ch. 45 MJ Flashcards
When reading a patient’s chart, the nurse notes that the patient has dysuria. To assess whether there is any improvement, which question will the nurse ask?
a. “Do you have any blood in your urine?”
b. “Do you have to urinate very frequently?”
c. “Do you have any pain when you urinate?”
d. “Do you have to get up at night to urinate?”
c. “Do you have any pain when you urinate?”
A patient’s urine dipstick indicates a small amount of protein in the urine. The next action by the nurse should be to
a. check which medications the patient is currently taking.
b. obtain a clean-catch urine for culture and sensitivity testing.
c. ask the patient about any family history of chronic renal failure.
d. send a urine specimen to the laboratory to test for ketones and glucose.
a. check which medications the patient is currently taking
A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which equipment will the nurse need to obtain?
a. Sterile specimen cup
b. Large container for urine
c. Foley catheter and drainage bag
d. Towelettes for perineal cleaning
b. Large container for urine
A 26-year-old patient who is employed as a hairdresser and has a 10 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
a. renal failure.
b. kidney stones.
c. pyelonephritis.
d. bladder cancer.
d. bladder cancer.
During assessment of a patient with decreased renal function, which of these medications taken by the patient at home will be of most concern to the nurse?
a. ibuprofen (Motrin)
b. warfarin (Coumadin)
c. folic acid (vitamin B9)
d. penicillin (Bicillin LA)
a. ibuprofen (Motrin)
An 82-year-old man has been admitted with benign prostatic hyperplasia. Which of the following is most appropriate to include in the nursing plan of care?
a. Limit fluid intake to no more than 1500 mL/day.
b. Leave a light on in the bathroom during the night.
c. Pad the patient’s bed to accommodate overflow incontinence.
d. Ask the patient to use a urinal so that all urine can be measured
b. Leave a light on in the bathroom during the night.
While assessing a patient’s urinary system, the nurse cannot palpate either kidney. Which action should the nurse take next?
a. Obtain a urine specimen to check for hematuria.
b. Document the information on the assessment form.
c. Ask the patient about any history of recent sore throat.
d. Ask the health care provider about scheduling a renal ultrasound
b. Document the information on the assessment form.
How will the nurse assess the flank area of a patient with pyelonephritis for tenderness?
a. Push gently into the two lowest intercostal spaces.
b. Palpate along both sides of the lumbar vertebral column.
c. Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
d. Use two fingers to percuss the area between the iliac crest and ribs along the midaxillary line.
c. Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
The result of a patient’s creatinine clearance test is 60 mL/min. The nurse equates this finding to a glomerular filtration rate (GFR) of _____ mL/min.
a. 30
b. 60
c. 120
d. 240
b. 60
The nurse uses auscultation during assessment of the urinary system to
a. check for ureteral peristalsis.
b. assess for bladder distention.
c. identify renal artery or aortic bruits.
d. determine the position of the kidneys.
c. identify renal artery or aortic bruits.
A patient who is scheduled for an intravenous pyelogram (IVP) gives the nurse the following information. Which information has the most immediate implications for the patient’s care?
a. The patient describes allergies to shellfish and penicillin.
b. The patient has not had anything to eat or drink for 8 hours.
c. The patient complains of costovertebral angle (CVA) tenderness.
d. The patient used a bisacodyl (Dulcolax) tablet the previous night.
a. The patient describes allergies to shellfish and penicillin.
When teaching a patient scheduled for a cystogram via a cystoscope about the procedure, the nurse tells the patient,
a. “Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney.”
b. “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.”
c. “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.”
d. “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.”
d. “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.”
The nurse informs the patient undergoing cystoscopy that following the procedure, the patient
a. will be NPO for 8 hours to prevent nausea and vomiting.
b. is expected to be on strict bed rest for about 4 to 6 hours.
c. should ask for the ordered narcotics as necessary for pain.
d. may experience blood-tinged urine and urinary frequency.
d. may experience blood-tinged urine and urinary frequency.
A patient with an elevated blood urea nitrogen (BUN) and serum creatinine is scheduled for a renal arteriogram. The nurse should question an order from radiology for bowel preparation with the use of
a. a Fleet enema.
b. a tap-water enema.
c. bisacodyl (Dulcolax) tablets.
d. senna/docusate (Sennakot-S)
a. a Fleet enema.
The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a patient with a suspected urinary tract infection (UTI). To obtain the specimen, the nurse will plan to
a. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
b. have the patient empty the bladder completely, and then obtain the next urine specimen that the patient is able to void.
c. insert a short, small “mini” catheter attached to a collecting container into the urethra and bladder to obtain the specimen.
d. clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have the patient void into a sterile container.
a. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
