Chapter 53Urinary Dysfunction: Nursing Management My Nursing Test Banks

Chapter 53Urinary Dysfunction: Nursing Management

MULTIPLE CHOICE

1.A client is being evaluated for a lower urinary tract infection. Which of the following symptoms would the nurse expect to find?

1.

Cloudy urine

2.

Flank pain

3.

Nausea

4.

Temperature 102.9F

ANS: 1

Symptoms of a lower urinary tract infection include dysuria, frequency, urgency, hesitancy, cloudy urine, lower abdominal pain, chills, malaise, and mild fever (less than 101F). The other options are symptoms of upper urinary tract infection.

PTS:1DIF:Apply

REF:Urinary Tract Infection: Assessment with Clinical Manifestations

2.An elderly client is diagnosed with a urinary tract infection. Which of the following will the nurse most likely assess in this client?

1.

Jaundice

2.

Vomiting

3.

Poor eating habits

4.

Change in mental status

ANS: 4

The elderly tend to have symptoms of fever or hypothermia, poor appetite, lethargy, and a change in mental status. Newborns demonstrate jaundice. Infants can experience vomiting. Children tend to have poor eating habits.

PTS:1DIF:Apply

REF:Urinary Tract Infection: Assessment with Clinical Manifestations

3.A nurse is collecting a post-void residual urine volume for a client. Which of the following volumes would be abnormal?

1.

30 mL

2.

60 mL

3.

95 mL

4.

125 mL

ANS: 4

A residual volume of greater than 100 mL is abnormal. The other volumes would be considered within normal limits.

PTS: 1 DIF: Apply REF: Box 53-1 Summary of Diagnostic Tests for UTI

4.A client is prescribed trimethoprim-sulfamethoxazole for a urinary tract infection. Which of the following instructions would not be appropriate for this medication?

1.

Complete all the medication even if you feel better.

2.

Drink extra water during the day.

3.

Take on an empty stomach with water.

4.

Take with an antacid.

ANS: 4

This medication does not need to be taken with an antacid. Trimethoprim-sulfamethoxazole (Bactrim) should be taken on an empty stomach with water. The client should consume extra water to prevent sedimentation in the urine and calculus formation. All medication should be taken to treat and eliminate the infection.

PTS:1DIF:Apply

REF:Box 53-2 Common Medications Used with Patients with UTI

5.A client with a urinary tract infection is being discharged with a prescription for ciprofloxacin. The nurse should include which of the following discharge instructions?

1.

Do not take within 2 hours of antacid use.

2.

Limit fluids.

3.

Restrict activity

4.

Expect to be nauseated with this medication.

ANS: 1

Ciprofloxacin should not be administered within 2 hours of taking an antacid. The client does not need to limit fluids or restrict activity. Nausea is not always a side effect of this medication.

PTS:1DIF:Apply

REF:Box 53-2 Common Medications Used with Patients with UTI

6.A client is recovering from a cystoscopy. The nurse would expect to assess which of the following regarding the clients urine after the procedure?

1.

Anuria

2.

Blood clots

3.

Hematuria

4.

Pink-tinged

ANS: 4

The bladder and urethra are usually irritated as a result of the procedure. This causes pink-tinged urine. Large amounts of blood in the urine, anuria, or blood clots are not expected findings after this procedure.

PTS: 1 DIF: Analyze REF: Urinary Tract Infection: Diagnostic Tests

7.A client is being treated for interstitial cystitis. Which of the following medications would not be prescribed for this client?

1.

Cortisone acetate (Cortone)

2.

Dimethyl sulfoxide (DMSO)

3.

Pimecrolimus (Elidel)

4.

Polysulfate sodium (Elmiron)

ANS: 3

Pimecrolimus (Elidel) is for the treatment of atopic dermatitis. The other options are medications that could be prescribed for a client diagnosed with interstitial cystitis.

PTS:1DIF:Analyze

REF:Box 53-4 Common Medications Used with Patients with IC

8.After being diagnosed, a client asks the nurse What is pyelonephritis? The nurse should respond:

1.

Pyelonephritis is an infection of the bladder.

2.

Pyelonephritis is an infection of the urethra.

3.

Pyelonephritis is an infection of the prostate.

4.

Pyelonephritis is a common infection that needs to be treated to prevent complications.

ANS: 4

Pyelonephritis is an infection of the upper urinary tract. It may involve the ureters, the renal pelvis, and the papillary tips of the collecting ducts. Without treatment, pyelonephritis can cause renal damage. Pyelonephritis is not an infection of the bladder, urethra, or prostate.

PTS: 1 DIF: Apply REF: Pyelonephritis: Pathophysiology

9.The nurse is reviewing the health history of a client diagnosed with glomerulonephritis. Which of the medical conditions would be a risk factor for developing glomerulonephritis?

1.

Asthma

2.

Hypertension

3.

Recent strep throat

4.

Renal failure

ANS: 3

Recent Streptococcus infection can lead to the development of glomerulonephritis. Hypertension and renal failure does not cause glomerulonephritis, but they can result from glomerulonephritis. Asthma is unrelated.

PTS: 1 DIF: Analyze REF: Glomerulonephritis: Etiology

10.The nurse is assessing a client diagnosed with glomerulonephritis. Which of the following findings is consistent with this disorder?

1.

Brown urine

2.

Hip pain

3.

Hypotension

4.

Bradycardia

ANS: 1

Brown-, tea-, or cola-colored urine; flank pain; and periorbital edema are expected findings. Hypotension, hip pain, and bradycardia are not associated with this disorder.

PTS:1DIF:Apply

REF:Glomerulonephritis: Assessment with Clinical Manifestations

11.A client is diagnosed with nephrotic syndrome. Which of the following is the nurse most likely going to assess in this client?

1.

Glucosuria

2.

Proteinuria

3.

Hematuria

4.

Oliguria

ANS: 2

In the client diagnosed with nephrotic syndrome, there is an increase in protein in the urine. Hematuria and oliguria are uncommon assessment findings in this disorder. Glucosuria would be associated with a client diagnosed with diabetes mellitus.

PTS:1DIF:Apply

REF:Nephrotic Syndrome: Assessment with Clinical Manifestations

12.A client is surprised to learn that his acute pain is caused by a kidney stone. The nurse should instruct the client that the most common type of renal calculi is composed of:

1.

calcium.

2.

cystine.

3.

struvite.

4.

uric acid.

ANS: 1

Calcium-based stones (renal calculi) are the most common type of stone. Dietary measures should be taken to decrease the potential of developing another stone. Struvite stones are made of magnesium, phosphate, and ammonium and are usually staghorn in nature. Only 5% of renal stones are from uric acid. Cystine stones are associated with hereditary factors.

PTS:1DIF:Apply

REF: Urinary Tract Calculi (Urolithiasis): Pathophysiology

13.A client is hospitalized with kidney trauma resulting in lacerations to the parenchyma. Which of the following would be included in the management of this clients care?

1.

Bed rest with antibiotic therapy

2.

Restrict fluids

3.

Encourage early ambulation

4.

Nephrectomy

ANS: 1

In the case of parenchymal lacerations to the kidney, the client should be hospitalized, kept on bed rest, and provided with antibiotics until the urine clears. Restricting fluids and encouraging early ambulation would not be appropriate for this clients injuries. A nephrectomy is not indicated for this type of kidney trauma.

PTS:1DIF:Analyze

REF: Renal System Trauma: Planning and Implementation

14.The nurse is reviewing a clients risk factors for the development of renal cancer. Which of the following would be considered a risk factor for the development of this disease?

1.

Cigarette smoking

2.

Being underweight

3.

History of hypotension

4.

History of type 2 diabetes mellitus

ANS: 1

Cigarettes smoking doubles the risk of renal cell carcinoma. Obesity, not being underweight, is a risk factor. Hypertension, not hypotension, is a risk factor. Type 2 diabetes mellitus is not a risk factor for the development of the disease.

PTS: 1 DIF: Analyze REF: Box 53-7 Causes for Renal Cancer

15.A client is scheduled for surgery to remove the bladder and create a urinary diversion. If the client has a history of complications after surgery, the type of urinary diversion that might be indicated would be:

1.

continent diversion with a surgical opening to the abdomen.

2.

continent diversion with a replacement bladder made out of intestine.

3.

noncontinent diversion with anastomose of the ureters to the anterior wall.

4.

noncontinent diversion with anastomose of the ureters to the rectum.

ANS: 3

Noncontinent urinary diversions are considered less technically demanding and are associated with the fewest postoperative complications. This type of diversion is performed by anastomosing the ureters to the anterior body wall. The rectum is not used as a site to anastomose the ureters. Continent diversions have more postoperative complications.

PTS: 1 DIF: Analyze REF: Urinary Diversion: Surgery

MULTIPLE RESPONSE

1.The nurse is instructing a client on ways to prevent urinary tract infections. Which of the following should be included in these instructions? (Select all that apply.)

1.

Drink cranberry juice.

2.

Drink eight glasses of water.

3.

Take baths instead of showers.

4.

Urinate before and after intercourse.

5.

In women, wipe back to front after voiding.

6.

Take the prescribed medication until the symptoms subside

ANS: 1, 2, 4

Interventions to reduce the onset of urinary tract infections include drinking cranberry juice and 6 to 8 glasses of water each day. The client should be instructed to urinate before and after intercourse. Women should wipe front to back when completing perineal care because of the close proximity of the urethra to the vagina and anus. Taking showers instead of baths helps prevent bacteria from entering the urethra while bathing.  The client should be instructed to take the entire course of the prescribed medication and not just until the symptoms subside.

PTS:1DIF:Apply

REF: Patient Playbook: Considerations for Patient Teaching

2.A client is diagnosed with an upper urinary tract infection. Which structures are affected by this infection? (Select all that apply.)

1.

Bladder

2.

Kidney

3.

Prostate

4.

Ureters

5.

Urethra

6.

Rectum

ANS: 2, 4

Upper urinary tract infections are of the ureters or kidney. Lower urinary tract infections are infections of the urethra, bladder, or prostate. The rectum is not affected by an upper urinary tract infection.

PTS: 1 DIF: Apply REF: Urinary Tract Infection: Pathophysiology

3.The nurse is instructing a client on ways to reduce formation of future kidney stones. Which of the following should be included in these instructions? (Select all that apply.)

1.

Drink plenty of fluids.

2.

Drink soft drinks.

3.

Limit the intake of spinach.

4.

Take a vitamin B-12 supplement or eat foods rich in vitamin B-12.

5.

Take a magnesium citrate supplement or eating foods rich in magnesium citrate.

6.

Adjust calcium intake.

ANS: 1, 3, 5, 6

Instructions to reduce the formation of kidney stones in the future include: drink plenty of fluids; avoid soft drinks; limit the intake of spinach to reduce urinary oxalate levels; vitamin B6 helps reduce the formation of kidney stones; magnesium citrate helps prevent the formation of kidney stones; and calcium intake should be adjusted to prevent the formation of kidney stones.

PTS: 1 DIF: Apply REF: Patient Playbook: Self-Care Nutrition Advice

4.A client is diagnosed with renal vein thrombosis. The nurse realizes that which of the following could be indicated in this clients plan of care? (Select all that apply.)

1.

Corticosteroids

2.

Nephrectomy

3.

Anticoagulants

4.

Antihypertensives

5.

Surgical intervention

6.

Antibiotics

ANS: 1, 3, 5

Management of the client diagnosed with renal vein thrombosis includes corticosteroids, anticoagulants, and surgical removal of the thrombi. Nephrectomy, antihypertensives, and antibiotics are not indicated in the treatment of this disorder.

PTS: 1 DIF: Analyze REF: Table 53-6 Renal Vascular Disorders

5.The nurse is assessing a client for type of urinary incontinence. Which of the following are considered types of this disorder? (Select all that apply.)

1.

Stress

2.

Radical

3.

Urge

4.

Temporary

5.

Overflow

6.

Functional

ANS: 1, 3, 5, 6

The four types of incontinence are stress, urge, overflow, and functional. Radical and temporary are not types of bladder incontinence.

PTS: 1 DIF: Analyze REF: Box 53-9 Types of Incontinence

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