Deck 63: Coordinating Care for Patients With Urinary Disorders

Question 1

The nurse on the medical unit is admitting an older adult patient whose primary symptoms include fatigue,pruritus,and pain in the right flank area.When conducting this patient's assessment,which technique is the most appropriate?

A) Palpation over the costovertebral angles and flanks
B) Blunt percussion over the costovertebral angles and flanks
C) Palpation of the lower pole of both kidneys
D) Capturing of both kidneys

Answer 1

Blunt percussion over the costovertebral angles and flanks

Question 2

A patient is admitted to the emergency department and diagnosed with urinary calculi after experiencing symptoms for one week.When planning care for this patient,which nursing diagnosis is the most appropriate?

A) Risk for Constipation
B) Risk for Disuse Syndrome
C) Imbalanced Nutrition
D) Activity Intolerance

Answer 2

Imbalanced Nutrition

Question 3

The nurse is triaging a patient who presents to the urgent care clinic with symptoms of severe flank pain with spasms,nausea,vomiting,and oliguria.The patient states that the pain was initially intermittent and radiated from the lower back to the lower quadrants of the abdomen.Which action by the nurse is the most appropriate?

A) Complete the physical assessment
B) Refer the patient to a urologist
C) Instruct the patient to increase fluids
D) Obtain a urine specimen for culture

Answer 3

Refer the patient to a urologist

Question 4

The nurse is preparing to discharge a patient who underwent lithotripsy in the treatment of a kidney stone.What should the nurse teach the patient to prevent further complications of urinary calculi after discharge?

A) "You will need to increase your oral fluid intake to 1 L/day."
B) "It will be important that you not drive while taking pain medications."
C) "It will be important to maintain a diet high in purines."
D) "You will need to monitor for the signs and symptoms of a urinary tract infection (UTI)
."

Question 5

The nurse is assessing an adult patient in a urology clinic.The patient reports that she has been having "accidents" and expresses frustration about this normal part of aging.Which response by the nurse is the most appropriate?

A) "Tell me more about what you are experiencing."
B) "You may need to have surgery to manage this problem."
C) "I understand you are frustrated about this occurrence."
D) "Unfortunately,aging and incontinence go hand in hand."

Question 6

The nurse is caring for a patient with a history of kidney stones.The stones have been analyzed and are all composed of calcium phosphate.Based on this data,which foods should the nurse teach the patient to avoid?

A) Chicken,beef,and ham products
B) Organ meats,sardines,and seafood
C) Tomatoes,fruits,and nuts
D) Flour,milk,and ice cream

Question 7

The nurse is caring for a patient with a history of chronic urinary tract infections.The nurse is planning care for this patient based on the priority nursing diagnosis of urinary retention related to scarring.Based on this data,which prescription does the nurse anticipate from the health-care provider?

A) Antibiotic therapy
B) An anticholinergic medication
C) Intermittent straight catheterization
D) Removal of bladder stones

Question 8

The nurse providing care to a patient whose medication therapy for the treatment of renal calculi has failed.Based on this data,which treatment option does the nurse anticipate for this patient?

A) Lithotripsy
B) Surgical removal
C) Dietary control
D) Initiation of IV fluids

Question 9

The nurse is caring for a patient who will be discharged with an indwelling catheter.The nurse has provided education to the patient and family about catheter care once the patient is discharged.Which patient or family action indicates a correct understanding of the information presented?

A) Hanging the drainage bag on the towel rod
B) Taking a shower each day instead of taking a tub bath
C) Restricting the amounts of fluids per day
D) Emptying the drainage bag twice a day

Question 10

The nurse is attempting to place a urinary catheter for an older adult female patient.The nurse is unable to visualize the patient's urinary meatus.Which alternate position for catheterization may be appropriate for this patient?

A) Side-lying,lifting up the buttock
B) Supine,with the HOB elevated at 30°
C) Supine,with the head of bed (HOB)elevated at 45°
D) Supine,with the bed flat,legs bent and apart in stirrups

Question 11

The nurse provides education for a patient who is experiencing urinary incontinence.Which statement by the patient indicates the need for further education?

A) "Relaxation of pelvic muscles may be a factor in incontinence."
B) "Reduced urethral resistance can be a cause of incontinence."
C) "Incontinence is normal with aging."
D) "A disturbance of my bladder is a factor in the development of incontinence."

Question 12

A patient admitted to the hospital with a diagnosis of gout has also been diagnosed with uric acid renal calculi.When planning meals for this patient,which diet will the nurse anticipate?

A) Low-purine diet
B) Low-sodium diet
C) A diet high in calcium
D) A diet low in calcium

Question 13

The nurse is providing care to a patient with a spinal cord injury.Which type of incontinence should the nurse include in this patient's plan of care?

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

Question 14

A patient with urinary calculi is admitted to the hospital.When planning care for this patient,which goal is most appropriate?

A) The patient will lose 25 pounds in three months.
B) The patient will ambulate three times a day.
C) The patient will request pain medication at the onset of pain.
D) The patient will shower independently.

Question 15

The nurse is caring for a patient with a urinary catheter.Which nursing diagnosis is a priority for this patient?

A) Chronic Pain related to an obstruction
B) Risk for Impaired Skin Integrity related to incontinence
C) Risk for Infection related to catheter placement
D) Self-Care Deficit related to presence of urinary catheter

Question 16

The nurse is working in a urology clinic and is providing care for a patient with urinary stress incontinence.The nurse has chosen the diagnosis of Stress Urinary Incontinence related to sphincter incompetence.Which is the desired outcome for a patient with this diagnosis?

A) The patient will stop the flow of urine when voiding.
B) The patient will improve her incontinence within one month.
C) The patient will empty her bladder every time she voids.
D) The patient will perform four to five squeezes (Kegel exercises)
For 10-15 seconds.

Question 17

The nurse educator is speaking with a group of students about renal disorders.Which statement is appropriate for the educator to include regarding renal stones?

A) "Older adult patients are particularly at risk for urolithiasis."
B) "Young- or middle-age adult men are at an increased risk for stones."
C) "Women have a greater risk overall than men."
D) "Frequency is greater in the northern United States."

Question 18

A nurse is providing care to a group of patients on a urology unit.Which patient does the nurse identify as being at the greatest risk for developing urinary stones?

A) A 35-year-old female with quadriplegia from an auto accident
B) A 65-year-old male with a recent history of myocardial infarction
C) A 50-year-old male with type II diabetes mellitus
D) A 25-year-old female with several episodes of urinary infection

Question 19

The nurse is reviewing discharge instructions for a patient diagnosed with urinary incontinence resulting from a urinary tract infection.Which statement made by the patient indicates the need for further education?

A) "I should drink plenty of water to prevent damage to my kidneys while I am on the antibiotics for the infection."
B) "Drinking cranberry juice will decrease the risk for developing urinary tract infections."
C) "I will contact the health-care provider prior to taking over-the-counter medications while on my antibiotic."
D) "I will continue to hold my urine while in public so that I do not get another infection."

Question 20

The nurse is providing care to a patient who is experiencing urine leakage when coughing or laughing.Which type of incontinence should the nurse include in this patient's plan of care?

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

Question 21

The nurse is providing care to a patient who is diagnosed with bladder cancer and receiving Bacille Calmette-Guérin therapy.Which is the priority teaching point for this patient?

A) Straining all urine to assess for calculi
B) Flushing the toilet immediately after urination
C) Pouring two cups of bleach in the toilet and flushing 20 minutes later
D) Notifying the health-care provider if the patient does not void every two hours

Question 22

The nurse is providing care to a patient with urge incontinence.Which drug classification should the nurse include in the patient's plan of care?

A) Anticholinergic
B) Topical estrogen
C) Alpha-adrenergic agonist
D) Calcium channel blocker

Question 23

The nurse is providing care to a patient with stress incontinence.Which drug classification should the nurse include in the patient's plan of care?

A) Anticholinergic
B) Topical estrogen
C) Alpha-adrenergic agonist
D) Calcium channel blocker

Question 24

The nurse is providing care to a patient with benign prostatic hyperplasia (BPH).Which drug classification should the nurse include in the patient's plan of care?

A) Diuretic
B) Anticholinergic
C) Topical estrogen
D) Alpha-adrenergic agonist

Question 25

Which intervention should the nurse include in the patient's plan of care to decrease the risk for developing a catheter-associated urinary tract infection?

A) Implementing intermittent catheterization
B) Administering the prescribed prophylactic antibiotic
C) Retaining the indwelling catheter throughout hospitalization
D) Encouraging the consumption of cranberry juice twice per day