N321 Renal/GU Quiz Practice Questions

The nurse expects to observe which of the following altered laboratory values in a patient diagnosed with renal failure?

A. Decreased calcium

B. Increased calcium

C. Decreased phosphorus

D. Increased hematocrit

A. Decreased calcium

The nurse is caring for an older adult with intermittent urinary incontinence. The nurse recognizes that the incontinence is a result of which structure failing to contract to keep urine in the bladder until micturition?

A. The detrusor muscle

B. The external urethral sphincter

C. The urethra

D. The internal urethral sphincter

D. The internal urethral sphincter

The nurse is assessing a patient for a routine physical examination. Which of the following are normal findings when assessing the renal and urinary systems? (Select all that apply.)

A. Inability to palpate the kidneys

B. CVA tenderness upon percussion

C. Absence of a renal artery bruit

D. Purulent drainage from the urinary meatus

E. Tympanic sounds over an empty bladder upon percussion

A. Inability to palpate the kidneys

C. Absence of a renal artery bruit

The nurse understands that an abnormal VCUG (voiding cystourethrogram) indicates which of the following?

A. The presence of a mass in the bladder

B. An increased risk of kidney infection

C. Incomplete emptying of the bladder

D. Decreased creatinine clearance

B. An increased risk of kidney infection

The nurse is caring for a patient receiving IV contrast for a renal CT scan. Nursing responsibilities related to the administration of IV contrast include which of the following? (Select all that apply.)

A. To assess for allergies to contrast, iodine, and seafood prior to the study

B. To educate the patient to increase fluid intake following the study

C. To obtain an order for NPO status following the study

D. To ensure that IV contrast is administered only through a central line

E. To assess the patient's baseline creatinine value prior to the study

A. To assess for allergies to contrast, iodine, and seafood prior to the study

B. To educate the patient to increase fluid intake following the study

E. To assess the patient's baseline creatinine value prior to the study

The nurse caring for an 86-year-old female patient who presents with nocturnal polyuria incorporates which priority nursing diagnosis into the plan of care?

A. Risk for deficient fluid volume

B. Risk for sleep deprivation

C. Risk for excess fluid volume

D. Risk for urge urinary incontinence

A. Risk for deficient fluid volume

The nurse recognizes that genetic counseling is appropriate for which patient?

A. A child with frequent urinary tract infections

B. An adult with frequent urinary tract infection

C. An adult with autosomal-dominant polycystic kidney disease

D. An adult with metastatic renal cancer

C. An adult with autosomal-dominant polycystic kidney disease

The nurse understands that which diagnostic study is most specific in identifying PKD?

A. Abdominal x-ray

B. Serum creatinine level

C. Urinalysis

D. Computed tomography scan

D. Computed tomography scan

The nurse correlates which clinical manifestations with the pathophysiology of acute pyelonephritis? (Select all that apply.)

A. Nausea and vomiting

B. Hematuria

C. Flank pain

D. Fever

E. Abdominal pain

A. Nausea and vomiting

B. Hematuria

C. Flank pain

D. Fever

What is the etiological process in glomerulonephritis?

A. Tubular necrosis caused by bacteria and antibody reactions

B. Deposition of immunological complexes and complement along the GBM

C. Deposition of bacteria and immunological components within the loop of Henle

D. Destruction of proteolytic enzymes contained in the GBM

B. Deposition of immunological complexes and complement along the GBM

Which of the following risk factors has been associated with renal cancer?

A. Aspirin use

B. Alcohol abuse

C. Use of artificial sweeteners

D. Cigarette smoking

D. Cigarette smoking

The nurse recognizes that which patient has the highest risk of renal cancer?

A. A 76-year-old African American female

B. A 50-year-old Caucasian male

C. A 24-year-old Caucasian male

D. A 50-year-old African American male

D. A 50-year-old African American male

The nurse providing care for the patient post-motor vehicle accident with a suspected injury to the renal system anticipates which of the following orders?

A. Perform an electrocardiogram (ECG).

B. Send a urinalysis to the laboratory.

C. Administer diuretics.

D. Administer antihypertensives.

B. Send a urinalysis to the laboratory.

Prior to the patient's CT scan, which information should be obtained from the patient or family member?

A. A family history of CT scans

B. Time of patient's last meal

C. List of patient's allergies

D. Time of last pain medication

C. List of patient's allergies

Which is a prerenal cause of AKI?

A. Acute glomerulonephritis and neoplasms

B. Septic shock and nephrotoxic injury from medications

C. Pyelonephritis and calculi formation

D. Hypovolemia and myocardial infarction

D. Hypovolemia and myocardial infarction

When the patient is in the diuretic phase of AKI, the nurse must monitor which serum electrolyte imbalance?

A. Hypokalemia and hyponatremia

B. Hypokalemia and hypernatremia

C. Hyperkalemia and hyponatremia

D. Hyperkalemia and hypernatremia

C. Hyperkalemia and hyponatremia

The risk factor or factors most often associated with CKD include which of the following? (Select all that apply.)

A. Hypertension

B. Diabetes mellitus

C. Malnutrition

D. Peripheral vascular disease

E. Smoking

A. Hypertension

B. Diabetes mellitus

The nurse understands that CKD is characterized by which of the following?

A. A rapid decrease in urine output with a CKD-elevated BUN

B. Progressive, irreversible destruction to the kidneys

C. Abrupt increasing creatinine clearance with a decrease in urinary output

D. Confusion and somnolence leading to coma and death

B. Progressive, irreversible destruction to the kidneys

The nurse understands that CRRT is indicated for which of the following patients?

A. A hospitalized but hemodynamically stable patient

B. A hospitalized, hemodynamically unstable patient

C. A hospitalized ESRD patient being discharged home soon

D. A hospitalized ESRD patient who is stable but in an intensive care setting

B. A hospitalized, hemodynamically unstable patient

The nurse recognizes which patient is at greatest risk for a UTI?

A. A 35-year-old sexually active male

B. A 23-year-old sexually active female

C. A 50-year-old sexually active female

D. An 18-year-old sexually active male

B. A 23-year-old sexually active female

The nurse understands which population is at increased risk for developing urinary stones?

A. Black females living in Florida

B. White males living in Georgia

C. Black males living in New York

D. White females living in Oregon

B. White males living in Georgia

Which statement by the patient indicates teaching about tamsulosin (Flomax) has been effective?

A. "Will this medicine help my nausea?"

B. "So, this medicine will help me pass the stone by relaxing the muscles?"

C. "I need to take this medicine so I don't get an infection."

D. "This medicine is for my pain."

B. "So, this medicine will help me pass the stone by relaxing the muscles?"

The patient with stress incontinence is prescribed Kegel exercises. The nurse tells the patient that Kegel exercises will help:

A. Strengthen the detrusor muscle

B. Strengthen the posterior urethral valves

C. Strengthen the internal sphincter

D. Strengthen the external sphincter

C. Strengthen the internal sphincter

The nurse understands that non-muscle urinary cancers affect only:

A. Muscle and surrounding fat

B. The urothelium, or inner lining of the bladder

C. Structures adjacent to the bladder

D. The lobes of the prostate

B. The urothelium, or inner lining of the bladder

Glomerulonephritis is characterized by glomerular damage. Which of the following statements describes the cause of this damage?

A. Accumulation of immune complexes in the glomeruli

B. Growth of microorganisms in the glomeruli

C. Hemolysis of red blood cells circulating in the glomeruli

D. Release of bacteria which is toxic to the glomeruli

A. Accumulation of immune complexes in the glomeruli

Which of the following clinical manifestations is more common in acute pyelonephritis than in a lower UTI?

A. Dysuria

B. Fever

C. Frequency

D. Urgency

B. Fever

Select the appropriate treatment options from the answer choices below that describe the following: "performed with equipment passed through the urethra".

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

Select the appropriate treatment options from the answer choices below that describe the following: "removal of the prostate gland".

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

A. Transurethral resection of the prostate

C. Open prostatectomy

Select the appropriate treatment options from the answer choices below that describe the following: :"shrinking or destroying the tissue of the prostate gland".

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

H. Water-induced thermotherapy and transurethral ethanol ablation

Select the appropriate treatment options from the answer choices below that describe the following: "options for men who are not surgical candidates".

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

G. Prostatic stents

Rationale: With this nonsurgical procedure, a prostatic stent is placed in the urethra to keep it open. Either metal or plastic stents may be used. Replacement may be required every 4-6 weeks. This is not a long-term solution because of the increased risk of UTIs.

Select the appropriate treatment options from the answer choices below that describe the following: "bleeding as a complication".

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

E. Transurethral microwave therapy

F. Transurethral needle ablation

Rationale: When the prostate gland is removed, risk for bleeding and infection arises. Often, clients who have these procedures experience bladder irrigation via a three-way catheter until the bleeding decreases.

Select the appropriate treatment options from the answer choices below that describe the following: "opens for small or moderately large prostate gland".

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

C. Open prostatectomy

D. Laser surgery

E. Transurethral microwave therapy

F. Transurethral needle ablation

G. Prostatic stents

H. Water-induced thermotherapy and transurethral ethanol ablation

A. Transurethral resection of the prostate

B. Transurethral incision of the prostate

D. Laser surgery

E. Transurethral microwave therapy

A client with benign prostatic hyperplasia is not responding to medications and is a high risk for surgery due to a bleeding disorder. Which procedure is the best option for him?

A. Transurethral resection of the prostate

B. Open prostatectomy

C. Laser surgery

D. Prostatic stents

D. Prostatic stents

A neighbor asks a nurse if he might have an enlarged prostate gland. Which symptoms are consistent with these suspicions? (Select all that apply.)

A. Urinating several times at night

B. A weak stream of urine

C. Difficulty starting the flow of urine

D. Premature ejaculation

E. Dribbling after urinating

A. Urinating several times at night

B. A weak stream of urine

C. Difficulty starting the flow of urine

E. Dribbling after urinating

A client with benign prostatic hyperplasia asks about medications that can help shrink the prostate tissue. Which type of medication should the nurse mention?

A. 5-alpha reductase inhibitors

B. Diuretic

C. Chemotherapy agents

D. Beta blockers

A. 5-alpha reductase inhibitors

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Select the statements that apply to the following:

"stress incontinence"

A. Childbirth

B. Postmenopausal smoking

C. Caffeine

D. Artificial sweeteners

E. Occurs with coughing

F. Treated by teaching Kegel exercises

G. Treated by fluid control

A. Childbirth

B. Postmenopausal smoking

E. Occurs with coughing

F. Treated by teaching Kegel exercises

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Select the statements that apply to the following:

"urge incontinence"

A. Nicotine

B. Postmenopausal obesity

C. Strong urge to urinate

D. Uncontrolled leakage of urine

E. More common in women

F. Treated with systemic estrogen

G. Teach patient to eliminate bladder irritants

A. Nicotine

C. Strong urge to urinate

D. Uncontrolled leakage of urine

G. Teach patient to eliminate bladder irritants

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Select the statements that apply to the following:

"mixed incontinence"

A. Associated with a flaccid, enlarged bladder caused by an enlarged prostate

B. Strong urge to urinate followed by uncontrolled leakage of urine

C. Occurs with coughing or laughing

D. Causes frequent urination

E. Caused by postmenopausal smoking and obesity

F. Include timed toileting in care plan

B. Strong urge to urinate followed by uncontrolled leakage of urine

C. Occurs with coughing or laughing

E. Caused by postmenopausal smoking and obesity

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Select the statements that apply to the following:

"overflow incontinence"

A. Caused by spinal cord injury

B. Caused by an inability to get to a toilet

C. Causes frequent urination

D. Causes a strong urge to urinate followed by leakage of urine

E. Causes a loss of urine in inappropriate places

F. Treatment includes the use of alpha-adrenergic medications

G. Treatment includes the use of antispasmodic medications

A. Caused by spinal cord injury

C. Causes frequent urination

F. Treatment includes the use of alpha-adrenergic medications

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Select the statements that apply to the following:

"functional incontinence"

A. Causes frequent urination

B. Causes a loss of urine in inappropriate places

C. Caused by an inability to communicate toileting needs

D. Caused by neurological conditions

E. Caused by an enlarged prostate

F. Implement timed toileting in the plan of care

G. Administer prescribed alpha-adrenergic medications

B. Causes a loss of urine in inappropriate places

C. Caused by an inability to communicate toileting needs

F. Implement timed toileting in the plan of care

A client presents to the clinic with new onset urinary incontinence. While determining treatment options, which of the following is priority?

A. Making sure the client gets to the bathroom

B. Educating about the increasing incidence of incontinence with age

C. Preventing skin breakdown and controlling odor

D. Educating about pelvic floor exercises

C. Preventing skin breakdown and controlling odor

A mother of three states she experiences urinary leakage when coughing or sneezing. Which intervention is most appropriate for the nurse to suggest first?

A. Clean intermittent catheterization

B. Anticholinergic medication

C. Restrict oral fluid intake

D. Kegel exercises

D. Kegel exercises

A client presents to the clinic after experiencing a strong need to urinate followed by uncontrolled leakage of urine. The nurse suspects the client will be diagnosed with which type of urinary incontinence?

A. Stress incontinence

B. Urge incontinence

C. Functional incontinence

D. Overflow incontinence

B. Urge incontinence

When teaching a client about irritants that may aggravate urinary incontinence, the nurse should include which substances? (Select all that apply.)

A. Caffeine

B. Alcohol

C. Gluten

D. Acidic foods

E. Carbonated beverages

A. Caffeine

B. Alcohol

D. Acidic foods

E. Carbonated beverages

The nurse is preparing to teach a client about interventions to help with functional incontinence. Which intervention should be included in the teaching?

A. Timed toileting

B. Take alpha adrenergic medication

C. Clean intermittent catheterization

D. Fluid restriction

A. Timed toileting

The nurse is caring for Samantha, a 30-year-old female who presents to the emergency department with symptoms associated with urolithiasis. Which of Samantha's symptoms supports a diagnosis of urolithiasis? (Select all that apply.)

A. Polyuria

B. Diarrhea

C. Flank pain

D. Nausea and vomiting

E. Abdominal distention

C. Flank pain

D. Nausea and vomiting

Which diagnostic test is Samantha likely to have prescribed to confirm urolithiasis?

A. Ultrasound

B. Non-contrast CT scan

C. Kidney ureter bladder (KUB) x-ray

D. Magnetic resonance imagery (MRI)

B. Non-contrast CT scan

Samantha is diagnosed with a urolithiasis smaller than 5 mm in diameter. She is in minimal pain and urinalysis does not indicate infection. What is the first line of treatment?

A. Trial passage

B. Ureteroscopy

C. Percutaneous nephrolithotomy

D. Extracorporeal shock wave lithotripsy

A. Trial passage

Rationale: Fifty percent of stones less than 5 mm in size will pass spontaneously.

Which medication classifications should you include in Samantha's plan of care based on the current data: reports of N/V and flank pain, confirm diagnosis of urolithiasis 5 mm in size? (Select all that apply.)

A. Narcotics

B. Antibiotics

C. Antiemetics

D. Alpha-adrenergic blockers

E. Nonsteroidal anti-inflammatory drugs (NSAIDs)

A. Narcotics

C. Antiemetics

D. Alpha-adrenergic blockers

E. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Rationale: Narcotics and/or nonsteroidal anti-inflammatory medicine along with antiemetics are utilized during the trial of passage. Alpha-adrenergic blockers such as tamsulosin (Flomax), doxazosin (Cardura), and terazosin (Hytrin) can be used to relax the musculature of the lower ureter and aid in stone passage.

When planning care, which nursing diagnoses should the nurse include for a patient diagnosed with urolithiasis? (Select all that apply.)

A. Acute pain

B. Risk for infection

C. Altered elimination

D. Fluid volume deficit

E. Decreased cardiac output

A. Acute pain

B. Risk for infection

C. Altered elimination

The nurse is providing discharge education about urolithiasis to Samantha. Which clinical manifestations might necessitate the need for surgical intervention? (Select all that apply.)

A. The development of renal colic

B. Pain and burning during urination

C. Pain controlled by narcotics

D. A stone that does not pass in 2 to 3 weeks

E. The decreased incidence of nausea and vomiting

A. The development of renal colic

B. Pain and burning during urination

Which action should the nurse teach Samantha to perform in order to determine if a kidney stone has passed?

A. Straining the urine

B. Measuring urine output

C. Documenting daily urine pH

D. Monitoring the urine for ketones

A. Straining the urine

Which topics should the nurse include in the teaching session to decrease the risk for Samantha developing urolithiasis in the future? (Select all that apply.)

A. Increasing fluid intake

B. Decreasing citrate intake

C. Increasing sodium intake

D. Decreasing oxalate intake

E. Increasing fatty acid intake

A. Increasing fluid intake

D. Decreasing oxalate intake

A client is diagnosed with hydronephrosis due to obstructive kidney stones. The nurse should assess for which electrolyte imbalance that might lead to cardiac dysrhythmia?

A. Potassium

B. Calcium

C. Magnesium

D. Sodium

A. Potassium

A pregnant female is assessed for suspected kidney stones. The nurse should prepare the client for which diagnostic test?

A. Computed tomography scan

B. Magnetic resonance imaging

C. Kidneys-ureters-bladder plain film

D. Ultrasound

D. Ultrasound

What is the priority teaching point when the nurse is discussing narcotic analgesic side effects with a client diagnosed with kidney stones?

A. Lightheadedness

B. Nausea and vomiting

C. Respiratory depression

D. Constipation

C. Respiratory depression

A male client diagnosed with kidney stones is unable to void. What procedure should the nurse anticipate next?

A. Nephrostomy tube placement

B. Percutaneous nephrolithotomy

C. Foley catheter insertion

D. Renal ultrasound imaging

C. Foley catheter insertion

An older male adult with a history of kidney stones presents to the emergency department with a family member. Which finding in the assessment would most likely alert the nurse to the possibility of a urinary tract infection while waiting on urinalysis results?

A. Family member states client is confused

B. History of benign prostatic hypertrophy

C. Takes alpha-adrenergic blocker daily

D. Voids 100 mL straw-colored urine

A. Family member states client is confused

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"rapid and reversible"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

A. Acute kidney injury (AKI)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"long-term dialysis"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

B. Chronic kidney disease (CKD)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"result of dehydration"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

A. Acute kidney injury (AKI)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"result of malnutrition"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

B. Chronic kidney disease (CKD)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"result of poorly controlled diabetes"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

B. Chronic kidney disease (CKD)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"sudden reduced GFR"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

A. Acute kidney injury (AKI)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"result of poorly controlled blood pressure"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

B. Chronic kidney disease (CKD)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"sudden increase in BUN and creatinine"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

A. Acute kidney injury (AKI)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"hemoglobin 8.6 and hematocrit 30%"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

B. Chronic kidney disease (CKD)

For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD).

"renal transplantation"

A. Acute kidney injury (AKI)

B. Chronic kidney disease (CKD)

B. Chronic kidney disease (CKD)

The nurse manager has taught a new staff nurse about assessing and caring for an arteriovenous graft. The staff nurse demonstrates understanding of appropriate care when performing which action?

A. Feeling for buzzing sensation

B. Auscultating carotid pulses

C. Palpating for a bruit

D. Accessing graft for labs

A. Feeling for buzzing sensation

What is the priority teaching point when the nurse is discussing the treatment regimen with a client who has received a kidney transplant for end-stage renal disease?

A. To take medications daily at the same time

B. To keep all follow-up appointments as scheduled

C. The need for meticulous immediate and lifelong care

D. To inform client of scarring at the incision site

C. The need for meticulous immediate and lifelong care

The nurse should recognize that which assessment findings are consistent with chronic kidney disease? (Select all that apply.)

A. Slow manifestation of symptoms

B. Decreased hemoglobin levels

C. Increased hematocrit levels

D. Trace of protein in the urine

E. History of hypertension

A. Slow manifestation of symptoms

B. Decreased hemoglobin levels

E. History of hypertension

The nurse should recognize which situations as risk factors for acute kidney injury? (Select all that apply.)

A. Dehydration

B. Trauma

C. Edema

D. Hypovolemia

E. Hypervolemia

A. Dehydration

B. Trauma

D. Hypovolemia

In which of the following disorders would a patient benefit from being taught how to perform self catheterization?

A. Nephrosclerosis

B. PKD

C. Renal trauma

D. Urethral stricture

D. Urethral stricture

When obtaining a nursing history on a patient with cancer of the urinary system, what does the nurse recognize as a risk factor for both bladder cancer and kidney cancer?

A. Chronic use of opioids

B. Family history of cancer

C. Kidney stones

D. Smoking

D. Smoking

The nurse is caring for a patient with an injury to the renal system. Which should be included in the initial treatment of the patient?

A. Promoting urinary drainage

B. Encouraging the patient to rest

C. Administering IV fluids

D. Determining the extent of damage

A. Promoting urinary drainage

Rationale: Promote urinary drainage by carefully monitoring the patient's vital signs and assessing the level of bleeding.

The laboratory reports of a patient with kidney disease indicate an increase in the blood urea nitrogen (BUN) levels. Which could be the reason behind this condition?

A. Decreased erythropoietin production

B. Decreased gastrointestinal absorption

C. Increased protein intake and breakdown

D. Increased production of nonvolatile acids

C. Increased protein intake and breakdown

The nurse is teaching about the nursing recommendations while assessing an elderly patient with urinary tract infections and delirium. Which statement made by the nursing student indicates the need for further teaching?

A. "I should consider the presence of neurological deficits."

B. "I should assess the baseline cognitive function."

C. "I should assess for symptoms of dysuria and urinary frequency."

D. "I should administer antibiotics before sampling for laboratory tests."

D. "I should administer antibiotics before sampling for laboratory tests."

The nurse is teaching about peritoneal dialysis in patients with end-stage renal disease. Which statements indicate the need for further teaching? (Select all that apply.)

A. "Patients can opt for peritoneal dialysis treatment at home. "

B. "The metabolic clearance of wastes occurs quickly in peritoneal dialysis."

C. "Peritoneal dialysis requires strict dietary restrictions by the patient."

D. "Longer training sessions are required to teach the patient and his or her family members about peritoneal dialysis."

E. "Peritoneal dialysis is suggested for patients who respond poorly to hemodialysis."

B. "The metabolic clearance of wastes occurs quickly in peritoneal dialysis."

C. "Peritoneal dialysis requires strict dietary restrictions by the patient."

D. "Longer training sessions are required to teach the patient and his or her family members about peritoneal dialysis."

The nurse is teaching about the process involved in hemodialysis. Arrange the correct steps of hemodialysis chronologically.

- The blood is pumped through a dialyzer

- The waste products are diffused into the dialysate

- Negative pressure should be maintained to allow fluid removal

- The blood moves through an artificial semipermeable membrane

- Bicarbonate is added to the dialysate for acidosis corrections

- A dialysate solution is pumped on the other side of the membrane

1. The blood is pumped through a dialyzer

2. The blood moves through an artificial semipermeable membrane

3. A dialysate solution is pumped on the other side of the membrane

4. The waste products are diffused into the dialysate

5. Bicarbonate is added to the dialysate for acidosis corrections

6. Negative pressure should be maintained to allow fluid removal

A patient reports anorexia along with cloudy and foul-smelling urine. Which condition should the nurse suspect?

A. Renal cancer

B. Renal trauma

C. Pyelonephritis

D. Glomerulonephritis

C. Pyelonephritis

The nurse is assessing the clinical manifestation reports of four patients. Which patient is most likely to have renal trauma?

A. Patient A with edema of the lower extremities and abdominal pain

B. Patient B with nocturia, fever, and chills

C. Patient C with flank mass, hypertension, and weight loss

D. Patient D with hypotension, flank bruising, and gross hematuria

D. Patient D with hypotension, flank bruising, and gross hematuria

What is the duration of the oliguric phase in acute kidney injury?

A. Hours to days

B. 15 to 35 days

C. 1 to 3 weeks

D. Several months to 1 year

B. 15 to 35 days

A 45-year-old male patient has undergone surgery for invasive bladder cancer. Which nursing intervention is most appropriate to clear blood clots from the bladder postsurgery?

A. Perform intravesical immunotherapy .

B. Perform continuous bladder irrigation.

C. Record accurate bladder intake and output.

D. Administer intravesical chemotherapy medications.

B. Perform continuous bladder irrigation.

Which medication is used to decrease discomfort in a patient with a urinary tract infection (UTI)?

A. Doxazosin (Cardura)

B. Ciprofloxacin (Cipro)

C. Phenazopyridium (Pyridium, AZO)

D. Trimethoprim-sulfamethoxazole (Bactrim)

C. Phenazopyridium (Pyridium, AZO)

A nurse is assessing the vital signs of a patient diagnosed with stones in his or her ureters. Which vital sign change is most likely to be observed?

A. Decreased heart rate

B. Decreased temperature

C. Decreased blood pressure

D. Decreased respiratory rate

C. Decreased blood pressure

Rationale: Decreased blood pressure is due to infection and sepsis, dehydration, and complication of untreated stones.

A nurse is providing instructions to a patient who is prescribed antibiotics and phenazopyridine for a urinary tract infection. Which statement made by the patient indicates effective learning?

A. "I should reduce my fluid intake."

B. "I should report if my urine turns orange."

C. "I should administer phenazopyridine for only 3 days."

D. "I should stop using antibiotics if my symptoms disappear."

C. "I should administer phenazopyridine for only 3 days."

Which clinical manifestation is observed in a patient with upper ureteral stones?

A. Flank pain

B. Genital pain

C. Urinary urgency

D. Urinary frequency

A. Flank pain

A patient is diagnosed with urolithiasis. Which treatment strategies are most likely to aid in the removal or prevention of small stones passing during urination? (Select all that apply.)

A. Ureteroscopy

B. Alpha-adrenergic blockers

C. Narcotics and antiemetics

D. Percutaneous nephrolithotomy

E. Extracorporeal shock wave lithotripsy

B. Alpha-adrenergic blockers

E. Extracorporeal shock wave lithotripsy

A pregnant patient with calculi in the lower ureter is prescribed tamsulosin for 6 weeks. During a follow-up visit, the patient reports severe intermittent genital pain and vomiting. The laboratory reports reveal that the pain is related to the stones. Which intervention is most likely to benefit the patient?

A. Ureteroscopy

B. Narcotics and antiemetics

C. Other alpha-adrenergic blockers

D. Extracorporeal shock wave lithotripsy

A. Ureteroscopy

A patient is undergoing treatment for stress incontinence. Which instruction provided by the nurse is most appropriate to manage this condition?

A. "Avoid coffee and cigarettes."

B. "Use diapers while traveling."

C. "Practice pelvic floor exercises regularly."

D. "Avoid taking large amount of fluids at once."

C. "Practice pelvic floor exercises regularly."

A patient with a urinary tract infection also has a history of incontinence. The provider orders a cystourethrogram, which notes the presence of the backflow of urine. Which treatment strategy is most likely to benefit the patient?

A. Administer antispasmodics.

B. Advise to administer a pessary.

C. Advise to perform Kegel exercises.

D. Provide clean intermittent catheterization

D. Provide clean intermittent catheterization

A patient is diagnosed with benign prostate hyperplasia (BPH) and failed to respond to alpha-adrenergic receptor blockers. The laboratory reports of the patient revealed that there are bladder stones of 2.5 cm. Which surgical procedure would the nurse expect to be beneficial for the patient?

A. Laser surgery

B. Open prostatectomy

C. Transurethral incision of the prostate (TUIP)

D. Transurethral resection of the prostate (TURP)

B. Open prostatectomy

The nurse is talking with a patient who says his friend has a procedure where hot water is used for causing coagulation necrosis of the prostate tissue. The patient says, "That's just crazy, I don't believe him." How should the nurse respond?

A. "It sounds like your friend is talking about an open prostatectomy."

B. "A transurethral needle ablation includes the use of hot water."

C. "That would be water-induced thermotherapy (WIT)."

D. "Yes, that's a transurethral ethanol ablation of the prostate (TEAP)."

C. "That would be water-induced thermotherapy (WIT)."

A patient is diagnosed with benign prostatic hyperplasia (BPH) and has minimal symptoms. The primary health-care provider recommends active surveillance of the patient. What should the nurse include with discharge teaching? (Select all that apply.)

A. "I should advise the patient to avoid sedatives."

B. "I should advise the patient to avoid all over-the-counter (OTC) medications."

C. "I should advise the patient to visit the provider yearly."

D. "I should advise the patient to increase fluid intake until bed time."

D. "I should advise the patient to avoid consumption of selenium-rich foods."

A. "I should advise the patient to avoid sedatives."

C. "I should advise the patient to visit the provider yearly."

A patient with benign prostatic hyperplasia is diagnosed with bladder damage from the outlet obstruction and asks the nurse why that occurred. Which could be the cause for the bladder damage?

A. Urinary stasis

B. Painful urination

C. Mineral deposits in the bladder

D. Incomplete emptying of bladder

D. Incomplete emptying of bladder

A patient reports frequency in urination leading to awakening at night, a weak stream of urine, and a feeling that the bladder has not completely emptied. Which diagnostic tests are beneficial to confirm the condition? (Select all that apply.)

A. Urinalysis

B. Ultrasound of the abdomen

C. Digital rectal exam

D. Magnetic resonance imaging

E. Prostate specific androgen (PSA) levels

A. Urinalysis

C. Digital rectal exam

Which symptoms in a patient indicate benign prostatic hyperplasia (BPH) to the primary health-care provider? (Select all that apply.)

A. Dribbling once urination is complete

B. Frequent nocturia

C. Erectile dysfunction

D. Swelling and hardness in the scrotum

E. Multiple interruptions during urination

A. Dribbling once urination is complete

B. Frequent nocturia

E. Multiple interruptions during urination

A patient was diagnosed with benign prostatic hyperplasia (BPH), and the primary health-care provider decides that watchful waiting is appropriate. Which statement made by the patient requires further teaching?

A. "I should receive yearly examinations."

B. "I should avoid over-the-counter drugs."

C. "I should drink lots of fluids in the evening."

D. "I should return to the clinic if I have symptoms."

C. "I should drink lots of fluids in the evening."

Which surgical option is beneficial for a patient with a medium size prostate who has benign prostatic hyperplasia?

A. Laser surgery

B. Open prostatectomy

C. Transurethral incision of the prostate (TUIP)

D. Transurethral resection of the prostate (TURP)

C. Transurethral incision of the prostate (TUIP)

A patient is diagnosed with a very large prostate and bladder stones. The primary health-care provider suggests surgery to remove the prostate. Which surgery does the nurse expect the primary health-care provider will advise?

A. Laser surgery

B. Open prostatectomy

C. Transurethral microwave therapy

D. Transurethral resection of the prostate

B. Open prostatectomy