CHAPTER 45 Renal and Urological Problems (10th Edition) Flashcards
- In teaching a patient with pyelonephritis about the disorder, the nurse informs the patient that the organisms that cause pyelonephritis most commonly reach the kidneys through
a. the bloodstream.
b. the lymphatic system.
c. a descending infection.
d. an ascending infection.
d. an ascending infection.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- The nurse teaches the female patient who has frequent UTIs that she should
a. take tub baths with bubble bath.
b. urinate before and after sexual intercourse.
c. take prophylactic sulfonamides for the rest of her life.
d. restrict fluid intake to prevent the need for frequent voiding.
b.urinate before and after sexual intercourse.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- The immunologic mechanisms involved in acute poststreptococcal glomerulonephritis include
a. tubular blocking by precipitates of bacteria and antibody reactions.
b. deposition of immune complexes and complement along the GBM.
c. thickening of the GBM from autoimmune microangiopathic changes.
d. destruction of glomeruli by proteolytic enzymes contained in the GBM.
b. deposition of immune complexes and complement along the GBM.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- One of the nurse’s most important roles in relation to acute poststreptococcal glomerulonephritis is to
a. promote early diagnosis and treatment of sore throats and skin lesions.
b. encourage patients to obtain antibiotic therapy for upper respiratory tract infections.
c. teach patients with APSGN that long-term prophylactic antibiotic therapy is necessary to prevent recurrence.
d. monitor patients for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane.
a. promote early diagnosis and treatment of sore throats and skin lesions.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- The edema that occurs in nephrotic syndrome is due to
a. increased hydrostatic pressure caused by sodium retention.
b. decreased aldosterone secretion from adrenal insufficiency.
c. increased fluid retention caused by decreased glomerular filtration.
d. decreased colloidal osmotic pressure caused by loss of serum albumin.
d. decreased colloidal osmotic pressure caused by loss of serum albumin.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- A patient is admitted to the hospital with severe renal colic. The nurse’s first priority in management of the patient is to
a. administer opioids as prescribed.
b. obtain supplies for straining all urine.
c. encourage fluid intake of 3 to 4 L/day.
d. keep the patient NPO in preparation for surgery.
a. administer opioids as prescribed.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- The nurse recommends genetic counseling for the children of a patient with
a. nephrotic syndrome.
b. chronic pyelonephritis.
c. malignant nephrosclerosis.
d. adult-onset polycystic kidney disease.
d. adult-onset polycystic kidney disease.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- The nurse identifies a risk factor for kidney and bladder cancer in a patient who relates a history of
a. aspirin use.
b. tobacco use.
c. chronic alcohol abuse.
d. use of artificial sweeteners.
b. tobacco use.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- In planning nursing interventions to increase bladder control in the patient with urinary incontinence, the nurse includes
a. teaching the patient to use Kegel exercises.
b. clamping and releasing a catheter to increase bladder tone.
c. teaching the patient biofeedback mechanisms to suppress the urge to void.
d. counseling the patient concerning choice of incontinence containment device.
a. teaching the patient to use Kegel exercises.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- A patient with a ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes
a. encouraging the patient to drink fruit juices and milk.
b. encouraging fluids of at least 2 to 3 L/day after nausea has subsided.
c. irrigating the nephrostomy tube with 10 mL of normal saline solution as needed.
d. notifying the physician if nephrostomy tube drainage is more than 30 mL/hr.
b. encouraging fluids of at least 2 to 3 L/day after nausea has subsided.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- A patient has had a cystectomy and ileal conduit diversion performed. Four days postoperatively, mucous shreds are seen in the drainage bag. The nurse should
a. notify the physician.
b. notify the charge nurse.
c. irrigate the drainage tube.
d. chart it as a normal observation.
d. chart it as a normal observation.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
Bridge to NCLEX Examination
- The nurse gives instructions to a 62-year-old woman taking tolterodine (Detrol) to treat urinary urgency and incontinence. The nurse should include which statement?
a. “Stop smoking for 2 to 3 weeks before starting to take this medication.”
b. “Suck on sugarless candy or chew sugarless gum if you develop a dry mouth.”
c. “Have your vision checked every 6 months because this drug can cause cataracts.”
d. “Ask your physician to prescribe an extended-release form if you have loose stools.”
b. “Suck on sugarless candy or chew sugarless gum if you develop a dry mouth.”
Dry mouth is a common side effect of tolterodine. Patients can suck on hard candy or ice chips or chew gum if dry mouth occurs. Tobacco use does not affect the initiation of this medication. Visual changes (but not cataracts) can occur while taking this medication. Constipation may occur as a side effect of this medication.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
EVOLVE Pre-Test
- The nurse teaches a 21-year-old female patient who came to the clinic to discuss interventions to prevent a recurrence of urinary tract infections. Which statement, if made by the patient, indicates that teaching was effective?
a. “I will urinate before and after having intercourse.”
b. “I will use vinegar as a vaginal douche every week.”
c. “I should drink three 8-ounce glasses of water daily.”
d. “I can stop the antibiotics when symptoms disappear.”
a. “I will urinate before and after having intercourse.”
The woman should empty her bladder before and after sexual intercourse. She should avoid vaginal douches and maintain adequate oral fluid intake (15 mL per pound of body weight). All of the antibiotics should be taken as prescribed even if symptoms are no longer present.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
EVOLVE Pre-Test
- The nurse provides nutritional counseling for a 45-year-old man with nephrotic syndrome. The nurse determines that teaching has been successful if the patient selects which breakfast menu?
a. Scrambled eggs, milk, yogurt, and sliced ham
b. Oatmeal, nondairy creamer, banana, and orange juice
c. Cottage cheese, peanut butter, white bread, and coffee
d. Waffle, bacon strips, tomato juice, and canned peaches
b. Oatmeal, nondairy creamer, banana, and orange juice
Patients with nephrotic syndrome should follow a low-sodium (2 to 3 g/day), low- to moderate-protein (0.5 to 0.6 g/kg/day) diet. Ham, milk products, peanut butter, and bacon are high in sodium. Eggs, milk products, and peanut butter are high in protein.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
EVOLVE Pre-Test
*** 4. The nurse is caring for a 73-year-old man patient with a history of benign prostatic hyperplasia and symptoms of a possible urinary tract infection. Which diagnostic finding would support this diagnosis?
a. White blood cell count is 7500 cells/μL.
b. Antistreptolysin-O (ASO) titer is 106 Todd units/mL.
c. Glucose, protein, and ketones are present in the urine.
d. Nitrites and leukocyte esterase are present in the urine.
d. Nitrites and leukocyte esterase are present in the urine.
A diagnosis of urinary tract infection is suspected if there are nitrites (indicating bacteriuria), white blood cells (WBCs), and leukocyte esterase (an enzyme present in WBCs indicating pyuria). Presence of glucose and ketones indicate uncontrolled diabetes mellitus. An elevated WBC count (>11,000 cells/μL) indicates a bacterial infection. Antistreptolysin-O (ASO) titer is a blood test to measure antibodies against streptolysin O, a substance produced by group A Streptococcus bacteria.
Chapter 46 Nursing Management: Renal and Urologic Problems (9th Edition)
EVOLVE Pre-Test
Jeff E.