Deck 23: Urological Disorders

Question 1

Which statement about the pathophysiology of lower urinary tract infections (UTIs) is true?
1)The low osmolarity of urine diminishes bacterial viability in the bladder.
2)Any obstruction of urinary outflow decreases the bladder's resistance to bacterial infection.
3)Immunoglobulin A (IgA) facilitates adherence of bacteria to the bladder wall.
4)The presence of IgA in women decreases the ability to combat bacterial invasion of the bladder.

Answer 1

2

Question 2

Which information does the nurse provide to a client regarding the rate of recurrence of urolithiasis within 5 years after it occurs in a client for the first time? 1.35%
2)45%
3)52%
4)62%

Answer 2

1

Question 3

The nurse is providing care for an adult female client who states, "I think I have a urinary infection." The client presents with frequency, pain on urination, urgency, and fever. Which is the most important action for the nurse to perform?
1)Administers prescribed pain medication
2)Reports a possibility of pyelonephritis
3)Collects sterile urine sample for culture
4)Explains the necessity of increased fluids

Answer 3

2

Question 4

The nurse is teaching an in-service to nurses about the epidemiology of lower urinary tract infections (UTIs). Which statement made by an attending nurse indicates a need for clarification?
1)"Young adult women are more likely to suffer a lower UTI than are young adult men."
2)"Up to 40% of men in the United States, aged 20 to 40 years, have suffered a lower UTI."
3)"Benign prostate hyperplasia is a common cause of UTI in men older than 60 years of age."
4)"Approximately 50% of all women are believed to have had a UTI at some point in their lifetime."

Question 5

The nurse is preparing a client for urodynamic studies. Which information does the nurse tell the client the study will provide?
1)Determines the extent of bladder overfilling
2)Provides views of the arterial system of the kidneys
3)Observes the actual process of voiding
4)Excludes masses in the pelvis or abdomen

Question 6

Which observation is associated with the nonulcerative type of interstitial cystitis (IC)?
1)Thickening of bladder mucosa
2)Hemorrhages when the bladder is distended
3)Erythema on the inner bladder surface
4)Inflammation on the inner bladder wall

Question 7

Which is a risk factor for both bacterial and fungal urinary tract infections (UTIs)?
1)Urinary catheters
2)Diabetes mellitus
3)Antibiotic use
4)Stagnation of urine flow

Question 8

The nurse is reviewing epidemiology of urolithiasis. Which conclusion drawn by the nurse indicates the need for additional review?
1)"Urolithiasis occurs in 1 to 3 per 1,000 men."
2)"Recurrence of calculi is 52% at 10 years after the initial incident."
3)"Incidence of urolithiasis increases among men in their 20s."
4)"The incidence of urolithiasis in women peaks in the late 50s."

Question 9

The nurse is providing care for a client with a spinal cord injury who is having difficulty urinating. If the client is diagnosed with a calculi in the ureter, which type of stone does the nurse expect to be present?
1)Calcium
2)Struvite
3)Uric acid
4)Cystine

Question 10

During a health screening a client's urine culture shows a colony count of 110,000 bacteria. A second culture confirms the initial finding. The client does not exhibit manifestations of a urinary tract infection (UTI). Which nursing intervention does the nurse initiate?
1)Explaining the protocols for antibiotic therapy
2)Reinforcing the necessity of follow-up testing
3)Teaching the reasons to wipe from front to back
4)Focusing on the importance of good hand hygiene

Question 11

The nurse is counseling a female client who is experiencing urinary incontinence. Which intervention does the nurse initiate for this client?
1)Explanation and directions for Kegel's exercises
2)Importance of drinking more than 3 liters of fluid daily
3)Preparations needed before cystoscopic surgery
4)Benefits of sound wave therapy on the bladder

Question 12

Which type of stone, in the case of urolithiasis, is associated with indwelling catheters?
1)Calcium
2)Struvite
3)Uric acid
4)Cystine

Question 13

An older adult male client reports difficulty with urination. Which does the nurse identify as the most common cause of urinary obstruction in men older than 60 years of age?
1)Cancers of the pelvic organs
2)Kidney stones
3)Benign prostate hyperplasia
4)Genetic mutation

Question 14

Which option indicates the minimum amount of urine the kidney produces in 1 day? 1.250 mL
2)400 mL
3)550 mL
4)700 mL

Question 15

The nurse is caring for an older adult client with a history of spinal injury that has necessitated the long-term use of an indwelling urinary catheter. A routine urine culture reveals the presence of Proteus mirabilis. For which complication does the nurse carefully monitor?
1)Prostate hyperplasia
2)Urosepsis
3)Vesicoureteral reflux
4)Urinary retention

Question 16

The nurse provides teaching to a client about lower urinary tract infections (UTIs). Which statements made by the client demonstrate an understanding of the clinical presentation related to UTIs? Select all that apply.
1)"Hematuria is a classic symptom."
2)"Suprapubic tenderness is commonly seen."
3)"Fever is commonly associated with lower UTIs."
4)"Severe pain in the glans penis is common."
5)"Frequency is a common symptom of UTIs."

Question 17

The nurse is reviewing the pathology report on a kidney stone passed by a client. If the client's stone is identified as a cysteine stone, which type of client teaching does the nurse perform?
1)Hypercalcemia
2)Ingestion of proteins
3)A genetic disorder
4)Anatomical abnormalities

Question 18

The new nurse in the urology unit is comparing treatment methods for urolithiasis and urinary incontinence. Which statement made by the nurse indicates proper understanding of the treatment methods? Select all that apply.
1)"Local estrogen therapy is very effective in treating incontinence in women."
2)"Kegel's exercises are contraindicated in women with incontinence."
3)"A transurethral catheter is recommended for long-term catheterization in the treatment of incontinence."
4)"Botulinum toxin injection is used as a last resort in the treatment of urolithiasis."
5)"Hydrochlorothiazide is the drug of choice for the treatment of calcium stones."

Question 19

Which factors does a nurse identify as associated with the formation of struvite stones after comparing struvite stones with calcium stones? Select all that apply.
1)Hypoparathyroidism
2)Dietary factors
3)Anatomical abnormalities in the urinary tract
4)Presence of urease-producing organisms
5)Neurological disorders of the bladder

Question 20

Which diagnostic procedures are used for the detection of interstitial cystitis (IC) in females? Select all that apply.
1)Positive leukocyte esterase
2)Laparoscopy
3)Intravenous pyelogram (IVP)
4)Urodynamic studies
5)Hysteroscopy

Question 21

Arrange in order the steps that depict how untreated urolithiasis can lead to kidney failure. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Bleeding occurs when ureteral mucosa is sheared off.
2) Urine flow pushes the stone down the ureter.
3) Backward accumulation of pressure occurs into the renal pelvis.
4) Urine gets supersaturated with stone-forming salts.
5) Intense pain is caused by buildup of pressure and spasms within the ureter.

Question 22

The nurse is taking the history of a female client suspected of having urolithiasis. Which questions does the nurse ask in order to facilitate the diagnosis? Select all that apply.
1)"Do you have pain in the lower back?"
2)"Are you taking any over-the-counter herbal supplements?"
3)"Has anyone in your family ever had kidney stones?"
4)"Have you been diagnosed with gout?"
5)"Have you been diagnosed with endometriosis?"

Question 23

Arrange in order the events associated with the micturition reflex when voiding is not appropriate. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) The cerebral cortex initiates impulses that travel back down the spinal cord to inhibit the reflex arc.
2) Contraction of the bladder wall takes place.
3) The parasympathetic nerves stimulate the detrusor muscle.
4) The spinal cord sends nerve impulses up to the cerebral cortex.
5) The bladder wall stretches to accommodate the increasing volume of urine.

Question 24

Arrange in order the events associated with the obstruction of the urinary tract that eventually leads to renal failure. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Glomerular filtration rate (GFR) decreases.
2) Ischemia and incremental nephron loss take place.
3) Ureteral peristalsis is overcome by ureteral pressure.
4) The intraluminal ureteral pressure becomes elevated.
5) Increased hydrostatic pressures are transmitted directly to the nephron tubules.

Question 25

Which statement is true regarding the bacteria that frequently cause lower urinary tract infections (UTIs)? Select all that apply.
1)Proteus mirabilis causes 70% to 95% of upper and lower UTIs.
2)Uropathogenic bacteria thrive by resisting the alkaline nature of urine.
3)Escherichia coli changes the pH of urine by secreting urease.
4)Urease-producing bacteria enhance the formation of struvite staghorn calculi in the kidney.
5)In hospital-acquired infections, multidrug-resistant bacterial organisms often cause UTIs.