Question 1

The nurse determines that further instruction is needed for a patient with interstitial cystitis when the patient says which of the following?

Accepted Answer

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

Question 2

A 28-year-old male patient is diagnosed with polycystic kidney disease.Which information is most appropriate for the nurse to include in teaching at this time?

Accepted Answer

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

Question 3

A 55-year-old woman admitted for shoulder surgery asks the nurse for a perineal pad,stating that laughing or coughing causes leakage of urine.Which intervention is most appropriate to include in the care plan?

Accepted Answer

A)   Assist the patient to the bathroom q3hr.
B)   Place a commode at the patient's bedside.
C)   Demonstrate how to perform the Credé maneuver.
D)   Teach the patient how to perform Kegel exercises. D

Question 4

A 58-year-old male patient who weighs 242 lb (110 kg)undergoes a nephrectomy for massive kidney trauma due to a motor vehicle crash.Which postoperative assessment finding is most important to communicate to the surgeon?

Accepted Answer

A)   Blood pressure is 102/58.
B)   Urine output is 20 mL/hr for 2 hours.
C)   Incisional pain level is reported as 9/10.
D)   Crackles are heard at bilateral lung bases.

Question 5

Which action will the nurse anticipate taking for an otherwise healthy 50-year-old who has just been diagnosed with Stage 1 renal cell carcinoma?

Accepted Answer

A)   Prepare patient for a renal biopsy.
B)   Provide preoperative teaching about nephrectomy.
C)   Teach the patient about chemotherapy medications.
D)   Schedule for a follow-up appointment in 3 months.

Question 6

A 63-year-old male patient had a cystectomy with an ileal conduit yesterday.Which new assessment data is most important for the nurse to communicate to the physician?

Accepted Answer

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

Question 7

It is most important that the nurse ask a patient admitted with acute glomerulonephritis about

Accepted Answer

A)   history of kidney stones.
B)   recent sore throat and fever.
C)   history of high blood pressure.
D)   frequency of bladder infections.

Question 8

Which information from a patient who had a transurethral resection with fulguration for bladder cancer 3 days ago is most important to report to the health care provider?

Accepted Answer

A)   The patient is voiding every 4 hours.
B)   The patient is using opioids for pain.
C)   The patient has seen clots in the urine.
D)   The patient is anxious about the cancer.

Question 9

A 56-year-old female patient is admitted to the hospital with new onset nephrotic syndrome.Which assessment data will the nurse expect?

Accepted Answer

A)   Poor skin turgor
B)   Recent weight gain
C)   Elevated urine ketones
D)   Decreased blood pressure

Question 10

After a ureterolithotomy,a female patient has a left ureteral catheter and a urethral catheter in place.Which action will the nurse include in the plan of care?

Accepted Answer

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

Question 11

Which finding by the nurse will be most helpful in determining whether a 67-year-old patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)?

Accepted Answer

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

Question 12

A 68-year-old male patient who has bladder cancer had a cystectomy with creation of an Indiana pouch.Which topic will be included in patient teaching?

Accepted Answer

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

Question 13

When preparing a female patient with bladder cancer for intravesical chemotherapy,the nurse will teach about

Accepted Answer

A)   premedicating to prevent nausea.
B)   obtaining wigs and scarves to wear.
C)   emptying the bladder before the medication.
D)   maintaining oral care during the treatments.

Question 14

A 58-year-old male patient who is diagnosed with nephrotic syndrome has ascites and 4+ leg edema.Which nursing diagnosis is a priority for the patient?

Accepted Answer

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

Question 15

Which information about a patient with Goodpasture syndrome requires the most rapid action by the nurse?

Accepted Answer

A)   Blood urea nitrogen level is 70 mg/dL.
B)   Urine output over the last 2 hours is 30 mL.
C)   Audible crackles bilaterally over the posterior chest to the midscapular level.
D)   Elevated level of antiglomerular basement membrane (anti-GBM)  antibodies.

Question 16

A patient has been diagnosed with urinary tract calculi that are high in uric acid.Which foods will the nurse teach the patient to avoid (select all that apply)? 2.

Accepted Answer

A)   Milk
B)   Liver
C)   Spinach
D)   Chicken
E)   Cabbage F)  Chocolate

Question 17

A patient who had surgery for creation of an ileal conduit 3 days ago will not look at the stoma and requests that only the ostomy nurse specialist does the stoma care.The nurse identifies a nursing diagnosis of

Accepted Answer

A)   anxiety related to effects of procedure on lifestyle.
B)   disturbed body image related to change in function.
C)   readiness for enhanced coping related to need for information.
D)   self-care deficit, toileting, related to denial of altered body function.

Question 18

After change-of-shift report,which patient should the nurse assess first?

Accepted Answer

A)   Patient with a urethral stricture who has not voided for 12 hours
B)   Patient who has cloudy urine after orthotopic bladder reconstruction
C)   Patient with polycystic kidney disease whose blood pressure is 186/98 mm Hg
D)   Patient who voided bright red urine immediately after returning from lithotripsy

Question 19

A 76-year-old with benign prostatic hyperplasia (BPH)is agitated and confused,with a markedly distended bladder.Which intervention prescribed by the health care provider should the nurse implement first?

Accepted Answer

A)   Insert a urinary retention catheter.
B)   Schedule an intravenous pyelogram (IVP) .
C)   Draw blood for a serum creatinine level.
D)   Administer lorazepam (Ativan)  0.5 mg PO.

Question 20

A patient in the urology clinic is diagnosed with monilial urethritis.Which action will the nurse include in the plan of care?

Accepted Answer

A)   Teach the patient about the use of antifungal medications.
B)   Tell the patient to avoid tub baths until the symptoms resolve.
C)   Instruct the patient to refer recent sexual partners for treatment.
D)   Teach the patient to avoid nonsteroidal antiinflammatory drugs (NSAIDs) .

Exam 42: Nursing Management: Renal and Urological Problems