Deck 45: Nursing Assessment: Urinary System

Question 1

While assessing a patient's urinary system, the nurse cannot palpate either kidney. Which action should the nurse take next?

A) Ask the patient about any history of recent sore throat.
B) Obtain a urine specimen to check for hematuria.
C) Ask the health care provider about scheduling a renal ultrasound.
D) Document the information on the assessment form.

Answer 1

Document the information on the assessment form.

Question 2

A patient with an elevated blood urea nitrogen (BUN) and serum creatinine is scheduled for a renal arteriogram. The nurse should question an order from radiology for bowel preparation with the use of

A) senna/docusate (Sennakot-S).
B) Fleet enema.
C) tap-water enema.
D) bisacodyl (Dulcolax) tablets.

Answer 2

Fleet enema.

Question 3

When reading a patient's chart, the nurse notes that the patient has had dysuria. To assess whether there is any improvement, which question will the nurse ask?

A) "Do you have any blood in your urine?"
B) "Do you have to get up at night to urinate?"
C) "Do you have any pain when you urinate?"
D) "Do you have to urinate very frequently?"

Answer 3

"Do you have any pain when you urinate?"

Question 4

Following an intravenous pyelogram (IVP), all of these assessment data are obtained. Which one requires immediate action by the nurse?

A) The urine output is 400 ml in the first 2 hours.
B) The patient complains of a dry mouth.
C) The heart rate is 58 beats/min.
D) The respiratory rate is 38 breaths/min.

Question 5

The result of a patient's creatinine clearance test is 60 ml/min. The nurse equates this finding to a glomerular filtration rate (GFR) of _____ ml/min.

A) 30
B) 60
C) 120
D) 240

Question 6

A patient who had a cystoscopy the previous day calls the urology clinic and gives the nurse all the following information. Which statement by the patient should be reported immediately to the health care provider?

A) "My urine still looks pink."
B) "I did not sleep well last night."
C) "I have a temperature of 101."
D) "My IV site is still bruised."

Question 7

The nurse uses auscultation during assessment of the urinary system to

A) determine the position of the kidneys.
B) assess for bladder distension.
C) check for ureteral peristalsis.
D) identify renal artery or aortic bruits.

Question 8

When reviewing the results of a patient's urinalysis, which information indicates that the nurse should notify the health care provider?

A) pH 6.2
B) Protein: 6 mg/dl
C) WBC: 20-26/hpf
D) Specific gravity: 1.021

Question 9

During assessment of a patient with a possible renal insufficiency, which of these medications taken by the patient at home will be of most concern to the nurse?

A) Warfarin (Coumadin)
B) Folic acid (vitamin B9)
C) Ibuprofen (Motrin)
D) Penicillin (Bicillin LA)

Question 10

When admitting a patient who has a history of paraplegia as a result of a spinal cord injury, the nurse will plan to

A) check the patient for urinary incontinence every 2 hours to maintain skin integrity.
B) assist the patient to the toilet on a scheduled basis to help ensure bladder emptying.
C) use intermittent catheterization on a regular schedule to avoid the risk of infection.
D) ask the patient about the usual urinary pattern and measures used for bladder control.

Question 11

When the nurse is planning care for an 82-year-old man, an appropriate intervention based on an understanding of age-related changes of the urinary system is for the nurse to

A) limit fluid intake to no more than 1500 ml/day.
B) leave a light on in the bathroom at night.
C) ask the patient to use a urinal so that all urine can be measured.
D) pad the patient's bed to accommodate overflow incontinence.

Question 12

A patient with a possible renal cell tumor who is scheduled for an intravenous pyelogram (IVP) and computed tomography (CT) scanning of the abdomen gives the nurse all the following data. Which information has the most immediate implications for the patient's care?

A) The patient has not had anything to eat or drink for 8 hours.
B) The patient used a bisacodyl (Dulcolax) tablet the previous night.
C) The patient describes allergies to shellfish and penicillin.
D) The patient complains of costovertebral angle (CVA) tenderness.

Question 13

How will the nurse assess the flank area for tenderness?

A) Percuss the area between the iliac crest and ribs along the midaxillary line.
B) Palpate along both sides of the lumbar vertebral column.
C) Place one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
D) Push gently into the two lowest intercostal spaces.

Question 14

A hospitalized patient with renal insufficiency is scheduled to have an IVP. Which nursing action will be needed during this procedure?

A) Assist with monitoring for conscious sedation.
B) Insert a large size urinary catheter prior to the IVP.
C) Monitor the urine output after the procedure.
D) Give oral contrast solution before the procedure.

Question 15

A patient's urine dipstick indicates a large amount of protein in the urine. The next action by the nurse should be to

A) check which medications the patient is currently taking.
B) ask the patient about any family history of chronic renal failure.
C) send a urine specimen to the laboratory to test for ketones and glucose.
D) obtain a clean-catch urine for culture and sensitivity testing.

Question 16

A 20-year-old patient who is employed as a hairdresser and has a 10 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for

A) bladder cancer.
B) renal failure.
C) pyelonephritis.
D) kidney stones.

Question 17

A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which equipment will the nurse need to obtain?

A) Foley catheter and drainage bag
B) Towelettes for perineal cleaning
C) Basin of ice
D) Sterile specimen cup

Question 18

The nurse informs the patient undergoing cystoscopy that following the procedure, the patient

A) should ask for the ordered narcotics as necessary for pain.
B) will be NPO for 8 hours to prevent nausea and vomiting.
C) may experience blood-tinged urine and urinary frequency.
D) is expected to be on strict bed rest for about 4 to 6 hours.

Question 19

The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a patient with a suspected urinary tract infection (UTI). To obtain the specimen, the nurse will plan to

A) teach the patient to clean the urethral area, void a small amount into the toilet, then void into a sterile specimen cup.
B) insert a short, small "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen.
C) clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have the patient void into a sterile container.
D) have the patient empty the bladder completely, and then obtain the next urine specimen that the patient is able to void.

Question 20

When teaching a patient scheduled for a cystogram via a cystoscope about the procedure, the nurse tells the patient,

A) "Your doctor will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys."
B) "Your doctor will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked."
C) "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."
D) "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney."

Question 21

A patient with diabetic nephropathy is admitted for a right renal biopsy. Immediately after the biopsy, which of these is an essential nursing action?

A) Check blood glucose to assess for hyperglycemia or hypoglycemia.
B) Obtain a urine specimen to check for hematuria.
C) Monitor the BUN and creatinine to assess renal function.
D) Place the patient on the right side to put pressure on the site.