Deck 4: Genitourinary

Question 1

Chin is scheduled for a voiding cystogram. Which nursing intervention would be essential to carry out several hours before the test?

A)Maintaining NPO status
B)Medicating with urinary antiseptics
C)Administering bowel preparations
D)Forcing fluids

Answer 1

Forcing fluids

Question 2

Rodriguez is to undergo a vasectomy the next day. The nurse discussed with him important points after the operation is done. Which of the following instructions should the nurse include in her health teaching?

A)No sexual activity for 2 weeks
B)Application of ice for pain or swelling
C)Bed rest for several days
D)Returning for suture removal in 1 week

Answer 2

Application of ice for pain or swelling

Question 3

The physician has ordered a 24-hour urine specimen collection. After explaining the procedure to the client, the nurse collects the first specimen. She is doing the right thing if she ________.

A)Discards the first specimen, and then starts the collection
B)Saves this specimen as part of the 24-hour collection
C)Tests the specimen, and then discards it
D)Places this specimen in a separate container and later adds to the collection

Answer 3

Discards the first specimen, and then starts the collection

Question 4

Drake, a 22-year-old male, has just developed chickenpox. The nurse will monitor him for acute glomerulonephritis for _________.

A)3 days
B)7 days
C)2 weeks
D)2 months

Question 5

Faye, a nurse in a urology clinic, conducts a community education program about benign prostatic hypertrophy. When asked to explain the condition, Faye should respond that BPH is:

A)Associated with multiple factors, including frequent UTIs
B)Thought to occur because of declining testosterone levels
C)Rare until the seventh decade of life
D)Responsible for the symptoms such as weak urinary stream and that the size of the prostate gland directly correlates to the severity of the symptoms.

Question 6

Paolo, a 37-year-old freelance writer, is scheduled for an intravenous pyelogram (IVP) to evaluate possible obstruction in the urinary tract. To prepare the client, the nurse will:
(Select all that apply.)

A)Give a laxative and/or enemas starting the night before the procedure.
B)Force fluids orally or by IV at least 4 hours before the test.
C)Verify that an informed consent has been signed.
D)Explain that there might be a salty taste in the mouth from the dye.
E)Drape a lead apron over the pelvic area for radiation protection.

Question 7

John, 15 years old, developed acute glomerulonephritis after a bout of complicated upper respiratory infection. The nurse is planning to teach about dietary restrictions. Which of the following dietary changes should be included in the plan?

A)Limit fluid intake to 500ml per day
B)Restrict protein intake by limiting meats and other high-protein foods
C)Increase intake of high-fiber foods, such as bran cereal
D)Increase intake of potassium-rich foods such as bananas or cantaloupe

Question 8

The indwelling Foley catheter was removed following an episode of prostatitis, but the client did not void for the next 8 hours, even when allowed to stand. The best action for the nurse to take is to:

A)Ask the physician for a prostate evaluation
B)Wait another 8 hours and encourage frequent attempts
C)Ask the physician for orders to catheterize the bladder
D)Encourage oral fluids and hot baths to relax the sphincter

Question 9

Which of the following clients would indicate that he/she is manifesting chronic renal failure?

A)A client with a total urinary output of 876 ml over 24 hours
B)A client with serum potassium level of 4.2 mEq/L
C)A client with serum creatinine level of 1.1 mg/dL
D)A client with serum blood urea nitrogen of 25 mg/dL

Question 10

Andrews, a 42-year-old dance instructor, returns to the unit after undergoing a right modified radical mastectomy with dissection of the axillary lymph nodes. Which measure is an appropriate intervention for the nurse to include in Ms. Andrews' postoperative care?

A)Instruct the client to watch the clock and use the PCA pump every 10 minutes
B)Insist that the client to examine the surgical incision when the surgical dressings are removed
C)Post a sign at the bedside to avoid pressure measurements or venipunctures in the right arm
D)Encourage the client to obtain a permanent breast prosthesis upon discharge from the hospital

Question 11

Kyle, a 28-year-old teacher, is admitted to the hospital with a diagnosis of renal calculi. The result of Kyle's blood studies shows a BUN of 20 mg/dL, serum calcium level of 4.5 mEq/L, serum phosphorus of 1.8 mEq/L, serum sodium of 138 mEq/L, and urine pH of 5.1. Calcium phosphate stone is suspected. What nursing intervention would be most effective in altering Kyle's urine pH?

A)Increasing activity
B)Forcing fluids
C)Administering allopurinol Zyloprim as ordered
D)Excluding high calcium fluids from his diet

Question 12

Which problem should the nurse expect following uterine isotope insertion?

A)Bladder atony
B)Constipation
C)Foul-smelling vaginal discharge
D)Loss of sexual libido

Question 13

The physician orders a combination of sulfamethoxazole and phenazopyridine hydrochloride (Pyridium) for a client with acute pyelonephritis. Which therapeutic effect should this combination drug have?

A)Pain relief and a decreased WBC count
B)Equal fluid intake and output
C)Polyuria with reddish stain
D)Increased complaints of bladder spasm after 20 minutes

Question 14

Forty-eight hours after a nephrectomy, a client complains of increasing nausea and abdominal pressure. The nurse's first nursing action is to:

A)Change the client's position to relieve abdominal pressure
B)Auscultate bowel sounds
C)Insert a rectal tube to relieve flatus
D)Administer morphine SO4, 6 mg, as ordered for the relief of discomfort

Question 15

The nurse caring for an adult client with polycystic kidney disease (PKD) knows that an early and commonly seen symptom of this disease process would be which of the following?

A)Steady, dull flank pain
B)Hypotension
C)Confusion
D)Sharp back pain

Question 16

For a client with a recurrent urinary tract infection (UTI), which of the following statements describes the primary drug therapy regimen for this disease process?

A)A one- to three-day treatment regimen of antibiotic therapy
B)A three- to five-day treatment regimen of antibiotic therapy
C)Consideration of a 10-day trial of suppressive antibiotic therapy
D)Phenazopyridine (Pyridium) to relieve discomfort associated with a UTI

Question 17

A client with nephrotic syndrome is educated by the nurse on his disease and course treatment. The following statement from the client would indicate a need for further instruction:

A)"I can expect to experience swelling in my hands and feet."
B)"The protein in my blood will probably be low and my cholesterol may be high."
C)"I will need to take medication to control the swelling and high cholesterol."
D)"I may eat a diet that is not restricted in salt or protein."

Question 18

One potential complication of an abdominal hysterectomy is abdominal distention. Postoperative nursing measures designed to avoid abdominal distention are:

A)Auscultation of the abdomen for bowel sounds
B)Abdominal massage and bed rest
C)Insertion of nasogastric and rectal tubes and ambulation, as ordered
D)Progression of postoperative diet

Question 19

During discharge teaching with a client following abdominal hysterectomy, the nurse should include the following instruction:

A)Avoid sitting for a long period of time
B)Evacuate bowels daily
C)Restrict sexual activity for 6 months after hysterectomy
D)Avoid all household chores for 2 months

Question 20

After teaching breast self-examination, Ms. Ry asked why it is important to move her arms in different positions while standing in front of a mirror. The correct response of the nurse is:

A)"It is more comfortable in this manner."
B)"Change in shape or contour of the breast is easily noticed when you do this."
C)"Nipple discharge will be determined with every movement."
D)"It gives more emphasis and time to analyze the breast."

Question 21

Ricardo is at risk for testicular cancer. You provided him with health teaching on testicular self-examination (TSE). Which of the following is correct about performing TSE?

A)Feel the testicles using the palms
B)The best time to examine the testes is after a warm shower
C)Abstinence from sexual acts is required 24 hours before the TSE
D)Testicles should be equal at the same height; any difference should be reported immediately.

Question 22

A male client presents to the Emergency Department with priapism, or sustained erection. The nurse understands that this client needs which of the following?

A)Immediate medical attention
B)A relaxing environment so his erection will recede
C)Warm soaks to the penis
D)An evaluation for sexual dysfunction

Question 23

Marcia, 68 years old, presents to the gynecology clinic with complaints of painless vaginal bleeding. The nurse should be certain the client is tested for which of the following health problems?

A)Ovarian cyst
B)Cervical or uterine cancer
C)Hormonal imbalances
D)Endometriosis

Question 24

A client complains of inability to inhibit urine flow long enough to reach the toilet. The nurse documents the presence of which type of urinary incontinence?

A)Stress
B)Reflex
C)Urge
D)Functional

Question 25

Francis, a long time mechanic, has undergone creation of an ileal conduit. Which of the following instructions to the client about ostomy care would be appropriate to include in the teaching plan?

A)Cut the faceplate of the appliance so that the opening is slightly smaller than the stoma
B)Plan to do appliance changes just before bedtime
C)Limit fluids to minimize odor from urine breakdown to ammonia
D)Cleanse the skin around the stoma using gentle soap and water, rinse, and dry well

Question 26

The nurse is assessing the client with epididymitis. The nurse anticipates which of the following findings on physical examination?

A)Fever, diarrhea, groin pain, and ecchymosis
B)Nausea, vomiting, scrotal edema, and ecchymosis
C)Fever, nausea, vomiting, and painful scrotal edema
D)Diarrhea, groin pain, testicular torsion, and scrotal edema

Question 27

Gretchen, 25 years old, is admitted to the Emergency Department following a fall from a hoarse and the physician orders insertion of a Foley catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should:

A)Notify the physician
B)Use a smaller size of catheter
C)Administer pain medication before inserting the catheter
D)Use extra povidone-iodine solution in cleansing the meatus

Question 28

The client returns to the nursing unit following a pyelolithotomy for removal of a kidney stone. A Penrose drain is in place. Which of the following actions would the nurse include in the client's postoperative plan of care?

A)Position the client on the affected side
B)Irrigating the Penrose drain using sterile procedure
C)Changing dressings frequently around the Penrose drain
D)Weighing dressings and adding the amount to the output

Question 29

An intravenous pyelogram reveals that Paulo, age 35, has a renal calculus. He is believed to have a small stone that will pass spontaneously. To increase the chance of the stone passing, the nurse would instruct the client to force fluids and to

A)Strain all urine
B)Ambulate
C)Remain on bed rest
D)Ask for medications to relax him

Question 30

Romeo Diaz, age 78, is admitted to the hospital with the diagnosis of benign prostatic hyperplasia (BPH). He is scheduled for a transurethral resection of the prostate (TURP). It would be inappropriate to include which of the following points in the preoperative teaching?

A)TURP is the most common operation for BPH.
B)Explain the purpose and function of a two-way irrigation system
C)Expect bloody urine, which will clear as healing takes place
D)He will be pain free.