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Patho-Urological Disorders AMNP
Summer 2024 Test With Solution
Which of the following are the most commonly assessed findings in cystitis? A. Frequency, urgency, dehydration, nausea, chills, and flank pain B. Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever C. High fever, chills, flank pain nausea, vomiting, dysuria, and frequency D. Nocturia, frequency, urgency dysuria, hematuria, fever and suprapubic pain - ANSWER D Rationale: Manifestations of cystitis include, frequency, urgency, dysuria, hematuria nocturia, fever, and suprapubic pain. Dehydration, hypertension, and chills are not typically associated with cystitis. High fever chills, flank pain, nausea, vomiting, dysuria, and frequency are associated with pvelonephritis. Interstitial cystitis is a condition of which organ of the body? A Colon B Uterus C Bladder D Prostate - ANSWER C Bladder Which of the following may cause an increase in the cystitis symptoms? A Orange juice
B Coffee C Mango juice D Water - ANSWER B. Coffee Rationale: A nurse is preparing to catheterize a female client. What will the nurse consider when comparing the anatomy of the female urethra with that of the male urethra? A) Has different innervation B) No connection with bladder C) Shorter in length D) Longer in length - ANSWER C. Shorter in length 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? a. The patient has not had food or drink for 8 hours. b. The patient lists allergies to shellfish and penicillin. c. The patient complains of costovertebral angle (CVA) tenderness. d. The patient used a bisacodyl (Dulcolax) tablet the previous night. - ANSWER B. The patient lists allergies to shellfish & penicillin Rationale: IVP uses contrast dye in the procedure so an allergy to shellfish needs to be identified before the procedure to avoid anaphylaxis
the nurse would be helpful to the client? Select all that apply. A Limit fluids to avoid the burning sensation on urination. B Review symptoms of UTI with the client. C Wipe the perineal area from back to front. D Wear cotton underclothes. E Take baths rather than showers. - ANSWER B & D Rationale: Option 2 validates the diagnosis. Cotton underwear promotes appropriate exposure to air, resulting in decreased bacterial growth (option 4). Increased fluids decrease concentration and irritation (option 1). The client should wipe the perineal area from front to back to prevent spread of bacteria from the rectal area to the urethra (option 3). Showers reduce exposure of area to bacteria (option 5). A 46-year-old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take? a. Teach the patient to take the prescribed Bactrim for 3 more days. b. Remind the patient about the need to drink 1000 mL of fluids daily. c. Obtain a midstream urine specimen for culture and sensitivity testing. d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms. - ANSWER C. Rationale: Because uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate antibiotic therapy
The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) has been effective for a 22-year-old female patient with cystitis when the patient states which of the following? a. "I can use vaginal antiseptic sprays to reduce bacteria." b. "I will drink a quart of water or other fluids every day." c. "I will wash with soap and water before sexual intercourse." d. "I will empty my bladder every 3 to 4 hours during the day." - ANSWER D Rationale: Voiding every 3 to 4 hours is recommended to prevent UTIs Which information will the nurse include when teaching the patient with a urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)? a. Pyridium may cause photosensitivity b. Pyridium may change the urine color. c. Take the Pyridium for at least 7 days. d. Take Pyridium before sexual intercourse. - ANSWER B. Pyridium may change the urine color To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to avoid eating a. milk and cheese. b. sardines and liver. c. legumes and dried fruit. d. spinach, chocolate, and tea. - ANSWER B. Sardines & Liver
- Discuss the importance of limiting vitamin D-enriched foods.
- Prepare the client for extracorporeal shock wave lithotripsy (ESWL) - ANSWER 3. Discuss the importance of limiting vitamin D-enriched foods Rationale: Dietary changes for preventing renal stones include reducing the intake of the primary substance forming the calculi. In this case, limiting vitamin D will inhibit the absorption of calcium from the gastrointestinal tract. 1. This would be appropriate for the client who has uric acid stones.2. The nurse should recommend drinking one to two glasses of water at night to prevent concentration of urine during sleep .4. This is a treatment for an existing renal stone, not a discharge teaching intervention for a client who has successfully passed a renal calculus.TEST-TAKING HINT: Remember to read the question carefully. The question asks for a "discharge teaching" intervention. This would rule out "4," which is a treatment, as a potential answer. A client with urolithiasis is scheduled for extracorporeal shock wave lithotripsy (ESWL). The nurse assesses to ensure that which of the following items are in place or maintained before sending the client for the procedure? a. IV line and a foley catheter b. NPO status and a foley catheter c. signed informed consent, NPO status, and an IV line d. signed informed consent and clear liquid restriction preprocedure - ANSWER C Rationale: ESWL is done with conscious sedation or general anesthesia. The client must sign an informed consent form for the procedure and must be
NPO for the procedure. The client needs an IV line for the procedure as well. A Foley catheter is not needed. A client is being admitted to the hospital with a diagnosis of urolithiasis and renal colic. The nurse assesses the client for pain that is: a. dull and aching in the costovetebal area b. aching and camplike thoughout the abdomen c. sharp and radiating posteriorly to the spinal column d. excruciating, wavelike, and radiating toward the genitalia - ANSWER D. Excruciating, wavelike, & radiating toward the genitalia Rationale: Renal colic is severe, intermittent pain that a patient experiences with urolithiasis. It last 20-60 minutes & is not continuous so comes in waves
The client with urolithiasis has an X-ray that shows the entire pelvis full of stones. This patient also has a history of spinal cord injury. The nurse concludes that this client most likely has which of the following types of urinary stones? a. Calcium oxalate b. Uric acid c. Struvite d. Cystine - ANSWER C. Struvite Rationale: Struvite stones fill up the entire pelvis on an X-ray & are prone to patients with spinal cord injuries or who have had a Proteus UTI. They are
D
Rationale: Renal calculi are commonly composed of calcium. Diets high in calcium may predispose a person to renal calculi. Milk and milk products are high in calcium. Cola soft drinks don't contain ingredients that would increase the risk of renal calculi. Jogging and increased stress aren't considered risk factors for renal calculi formation.
A nurse is instructing a client with renal calculi about recommended daily fluid consumption. The nurse would be most helpful by telling the client to drink approximately: a. 4 cups per day b. 8 cups per day c. 12 cups per day d. 16 cups per day - ANSWER C Rationale: A client with renal calculi should drink 3L (12 cups) of fluid per day.
A client has passed a renal calculus. The nurse sends the specimen to the laboratory so it can be analyzed for which of the following factors? a. Antibodies b. Type of infection c. Composition of calculus
d. Size and number of calcul - ANSWER C Rationale: The calculus should be analyzed for composition to determine appropriate interventions such as dietary restrictions. Calculi don't result in infections. The size and number of calculi aren't relevant, and they don't contain antibodies.
A patient with a history of renal calculi is hospitalized with gross hematuria and severe colicky left flank pain that radiates to his left testicle. In planning care for the patient, the nurse gives the highest priority to the nursing diagnosis of a. acute pain related to irritation by the stone. b. deficient fluid volume related to inadequate intake. c. risk for infection related to urinary system damage. d. risk for nausea related to pain and renal colic - ANSWER A Rationale: Although all the diagnoses are appropriate, the initial nursing actions should focus on relief of the acute pain.
The nurse recognizes that urinary elimination changes may occur even in healthy older adults because of which of the following? A) The bladder distends and its capacity increases. B) Older adults ignore the need to void. C) Urine becomes more concentrated.
