Deck 35: Care of Patients With Disorders of the Urinary System

Question 1

The nurse is reviewing the history and physical examination of a 22-year-old man hospitalized for acute glomerulonephritis.The nurse recognizes the significant information of the probable etiology of this disease as:

A)a recent trip to Mexico.
B)unprotected sexual activity.
C)a recent "strep throat" infection.
D)a recent protocol of ciprofloxacin (Cipro).

Answer 1

a recent "strep throat" infection.

Question 2

To relieve hydronephrosis,the patient has undergone a right nephrostomy.The nursing responsibility in this condition is:

A)keeping the patient positioned on the unaffected side.
B)irrigating the nephrostomy tube.
C)assessing urinary output from the left kidney.
D)keeping the nephrostomy tube clamped.

Answer 2

assessing urinary output from the left kidney.

Question 3

During the review of the medications to be administered,the nurse notes that a patient has been prescribed liquid nitrofurantoin (Furadantin).The nurse will add an intervention to the nursing care plan to:

A)give the drug on an empty stomach.
B)rinse the mouth after administration.
C)schedule a morning dose to avoid insomnia.
D)assess the urine for hematuria.

Answer 3

rinse the mouth after administration.

Question 4

After an instillation of doxorubicin (Adriamycin)into the bladder for treatment of cancer in situ,the patient is then:

A)positioned on his back for 2 hours.
B)seated upright for 2 hours.
C)moved from side to side and from prone to supine.
D)requested to ambulate for 5 minutes every 15 minutes for 2 hours.

Question 5

When a 90-year-old resident in a long-term care facility becomes progressively confused and irritable,the nurse should:

A)request an order for a urinalysis.
B)hold antihypertensive medications.
C)assess for fecal impaction.
D)notify the charge nurse.

Question 6

The nurse cautions a young man who is taking ciprofloxacin (Cipro)for pyelonephritis to take all the prescription as directed in order to prevent recurrence,which can cause:

A)scarring of the renal pelvis.
B)chronic pyelonephritis.
C)glomerulonephritis.
D)obstruction of the ureters.

Question 7

The nurse explains that as chronic glomerulonephritis develops,the kidney:

A)swells.
B)atrophies.
C)becomes increasingly scarred.
D)produces copious urine.

Question 8

The nurse is caring for a patient who is being treated for acute pyelonephritis.When performing the assessment,the nurse correctly recognizes that which symptom is consistent with the early stages of the disease?

A)Smoky-colored urine
B)Low-grade fever
C)Weakness
D)Nausea

Question 9

When the patient enters into nephrotic syndrome after an exacerbation of glomerulonephritis,the nurse would expect to see:

A)decreased serum albumin.
B)decreased lipids.
C)decreased proteinuria.
D)increased hematuria.

Question 10

The nurse evaluates a need for further instruction about a sodium-restricted diet when the patient with glomerulonephritis says:

A)"I won't add salt to my food."
B)"I'm glad I can still drink carbonated drinks."
C)"I will not eat processed meats, like hot dogs."
D)"I'm going to miss eating potato chips."

Question 11

A patient who has a kidney stone lodged in the ureter questions why it must be removed.What response by the nurse is most appropriate?

A)"If the stone is not promptly removed, you will continue to have blood in your urine."
B)"You may experience a condition known as hydronephrosis, which will result in increased pressure in your renal structures above the stone."
C)"Keeping the stone in your body may result in a condition called glomerulonephritis."
D)"You may experience scarring of the renal structures and a condition known as nephrotic syndrome may result."

Question 12

Before hemodialysis,the nurse will withhold:

A)anticoagulants.
B)antacids.
C)antianxiety agents.
D)antibiotics.

Question 13

The nurse is caring for a child suspected of having acute glomerulonephritis.When reviewing the data collected,the nurse is most likely to note what in the health history?

A)Recent upper respiratory infection
B)Recent outpatient surgery
C)History of asthma
D)Recent history of gastroenteritis

Question 14

A 25-year-old man comes to the college clinic with fever of 101° F and pain in the flank radiating into the thigh and genitals.He complains of nausea.The nurse recognizes these complaints as being indicative of:

A)urethritis.
B)pyelonephritis.
C)glomerulonephritis.
D)cystitis.

Question 15

The nurse is caring for a patient diagnosed with glomerulonephritis.The nurse notes that the patient is feeling confined with reports of feeling "bored and caged." During the interaction,the patient asks when he can resume his normal activities.The nurse clarifies that bed rest is enforced until:

A)medication has been in effect for 2 weeks.
B)serum sodium level decreases to 140 mEq/L.
C)weight has returned to the preillness level.
D)hypertension and hematuria are gone.

Question 16

A patient who had a bladder repair following an injury from an automobile accident complains of pain.Which action would be considered an independent nursing intervention that does not require a physician's order?

A)Give an analgesic medication.
B)Apply a cold compress to the surgical site.
C)Give a muscle relaxant.
D)Irrigate the drainage tube.

Question 17

Plasmapheresis has been ordered for the patient diagnosed with glomerulonephritis.Before the procedure,the patient correctly reports that the procedure will help her when she states that it will:

A)"Identify specific organisms causing my disease."
B)"Remove autoantibodies causing the disease."
C)"Clear the tubules of the nephron for better filtration."
D)"Cause vasodilation and reduce hypertension."

Question 18

The nurse assessing a 50-year-old woman who was involved in a car accident 2 hours ago finds marked tenderness and spasm in the suprapubic area and a nonpulsating mass.The nurse interprets these findings as indication of:

A)bladder trauma.
B)a damaged kidney.
C)a urethral tear.
D)an obstructed bladder neck.

Question 19

The nurse is discussing alternative therapies with a patient who has had repeated urinary tract infections (UTIs)over the past year.The patient asks the nurse if there are any foods that might help her to potentially avoid developing more infections.What response by the nurse is most appropriate?

A)"Drinking lots of water is about all you can do to avoid getting another urinary tract infection."
B)"There are many rumors out about preventative foods and drinks but none are proven at this time."
C)"Studies show support for including vitamin C in the diet to help avoid urinary tract infections."
D)"Increasing the amount of leafy green vegetables in your daily diet is very helpful in preventing urinary tract infections."

Question 20

When a 25-year-old woman comes to the emergency department with nonspecific urethritis,the nurse is prompted to inquire about the patient's use of:

A)tight-fitting underwear.
B)alcohol consumption.
C)bath salts.
D)bicycle exercise.

Question 21

When a patient with a urinary tract infection (UTI)is placed on cefazolin (Ancef),the nurse will monitor for: (Select all that apply.)

A)vaginitis.
B)decreased clotting time.
C)arrhythmias.
D)rash.
E)confusion.

Question 22

Matching
The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

Hypovolemic shock

A)Prerenal ARF
B)Intrarenal ARF
C)Postrenal ARF

Question 23

A patient has been admitted to the acute care facility to rule out glomerulonephritis.Assessment findings that are supportive of the potential diagnosis include: (Select all that apply.)

A)flank pain.
B)hematuria.
C)periorbital edema.
D)decrease in blood urea nitrogen (BUN) and creatinine.
E)hypertension.

Question 24

Matching
The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

Ureteral obstruction

A)Prerenal ARF
B)Intrarenal ARF
C)Postrenal ARF

Question 25

Matching
The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

Prostate hypertrophy

A)Prerenal ARF
B)Intrarenal ARF
C)Postrenal ARF

Question 26

The nurse is aware that 80% of urinary tract infections (UTIs)in females are the result of contamination from __________.

Question 27

The nurse would question an order for carbenicillin for a patient with a urinary infection if the patient is: (Select all that apply.)

A)over 80 years of age.
B)allergic to penicillin.
C)taking warfarin.
D)taking oral contraceptives.
E)hypertensive.

Question 28

Matching
The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

Vascular changes related to diabetes mellitus

A)Prerenal ARF
B)Intrarenal ARF
C)Postrenal ARF

Question 29

The nurse is collecting the health history of a patient who has had multiple episodes of renal calculi formation.Which findings place the patient at an increased risk for the development of the renal calculi? (Select all that apply.)

A)Uric acid crystals in urine
B)Frequent bacterial urinary infections
C)Inadequate fluid intake
D)Prolonged bed rest
E)Tumor of parathyroid gland
F)None of the above.

Question 30

The nurse caring for a patient who has just had an arteriovenous (AV)access created in his right forearm this morning should assess: (Select all that apply.)

A)for a bruit on auscultation of the AV site.
B)capillary refill in the left hand.
C)blood pressure in the right arm.
D)adequate elevation of the right arm.
E)clotting of the AV access.

Question 31

Matching
The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

Cardiogenic shock

A)Prerenal ARF
B)Intrarenal ARF
C)Postrenal ARF

Question 32

The home health nurse recognizes uremic signs in a patient with chronic renal failure,which include: (Select all that apply.)

A)restless legs syndrome.
B)dry, scaly skin.
C)urea crystals in eyebrows.
D)muscle cramps.
E)hypotension.

Question 33

While the patient is on plasmapheresis,the nurse should monitor for: (Select all that apply.)

A)an allergic reaction.
B)bleeding at the puncture site.
C)a bruit at the shunt site.
D)decreasing blood pressure.
E)signs of hyperkalemia.