Deck 34: Care of Patients with Disorders of the Urinary System

Question 1

The nurse is caring for a child suspected of having acute glomerulonephritis.When reviewing the health history,which finding is most concerning to the nurse?

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

Answer 1

Recent upper respiratory infection

Question 2

The nurse is assessing a patient who is being treated for acute pyelonephritis.When finding best indicates to the nurse that the patient is in the early stages of pyelonephritis?

A) Smoky-colored urine
B) Temperature of 99.4° F
C) Weakness
D) Flank pain

Answer 2

Flank pain

Question 3

A 25-year-old woman comes to the emergency department with nonspecific urethritis.Which information is most important for the nurse to obtain?

A) "How many servings of green vegetables do eat each day?"
B) "How often, if any, do you consume alcohol?"
C) "How often do you use bath salts or take bubble baths?"
D) "Do you take a daily multivitamin?"

Answer 3

"How often do you use bath salts or take bubble baths?"

Question 4

As chronic glomerulonephritis progresses,how is the kidney usually affected?

A) The kidney swells.
B) The kidney atrophies.
C) The kidney develops "skip lesions."
D) The kidney develops multiple cysts.

Question 5

The nurse is caring for a patient with glomerulonephritis.Which finding best leads the nurse to suspect that the patient is developing nephrotic syndrome?

A) Ascites
B) Anorexia
C) Pruritis
D) Lethargy

Question 6

The nurse is caring for patient who is postoperative after a bladder repair.The patient complains of pain.Which independent nursing intervention is best?

A) Administer an analgesic medication.
B) Apply a cold compress to the surgical site.
C) Dim the lights in the room.
D) Irrigate the drainage tube.

Question 7

A patient with glomerulonephritis has an order to undergo plasmapheresis.Which statement indicates that the patient accurately understands teaching about the procedure?

A) "This procedure removes my affected plasma and gives me a clean replacement."
B) "This procedure will use the IV in my hand."
C) "I will need to lie very still while the pictures are taken."
D) "I should drink this contrast with a straw to keep it from staining my teeth."

Question 8

The nurse is caring for a patient who received an instillation of doxorubicin (Adriamycin)into the bladder for treatment of cancer in situ.What should the nurse do next?

A) Reposition the patient every 15 to 30 minutes.
B) Unclamp the catheter.
C) Educate the patient about the possibility of false positive tuberculin skin testing.
D) Apply nonslip footwear for ambulation.

Question 9

The nurse is caring for a 90-year-old resident in a long-term care facility who is becoming progressively confused and irritable.What should the nurse do next?

A) Request an order for a urinalysis.
B) Hold the patient's antihypertensive medications.
C) Assess the patient for fecal impaction.
D) Notify the charge nurse.

Question 10

The nurse is caring for a patient who is scheduled to undergo hemodialysis.Based on awareness of potential complications,the nurse correctly withholds which medication?

A) Lisinopril (Zestril)
B) Famotidine (Pepcid)
C) Paroxetine (Paxil)
D) Ciprofloxacin (Cipro)

Question 11

Which statement best indicates that the patient understands teaching about dietary restrictions in glomerulonephritis?

A) "I should avoid canned soups and hot dogs."
B) "I should drink more water."
C) "I should eat more meat and cheeses."
D) "I should not eat fresh produce."

Question 12

The nurse is caring for a young man who has been prescribed ciprofloxacin (Cipro)for pyelonephritis.Which information should the nurse include in order to prevent recurrence?

A) Take this medication with a full glass of water.
B) Take antacids 2 hours after this medication.
C) Take the entire prescription.
D) Take this medication on an empty stomach.

Question 13

A 25-year-old man comes to the college clinic with fever of 101° F,nausea,and flank pain that radiates into the thigh and genitals.The nurse anticipates that the patient will undergo workup for which infection?

A) Urethritis
B) Pyelonephritis
C) Glomerulonephritis
D) Cystitis

Question 14

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

A) "If the stone is not promptly removed, you will continue to have blood in your urine."
B) "If the stone is not removed, it could block urine flow from the kidney and cause swelling within the kidney."
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 15

While reviewing a patient's medications,the nurse notes that a patient has been prescribed liquid nitrofurantoin (Furadantin).Which intervention should the nurse add to the nursing care plan?

A) Administer nitrofurantoin on an empty stomach.
B) Provide a straw and instruct the patient to rinse the mouth after taking nitrofurantoin.
C) Administer nitrofurantoin early in the morning to avoid insomnia.
D) Assess the urine for hematuria.

Question 16

The nurse is caring for a 50-year-old female who presented to the emergency department after being involved in a motor vehicle collision.The patient displays marked tenderness and spasm in the suprapubic area and a nonpulsating mass.The nurse anticipates that this patient will undergo additional workup for which complication?

A) Bladder trauma
B) A damaged kidney
C) A urethral tear
D) Ruptured spleen

Question 17

The nurse is discussing alternative therapies with a patient who has cystitis.The patient asks the nurse if there are any dietary changes that might help.What response is most appropriate?

A) "Drinking lots of water is the only dietary change that would help."
B) "Many rumors exist about dietary prevention of UTIs but none are proven at this time."
C) "Vitamin C may help decrease the frequency of cystitis."
D) "Increase the amount of leafy green vegetables in your daily diet."

Question 18

The nurse is caring for a patient who underwent a right nephrostomy to relieve hydronephrosis.Which intervention is most important for this patient?

A) Assist the patient with turning every 2 hours.
B) Irrigate the nephrostomy tube once per shift.
C) Assess urinary output from the left kidney.
D) Keep the nephrostomy tube clamped.

Question 19

The nurse is reviewing a history and physical examination of a 22-year-old man hospitalized for acute glomerulonephritis.Which finding best alerts the nurse to a potential causative agent?

A) A recent trip to Mexico
B) Unprotected sexual activity
C) A recent strep throat infection
D) A recent protocol of ciprofloxacin (Cipro)

Question 20

The nurse is caring for a patient diagnosed with glomerulonephritis.The patient reports feeling "bored and caged," and asks when he can resume normal activities.Which finding indicates that bed rest may be discontinued?

A) The patient has been compliant with medication for 2 weeks.
B) The serum sodium level is 140 mEq/L.
C) The patient's weight returns to preillness baseline.
D) The patient's blood pressure is 110/74.

Question 21

The home health nurse is caring for a patient with chronic renal failure.Which assessment finding(s)indicate(s)that the patient is experiencing uremic syndrome?

A) Restless legs
B) Dry, scaly skin
C) Crystals in the eyebrows
D) Muscle cramps
E) Hypotension

Question 22

In which situation(s)should the nurse question an order for carbenicillin for a patient with a urinary infection?

A) The patient is older than 80 years of age.
B) The patient is allergic to penicillin.
C) The patient takes warfarin daily.
D) The patient takes oral contraceptives.
E) The patient has a history of hypertension.

Question 23

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 24

The nurse is collecting the health history of a patient who has had multiple episodes of renal calculi formation.Which finding(s)increase(s)the patient's risk for the development of renal calculi?

A) Uric acid crystals in urine
B) Frequent bacterial urinary infections
C) Excessive fluid intake
D) Prolonged bed rest
E) Parathyroid gland tumor
F)None of above

Question 25

The nurse is aware that 80% of UTIs in females are the result of contamination from __________.

Question 26

The nurse caring for a patient who has just had an arteriovenous (AV)access created in his right forearm.Which finding(s)is/are important for the nurse to assess?

A) Presence of 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) Abdominal incision site

Question 27

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 28

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 29

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 30

The nurse is caring for a patient who is undergoing plasmapheresis.The nurse should carefully monitor the patient for which potential complication(s)?

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

Question 31

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 32

The nurse is caring for patient with a urinary tract infection (UTI)who is to receive cefazolin (Ancef).The nurse should carefully monitor the patient for which side effect(s)?

A) Vaginitis
B) Decreased clotting time
C) Arrhythmias
D) Rash
E) Confusion

Question 33

A patient has been admitted to the acute care facility to rule out glomerulonephritis.Which assessment finding(s)is/are supportive of the potential diagnosis?

A) Flank pain
B) Hematuria
C) Periorbital edema
D) Decrease in blood urea nitrogen (BUN) and creatinine
E) Hypertension