Question 1

The nurse is caring for a client who has had left-sided extracorporeal shock wave lithotripsy. Which of the following findings is most important to report to the health care provider?

Accepted Answer

A) Blood in urine 
B) Left flank pain 
C) Left flank bruising 
D) Drop in urine output

Question 2

The nurse is admitting a client with new onset nephrotic syndrome. Which of the following findings should the nurse expect to assess related to this illness?

Accepted Answer

A) Poor skin turgor 
B) High urine ketones 
C) Recent weight gain 
D) Low blood pressure

Question 3

The nurse is caring for a client who has had a segmental cystectomy. Which of the following information should the nurse include in the postoperative teaching for the client?

Accepted Answer

A) Limit fluid intake for at least 7 days. 
B) Urine should be amber and not contain blood clots. 
C) In about one week urine will have rust-coloured flecks. 
D) Avoid sitz baths for a week after surgery.

Question 4

The nurse is caring for a client following an open loop resection and fulguration of the bladder who is unable to void. Which of the following actions should the nurse implement first?

Accepted Answer

A) Insert a straight catheter and drain the bladder. 
B) Assist the client to take a 15-minute sitz bath. 
C) Encourage the client to drink several glasses of water. 
D) Teach the client how to do isometric perineal exercises.

Question 5

The nurse is teaching a client with interstitial cystitis about management of the condition. Which of the following client statements indicate that further instruction is required?

Accepted Answer

A) "I will have to stop having coffee and orange juice for breakfast." 
B) "I should start taking a high potency multiple vitamin every morning." 
C) "I will buy some calcium glycerophosphate (Prelief) at the pharmacy." 
D) "I should call the doctor about increased bladder pain or odorous urine."

Question 6

The nurse is caring for a young adult female client who is diagnosed with polycystic kidney disease. Which of the following information should the nurse include in teaching at this time?

Accepted Answer

A) Importance of genetic counselling 
B) Complications of renal transplantation 
C) Methods for treating chronic and severe pain 
D) Differences between hemodialysis and peritoneal dialysis

Question 7

The nurse is caring for a client whose renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, which of the following foods should the nurse teach the client to avoid eating?

Accepted Answer

A) Milk and dairy products 
B) Legumes and dried fruits 
C) Organ meats and sardines 
D) Spinach, chocolate, and tea

Question 8

The nurse is obtaining the health history for a client who smokes two packs of cigarettes daily. Which of the following conditions should the nurse include in the teaching plan that the client is at an increased risk for developing?

Accepted Answer

A) Kidney stones 
B) Bladder cancer 
C) Bladder infection 
D) Interstitial cystitis

Question 9

The nurse is caring for a client who has bladder cancer and had a cystectomy with creation of an Indiana pouch. Which of the following topics should the nurse include in client teaching?

Accepted Answer

A) Application of ostomy appliances 
B) Catheterization technique and schedule 
C) Analgesic use before emptying the pouch 
D) Use of barrier products for skin protection

Question 10

The nurse is caring for a client who is two days postoperative with an ileal conduit, and the client will not look at the stoma or participate in care, and insists that no one but the ostomy nurse specialist care for the stoma. Which of the following nursingdiagnoses best reflects the data that the nurse has obtained?

Accepted Answer

A) Anxiety related to threat to current status (effects of procedure on lifestyle) 
B) Disturbed body image related to alteration in self-perception 
C) Ineffective coping related to insufficient sense of control 
D) Ineffective denial related to ineffective coping strategies (denial of altered body function)

Question 11

Which of the following findings by the nurse for a client admitted with glomerulonephritis indicates that treatment has been effective?

Accepted Answer

A) The client denies pain with voiding. 
B) The urine dipstick is negative for nitrites. 
C) Peripheral and periorbital edema is resolved. 
D) The antistreptolysin-O (ASO) titre is decreased.

Question 12

The nurse is admitting a client with acute glomerulonephritis. Which of the following assessments is most important for the nurse to include?

Accepted Answer

A) Recent sore throat and fever 
B) History of high blood pressure 
C) Frequency of bladder infections 
D) Family history of kidney stones

Question 13

The nurse is caring for a client with benign prostatic hyperplasia who has chills, fever, and is vomiting. Which of the following findings by the nurse is most helpful in determining whether the client has an upper urinary tract infection (UTI)?

Accepted Answer

A) Suprapubic pain 
B) Bladder distention 
C) Foul-smelling urine 
D) Costovertebral tenderness

Question 14

The nurse is caring for a client who has had an ureterolithotomy with a left ureteral catheter and a urethral catheter in place. Which of the following actions should the nurse include in the plan of care?

Accepted Answer

A) Provide education about home care for both catheters. 
B) Apply continuous steady tension to the ureteral catheter. 
C) Clamp the ureteral catheter unless output from the urethral catheter stops. 
D) Call the health care provider if the ureteral catheter output drops suddenly.

Question 15

The nurse is admitting an older-adult client with dehydration who is confused and incontinent of urine. Which of the following nursing actions is best to include in the plan of care?

Accepted Answer

A) Apply absorbent incontinent pads. 
B) Restrict fluids after the evening meal. 
C) Insert an in-dwelling catheter until the symptoms have resolved. 
D) Assist the client to the bathroom every 2 hours during the day.

Question 16

The nurse is caring for a client who is diagnosed with nephrotic syndrome and has 3+ ankle and leg edema with ascites. Which of the following nursing diagnoses is a priority for the client?

Accepted Answer

A) Excess fluid volume related to low serum protein levels 
B) Activity intolerance related to increased weight and fatigue 
C) Disturbed body image related to peripheral edema and ascites 
D) Altered nutrition: less than required related to protein restriction

Question 17

The nurse is caring for a client who had a nephrectomy after having massive trauma to the kidney. Which of the following assessment findings obtained postoperatively is most important to communicate to the surgeon?

Accepted Answer

A) Blood pressure is 102/58. 
B) Incisional pain level is 8/10. 
C) Urine output is 20 mL/hour for 2 hours. 
D) Crackles are heard at both lung bases.

Question 18

Which of the following findings for a client who has had a cystectomy with an ileal conduit the previous day is most important for the nurse to communicate to the health care provider?

Accepted Answer

A) Cloudy appearing urine 
B) Hypotonic bowel sounds 
C) Heart rate 102 beats/minute 
D) Continuous drainage from stoma

Question 19

The nurse is assessing a client who has a lower urinary tract infection (UTI). Which of the following symptoms should the nurse ask about initially?

Accepted Answer

A) Nausea 
B) Flank pain 
C) Poor urine output 
D) Pain with urination

Exam 48: Nursing Management Renal and Urologic Problems