Chapter 45

Question 1

The clinic nurse is teaching a young wife about preventing recurrent urinary tract infections. What information should the nurse include?

Answer 1

Drink liberal amounts of fluids.

Question 2

A 42-year-old woman comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware this is what type of incontinence?

Answer 2

Stress incontinence

Question 3

A nurse is caring for a female patient with urinary retention. The nurse teaches this patient to follow which principle for self-catheterization?

Answer 3

Use a clean technique at home to catheterize.

Question 4

A 52-year-old patient is scheduled to undergo ileal conduit surgery. The patient has several appropriate questions. What would be the most appropriate nursing diagnosis for this patient?

Answer 4

Knowledge deficit about the surgical procedure and postoperative care

Question 5

The educator on your unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patient’s teaching what nutritional guidelines would the educator include?

Answer 5

Restrict protein intake to 60 g/d.

Question 6

The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. What instruction should the nurse give the patient?

Answer 6

Notify the physician about cloudy or foul-smelling urine.

Question 7

A new patient has been admitted to your unit. The patient’s laboratory data has been posted in the computer and the nurse is reviewing the data. The nurse recognizes the patient has a bacteriuria when the bacteria count in the urine exceeds:

Answer 7

105 colonies/mL of clean-catch midstream urine

Question 8

The clinic nurse is preparing a plan of care for a patient complaining of stress incontinence. The plan of care incorporates behavioral therapy as an approach to the management of stress incontinence. What role will the nurse have in implementing the behavioral therapy approach?

Answer 8

Teach the patient to perform pelvic floor muscle exercises.

Question 9

You are a urology nurse caring for a male patient admitted to your unit with bladder distention from prostatic hypertrophy. The physician orders placement of an indwelling urinary catheter. The nurse and urologist are both unsuccessful in catheterizing this patient due to the prostatic obstruction. What approach does the nurse anticipate the physician using to drain the patient’s bladder?

Answer 9

Insertion of a suprapubic catheter

Question 10

The nurse has implemented a bladder retraining program in a 65-year-old woman after the removal of an indwelling urinary catheter from this patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient has 50 mL of urine remaining in her bladder after voiding. What would be the nurse’s best response to this finding?

Answer 10

Avoid further interventions at this time, as this is an acceptable finding

Question 11

You are caring for a patient admitted to your unit with renal calculi. A renal ultrasound indicates that the patient does not have hydronephrosis and the physician writes orders to increase the patient’s fluid intake. The nurse instructs the patient to increase her fluid intake to a level where the patient produces at least how many mL/day of urine?

Answer 11

2000 mL urine/day

Question 12

A patient with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The nurse is monitoring the patient’s urine output hourly and notifies the physician when the hourly output is less than what?

Answer 12

30 mL/hour

Question 13

The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a patient with an indwelling catheter?

Answer 13

Empty the drainage bag at least every 8 hours.

Question 14

The school nurse is teaching a health class to a group of seniors. Today the nurse is talking about urinary tract infections. The nurse is correct when she informs the group that:

Answer 14

The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group.

Question 15

A patient newly admitted to your unit has an ileal conduit. You need to determine the appliance size to order for this patient. What does the nurse measure to determine the size of the appliance needed?

Answer 15

The widest part of the stoma

Question 16

A patient comes to the clinic complaining of difficulty voiding. What nursing action should the nurse take to encourage a patient who is having difficulty voiding?

Answer 16

Provide privacy for the patient.

Question 17

A nurse is caring for an 85-year-old patient experiencing urinary incontinence. This nurse is aware that:

Answer 17

Urinary incontinence is not a consequence of aging.

Question 18

You are admitting a patient diagnosed with urinary retention. What question should be included as part of the assessment?

Answer 18

“Do you have dribbling urine?”

Question 19

A patient with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). The patient asks the nurse to explain what will be done. What is the nurse’s best response?

Answer 19

“Shock waves will break the stones in the kidney to the size of sand grains.”

Question 20

You are caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours postoperatively the patient verbalizes that the stoma is a dark purplish color. This nurse is aware of what?

Answer 20

Vascular supply to the stoma may be compromised.

Question 21

Where are most uncomplicated UTIs acquired?

Answer 21

Community

Question 22

You work in a urology clinic. A patient, 35 years of age, is diagnosed with a urinary tract infection (UTI). What is your role in managing this patient’s treatment?

Answer 22

How to improve nutrition or how to manage prescribed medications

Question 23

You are writing a nursing plan of care for a patient with a UTI. What would be an appropriate nursing diagnosis for this patient?

Answer 23

Deficient knowledge about factors predisposing to infection

Question 24

A 35-year-old female with chronic recurrent UTIs is admitted to the hospital for diagnostic testing of an upper urinary tract problem. You know that incomplete emptying of the bladder due to bladder outlet obstruction can cause what?

Answer 24

Hydronephrosis

Question 25

An 82-year-old female is brought to the clinic by her daughter for transient episodes of incontinence. While assessing this patient, what question should be a priority for the nurse to ask the patient and the family?

Answer 25

Has there been a change in other systems of the body?

Question 26

The nurse is presenting an educational event at a local senior center. You have been asked to talk about “Keeping Your Urinary System Healthy.” What important information should you include in your presentation?

Answer 26

“Urinary incontinence is more prevalent in the United States than diabetes or ulcer disease.”

Question 27

A 55-year-old male patient is admitted to the medical-surgical unit with a presumptive diagnosis of renal stones. While assessing the patient you note increased tenderness over the costovertebral area. The patient complains of increased pain and nausea, and then has an episode of vomiting. You know that these symptoms are indicative of what?

Answer 27

Renal colic

Question 28

A patient has been admitted to the renal unit for lithotripsy. After the procedure you instruct the patient on straining their urine to collect stone fragments for analysis. The results of the stone analysis show that the stones are made of urate. What does this finding indicate?

Answer 28

A disturbance in uric acid metabolism

Question 29

A patient had a ileal conduit and is being cared for by a critical care nurse. What is a complication the nurse would monitor this patient for in the immediate postoperative unit?

Answer 29

Ureteral obstruction

Question 30

A patient who has been admitted to your unit for urinary diversion surgery has asked to talk with you. The patient asks what complications she may have from the surgery. What would be an appropriate response by the nurse?

Answer 30

“Potential complications may include stoma retraction and separation of mucocutaneous border due to tension or trauma.”

Question 31

The nurse is writing a plan of care for a patient who has just returned from the PACU following surgery for urinary diversion. What would be a major postoperative nursing diagnosis following surgery for urinary diversion?

Answer 31

Potential for sexual dysfunction related to structural and physiologic alterations

Question 32

You are formulating a plan of care for a patient who is scheduled to have urinary diversion surgery. What would be an appropriate preoperative nursing diagnosis for this patient?

Answer 32

Imbalanced nutrition, less than body requirements related to inadequate nutritional intake

Question 33

A patient has been admitted to the unit you are working on for a scheduled cutaneous ureterostomy. Another staff nurse comes to you asking why this patient is having this particular procedure. How should you respond?

Answer 33

“Patients who get cutaneous ureterostomies are patients who have obstructed ureters due to advanced pelvic cancer.”

Question 34

A patient, 6 months postoperative from the placement of an ileal conduit, has come to the clinic for routine follow-up. What long-term complications should this patient be assessed for?

Answer 34

Ureteral obstruction

Question 35

You are writing a teaching plan for a 45-year-old male patient with recurrent UTIs. What diagnostic test would the nurse expect to teach this patient about?

Answer 35

Transrectal ultrasonography

Question 36

A patient with urinary retention is admitted to your unit. What may be a causative factor in adult urinary retention?

Answer 36

Multiple sclerosis

Question 37

You are caring for an 84-year-old female patient who was brought to the emergency room by her family, who related that their mother had had mental status changes and periods of incontinence and they were very concerned. What condition would the nurse suspect the patient had?

Answer 37

Urinary tract infection