Deck 37: Nursing Care of Patients With Disorders of the Urinary System

Question 1

The nurse is providing support for a client who just finished a hemodialysis session. Which patient symptom is considered to be a complication of hemodialysis?

A)Headache from a drop-in blood pressure
B)Increased clotting time from dialysate
C)Cardiac arrhythmias and angina from fluid loss
D)High energy level related to loss of toxins

Answer 1

Cardiac arrhythmias and angina from fluid loss

Question 2

The nurse is providing care for a patient who is diagnosed with urinary obstruction from a blockage of the urethra. An emergency surgery is scheduled. The nurse is aware of which complication occurring without resolution of the condition?

A)Bilateral hydronephrosis
B)Urinary bladder rupture
C)Irreparable kidney damage
D)Dilation of the ureters

Answer 2

Irreparable kidney damage

Question 3

The nurse is providing care for a patient admitted with severe flank pain identified as renal colic. Urinalysis is positive for microscopic hematuria. Which nursing intervention is most important for the nurse to implement?

A)Administer prescribed narcotic medication.
B)Maintain IV fluids and encourage oral fluids.
C)Promote assisted ambulation as tolerated.
D)Strain urinary output and observe for stones.

Answer 3

Strain urinary output and observe for stones.

Question 4

The nurse is planning care for a patient diagnosed with chronic renal failure. The nurse notes that the patient's output is 620 mL for the last 24 hours. The patient has periorbital edema and crackles in all lung fields upon auscultation. Which intervention is most important for the nurse to implement during care of this patient?

A)Administer oxygen therapy.
B)Measure abdominal girth.
C)Obtain daily weights.
D)Maintain fluid restrictions.

Question 5

The nurse is providing care for a patient who is scheduled for the formation of access for hemodialysis. Which important action does the nurse take with this patient?

A)Refrains from drawing blood or placing IV lines in the nondominate arm
B)Prepares the patient for permanent placement of a central venous catheter
C)Instructs the patient about the need for showering with antimicrobial soap
D)Reviews the type of underclothing that will be worn to protect the access

Question 6

The nurse is visiting a patient who performs peritoneal dialysis at home. The nurse is evaluating the patient's technique and environment. Which situation is least likely to cause the nurse concern?

A)The patient has several pets who roam around the house.
B)The patient verbally expresses symptoms to report to the HCP.
C)The patient uses clean technique when instilling the dialysate.
D)The patient voices the reasons for limiting dietary protein intake.

Question 7

The nurse is collecting data from a male patient who reports hematuria and bladder cramping. The patient's history indicates a 20-year history of smoking and long-term employment in a tool factory. Which specific test does the nurse expect the HCP to order?

A)Complete blood count
B)Urine test for telomerase
C)Urinalysis for bladder infection
D)Urine culture for presence of bacteria

Question 8

The nurse is reinforcing teaching about the most serious side effect of peritoneal dialysis with a patient scheduled for the first treatment. Which side effect stated by the patient indicates correct understanding?

A)Peritonitis
B)Paralytic ileus
C)Respiratory distress
D)Cramps in the abdomen

Question 9

The nurse is reinforcing teaching provided to a patient with a history of calcium oxalate kidney stones. The nurse recognizes that teaching has been effective if the patient avoids which foods? (Select all that apply.)

A)Bread
B)Cocoa
C)Lettuce
D)Spinach
E)Instant coffee

Question 10

The nurse is preparing to reinforce teaching to a patient newly diagnosed with PKD. Which information does the nurse include? (Select all that apply.)

A)Typically, first signs of the disease appear during late childhood.
B)Grape-like cysts will replace normal, functioning structures.
C)Initial symptoms are dull heaviness in the flank area and hematuria.
D)Patients are at risk for brain aneurysms and diverticulosis in the colon.
E)Disease is likely to require additional treatment for hypertension and UTIs.

Question 11

A female patient with a history of diabetes mellitus presents at the health care provider's (HCP) office with chills, a high fever, and flank pain. The nurse notes that a collected urine specimen appears cloudy. Which condition does the nurse expect?

A)Diabetic related sepsis
B)Infection from hepatitis
C)Urethritis and bladder infection
D)Complicated pyelonephritis

Question 12

The nurse is providing care for a patient with glomerulonephritis. Which form of kidney injury should the nurse realize has occurred with this patient?

A)Prerenal
B)Postrenal
C)Intrarenal
D)Suprabladder

Question 13

The nurse is preparing a patient for a cystectomy and the creation of a continent urinary diversion. For which reason does the nurse identify creation of this type of diversion?

A)Convenience for the patient
B)Extensive bladder destruction exists
C)Prevention of skin breakdown
D)Failed previous incontinent diversion

Question 14

A 19-year-old patient reports flank pain and scanty urination. The nurse notices periorbital edema, and the urinalysis reveals white blood cells, red blood cells, albumin, and casts. Which question will provide important information for the nurse to include in data collection?

A)"Have you noticed changes in your vision?"
B)"Have you ever had unprotected sex?"
C)"Have you had any gastrointestinal problems lately?"
D)"Have you had any type of strep infection recently?"

Question 15

Which patient will the nurse consider to be at greatest risk for cancer of the kidney?

A)A 30-year-old male who smokes a pack a day and is treated for hypertension
B)A 46-year-old female who is obese and works full time as an x-ray technician
C)A 55-year-old female who has undergone dialysis for 6 years for renal disease
D)A 50-year-old male with a 20-year history of smoking and works in a chemical laboratory

Question 16

The nurse is providing care for older adult clients in an extended care facility. Which patient will the nurse monitor most closely for symptoms of urosepsis?

A)The patient with continuous urinary incontinence
B)The patient who is unable to obtain fluids independently
C)The patient who has an indwelling catheter for a urinary tract infection (UTI)
D)The patient who has surgery for placement of an ileostomy

Question 17

The nurse is providing postoperative care for a patient with a newly formed ileal conduit for a diagnosis of cancer. Which factor regarding the patient's surgery does the nurse identify as incorrect?

A)The nurse can expect the urine to contain mucus.
B)Urine will drain continuously from the reservoir.
C)Bladder continence will develop after healing.
D)The surgery includes the formation of an ileostomy.

Question 18

The nurse is reinforcing teaching provided to a patient about caring for a new arteriovenous (AV) fistula in the left arm for dialysis. Which patient statements indicate correct understanding? (Select all that apply.)

A)"Do not sleep on my arm."
B)"Keep my arm elevated at all times."
C)"Keep a firm bandage on my arm."
D)"Wear loose clothing on my left arm."
E)"Avoid carrying heavy things with my left arm."

Question 19

The nurse is providing care for a patient scheduled for surgery for the formation of an orthotopic bladder substitution. Which patient teaching is important for the nurse to review during the patient's recovery?

A)How to monitor the stoma
B)How to prevent skin injury
C)How to perform catheterization
D)How to apply an ostomy appliance

Question 20

The nurse is collecting data on a patient admitted for symptoms of renal insufficiency. Which factor will cause the nurse to suspect prerenal injury?

A)A family history of polycystic kidney disease (PKD)
B)Medications for chronic joint pain and hypertension
C)Laboratory results indicating a high level of an aminoglycoside
D)A tumor obstruction diagnosed as being present in the right ureter