Med surg quiz

Question 1

A patient with renal failure secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of renal failure for which the nurse should monitor the patient?

Answer 1

Retention of potassium

Question 2

To calculate the approximate weight gain from fluid retention

Answer 2

To calculate the approximate weight gain from fluid retention, remember that 1 kg of weight gain equals approximately 1,000 mL of fluid. Five lbs = 2.27 kg = 2,270 mL.

Question 3

costovertebral angle

Answer 3

At the lower border of the 12th rib and the spine

Question 4

The staff educator is giving a class for a group of nurses new to the renal unit. The educator is discussing renal biopsies. In what patient would the educator tell the new nurses that renal biopsies are contraindicated?

Answer 4

A 42-year-old patient with morbid obesity.

There are several contraindications to a kidney biopsy, including bleeding tendencies, uncontrolled hypertension, a solitary kidney, and morbid obesity.

Question 5

A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?

Answer 5

ultrasound

Question 6

A patient admitted to the medical unit with impaired renal function is complaining of severe, stabbing pain in the flank and lower abdomen. The patient is being assessed for renal calculi. The nurse recognizes that the stone is most likely in what anatomic location?

Answer 6

ureter

Question 7

The nurse is caring for a patient who had a brush biopsy 12 hours ago. The presence of what assessment finding should prompt the nurse to notify the physician?

Answer 7

Temperature 100.2F orally

Question 8

A patient is complaining of genitourinary pain shortly after returning to the unit from a scheduled cystoscopy. What intervention should the nurse perform?

Answer 8

Apply moist heat to the patients lower abdomen.

Question 9

The nurse is caring for a patient scheduled for renal angiography following a motor vehicle accident. What patient preparation should the nurse most likely provide before this test?

Answer 9

Administration of a laxative

Question 10

A patient asks the nurse why kidney problems can cause gastrointestinal disturbances. What relationship should the nurse describe?

Answer 10

The right kidneys proximity to the pancreas, liver, and gallbladder

Question 11

The nurse is reviewing the electronic health record of a patient with a history of incontinence. The nurse reads that the physician assessed the patients deep tendon reflexes. What condition of the urinary/renal system does this assessment address?

Answer 11

Bladder dysfunction

Question 12

A nurse is working with a patient who will undergo invasive urologic testing. The nurse has informed the patient that slight hematuria may occur after the testing is complete. The nurse should recommend
what
action to help resolve hematuria?

Answer 12

Increased fluid intake following the test

Question 13

Urine testing includes

Answer 13

testing for specific gravity, glucose, RBCs, and casts. BUN and creatinine are components of serum, not urine.

Question 14

Dipstick testing of an older adult patients urine indicates the presence of protein. Which of the following statements is true of this assessment finding?

Answer 14

B) This finding is a risk factor for urinary incontinence.
C) This finding is likely the result of an age-related physiologic change.
D) This result confirms that the patient has diabetes. Select all that apply.

Question 15

The nurse is assessing a patient suspected of having developed acute glomerulonephritis. The nurse should expect to address what clinical manifestation that is characteristic of this health problem?

Answer 15

Hematuria

Question 16

The nurse is caring for acutely ill patient. What assessment finding should prompt the nurse to inform the physician that the patient may be exhibiting signs of acute kidney injury (AKI)?

Answer 16

The patients average urine output has been 10 mL/hr for several hours.

Question 17

The nurse coming on shift on the medical unit is taking a report on four patients. What patient does the nurse know is at the greatest risk of developing ESKD?

Answer 17

A patient with diabetes mellitus and poorly controlled hypertension

Question 18

The nurse is caring for a patient in acute kidney injury. Which of the following complications would
most clearly warrant the administration of polystyrene sulfonate (Kayexalate)?

Answer 18

Hyperkalemia

Question 19

fluid restriction for

Answer 19

ESKD

Question 20

The nurse performing the health interview of a patient with a new onset of periorbital edema has completed a genogram, noting the health history of the patients siblings, parents, and grandparents. This assessment addresses the patients risk of what kidney disorder?

Answer 20

Polycystic kidney disease (PKD)

Question 21

A nurse is caring for a patient who is in the diuresis phase of AKI. The nurse should closely monitor the patient for what complication during this phase?

Answer 21

dehydration

Question 22

A patient with chronic kidney disease has been hospitalized and is receiving hemodialysis on a scheduled basis. The nurse should include which of the following actions in the plan of care?

Answer 22

Assess for a thrill or bruit over the vascular access site each shift.

Question 23

The nurse is caring for a patient after kidney surgery. The nurse is aware that bleeding is a major complication of kidney surgery and that if it goes undetected and untreated can result in hypovolemia and hemorrhagic shock in the patient. When assessing for bleeding, what assessment parameter should the nurse evaluate?

Answer 23

A) Oral intake
B) Pain intensity
C) Level of consciousness
D) Radiation of pain

C - LOC

Question 24

A 42-year-old woman comes to the clinic complaining of occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence?

Answer 24

Stress incontinence

Question 25

A female patients most recent urinalysis results are suggestive of bacteriuria. When assessing this patient, the nurses data analysis should be informed by what principle?

Answer 25

Urine samples are frequently contaminated by bacteria normally present in the urethral area.

Question 26

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 26

Empty the drainage bag at least every 8 hours.

Question 27

A patient with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the patients post-procedure care?

Answer 27

Strain the patients urine following the procedure.

Question 28

A patient is undergoing diagnostic testing for a suspected urinary obstruction. The nurse should know that incomplete emptying of the bladder due to bladder outlet obstruction can cause what?

Answer 28

Hydronephrosis

Question 29

The nurse is assessing a patient admitted with renal stones. During the admission assessment, what parameters would be priorities for the nurse to address? Select all that apply.

Answer 29

A) Dietary history
B) Family history of renal stones
C) Medication history
D) Surgical history
E) Vaccination history

A, B, C

Question 30

A gerontologic nurse is assessing a patient who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply.

Answer 30

A) Food cravings
B) Upper abdominal pain
C) Insatiable thirst
D) Uncharacteristic fatigue
E) New onset o`f confusion

Ans: D

Question 31

A patient has been admitted to the medical unit with a diagnosis of ureteral colic (PAIN) secondary to urolithiasis (bladder stone) . When planning the patients admission assessment, the nurse should be aware of the signs and symptoms that are characteristic of this diagnosis? Select all that apply.

Answer 31

A) Diarrhea
B) High fever
C) Hematuria
D) Urinary frequency
E) Acute pain

Ans: C, D, E

Question 32

A patient who has recently undergone ESWL (lithotripsy) for the treatment of renal calculi has phoned the urology unit where he was treated, telling the nurse that he has a temperature of 101.1F (38.4C). How should the nurse best respond to the patient?

Answer 32

A) Remind the patient that renal calculi have a noninfectious etiology and that a fever is unrelated to their recurrence.
B) Remind the patient that occasional febrile episodes are expected following ESWL.
C) Tell the patient to report to the ED for further assessment.
D) Tell the patient to monitor his temperature for the next 24 hours and then contact his urologists office.

Ans: C

Question 33

The nurse has tested the pH of urine from a patients newly created ileal conduit and obtained a result of 6.8. What is the nurses best response to this assessment finding?

Answer 33

Obtain an order to increase the patients dose of ascorbic acid. - should keep below 6.5

Question 34

The nurse is collaborating with the wound-ostomy-continence (WOC) nurse to teach a patient how to manage her new ileal conduit in the home setting. To prevent leakage or skin breakdown, the nurse should encourage which of the following practices?

Answer 34

Avoid using moisturizing soaps and body washes when cleaning the peristomal area.

Question 35

A nurse practitioner is assessing a 55-year-old male patient who is complaining of perineal discomfort, burning, urgency, and frequency with urination. The patient states that he has pain with ejaculation. The nurse knows that the patient is exhibiting symptoms of what?

Answer 35

Prostatitis

Question 36

A public health nurse has been asked to provide a health promotion session for men at a wellness center. What should the nurse inform the participants about testicular cancer?

Answer 36

A) It is most common among men over 55.
B) It is one of the least curable solid tumors.
C) It typically does not metastasize.
D) It is highly responsive to treatment.

Ans: D

Question 37

A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?

Answer 37

The patient should avoid close contact with his daughter for 2 months.

Question 38

A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?

Answer 38

A) Hypertension
B) Peripheral edema
C) Tachycardia and other dysrhythmias
D) Increased blood urea nitrogen (BUN)

Ans: D

Question 39

A 35-year-old man is seen in the clinic because he is experiencing recurring episodes of urinary frequency, dysuria, and fever. The nurse should recognize the possibility of what health problem?

Answer 39

Chronic bacterial prostatitis

Question 40

A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located?

Answer 40

Below the prostate, within the posterior aspect of the urethra