NCLEX Urinary System Questions

NCLEX Urinary System Questions 4.8 (13 reviews) Students also studied Terms in this set (24) George Brown College Nursing Save Urinary NCLEX QUESTIONS Teacher 32 terms bojel1Preview NCLEX Questions for Renal Disorder...40 terms mdunlap5920Preview Renal & urinary nclex questions 24 terms Angiieee07Preview Urinary 12 terms lmr To assess whether there is any improvement in a patient's dysuria, which question will the nurse ask?

• "Do you have to urinate at night?"
• "Do you have blood in your urine?"
• "Do you have to urinate frequently?"
• "Do you have pain when you urinate?"

d When a patient's urine dipstick test indicates a small amount of protein, the nurse's next action should be to

• send a urine specimen to the laboratory to test for

ketones.

• obtain a clean-catch urine for culture and sensitivity

testing.

• inquire about which medications the patient is currently

taking.

• ask the patient about any family history of chronic renal

failure.c- some medications may give false-positive readings.A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a creatinine clearance test. Which equipment will the nurse need to obtain?

• Urinary catheter
• Cleaning towelettes
• Large container for urine
• Sterile urine specimen cup

c Because creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection

A 32-year-old patient who is employed as a hairdresser and has a 15 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for

• renal failure.
• kidney stones.
• pyelonephritis.
• bladder cancer.

d Exposure to the chemicals involved with working as a hairdresser and in smoking both increase the risk of bladder cancer Which medication taken at home by a 47-year-old patient with decreased renal function will be of most concern to the nurse?

• ibuprofen (Motrin)
• warfarin (Coumadin)
• folic acid (vitamin B9)
• penicillin (Bicillin LA)

a NSAIDs are nephrotoxic and should be avoided in patients with impaired renal function A 79-year-old man has been admitted with benign prostatic hyperplasia. What is most appropriate to include in the nursing plan of care?

• Limit fluid intake to no more than 1000 mL/day.
• Leave a light on in the bathroom during the night.
• Ask the patient to use a urinal so that urine can be

measured.

• Pad the patient's bed to accommodate overflow

incontinence.b The patient's age and diagnosis indicate a likelihood of nocturia The nurse completing a physical assessment for a newly admitted male patient is unable to feel either kidney on palpation. Which action should the nurse take next?

• Obtain a urine specimen to check for hematuria.
• Document the information on the assessment form.
• Ask the patient about any history of recent sore throat.
• Ask the health care provider about scheduling a renal

ultrasound.b The kidneys are protected by the abdominal organs, ribs, and muscles of the back, and may not be palpable under normal circumstances, so no action except to document the assessment information is needed How will the nurse assess for flank tenderness in a 30- year-old female patient with suspected pyelonephritis?

• Palpate along both sides of the lumbar vertebral

column.

• Strike a flat hand covering the costovertebral angle

(CVA).

• Push fingers upward into the two lowest intercostal

spaces.

• Percuss between the iliac crest and ribs along the

midaxillary line.b Checking for flank pain is best performed by percussion of the CVA and asking about pain.

What glomerular filtration rate (GFR) would the nurse estimate for a 30-year-old patient with a creatinine clearance result of 60 mL/min?

• 60 mL/min
• 90 mL/min
• 120 mL/min
• 180 mL/min

a The creatinine clearance approximates the GFR The nurse assessing the urinary system of a 45-year-old female would use auscultation to

• determine kidney position.
• identify renal artery bruits.
• check for ureteral peristalsis.
• assess for bladder distention.

b The presence of a bruit may indicate problems such as renal artery tortuosity or abdominal aortic aneurysm A patient gives the nurse health information before a scheduled intravenous pyelogram (IVP). Which item has the most immediate implications for the patient's care?

• The patient has not had food or drink for 8 hours.
• The patient lists allergies to shellfish and penicillin.
• The patient complains of costovertebral angle (CVA)

tenderness.

• The patient used a bisacodyl (Dulcolax) tablet the

previous night.b A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate?

• "Your doctor will place a catheter into an artery in your

groin and inject a dye that will visualize the blood supply to the kidneys."

• "Your doctor will insert a lighted tube into the bladder,

and little catheters will be inserted through the tube into your kidney."

• "Your doctor will insert a lighted tube into the bladder

through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."

• "Your doctor will inject a radioactive solution into a

vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked." c In a cystoscope and cystogram procedure, a cystoscope is inserted into the bladder for direct visualization, and then contrast solution is injected through the scope so that x-rays can be taken.The nurse caring for a patient after cystoscopy plans that the patient

• learns to request narcotics for pain.
• understands to expect blood-tinged urine.
• restricts activity to bed rest for a 4 to 6 hours.
• remains NPO for 8 hours to prevent vomiting.

b

A patient has elevated blood urea nitrogen (BUN) and serum creatinine levels. Which bowel preparation order would the nurse question for this patient who is scheduled for a renal arteriogram?

• Fleet enema
• Tap-water enema
• Senna/docusate (Senokot-S)
• Bisacodyl (Dulcolax) tablets

a High-phosphate enemas, such as Fleet enemas, should be avoided in patients with elevated BUN and creatinine because phosphate cannot be excreted by patients with renal failure A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will

• have the patient empty the bladder completely, then

obtain the next urine specimen that the patient is able to void.

• teach the patient to clean the urethral area, void a

small amount into the toilet, and then void into a sterile specimen cup.

• insert a short sterile "mini" catheter attached to a

collecting container into the urethra and bladder to obtain the specimen.

• clean the area around the meatus with a povidone-

iodine (Betadine) swab, and then have the patient void into a sterile container.b The nurse is caring for a 68-year-old hospitalized patient with a decreased glomerular filtration rate who is scheduled for an intravenous pyelogram (IVP). Which action will be included in the plan of care?

• Monitor the urine output after the procedure.
• Assist with monitored anesthesia care (MAC).
• Give oral contrast solution before the procedure.
• Insert a large size urinary catheter before the IVP.

a Patients with impaired renal function are at risk for decreased renal function after IVP because the contrast medium used is nephrotoxic, so the nurse should monitor the patient's urine output.Which nursing action is essential for a patient immediately after a renal biopsy?

• Check blood glucose to assess for hyperglycemia or

hypoglycemia.

• Insert a urinary catheter and test urine for gross or

microscopic hematuria.

• Monitor the blood urea nitrogen (BUN) and creatinine

to assess renal function.

• Apply a pressure dressing and keep the patient on the

affected side for 30 minutes.d A pressure dressing is applied and the patient is kept on the affected side for 30 to 60 minutes to put pressure on the biopsy side and decrease the risk for bleeding.A male patient in the clinic provides a urine sample that is red-orange in color. Which action should the nurse take first?

• Notify the patient's health care provider.
• Teach correct midstream urine collection.
• Ask the patient about current medications.
• Question the patient about urinary tract infection (UTI)

risk factors.c A red-orange color in the urine is normal with some over-the-counter (OTC) medications such as phenazopyridine (Pyridium).