EAQ: Renal, Urinary & Reproductive System Flashcards

1
Q

Which substance is released in response to low serum levels of calcium?

Renin

Erythropoietin

Parathyroid hormone

Atrial natriuretic peptide

A

Parathyroid hormone

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2
Q

Which condition would be indicated by the presence of ketones in the urine of a client?

Cystitis

Heart failure

Urinary calculi

Fat metabolism

A

Fat metabolism

The body of a client who is ingesting fewer calories than are needed for maintenance produces ketones from fat metabolism as an alternate source of fuel for muscles and organs. Increased red blood cells in the urine indicate cystitis. Increased specific gravity of the urine indicates heart failure. The presence of casts in the urine indicates urinary calculi.

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3
Q

In which component of the nephron does furosemide decrease fluid reabsorption? Select all that apply. One, some, or all responses may be correct.

Glomerulus

Loop of Henle

Distal tubules

Proximal tubules

Bowman capsule (BC)

A

Loop of Henle

Distal tubules

Proximal tubules

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4
Q

Which structure is included in the external genitalia of the male anatomy? Select all that apply. One, some, or all responses may be correct.

Penis

Testes

Scrotum

Urethra

Seminal vesicles

A

Penis

Scrotum

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5
Q

Which finding in a urinalysis indicates a urinary tract infection?

Crystals

Bilirubin

Ketones

Leukoesterase

A

Leukoesterase

Leukoesterases are released by white blood cells in response to an infection or inflammation. The presence of this chemical in urine indicates a urinary tract infection. The presence of crystals in the urine indicates that the specimen had been allowed to stand. Presence of bilirubin in the urine indicates anorexia nervosa, diabetic ketoacidosis, and prolonged fasting. The presence of ketones indicates diabetic ketoacidosis.

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6
Q

Which successful therapy outcome would the nurse expect in a client diagnosed with invasive cancer of the bladder who has brachytherapy scheduled?

Decrease in urine output

Increase in pulse strength

Shrinkage of the tumor when scanned

Increase in the quantity of white blood cells (WBCs)

A

Shrinkage of the tumor when scanned

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7
Q

The __________ holds the testes by forming a protective sac.

A

scrotum

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8
Q

Which hormone is crucial in maintaining the implanted ovum at its site?

Inhibin

Estrogen

Progesterone

Testosterone

A

Progesterone

Progesterone is necessary to maintain an implanted egg. Inhibin regulates the release of follicle-stimulating hormone and gonadotropin-releasing hormone. Estrogen plays a vital role in the development and maintenance of secondary sexual characteristics. Testosterone is important for bone strength and development of muscle mass.

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9
Q

Which term would the nurse document in the client’s medical record after observing reduced urinary output?

Anuria

Dysuria

Oliguria

Nocturia

A

Oliguria

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10
Q

Which statement describes erythropoietin?

Erythropoietin is released by the pancreas.

An erythropoietin deficiency causes diabetes.

An erythropoietin deficiency is associated with renal failure.

Erythropoietin is released only when there is adequate blood flow.

A

An erythropoietin deficiency is associated with renal failure.

Erythropoietin is produced by the kidneys; its deficiency occurs in renal failure. Erythropoietin is released by the kidneys, not the pancreas. Erythropoietin deficiency causes anemia. Erythropoietin is secreted in response to hypoxia, which results in decreased oxygenated blood flow to the tissues.

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11
Q

Which term is used to indicate an absence of menstruation?

Gonorrhea

Amenorrhea

Dysmenorrhea

Ectopic pregnancy

A

Amenorrhea

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12
Q

Which term is used for the tip of a pyramid in the kidney?

Calyx

Papilla

Renal pelvis

Renal column

A

Papilla

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13
Q

Which part of the kidney senses changes in blood pressure?

Calices

Glomerulus

Macula densa

Juxtaglomerular cells

A

Macula densa

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14
Q

Which structure of the penis would the nurse tell the parents is removed when educating new parents about circumcision?

Glans

Prepuce

Epididymis

Vas deferens

A

Prepuce

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15
Q

Which part of the female reproductive system produces testosterone?

Uterus

Ovary

Fallopian tube

Ovarian follicle

A

Ovary

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16
Q

Which test provides information on bladder capacity, bladder pressure, and voiding reflexes?

Radiography

Renal arteriography

Electromyography (EMG)

Cystometrography (CMG)

A

Cystometrography (CMG)

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17
Q

Which procedure involves the examination of the ureters and the renal pelvises?

Cystogram

Pyelogram

Urethrogram

Voiding cystourethrogram

A

Pyelogram

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18
Q

Which term refers to the Cowper gland?

Skene gland

Prostate gland

Bartholin gland

Bulbourethral gland

A

Bulbourethral gland

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19
Q

Which factor would the nurse explain as a reason why women are at a greater risk than men for contracting a urinary tract infection?

Altered urinary pH levels

Hormonal secretions

Juxtaposition of the bladder

Proximity of the urethra and anus

A

Proximity of the urethra and anus

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20
Q

Which part of the nephron secretes creatinine for elimination?

Glomerulus

Loop of Henle

Collecting duct

Proximal tubule

A

Proximal tubule

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21
Q

Which glands help in lubricating the female urinary meatus?

Skene glands

Prostate glands

Cowper glands

Bartholin glands

A

Skene glands

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22
Q

Which structure is removed during circumcision?

Glans

Prepuce

Epididymis

Vas deferens

A

Prepuce

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23
Q

How long will a client’s ovum stay viable for fertilization after its release?

72 hours

84 hours

96 hours

112 hours

A

72 hours

An ovum can be fertilized up to 72 hours after its release. The ovum disintegrates after 72 hours, and menstruation begins soon after. The ovum cannot be viable for 84, 96, or 112 hours, and fertilization will not occur.

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24
Q

Which prescribed diagnostic test would the nurse expect to confirm a tentative urinary tract infection diagnosis in a client recovering from deep, partial-thickness burns who develops chills, fever, flank pain, and malaise?

Cystoscopy and bilirubin level

Specific gravity and pH of the urine

Urinalysis and urine culture and sensitivity

Creatinine clearance and albumin/globulin (A/G) ratio

A

Urinalysis and urine culture and sensitivity

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25
Q

Which response would the nurse use after receiving instructions regarding dressing changes and care of a recently inserted nephrostomy tube when the client states “I hope I can handle all this at home; it’s a lot to remember”?

“I’m sure you can do it.”

“Oh, a family member can do it for you.”

“You seem to be nervous about going home.”

“Perhaps you can stay in the hospital another day.”

A

“You seem to be nervous about going home.”

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26
Q

Which client statement indicates understanding of content taught about removing his or her three-way indwelling catheter and continuous bladder irrigation (CBI)?

“I probably will have diluted urine.”

“I probably will be unable to urinate.”

“I probably will produce dark red urine.”

“I probably will experience some burning on urination.”

A

“I probably will experience some burning on urination.”

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26
Q

Which strategy would the nurse include in the client’s plan of care regarding preventing the development of ureteral colic from renal calculi in the future?

Instruct the client to drink at least 3 L of fluid daily.

Suggest interventions to decrease the serum creatinine level.

Establish a urinary output goal of 2000 mL per 24 hours.

Teach the client to exclude milk products from their diet.

A

Instruct the client to drink at least 3 L of fluid daily.

26
Q

Which statement indicates the nurse has a correct understanding of kidney ultrasonography?

“Kidney ultrasonography primarily makes use of iodinated contrast dye.”

“Kidney ultrasonography is performed on the client with an empty bladder.”

“Kidney ultrasonography makes use of sound waves and has minimal risk.”

“Kidney ultrasonography provides three-dimensional information regarding kidneys.”

A

“Kidney ultrasonography makes use of sound waves and has minimal risk.”

27
Q

Which hormone would the nurse explain as stimulating the release of estrogen and progesterone after fertilization?

Inhibin

Testosterone

Follicle-stimulating hormone (FSH)

Human chorionic gonadotropin (hCG)

A

Human chorionic gonadotropin (hCG)

28
Q

Which method is a barrier type of contraception? Select all that apply. One, some, or all responses may be correct.

Condom

Diaphragm

Lea’s shield

Spermicidal foam

Coitus interruptus

A

Condom

Diaphragm

Lea’s shield

29
Q

Which intervention is the best approach to condom use for prevention of sexually transmitted infection?

Use of spermicide

Use of oil-based lubricants

Use of a condom with oral sex

Use of natural membrane condoms

A

Use of a condom with oral sex

30
Q

Which report by the client post transrectal prostate biopsy needs to be communicated to the health care provider as a possible sign of infection?

Soreness

Rust-colored semen

Light rectal bleeding

Discharge from the penis

A

Discharge from the penis

31
Q

Where is the blood pressure cuff placed on a client with a dialysis access fistula in the right arm?

On the left arm

Over the fistula

Below the fistula

Above the fistula

A

On the left arm

32
Q

Which action is promoted by vasopressin?

Sodium reabsorption

Reabsorption of water

Tubular secretion of sodium

Red blood cell production

A

Reabsorption of water

33
Q

Which instruction would the nurse include when teaching the client how to perform peritoneal dialysis and the importance of preventing peritonitis? Select all that apply. One, some, or all responses may be correct.

Wear a mask during the procedure.

Clean the catheter exit site every day.

Maintain meticulous aseptic technique.

Wash your hands before the exchange.

Store supplies in a clean and dry location.

A

all of the above

34
Q

Which laboratory value would the nurse assess when preparing a client for a renal biopsy? Select all that apply. One, some, or all responses may be correct.

Hematocrit

Hemoglobin

Platelet count

Prothrombin time (PT) with international normalized ratio (INR)

Partial thromboplastin time (PTT)

A

all of the above

35
Q

Which instruction on infection prevention would the nurse include when providing discharge education to a client who received a cadaveric renal transplant? Select all that apply. One, some, or all responses may be correct.

Avoid eating from buffets.

Obtain annual flu vaccinations.

Perform regular hand hygiene.

Stay away from crowded areas.

Report a temperature greater than 100.5°F.

A

all of the above

36
Q

Which medication used to treat syphilis is contraindicated in pregnancy?

Amoxicillin

Clotrimazole

Tetracycline

Metronidazole

A

Tetracycline

Tetracycline can be administered to clients with syphilis who are allergic to penicillin G. This medication is contraindicated in pregnant women, because it can cause birth defects or staining/discoloration to the fetus’ developing teeth if given during the second trimester. Amoxicillin is an antibiotic that can treat syphilis and is safe in pregnancy. Clotrimazole is used to treat candidiasis. Metronidazole is used to treat bacterial vaginosis.

37
Q

Which information would the nurse include when teaching about why women are more susceptible to urinary tract infections than men?

Inadequate fluid intake

Poor hygienic practices

The length of the urethra

The disruption of mucous membranes

A

The length of the urethra

37
Q

Which structure surrounding the male urethra would the nurse describe to a client scheduled for a dilation of the urethra?

Epididymis

Prostate gland

Seminal vesicle

Bulbourethral gland

A

Prostate gland

The prostate gland is shaped like a ring, with the urethra passing through its center. The epididymis lies along the top and sides of the testes. The seminal vesicles are on the posterior surface of the bladder. The bulbourethral gland lies below the prostate.

38
Q

Which characteristic of urine changes in the presence of a urinary tract infection (UTI)?

Clarity

Viscosity

Glucose level

Specific gravity

A

Clarity

Cloudy urine usually indicates drainage associated with infection. Viscosity is a characteristic that is not measurable in urine. Urinary glucose levels are not affected by UTIs. Specific gravity yields information related to fluid balance.

39
Q

Which disorder is a primary glomerular disease?

Diabetic glomerulopathy

Chronic glomerulonephritis

Hemolytic-uremic syndrome

Systemic lupus erythematosus

A

Chronic glomerulonephritis

Chronic glomerulonephritis is a primary glomerular disease. Diabetic glomerulopathy, hemolytic-uremic syndrome, and systemic lupus erythematosus are secondary glomerular diseases.

40
Q

Which value indicates a normal vaginal pH?

4.2

6.8

7.5

9.3

A

4.2

Normal vaginal pH ranges from 3.5 to 5. Clients with a higher vaginal pH (6.8, 7.5, and 9.3) are more prone to infections.

41
Q

Normal vaginal pH ranges from ____________

Clients with a higher vaginal pH are more prone to infections.

A

3.5 to 5.

42
Q

Which test helps identify reproductive tract fibroids, tumors, and fistulas?

Mammography

Ultrasonography

Hysterosalpingography

Computed tomography

A

Hysterosalpingography

43
Q

Which hormone influences kidney function?

Renin

Bradykinin

Aldosterone

Erythropoietin

A

Aldosterone

Released from the adrenal cortex, aldosterone influences kidney function. Renin, bradykinin, and erythropoietin are kidney hormones.

44
Q

Which process is a function of the kidney hormones?

Prostaglandin increases blood flow and vascular permeability.

Bradykinin regulates intrarenal blood flow via vasodilation or vasoconstriction.

Renin raises blood pressure because of angiotensin and aldosterone secretion.

Erythropoietin promotes calcium absorption in the gastrointestinal tract tract.

A

Renin raises blood pressure because of angiotensin and aldosterone secretion.

Renin is a kidney hormone that raises blood pressure as a result of angiotensin and aldosterone secretion. Prostaglandin is a kidney hormone that regulates intrarenal blood flow via vasodilation or vasoconstriction. Bradykinin is a kidney hormone that increases blood flow and vascular permeability. Erythropoietin is a kidney hormone that stimulates the bone marrow to make red blood cells.

45
Q

Which medication turns urine reddish-orange in color?

Amoxicillin

Ciprofloxacin

Nitrofurantoin

Phenazopyridine

A

Phenazopyridine

46
Q

Which hormone is crucial for ovulation and complete maturation of the ovarian follicles?

Luteinizing hormone

Follicle-stimulating hormone

Gonadotropin-releasing hormone

Human chorionic gonadotropin hormone

A

Luteinizing hormone

Ovulation and complete maturation of ovarian follicles can only take place in the presence of luteinizing hormone. However, follicle-stimulating hormone initiates maturation of the follicles. Gonadotropin-releasing hormone stimulates the pituitary gland to release follicle-stimulating hormone and luteinizing hormone. Human chorionic gonadotropin hormone is released after implantation and is responsible for secretion of progesterone and estrogen during pregnancy.

47
Q

Which part of the female reproductive system secretes androgens?

Uterus

Ovaries

Fallopian tube

Ovarian follicle

A

Ovaries

48
Q

Which statement indicates the client with chronic kidney disease understands the purpose of using continuous ambulatory peritoneal dialysis (CAPD)?

“The treatment provides continuous contact of dialyzer and blood to clear toxins by ultrafiltration.”

“The treatment exchanges and cleanses blood by correction of electrolytes and excretion of creatinine.”

“The treatment decreases the need for immobility, because the fluids clear the toxins in short and intermittent periods.”

“The treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion.”

A

“The treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion.”

Diffusion moves particles from an area of greater concentration to an area of lesser concentration. Osmosis moves fluid from an area of lesser concentration to an area of greater concentration of particles, thereby removing waste products into the dialysate, which is then drained from the abdomen. The principle of ultrafiltration involves a pressure gradient, which is associated with hemodialysis, not peritoneal dialysis. Peritoneal dialysis uses the peritoneal membrane for indirect cleansing of the blood. Dialysate does not clear toxins in a short time; exchanges may occur four or five times a day.

49
Q

Which clinical manifestation of a UTI would the nurse teach to a male client with a history of recurrent urinary tract infections (UTIs) when preparing for discharge after a ureterolithotomy?

Urgency or frequency of urination

An increase of ketones in the urine

The inability to maintain an erection

Pain radiating to the external genitalia

A

Urgency or frequency of urination

50
Q

Which food item would the nurse instruct a client whose pathology report states a urinary calculus is composed of uric acid to avoid?

Milk

Liver

Cheese

Vegetables

A

Liver

A low-purine diet controls the development of uric acid stones. Clients with uric acid stones should avoid foods high in purine, such as organ meats and extracts. The client should avoid milk if he or she had calcium stones, not uric acid stones. The client should avoid cheese or animal protein if he or she had cysteine stones, not uric acid stones. The client does not need to avoid vegetables when on a low-purine diet.

51
Q

Which instruction would the nurse include in a health practices teaching plan for a female client with a history of recurrent urinary tract infections?

“Wear cotton underwear or lingerie.”

“Void at least every 6 hours around the clock.”

“Increase foods containing alkaline ash in the diet.”

“Wipe the perineum from back to front after toileting.”

A

“Wear cotton underwear or lingerie.”

Cotton allows air to circulate and does not retain moisture the way synthetic fabrics do; microorganisms multiply in warm, moist environments. Voiding frequently helps flush ascending microorganisms from the bladder, thereby reducing the risk for urinary tract infections; holding urine for more than 6 hours can lead to urinary tract infections. Foods high in acid, not alkaline ash, help acidify urine; this urine is less likely to support bacterial growth. Alkaline urine promotes bacterial growth. Wiping the genitals from back to front after toileting may transfer bacteria from the perianal area toward the urinary meatus, which will increase the risk for urinary tract infection.

52
Q

Which laboratory test would the nurse discuss the need to monitor throughout the course of prostate cancer when a client asks, “How much more blood will they need? Don’t they have enough?”

Albumin

Creatinine

Blood urea nitrogen (BUN)

Prostate-specific antigen (PSA)

A

Prostate-specific antigen (PSA)

The PSA is an indication of the presence of prostate cancer; the higher the level, the greater the tumor burden. The health care provider will monitor the PSA levels throughout the course of the disease and periodically thereafter. Albumin is a protein and an indicator of nutritional and fluid status. Creatinine and BUN levels indicate renal function and may elevate when blockage of the urethra occurs from an enlarged prostate, but the reports do not indicate metastasis or prostate cancer.

53
Q

Which statement made by the student nurse regarding the gross anatomy and physiology of the kidneys indicates the need for additional teaching?

“The right kidney is a little longer and narrower than the left kidney.”

“The existence of three kidneys with normal kidney function is normal.”

“The presence of a single kidney with normal kidney function is normal.”

“The urinary bladder lies directly behind the pubic bone.”

A

“The right kidney is a little longer and narrower than the left kidney.”

Generally in a human body, the left-side kidney is slightly longer and narrower compared with the right-side kidney. The nurse should intervene to correct this misconception. All the other statements are correct. There could be three kidneys in a human body, and as long as the kidney function is normal, the client would be normal. A single horseshoe-shaped kidney could occasionally be found in certain clients, and this is normal if the kidney function is normal. The urinary bladder lies directly behind the pubic bone.

54
Q

Which part of the kidney produces the hormone bradykinin?

Kidney tissues

Kidney parenchyma

Renin-producing granular cells

Juxtaglomerular cells of the arterioles

A

Juxtaglomerular cells of the arterioles

55
Q

Which concentration of estradiol would be found in the blood during the follicular phase of the menstrual cycle?

20-350 pg/mL

150-750 pg/mL

30-450 pg/mL

<20 pg/mL

A

20-350 pg/mL

56
Q

Which statement reflects the nurse’s suspicions regarding a client’s cloudy urine noted on a urinalysis report?

The client has a urinary infection.

The client has a biliary obstruction.

The client has diabetic ketoacidosis.

The client has been on a starvation diet.

A

The client has a urinary infection.

57
Q

Which instruction would the nurse provide a client needing to collect a clean-catch urine specimen?

“Urinate a small amount, stop flow, and then fill one half of the specimen cup.”

“Collect a sample of the last urine voided during the night.”

“If anticipating a delay in delivery, keep the urine sample in a warm, dry area.”

“Send the urine sample to the laboratory within 6 hours of collection.”

A

“Urinate a small amount, stop flow, and then fill one half of the specimen cup.”

58
Q

Which phase of a woman’s sexual response is characterized by elevation of the uterus?

Plateau phase

Orgasmic phase

Excitation phase

Resolution phase

A

Plateau phase

Elevation of the uterus is a characteristic of the plateau phase of a woman’s sexual response. The plateau phase occurs after the excitation phase, and excitation is maintained through the plateau phase, wherein the vagina expands and the uterus is elevated. The orgasmic phase is characterized by uterine and vaginal contractions. In the excitation phase the clitoris is congested and vaginal lubrication increases. The resolution phase is characterized by returning to the preexisting state.

59
Q

Which issue must be addressed before a client with syphilis can be treated?

Portal of entry

Size of chancre

Existence of allergies

Names of sexual contacts

A

Existence of allergies

60
Q

Which goal would the nurse expect a client receiving treatment for bacterial cystitis to achieve before their discharge from the hospital?

Understand the need to drink 4 L of water per day to prevent dehydration.

Demonstrate an ability to identify dietary restrictions and plan menus.

Achieve relief of clinical symptoms and maintain kidney function.

Recognize signs of bleeding as a complication associated with this type of procedure.

A

Achieve relief of clinical symptoms and maintain kidney function.

61
Q

Which instruction would the nurse share when discussing prevention in a female client with a cycle of recurring urinary tract infections?

“Urinate as soon as possible after intercourse.”

“Increase your daily intake of citrus juice.”

“Douche regularly with alkaline agents.”

“Take bubble baths on a frequent basis.”

A

“Urinate as soon as possible after intercourse.”

Intercourse may cause urethral inflammation, increasing the risk of infection; voiding clears the urinary meatus and urethra of microorganisms. Most fruit juices, with the exception of cranberry juice, cause alkaline urine, which promotes bacterial growth. Douching is no longer recommended because it alters the vaginal flora. Bubble baths can promote urinary tract infections.

62
Q

Which goal is the nurse trying to achieve with continuous bladder irrigations (CBI) of a client who has undergone a suprapubic prostatectomy for cancer of the prostate?

Stimulate continuous formation of urine.

Facilitate the measurement of urinary output.

Prevent the development of clots in the bladder.

Provide continuous pressure on the prostatic fossa.

A

Prevent the development of clots in the bladder.

63
Q

Which safety precaution would the nurse employ when assisting with the removal of a client’s vaginal radium seeds?

Clean the radium in ether or alcohol.

Wear foil-lined rubber gloves while handling the radium.

Ensure long forceps are available for removing the radium.

Document how long the radium seeds were in the vaginal vault.

A

Ensure long forceps are available for removing the radium.

Radium must be handled with long forceps because distance helps limit exposure. The nurse does not clean radium implants. Foil-lined rubber gloves do not provide adequate shielding from the gamma rays emitted by radium. The amount and duration of exposure are important in assessing the effect on the client; however, documentation will not affect safety during removal.

64
Q

Which term is used to describe a client passing air and bubbles during urination?

Nocturia

Oliguria

Pneumaturia

Stress incontinence

A

Pneumaturia