Deck 40: Urologic Disorders

Question 1

The nurse is aware that if the kidney is adequately functioning,the osmolality of the urine will be:

A) Equal to the osmolality of the serum
B) Approximately one-half of the serum
C) In a ratio of 10:1 with the serum
D) Equal to the excretion of urea

Answer 1

Equal to the excretion of urea

Question 2

The patient who has cystitis has been told to drink at least 30 ml for each kilogram of body weight.Her weight is 154 pounds.The nurse instructs the patient to drink:

A) 1500 ml/day
B) 2100 ml/day
C) 2700 ml/day
D) 3100 ml/day

Answer 2

2100 ml/day

Question 3

The nurse who is performing frequent catheterizations for residual urine has a concern related to the potential for:

A) Introduction of pathogens into the bladder
B) Frequent genital exposure of the patient
C) Presence of the indwelling catheter
D) Causing urethral erosion

Answer 3

Introduction of pathogens into the bladder

Question 4

The nurse explains that the autoimmune disease of acute glomerulonephritis is most usually caused by:

A) Frequent cystitis
B) Streptococcal infection
C) Childhood disease of mumps
D) Recent wound infection

Question 5

When the 16-year-old patient with acute glomerulonephritis complains of boredom with bedrest and asks when he can become more active,the nurse states that bedrest will continue until:

A) Dialysis starts
B) Antibiotic protocol is completed
C) Potassium levels are normal
D) Blood pressure drops to normal levels

Question 6

The nurse caring for a patient after urinary diversion surgery will add the postoperative assessments of:

A) Level of fluid intake
B) Position on the left side
C) Keep the bed flat
D) Bowel sounds

Question 7

The nurse becomes alarmed when the patient on dialysis who is taking gentamicin (Garamycin)says:

A) "I have a horrible headache."
B) "Speak up! I can't hear you."
C) "I've had diarrhea once or twice today."
D) "I'm thirsty. I can't get enough water."

Question 8

Before discharge,the nurse teaches a patient who has had a lithotripsy that he should:

A) Check for edema of the legs and ankles.
B) Watch for stone debris in the urine in 1 to 4 weeks.
C) Decrease fluid intake to 1000 ml/day.
D) Remain on restricted activity for a week.

Question 9

The patient has a nephrostomy tube that has been inserted because of an obstruction in the ureter.Special precautions in the care of the nephrostomy tube include:

A) Clamping every 2 hours to allow expansion of the kidney pelvis.
B) Instilling no more than 50 ml of sterile water if sterile irrigations are ordered.
C) Being certain the tube is connected, not kinked, or not clamped to ensure that it continually drains.
D) Leaving the nephrostomy site open to air.

Question 10

When the nurse caring for a patient with an atrioventricular (AV)fistula in the forearm assesses that a trill is absent when palpating the venous side of the fistula,the nurse should:

A) Inject the ordered amount of heparin into the fistula.
B) Apply warm compresses, and lower the arm below the heart level.
C) Send the patient to dialysis for remedy.
D) Report to the charge nurse that the fistula is occluded.

Question 11

When the patient comes to the medical clinic with complaints of urgency,frequency,pain in the area of the symphysis pubis,and dark cloudy urine,the nurse suspects that this patient has:

A) Urinary calculi, probably located in the ureter
B) Kidney infection, most likely pyelonephritis
C) Cystitis, probably from bacterial contamination
D) Interstitial cystitis (although rare in a male patient)

Question 12

The nurse recognizes that the patient with renal failure has entered the oliguric stage when:

A) Blood urea nitrogen (BUN) level rises.
B) Serum calcium increases.
C) Blood volume decreases.
D) Urine osmolality increases.

Question 13

The home health patient who has cystitis has been placed on the drug,phenazopyridine (Pyridium),and should be cautioned about:

A) Staying out of the heat
B) Nausea
C) Staining of clothing
D) Skin rash

Question 14

As the nurse assesses the patient with renal impairment,a facial characteristic that is a sign of fluid retention is:

A) Broken blood vessels around the nose
B) Periorbital edema
C) Rash on cheeks and neck
D) Facial twitching

Question 15

The nurse caring for a patient with acute glomerulonephritis is aware that the inflammation of the capillary loops in the glomeruli leads to:

A) Moderate-to-high blood pressure
B) Low blood volume with polyuria
C) Irritability and hyperactivity
D) Low levels of BUN and creatinine

Question 16

Because recurrence of renal calculi is likely,the patient must:

A) Is aware of signs and symptoms of kidney stones and know where to find pain relief.
B) Measures intake and output so that they will be approximately equal.
C) Avoids infections and situations that would increase stress.
D) Is able to describe measures to prevent recurrence of calculi.

Question 17

The patient on dialysis asks why he is receiving aluminum hydroxide gel (Amphojel),a phosphate binder,for his renal disorder.The nurse explains that Amphojel will:

A) Calm the frequent upset stomach experienced by patients on dialysis.
B) Bind with phosphorus to increase the serum calcium level.
C) Increases the appetite.
D) Correct the pH of the bowel.

Question 18

The nurse caring for a patient who had a ureteral catheter in place after the removal of a kidney stone would focus care on:

A) Irrigating the catheter regularly.
B) Assessing for patency.
C) Including ureteral output with the bladder output.
D) Early ambulation.

Question 19

The nurse is collecting data from a hospital patient who has been admitted with pyelonephritis.He is acutely ill with a high fever,chills,nausea,and vomiting.He also has severe pain in the flank area.The primary goal of his treatment is to:

A) Provide adequate nutrition with a stable body weight.
B) Provide adequate hydration with pulse and blood pressure within patient norms.
C) Give pain relief with analgesics and antispasmodics.
D) Prevent further damage to his kidneys that could lead to renal failure.

Question 20

Because the urine test for ___________ is not influenced by diet,hydration,or liver function,it is a good measurement of renal function:

A) BUN
B) Phosphates
C) Specific gravity
D) Creatinine

Question 21

When the nurse reads the serum calcium laboratory report of 4.2 mEq/L the nurse would anticipate the patient to exhibit:

A) Irritability
B) Tingling sensations in limbs
C) Tetany
D) Nausea
E) Visual disturbances

Question 22

Erythropoietin is a hormone produced by the kidney.When the patient in chronic renal failure has a deficiency of erythropoietin,it will result in:

A) Diminished immunologic function with fewer white blood cells
B) Elevated lipid levels in the bloodstream, contributing to accelerated atherosclerosis
C) Anemia as a result of the diminished number of red blood cells being produced
D) Hypertension as a result of the increased, concentrated blood volume

Question 23

The nurse is aware that if a ureter is blocked by a kidney stone,the urine backs up into the kidney causing _________________.

Question 24

The nurse explains to a 10-year-old boy who wants to give his kidney to his grandfather that kidney donors must be at least how many years old?

A) 14
B) 16
C) 18
D) 21

Question 25

A family member of a patient who has returned to the special unit after renal transplantation is alarmed by blood in the urine of the patient.The nurse's best explanation would be that the hematuria is:

A) Related to the immunosuppressant drugs taken before transplantation
B) A normal postoperative expectation
C) Not blood but dye injected during surgery
D) A small vessel that may be bleeding but will coagulate as urine flow increases

Question 26

The patient with chronic renal failure who is to begin renal dialysis treatment asks for advice about which type of dialysis would be best.The patient is considering peritoneal dialysis because it is less expensive and has fewer dietary and fluid restrictions.The nurse's best advice is that peritoneal dialysis:

A) Has literally no drawbacks.
B) Gives more independence and more closely resembles normal kidney function.
C) Is a lot more work than hemodialysis, in which the health care staff takes care of everything.
D) Usually does not work very well and has many complications, such as a high blood sugar level.

Question 27

Patients with chronic renal failure who are receiving dialysis are prone to injury because of:

A) Bone demineralization and peripheral neuropathy
B) Fatigue and drug side effects
C) Impaired immune response and malnutrition
D) Multiple life changes and hormone deficiencies

Question 28

When the female patient complains of a very painful urethritis,the home health care nurse questions the patient about the use of:

A) Bubble bath
B) Vitamin preparations
C) Herbal remedies
D) Vaginal sprays
E) Exercise machines

Question 29

The major risk of peritoneal dialysis is _____________.

Question 30

The nurse,in planning the care for an older adult patient,takes into consideration the changes in kidney function,which are related to age.These changes are:

A) Thinning of nephron membranes
B) Sclerosis of renal blood vessels
C) Decreasing glomerular filtrations
D) Decreasing ability to concentrate or dilute urine
E) Decreasing erythropoietin

Question 31

The nurse caring for a patient with a Foley catheter will include implementations for the nursing diagnosis risk for infection,such as:

A) Keep the bag below the level of the bed.
B) Provide perineal care twice a day.
C) Coil tubing on the bed.
D) Using standard precautions when handling urine and tubing.
E) Keep the drainage system closed.

Question 32

The nurse assesses a Grey Turner sign in a patient who was admitted 2 days earlier after an automobile accident.This finding indicates:

A) Retroperitoneal bleeding and bruising over the flank
B) Hematuria with abdominal bruising
C) Distended bladder with painful urination
D) Bladder spasms on palpation of abdomen