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Hesi Med Surg III Final Exam 2023 Study Exam

• A 79 year old patient has been admitted with BPH. What is most

appropri- ate 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 patients bed to accommodate overflow incontinence✔✔ B

The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom is appropriate. Fluids should be encouraged because dehydration is more common in older patients.The information in the question does not indicate that measurement of the patient's output is necessary or that the patient has overflow incontinence.

• A female patient with a suspected 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

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• 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 povidine-iodine (betadine)

swab and then have the patient void into a sterile container✔✔ B This answer describes the technique for obtaining a clean-catch specimen. The answer beginning, "insert a short, small, 'mini' catheter attached to a collecting container" describes a technique that would result in a sterile specimen, but a health care provider's order for a catheterized specimen would be required. Using Betadine before obtaining the specimen is not necessary, and might result in suppressing the growth of some bacteria. The technique described in the answer beginning "have the patient empty the bladder completely" would not result in a sterile specimen.

• Which statement made by a patient who had a cystoscopy the

previous day should be reported immediately to the HCP?

• My urine looks pink
• My IV site is bruised
• My sleep was restless
• My temperature is 101✔✔ D

The patient's elevated temperature may indicate a bladder infection, a possible complication of cystoscopy. The health care provider should be notified so that

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antibiotic therapy can be started. Pink-tinged urine is expected after a cystoscopy. The insomnia and bruising should be discussed further with the patient but do not indicate a need to notify the health care provider.

• To determine possible causes, the nurse will ask a patient admitted

with acute glomerulonephritis about

• Recent bladder infection
• History of kidney stones
• Recent sore throat and fever
• History of high blood pres✔✔ B

Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is not caused by kidney stones, hypertension, or urinary tract infection (UTI).

• The nurse will anticipate teaching a patient with nephrotic syndrome

who develops flank pain about treatment with

• Antibiotics
• Antifungals
• Anticoagulants
• Antihypertensive✔✔ C

Flank pain in a patient with nephrotic syndrome suggests a renal vein thrombosis, and anticoagulation is needed. Antibiotics are used to treat a patient with flank pain caused by pyelonephritis. Fungal pyelonephritis is uncommon and is treated with antifungals.Antihypertensives are used if the patient has high blood pressure

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• The nurse will plan to teach a 27 year old woman who smokes two

packs a day about the risk for

• Kidney stones
• Bladder cancer
• Bladder infection
• Interstitial cystitis✔✔ B

Cigarette smoking is a risk factor for bladder cancer. The patient's risk for devel- oping interstitial cystitis, urinary tract infection (UTI), or kidney stones will not be reduced by quitting smoking.

• Following rectal surgery, a patient voids about 50 mL of urine every 30-

60 minutes for the first 4 hours. Which nursing intervention is most appropriate?

• Monitor the patients intake and output overnight
• Have the patient drink small amounts of fluid frequently
• Use an ultrasound scanner to check the postvoid residual volume
• Reassure the patient that this is normal after anesthesia for rectal surgery

✔✔ C

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