehab unit where you practice nursing. Ron was involved in an MVA, which left him with paraplegia, and he is working toward living at home with his wife. He is currently developing an individualized CIC schedule, as he prefers to not wear a leg bag. What is the maximum amount of urine he should allow to collect before catheterization? a) 100 mL b) 600 mL c) 500 mL d) 350 mL
350 mL
Which of the following is a term used to describe excessive nitrogenous waster in the blood, as seen in acute glomerulonephritis? a) Proteinuria b) Hematuria c) Azotemia d) Bacteremia
Azotemia
The nurse is caring for a patient with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which of the following nursing actions is contraindicated? a) Obtaining a blood pressure reading from the right arm b) Placing the patient's watch on the left wrist c) Obtaining blood samples from the left arm d) Palpating the fistula for a "thrill"
Obtaining a blood pressure reading from the right arm
A patient has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this patient? a) A thiazide diuretic will provide peak effects in 2 hours b) A thiazide diuretic will be excreted in more than 72 hours c) A thiazide diuretic will reabsorb potassium in the distal tubule d) A thiazide diuretic will be ineffective for immediate diuresis
A thiazide diuretic will be ineffective for immediate diuresis
A patient with glaucoma has been prescribed a diuretic as treatment of her disease process. What drug does the nurse suspect that the patient will be prescribed? a) Acetazolamide (Diamox) b) Chlorthalidone (Hygroton) c) Bendroflumethiazide (Naturetin) d) Spironolactone (Aldactone)
Acetazolamide (Diamox)
Which of the following diuretics exerts its effect by inhibiting the enzyme carbonic anhydrase? (Choose one a) Acetazolamide (Diamox) b) Furosemide (Lasix) c) Spironolactone (Aldactone) d) Hydrochlorothiazide (Microzide)
Acetazolamide (Diamox)
Which hormone causes the kidney to reabsorb sodium? a) Aldosterone b) Antidiuretic hormone (ADH) c) Growth hormone d) Prostaglandins
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) Elevated temperature b) Malaise c) All options are correct. d) Flank pain
All options are correct.
Which of the following would be a contraindication to the use of carbonic anhydrase inhibitors? a) Respiratory acidosis b) Chronic obstructive pulmonary disease c) Allergy to sulfonamides d) Adrenocortical insufficiency
Allergy to sulfonamides
The nurse is caring for a patient who is not allowed oral intake of fluid or food. When evaluating this patient's urinalysis, what would the nurse anticipate? a) An increased urine specific gravity b) A fixed urine specific gravity c) A decreased urine specific gravity d) A fluctuating urine specific gravity
An increased urine specific gravity
An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? a) Application of an ostomy pouch b) Irrigating the urinary diversion c) Intermittent catheterizations d) Exercises to promote sphincter control
Application of an ostomy pouch
The nurse has implemented a bladder retraining program in a 65-year-old woman after the removal of an indwelling urinary catheter from this patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient has 50 mL of urine remaining in her bladder after voiding. What would be the nurse's best response to this finding? a) Avoid further interventions at this time, as this is an acceptable finding b) Press on the patient's bladder in an attempt to encourage complete emptying c) Perform a straight catheterization on this patient d) Place an indwelling urinary catheter
Avoid further interventions at this time, as this is an acceptable finding
Which of the following is the most effective intravesical agent for recurrent bladder cancer? a) Methotrexate b) Bacillus Calmette-Guérin (BCG) c) Cisplatin d) Vinblastine
Bacillus Calmette-Guérin (BCG)
The nurse is caring for a patient with a medical history of sickle cell anemia. The nurse understands this predisposes the patient to which of the following possible renal or urologic disorders? a) Chronic kidney disease b) Kidney stone formation c) Neurogenic bladder d) Proteinuria
Chronic kidney disease
John Ericsson, a 57-year-old railroad worker, is a client on the hospital unit where you practice nursing. As a result of trauma, Mr. Ericsson has developed urinary incontinence and is beginning bladder training to regain control over his urine elimination. What is the initial step to begin bladder training for a client with an indwelling catheter? a) Unclamp the catheter b) Clamp the catheter c) Remove the catheter d) Perform catheter care
Clamp the catheter
An older client is receiving prolonged doses of nephrotoxic drugs. Which of the following would the nurse need to report? a) Increased chloride levels b) Oliguria c) Decreased serum creatinine levels d) Decreased blood urea nitrogen (BUN) levels
Oliguria
A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication? a) Obstruction of urine flow from the kidneys b) Decrease in the blood flow through the kidneys c) Blood clot formed in the kidneys interfered with the flow d) Structural damage occurred in the nephrons of the kidneys
Decrease in the blood flow through the kidneys
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which of the following? a) Diabetes insipidus b) Increased fluid intake c) Glomerulonephritis d) Decreased fluid intake
Decreased fluid intake
Which of the following would be included in a teaching plan for a patient diagnosed with a urinary tract infection? a) Use tub baths as opposed to showers b) Void every 4 to 6 hours c) Drink liberal amount of fluids d) Drink coffee or tea to increase diuresis
Drink liberal amount of fluids
A client is being discharged home after a radical cystectomy and creation of ureterosigmoidoscopy. Which of the following must be avoided? a) Stoma irritation b) Sodium intake c) Enemas d) Intermittent self-catheterization
Enemas
In starting your new job as a nurse with a group of renal specialists, you begin your orientation with a thorough review of renal function. While the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which of the following is NOT a function of the kidneys? a) Regulating blood pressure b) Stimulating RBC production c) Excreting nitrogen waste products d) Excreting protein
Excreting protein
An older adult male client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises him to wear barrier garments such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity? a) Exposing the affected area to air. b) Avoiding using an electric room deodorizer. c) Avoiding the application of moisture sealant. d) Using scented sprays or perfumes.
Exposing the affected area to air.
A group of students are reviewing the various classes of diuretics. The students demonstrated understanding of the information when they identify which of the following as a loop diuretic? a) Triamterene b) Furosemide (Lasix) c) Mannitol (Osmitrol) d) Indapamide
Furosemide (Lasix)
A 42-year-old client is being seen by an urologist in the group where you practice nursing. She is experiencing some secretion abnormalities, for which diagnostics are being performed. Which of the following substances are typically reabsorbed and not secreted in urine? a) Potassium b) Creatinine c) Glucose d) Chloride
Glucose
The nurse caring for a patient with acute glomerulonephritis would expect the patient's urine to what? a) Have a cola-color b) Be copious in amount c) Have fibrinous threads d) Contain renal calculi
Have a cola-color
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? a) Increased serum creatinine b) Decreased blood urea nitrogen (BUN) c) Increased serum albumin d) Decreased potassium
Increased serum creatinine
Which of the following is used to decrease potassium level seen in acute renal failure? a) Sorbitol b) Kayexalate c) IV dextrose 50% d) Calcium supplements
Kayexalate
The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? a) Fistula b) Chronic renal failure c) Kidney stones d) Neurogenic bladder
Kidney stones
Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? a) Limit sodium and water intake. b) Teach client behaviors that decrease urination. c) Give medications that promote fluid retention. d) Assess for dehydration.
Limit sodium and water intake.
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? a) Low oxalate b) Low purine c) High sodium d) High protein
Low purine
A patient is brought to the renal unit from the PACU status post resection of a renal tumor. What would be a priority nursing action in the care of this patient? a) Decrease urine output b) Increase oral intake c) Increase mobility d) Management of postoperative pain
Management of postoperative pain
You are caring for a patient who is experiencing elevated intracranial pressure following neurosurgery. The physician orders an osmotic diuretic to reduce pressure. Which of the following agents would the physician select? a) Furosemide (Lasix) b) Bumetanide (Bumex) c) Mannitol (Osmitrol) d) Spironolactone (Aldactone)
Mannitol (Osmitrol)
Which finding is an early indicator of bladder cancer? a) Nocturia b) Occasional polyuria c) Dysuria d) Painless hematuria
Painless hematuria
A patient is receiving patient education prior to beginning continuous ambulatory peritoneal dialysis. What would the nurse teach the patient that the most common complication associated with this procedure is? a) Blood loss b) Constipation c) Dehydration d) Peritonitis
Peritonitis
Which of the following medications may be ordered to relieve discomfort associated with a UTI? a) Ciprofloxacin (Cipro) b) Levofloxacin (Levaquin) c) Nitrofurantoin (Furadantin) d) Phenazopyridine (Pyridium)
Phenazopyridine (Pyridium)
Which of the following is a characteristic of a normal stoma? a) Pink color b) Painful c) Dry in appearance d) No bleeding when cleansing stoma
Pink color
Drag and Drop question - Click and drag the following steps to place them in the correct order. Question: A nursing instructor is reviewing with the class the steps in urine formation. Place in the correct order from first to last the sequence the instructor would present. 1.Formed urine drains from the collecting tubules, into the renal pelvis, and down each ureter to the bladder. 2. Filtrate moves through the tubular system of the nephron and is either reabsorbed or excreted as urine. 3. Filtrate enters Bowman's capsule. 4.Plasma is filtered by the glomerulus.
Plasma is filtered by the glomerulus. Filtrate enters Bowman's capsule. Filtrate moves through the tubular system of the nephron and is either reabsorbed or excreted as urine. Formed urine drains from the collecting tubules, into the renal pelvis, and down each ureter to the bladder.
What disease of the kidney is genetic in nature and leads to kidney failure? a) Nephritic syndrome b) Polycystic kidney disease c) Nephrotic syndrome d) Acute glomerulonephritis
Polycystic kidney disease
The nurse is caring for a patient complaining of orange-colored urine. The nurse suspects which of the following as the cause of the urine discoloration? a) Metronidazole (Flagyl) b) Pyridium (phenazopyridium HCl) c) Infection d) Phenytoin (Dilantin)
Pyridium (phenazopyridium HCl)
A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant? a) Recent history of streptococcal infection b) History of osteoporosis c) History of hyperparathyroidism d) Previous episode of acute pyelonephritis
Recent history of streptococcal infection
Which of the following hormones is secreted by the juxtaglomerular apparatus? a) Calcitonin b) Aldosterone c) Antidiuretic hormone (ADH) d) Renin
Renin
A diabetic patient with renal failure has been admitted to your unit. What is the most life-threatening effect of renal failure you will monitor for? a) Depletion of calcium b) Accumulation of wastes c) Retention of potassium d) Lack of blood pressure control
Retention of potassium
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a) Impaired urinary elimination b) Toileting self-care deficit c) Activity intolerance d) Risk for infection
Risk for infection
A 40-year-old client has just been diagnosed with acute pyelonephritis. What client education would you offer Mr. McDermott regarding fluids? a) No change in fluids needed b) Increase caffeinated beverages c) Significantly increase fluid intake d) Significantly decrease fluid intake
Significantly increase fluid intake
A 42-year-old woman comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware this is what type of incontinence? a) Functional incontinence b) Reflex incontinence c) Overflow incontinence d) Stress incontinence
Stress incontinence
Which nursing intervention should the nurse caring for the client with pyelonephritis implement? a) Administer acetaminophen (Tylenol). b) Teach client to increase fluid intake up to 3 liters per day. c) Straight catheterize the client every 4 to 6 hours. d) Restrict fluid intake to 1 liter per day.
Teach client to increase fluid intake up to 3 liters per day.
James Roth, a 63-year-old accountant, is a client on the hospital unit where you practice nursing. Mr. Roth has developed urinary incontinence and is beginning bladder training to regain control over his urine elimination. Why is the catheter being clamped and unclamped? a) To prevent bladder distention b) To promote normal bladder function c) To prevent urinary retention d) To promote urine production
To promote normal bladder function
You are providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include? a) Decrease exercise to conserve energy b) Measuring their intake and output of urine c) To weigh themselves on the same scale, at the same time of day, in the same clothing d) Restrict fluids to 500 cc per day to limit the need to urinate
To weigh themselves on the same scale, at the same time of day, in the same clothing
A group of students are reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract? a) Ureters b) Bladder c) Pelvic floor muscles d) Urethra
Ureters
A client regularly recognizes the sensation of needing to void but cannot control voiding in time to reach a toilet. How would the nurse document this type of incontinence? a) Reflex b) Urge c) Total d) Overflow
Urge
A client comes to the Emergency Department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? a) Ureteral stricture b) Urinary calculi c) Acute glomerulonephritis d) Renal cell carcinoma
Urinary calculi
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? a) Serum sodium level of 135 mEq/L b) Temperature of 99.2° F (37.3° C) c) Serum potassium level of 4.9 mEq/L d) Urine output of 20 ml/hour
Urine output of 20 ml/hour
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? a) Temperature of 100.2° F (37.8° C) b) Serum creatinine level of 1.2 mg/dl c) Urine output of 250 ml/24 hours d) Blood urea nitrogen (BUN) level of 22 mg/dl
Urine output of 250 ml/24 hours
The nurse is caring for a patient who describes his changes in voiding patterns. The patient states, "I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there does not seem to be a great deal of urine flow." What would the nurse expect this patient's physical assessment will likely reveal? a) Hematuria b) Renal failure c) Dehydration d) Urine retention
Urine retention
You are caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours postoperatively the patient verbalizes that the stoma is a dark purplish color. This nurse is aware of what? a) Vascular supply to the stoma may be compromised. b) The stoma is infected. c) The ostomy appliance around the stoma is too loose. d) The stoma is healthy.
Vascular supply to the stoma may be compromised
The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include: a) WBC 50 b) proteinuria c) RBC 3 d) glucose trace
WBC 50
A nurse is caring for an acutely ill patient. The nurse understands that the most accurate indicator of fluid loss or gain in an acutely ill patient is which of the following? a) Edema b) Blood pressure c) Weight d) Pulse rate
Weight
You are caring for a 68-year-old female client with type 1 diabetes mellitus whose physician has ordered hydrochlorothiazide. As a consequence of taking the diuretic, the client may need to a) increase her insulin dose b) decrease her insulin dose. c) decrease her consumption of potassium-rich foods. d) increase her consumption of sodium-rich foods
increase her insulin dose
Choice Multiple question - Select all answer choices that apply. Within the urology group where you practice nursing, clients with urinary tract infections are frequently seen by physicians. In a diagnosis of a lower urinary tract infection, which structures could be affected? Choose all correct options. a) Kidney b) Ureter c) Urethra d) Bladder
• Urethra • Bladder
