Deck 17: The Genitourinary and Renal Systems

Question 1

An older patient who is postmenopausal is experiencing uterine bleeding. Which action would be appropriate for the nurse to take at this time?
1) Provide hygienic care.
2) Collect a urine specimen.
3) Direct the patient for evaluation for endometrial cancer.
4) Instruct the patient on normal changes of the reproductive system in the elderly.

Answer 1

3

Question 2

The nurse reviewing the laboratory results for an older client notes the specific gravity is below normal. The nurse's assessment findings include a temperature of 98.9℉, heart rate 102 bpm, B/P 110/64, and respirations 20/min. Which condition does the nurse suspect the client is experiencing?
1) Dehydration
2) Hypernatremia
3) Glomerulonephritis
4) Hypokalemia

Answer 2

1

Question 3

The nurse has completed teaching about the methods for alleviating stress incontinence for an older client. Which statement made by the client indicates that further teaching is needed?
1) "I will make sure to include citrus juice with my breakfast."
2) "My family is going to help me to remember to go to the bathroom."
3) "I am going to practice Kegel exercises at least 3 days a week."
4) "I will keep a chart to help me track the scheduled times I should void."

Answer 3

1

Question 4

The nurse is caring for a client who states, "I feel fine other than I have been frequently getting up at night to go to the bathroom." Which clinical manifestation is this client experiencing?
1) Fluid overload
2) Increased glycosuria
3) Hormonal imbalance
4) Age-related changes

Question 5

The nurse is caring for an older client with acute renal failure. Which statement made by the client is reflective of the disease?
1) "I feel so dizzy when I get up out of bed."
2) "I have been getting frequent headaches lately."
3) "I do not feel like eating, I have not had an appetite."
4) "I could not get my slippers on my feet this morning."

Question 6

The nurse is providing teaching for reproductive cancer screenings for an older female client. Which information will the nurse include in the teaching?
1) "A pelvic ultrasound should be done annually."
2) "Obtain an CA-125 on your next annual exam."
3) "Pap smears can be eliminated if the previous one was normal."
4) "Either a mammogram or clinical breast exam should be done annually."

Question 7

The nurse is reviewing the chart of an older adult client with acute renal failure. Which assessment finding is most likely?
1) Excoriated areas on the skin
2) Muscle weakness and cramping
3) +3 edema in the lower extremities
4) Weight loss of 13 pounds in a month

Question 8

An older patient who is a widower explains that routine sexual encounters remain an important part of his life. What teaching should the nurse provide to this patient?
1) Actions to ensure safe sex
2) Importance of an adequate fluid intake
3) Reasons to abstain from sexual activity
4) Interventions to prevent erectile dysfunction

Question 9

The nurse is obtaining a history from an older male client with benign prostatic hypertrophy (BPH) experiencing urinary retention. Which question is the most important to include in the assessment?
1) "Do you take any medications?"
2) "Have you experienced pain with urination?"
3) "Are you experiencing erectile dysfunction?"
4) "Are you urinating more than 8 times in 24 hours?"

Question 10

The nurse teaches the client about a new prescription for hormone replacement therapy. Which information in the client history most concerns the nurse?
1) Mother had breast cancer
2) History of oral contraceptives for fifteen years
3) Anticoagulant therapy for the past six months
4) Treatment for hypercholesterolemia

Question 11

The nurse is providing teaching about lifestyle changes for an older client with BPH. Which statement made by the client indicates further teaching is required?
1) "I will avoid drinking alcohol."
2) "I will increase the fiber in my diet."
3) "I will decrease my intake of fluids."
4) "I will no longer take any antihistamines."

Question 12

The nurse has administered a beta blocker to an older adult client. Which finding alerts the nurse that the client may be experiencing toxicity?
1) Hypokalemia
2) Hypoglycemia
3) Hyponatremia
4) Hypocalcemia

Question 13

The nurse preceptor is providing information for a novice nurse on the normal changes in the renal system of an older female adult. Which statement will the preceptor include in the teaching?
1) "Hyperglycemia is common in the older adult."
2) "The older adult experiences overflow incontinence."
3) "The older adult experiences chronic urinary tract infections."
4) "Incontinence occurs in the older adult due to the loss of bladder capacity."

Question 14

The nurse is providing teaching for an older female client about decreasing the risk of a urinary tract infection. Which information will the nurse include in the teaching?
1) Use powder to keep dry
2) Douche after intercourse
3) Drink cranberry juice daily
4) Take showers instead of baths

Question 15

The nurse is teaching an older adult client how to perform Kegel exercises. Which information will the nurse include in the teaching?
1) "Tighten your perineal muscles."
2) "Tighten your buttocks, perineum, and thighs."
3) "Tighten the muscles of your perineum and buttocks."
4) "Tighten the muscles of your abdomen, buttocks, and perineum."

Question 16

The nurse is obtaining a sexual history from an older male client. Which statement made by the client is most concerning to the nurse?
1) "I just don't want to have sex anymore."
2) "Sex is over much too quickly these days."
3) "My erections are not as firm anymore."
4) "I would like to be able to have sex more often."

Question 17

A 60-year-old male patient is planning to marry a woman in her 30s and is concerned about the need for contraception. How should the nurse respond to this patient?
1) "After age 50, you are considered virtually infertile."
2) "It is still possible at this time of life to father a child."
3) "You should have a vasectomy to avoid fathering a child."
4) "You will only need to be concerned about fertility for another few years."

Question 18

The nurse cares for a client with urinary incontinence. Which client statement most concerns the nurse?
1) "Every time I cough or sneeze, I urinate on myself a little."
2) "I have never had urinary incontinence before this week."
3) "I experience a strong urge to urinate but cannot make it to the bathroom."
4) "I have had several accidents because I just couldn't get up fast enough."

Question 19

An older female patient asks the home care nurse what can be done to help with painful intercourse. What recommendations should the nurse make to the patient? Select all that apply.
1) Avoid intercourse.
2) Decrease the frequency of intercourse.
3) Use vaginal lubricants during intercourse.
4) Use the hand to guide the penis into the vagina.
5) Tolerate the problem because it is a normal part of aging.

Question 20

The nurse is having difficulty inserting a urinary catheter in an older female client. Which position should the nurse place the client in to facilitate the insertion of the catheter?
1) Lithotomy with head of bed at 20 degrees
2) Side-lying, lifting up the buttock
3) Side-lying with both knees flexed
4) Supine with legs flexed and knees apart

Question 21

The nurse is teaching bladder retraining to an older client recovering from bladder surgery. Which statement by the client indicates an understanding of the teaching?
1) "I will gradually space my voiding times to longer periods."
2) "I will increase my fluids so my bladder will fill up faster."
3) "I will try and hold my urine as long as possible to help stretch my bladder."
4) "I will make sure that I empty my bladder every two hours while I am awake."

Question 22

The preceptor and novice nurse care for a male older adult client diagnosed with prostate cancer. The novice nurse asks, "Why is there no treatment ordered for this client?" Which response should the preceptor provide?
1) "The cancer is slow growing, so no treatment will be provided."
2) "The treatment significantly diminishes the patient's quality of life."
3) "The treatment available is only used to reduce the symptoms of the disease."
4) "Older patients that receive treatment have a significant risk for renal failure."

Question 23

The nurse is monitoring an older adult at risk for a urinary tract infection. Which assessment finding is most frequently associated with a symptomatic urinary tract infection in an older adult?
1) Urgency
2) Frequency
3) Confusion
4) Incontinence

Question 24

The nurse cares for a client with benign prostatic hyperplasia (BPH). Which statement most concerns the nurse?
1) "I take saw palmetto everyday with my regular medications."
2) "Getting up to go to the bathroom every two hours is annoying."
3) "Occasionally, I experience pain after ejaculation."
4) "The pain in my hip has been keeping me up at night."

Question 25

The nurse is planning a seminar on ways to ensure healthy genitourinary functioning when aging. What information should the nurse include in this presentation? Select all that apply.
1) Drink plenty of water.
2) Expect to develop urinary incontinence.
3) Be aware of responses to new medications.
4) It is normal to continue to desire sexual activity.
5) Take steps to prevent sexually transmitted infections.