Lewis's Medical-Surgical Nursing Chapter 49, Assessment Urinary System

Which finding would the nurse document in the subjective data as related to the urinary assessment?

A. Hematuria

B. Bladder distension

C. Patient report of history of gout and hypertension

D. 2+ pitting edema noted in the bilateral lower extremities

C. Patient report of history of gout and hypertension

Which patient statement would alert the nurse that the patient may have a urinary tract infection?

A. "I cannot get enough to drink."

B. "My mom has become more confused over the past few days."

C. "My vision has changed, and things look blurry."

D. "I am having more swelling in my legs."

B. “My mom has become more confused over the past few days.”

Which manifestation of pain may alert the nurse to a possible urinary system disorder?

A. Pain located in the lower right quadrant of the abdomen

B. Pain radiating from lower back down one of the legs

C. Pain located on the side of torso below the ribs

D. Upper abdominal pain

C. Pain located on the side of torso below the ribs

Rational: Pain located on the side of torso below the ribs. Pain located on the side of the torso below the ribs is referred to as flank pain. Patients with flank pain may have a urinary system disorder that needs further work up.

Which assessment finding would the nurse observe in a patient with a urinary system disease?

A. Jaundice

B. Increased energy

C. Rash on the trunk

D. Excoriations

D. Excoriations

Which technique would be used by the nurse to determine potential kidney infection or kidney disease?

A. Auscultating for bruits

B. Palpation of the kidney

C. Percussion of the flank

D. Percussion of the bladder

C. Percussion of the flank

Rational: Percussion of the flank

Percussion of the kidney is also called a "kidney punch." This is performed to determine infection and polycystic kidney disease.

Which assessment technique would the nurse plan to include when performing a physical assessment of the urinary system? Select all that apply. One, some, or all responses may be correct.

A. Inspecting the urinary meatus

B. Asking the patient about voiding patterns

C. Palpating the bladder to check for bladder distention

D. Reviewing the serum creatinine level on recent lab tests

E. Performing percussion to the costovertebral angle

A. Inspecting the urinary meatus

C. Palpating the bladder to check for bladder distention

E. Performing percussion to the costovertebral angle

Which action would the nurse include when collecting a urine specimen for urinalysis (UA)? Select all that apply. One, some, or all responses may be correct.

A. Collect the specimen in the morning.

B. Keep the urine specimen at room temperature.

C. Cleanse the perineal area prior to collection.

D. Explain to the patient that catheterization is required for obtaining the UA.

E. Press gently on the bladder to ensure all urine is collected for the specimen.

A. Collect the specimen in the morning.

C. Cleanse the perineal area prior to collection.

Which laboratory test requires a 24-hour urine collection?

A. Residual urine

B. Clean catch urine

C. Urine cytologic study

D. Creatinine clearance

D. Creatinine clearance

Which laboratory result would the nurse report to the provider as abnormal?

A. Potassium – 5.0 mEq/L

B. Sodium – 118 mEq/L

C. Creatine – 1.1 mg/dl

D. Calcium – 9.0 mg/dl

B. Sodium – 118 mEq/L

Rational: The normal range for sodium levels are 136–145 mEq/L. This lab level should be reported and addressed.The normal range for sodium levels are 136–145 mEq/L. This lab level should be reported and addressed.

Which antimicrobial may be nephrotoxic?

A. Vancomycin

B. Azithromycin

C. Clindamycin

D. Doxycycline

A. Vancomycin: is an antimicrobial that may be nephrotoxic. It is important to monitor renal function in patients on this medication.

3 multiple choice options

Which neurological symptom would cause the nurse to suspect a patient has abnormal kidney function?

A. Tremors

B. Blurred vision

C. Hallucinations

D. Numbness in fingers and hands

B. Blurred vision

Blurred vision can suggest there is abnormal kidney function and should be further assessed.

3 multiple choice options

Which urinary condition may be caused by dehydration?

A. Urinary inflammatory disease worsening

B. Hematuria

C. Incontinenceterm-13

D. Stone formation

D. Stone formation: Dehydration is linked with conditions, including UTIs, kidney failure, and stone formation.

3 multiple choice options

Which technique would the nurse use to palpate the right kidney?

A. Place left hand behind and support the patient’s right side between the rib cage and the iliac crest.

B. Place the patient in a lateral position on their right side with the knees flexed.

C. Have the patient lay in the prone position and lean into the left side.

D. Use both hands to deeply palpate the right lower abdomen.

A. Place left hand behind and support the patient’s right side between the rib cage and the iliac crest.

To palpate for the right kidney, the right side should be supported, and right flank elevated with the left hand. The right hand is then used to palpate the right kidney. The lower pole of the right kidney may be felt as a smooth, rounded mass that descends on inspiration.

Which question would the nurse include in a focused urinary assessment? Select all that apply. One, some, or all responses may be correct.

A. “Have you had painful urination?”

B. " Do you drink at least 2 L of water a day?"

C. “Have you had recent urine tests? ”

D. “Are you waking up to urinate at night?”

E. “Have you noticed any swelling on your lower extremities or fluid retention?”

A. "Have you had painful urination?”

C. "Have you had recent urine tests? "

D. "Are you waking up to urinate at night?"

Which patient statement would demonstrate understanding of the purpose of a bowel prep for imaging of the urinary tract? Select all that apply. One, some, or all responses may be correct.

A. “It’s okay to not use what my provider ordered for my bowel preparation as long as I take a laxative. “

B. “I will need to have hydration prior to my test to help the bowel prep work better.”

C. “I will need to be on a clear liquid diet for a few days prior to my scans.”

D. “I should begin the bowel preparation the evening before my study. “

E. “If my bowel clearance isn’t complete, they may need to repeat the test.”

D. “I should begin the bowel preparation the evening before my study. “

E. “If my bowel clearance isn’t complete, they may need to repeat the test.”

Which result would the nurse recognize as an abnormal bicarbonate level? Select all that apply. One, some, or all responses may be correct.

A. 20 mEq/L

B. 22 mEq/L

C. 24 mEq/L

D. 26 mEq/L

E. 28 mEq/L

A. 20 mEq/L

A bicarbonate level of 20 mEq/L is low and could signal the patient is experiencing metabolic acidosis.

E. 28 mEq/L

A bicarbonate level of 28 mEq/L would be expected for a patient in metabolic alkalosis.

3 multiple choice options

Which term would the nurse use to document a patient’s report of involuntary nocturnal urination?

A. Anuria

B. Dysuria

C. Enuresis

D. Incontinence

C. Enuresis

Enuresis means involuntary nocturnal urination. It may indicate a lower urinary tract disorder.

3 multiple choice options

Which diagnostic finding on a urinalysis can indicate liver problems?

A. Casts

B. Protein

C. RBCs

D. Bilirubin

D. Bilirubin

Bilirubin in the urine indicates liver problems. Often bilirubin in the urine will appear before jaundice appears.

3 multiple choice options