Deck 23: Urological Disorders

Question 1

Which statement about the pathophysiology of lower urinary tract infections is true?
1) The low osmolarity of urine diminishes bacterial viability in the bladder.
2) Any obstruction of urinary outflow decreases the bladder's resistance to bacterial infection.
3) Immunoglobulin A (IgA) facilitates adherence of bacteria to the bladder wall.
4) The presence of IgA in all women decreases their ability to combat bacterial invasion of the bladder.

Answer 1

2

Question 2

Which type of stone in the case of urolithiasis is associated with indwelling catheters?
1) Calcium
2) Struvite
3) Uric acid
4) Cystine

Answer 2

2

Question 3

Which statements made by a student nurse demonstrate an understanding of the clinical presentation for lower urinary tract infections (UTIs)?
1) "Hematuria is a classic symptom of lower UTIs."
2) "Suprapubic tenderness is commonly seen in lower UTIs."
3) "Fever is commonly associated with lower UTIs."
4) "Severe pain in the glans penis is common in case of lower UTIs."
5) "Frequency is a common symptom of UTIs."

Answer 3

4, 5

Question 4

A nurse is teaching student nurses about the epidemiology of urolithiasis. Which statement made by a student nurse indicates the need for further learning?
1) "Urolithiasis occurs in 1 to 3 per 1,000 in men."
2) "The incidence of recurrence of calculi is 52% at 10 years after the initial incident."
3) "The incidence of urolithiasis increases among men in their twenties."
4) "The incidence of urolithiasis in women peaks in the late fifties."

Question 5

Which type of renal calculi is caused by a genetic disorder associated with the faulty metabolism of an amino acid?
1) Calcium stones
2) Uric acid stones
3) Cystine stones
4) Struvite stones

Question 6

A nurse is caring for an older adult with a urinary tract infection (UTI). A spinal injury has necessitated the long-term use of an indwelling urinary catheter in this client. Which is the most likely complication that the nurse would anticipate in this client?
1) Benign prostate hyperplasia
2) Urosepsis
3) Vesicoureteral reflux
4) Bladder cancer
5) Both B and D

Question 7

What is the rate of recurrence of urolithiasis within 5 years after it occurs in a client for the first time?
1) 35%
2) 45%
3) 52%
4) 62%

Question 8

Which type of calculi in the ureter is found most often in clients with spinal cord injuries?
1) Calcium
2) Struvite
3) Uric acid
4) Cystine

Question 9

Which statement by the nurse to a client demonstrates an understanding of the factors responsible for the formation of different types of ureter stones?
1) "Prolonged use of indwelling catheters has predisposed you to uric acid stones."
2) "You are likely to have developed cystine stones because your diet is excessively rich in animal proteins."
3) "You are likely to have developed calcium stones because of a genetic predisposition."
4) "Prolonged use of supplements has contributed to your developing calcium stones."

Question 10

A student nurse is comparing treatment methods for urolithiasis and urinary incontinence. Which statement made by the student nurse indicates proper understanding of the treatment methods?
1) "Local estrogen therapy is very effective in treating incontinence in women."
2) "Kegel exercises are contraindicated in women with incontinence."
3) "A transurethral catheter is recommended for long-term catheterization in the treatment of incontinence."
4) "Botulinum toxin injection is used as a last resort in the treatment of urolithiasis."
5) "Hydrochlorothiazide is the drug of choice for treatment of calcium stones."

Question 11

Which is the most common cause of urinary obstruction in men older than 60 years of age?
1) Cancers of the pelvic organs
2) Kidney stones
3) Benign prostate hyperplasia
4) Genetic mutation

Question 12

Which situation makes an individual susceptible to developing a lower urinary tract infection (UTI)?
1) Urea in the urine
2) Immunoglobulin A (IgA) secretion
3) Vesicoureteral reflux
4) Urease-secreting bacterium
5) Both C and D

Question 13

How much urine can the urinary bladder usually hold?
1) 150 to 250 mL
2) 300 to 400 mL
3) 450 to 550 mL
4) 600 to 700 mL

Question 14

Which factors will a nurse identify to be associated with the formation of struvite stones, after comparing struvite stones with calcium stones?
1) Hypoparathyroidism
2) Dietary factors
3) Anatomical abnormalities in the urinary tract
4) Presence of urease-producing organisms
5) Neurological disorders of the bladder

Question 15

Which observation is associated with the nonulcerative type of interstitial cystitis (IC)?
1) Thinning of bladder mucosa
2) Hemorrhages on the bladder wall when the bladder is distended
3) Erythema on the inner bladder surface
4) Inflammation on the inner bladder wall
5) Both A and B

Question 16

A nurse is teaching student nurses about the epidemiology of lower urinary tract infections (UTIs). Which statement made by a student nurse indicates a need for further learning?
1) "Young adult women are more likely to suffer a lower UTI than are young adult men."
2) "Up to 40% of men in the United States, aged 20 to 40 years, have suffered a lower UTI."
3) "Benign prostate hyperplasia is a common cause of UTI in men older than 60 years of age."
4) "Approximately 50% of all women are believed to have had a UTI at some point in their lifetime."

Question 17

Which factor does the nurse identify to be responsible for potentially lower urinary tract infections (UTIs) in young men?
1) Lack of circumcision
2) Anal intercourse
3) Benign prostate hyperplasia
4) Both A and B

Question 18

How long does a typical wave of renal colic last?
1) 10 to 15 minutes
2) 20 to 60 minutes
3) 70 to 90 minutes
4) 5 to 7 minutes

Question 19

Which is a risk factor for both bacterial and fungal urinary tract infections (UTIs)?
1) Chronic voluntary suppression of urination
2) Urinary catheters
3) Diabetes mellitus
4) Antibiotic use
5) Stagnation of urine flow
6) All of the above

Question 20

Which diagnostic procedures are used for the detection of interstitial cystitis (IC) in females?
1) Positive leukocyte esterase
2) Laparoscopy
3) Intravenous pyelogram (IVP)
4) Urodynamic studies
5) Hysteroscopy

Question 21

Which statement is true regarding the bacteria that frequently cause lower urinary tract infections (UTIs)?
1) Proteus mirabilis causes 70% to 95% of upper and lower urinary tract infections (UTIs).
2) Uropathogenic bacteria thrive by resisting the alkaline nature of urine.
3) Escherichia coli changes the pH of urine by secreting urease.
4) Urease-producing bacteria enhance formation of struvite staghorn calculi in the kidney.
5) Both A and D
Other

Question 22

Arrange in order the steps that depict how untreated urolithiasis can lead to kidney failure (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
A. Bleeding occurs when ureteral mucosa is sheared off.
B. Urine flow pushes the stone down the ureter.
C. Backward accumulation of pressure occurs into the renal pelvis.
D. Urine gets supersaturated with stone-forming salts.
E. Toxicity occurs in nephrons.
F. Intense pain is caused by buildup of pressure and spasms within the ureter.
G. Swelling of the renal pelvis is seen.

Question 23

A nurse is taking the history of a female client who is suspected of having urolithiasis. Which are effective questions that the nurse can ask the client in order to facilitate the diagnosis?
1) "Do you have pain in the lower back?"
2) "Are you taking any over-the-counter herbal supplements?"
3) "Has anyone in your family ever had kidney stones?"
4) "Do you have gout?"
5) "Have you been diagnosed with endometriosis?"
6) "Do you use strongly scented bath products?"

Question 24

Arrange in order the events associated with the obstruction of the urinary tract that eventually leads to renal failure (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
A. Glomerular filtration rate (GFR) decreases.
B. Ischemia and incremental nephron loss take place.
C. Ureteral peristalsis is overcome by the pressure.
D. The intraluminal ureteral pressure becomes elevated.
E. Depressed GFR is maintained if complete obstruction is not relieved after 12 to 24 hours.
F. Renal blood flow progressively falls.
G. Increased hydrostatic pressures are transmitted directly to the nephron tubules.

Question 25

Arrange in order the events associated with the micturition reflex, when voiding is not appropriate (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
A. The cerebral cortex initiates impulses that travel back down the spinal cord to inhibit the reflex arc.
B. Contraction of the bladder wall takes place.
C. The parasympathetic nerves stimulate the detrusor muscle.
D. The individual then makes a conscious decision about whether it is appropriate to void.
E. The bladder wall stretches to accommodate the increasing volume of urine.
F. The external urinary sphincter stays contracted.
G. Simultaneously, the spinal cord sends nerve impulses up to the cerebral cortex.