Nursing textbooks renal and urinary practice questions
Nursing textbooks · renal and urinary
Nursing textbooks renal and urinary practice questions
You use fluids, electrolytes, and kidney cues to decide what to hold, give, or report. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five renal and urinary questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
The nurse is caring for a patient status after a motor vehicle accident. The patient has developed AKI. What is the nurses role in caring for this patient? Select all that apply.
A. Providing emotional support for the family
B. Monitoring for complications
C. Participating in emergency treatment of fluid and electrolyte imbalances
D. Providing nursing care for primary disorder (trauma)
E. Directing nutritional interventions
Show answer and rationale
Correct answer: A — Providing emotional support for the family
The nurse has an important role in caring for the patient with AKI. The nurse monitors for complications, participates in emergency treatment of fluid and electrolyte imbalances, assesses the patients progress and response to treatment, and provides physical and emotional support. Additionally, the nurse keeps family members informed about the patients condition, helps them understand the treatments, and provides psychological support. Although the development of AKI may be the most serious problem, the nurse continues to provide nursing care indicated for the primary disorder (e.g., burns, shock, trauma, obstruction of the urinary tract). The nurse does not direct the patients nutritional status; the dietician and the physician normally collaborate on directing the patients nutritional status.
Question 2
A nurse is caring for a male patient who had a urinary sheath applied following hip surgery. What nursing interventions are appropriate to include when caring for this patient?
A. Preventing the tubing from kinking to maintain free urinary drainage
B. Changing the sheath weekly and provide hygiene
C. Fastening the sheath tightly to prevent the possibility of leakage
D. Having the patient maintain bedrest to prevent the sheath from slipping off
E. Leaving 1 to 2 inches (2.5 to 5 cm) beyond the tip of the penis
Show answer and rationale
Correct answer: A — Preventing the tubing from kinking to maintain free urinary drainage
Maintaining free urinary drainage is a nursing priority. Institute measures to prevent the tubing from becoming kinked and urine from backing up in the tubing. The catheter should be allowed to drain freely through tubing that is not kinked. Nursing care of a patient with a urinary sheath includes skin care to prevent excoriation. Remove the condom daily and wash the penis with soap and water, and dry it carefully. Care must be taken to fasten the sheath securely enough to prevent leakage, yet not so tightly as to constrict the blood vessels in the area. The tip of the tubing should extend 1 to 2 inches (2.5 to 5 cm) beyond the tip of the penis to prevent irritation to the sensitive glans area. Confining a patient to bedrest increases the risk for hazards of immobility.
Question 3
A nurse is caring for an older adult client who is hospitalized. The client develops a UTI and is receiving prescribed anti-infective therapy. Which of the following should the nurse perform while caring for this client?
A. Document symptoms of the client's condition.
B. Monitor the client's vital signs every 4 hours.
C. Document the client's urine output every hour.
D. Assess the client for bladder distension.
Show answer and rationale
Correct answer: B — Monitor the client's vital signs every 4 hours.
When caring for a client with a UTI undergoing urinary tract anti-infective drug therapy, the nurse should monitor the vital signs of the client every 4 hours after administration of the drug or as ordered by the primary health care provider. Any significant rise in body temperature is reported to the primary health care provider because the methods of reducing the fever or culture and sensitivity tests may need to be repeated. The nurse should document the symptoms experienced by the client and assess the client for bladder distension as part of the preadministration assessment before administering the drug to the client. The nurse need not document the client's urine output every hour or monitor the client's respiratory rate in this case.
Question 4
The nurse is caring for a patient who is receiving hemodialysis and has symptoms of nausea, vomiting, and sudden onset of confusion. Which of the following actions is priority?
A. Infuse a hypotonic solution.
B. Increase the rate of the dialysis.
C. Administer an antiemetic medication.
D. Stop the dialysis solution.
Show answer and rationale
Correct answer: D — Stop the dialysis solution.
The patient's symptoms suggest disequilibrium syndrome, which is a rare complication of modern HD and develops as a result of very rapid changes in the composition of the extracellular fluid. Urea, sodium, and other solutes are removed more rapidly from the blood than from the cerebrospinal fluid and the brain. This creates a high osmotic gradient in the brain resulting in the shift of fluid into the brain, causing cerebral edema. Manifestations include nausea, vomiting, confusion, restlessness, headaches, twitching and jerking, and seizures. Treatment consists of slowing or stopping dialysis and infusing hypertonic saline solution, albumin, or mannitol to draw fluid from the brain cells back into the systemic circulation.
Question 5
The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse interprets the presence of which substances in the urine as most suggestive of pathology?
A. Potassium and sodium
B. Bicarbonate and urea
C. Glucose and protein
D. Creatinine and chloride
Show answer and rationale
Correct answer: C — Glucose and protein
The various substances normally filtered by the glomerulus, reabsorbed by the tubules, and excreted in the urine include sodium, chloride, bicarbonate, potassium, glucose, urea, creatinine, and uric acid. Within the tubule, some of these substances are selectively reabsorbed into the blood. Glucose is completely reabsorbed in the tubule and normally does not appear in the urine. However, glucose is found in the urine if the amount of glucose in the blood and glomerular filtrate exceeds the amount that the tubules are able to reabsorb. Protein molecules are also generally not found in the urine because amino acids are also filtered at the level of the glomerulus and reabsorbed so that it is not excreted in the urine.
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Question 6
The nurse is caring for a patient who has had a segmental cystectomy. Which of the following information should the nurse include in the postoperative teaching for the patient?
A. Limit fluid intake for at least 7 days.
B. Urine should be amber and not contain blood clots.
C. In about one week urine will have rust-coloured flecks.
D. Avoid sitz baths for a week after surgery.
Correct answer:
Approximately 7-10 days following tumour resection or ablation, the patient may observe dark red or rust-coloured flecks in the urine. These are anticipated and represent scabs from the healing tumour resection sites. Other postoperative instructions for a segmental cystectomy include to drink a large volume of fluid each day for the first week following the procedure and to avoid intake of alcoholic beverages. Urine is anticipated to be pink during the first several days after the procedure, but it should not be bright red or contain blood clots. The patient can be encouraged to take a 15-20-minute sitz bath two to three times a day to promote muscle relaxation and to reduce the risk of urinary retention.
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). Which of the following actions should the nurse implement to obtain the specimen?
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 swab, and then have the patient void into a sterile container.
Correct answer:
Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup best describes the technique for obtaining a clean-catch specimen. The answer beginning, 'insert a short, small, 'mini' catheter attached to a collecting container' describes a technique that would result in a sterile specimen, but a health care provider's order for a catheterized specimen would be required. Using povidone-iodine before obtaining the specimen is not necessary and might result in suppressing the growth of some bacteria. And the technique described in the answer beginning 'have the patient empty the bladder completely' would not result in a sterile specimen.
After nitrofurantoin is administered to a client with an acute bacterial UTI, assessment reveals dyspnea, chest pain, cough, fever, and chills. Which of the following actions would be most appropriate?
A. Monitor client for tightness of the chest.
B. Offer fluids to the client at regular intervals.
C. Provide oxygen support to the client.
D. Withhold the drug and contact the primary health care provider.
Correct answer:
The nurse should immediately notify the primary health care provider and withhold the next dose of the drug until the client is seen by the primary health care provider if acute pulmonary reactions are observed in the client. The nurse should monitor the client for signs of a nonproductive cough or malaise, which may indicate a chronic pulmonary reaction, which may occur during prolonged therapy. Tightness of the chest is not known to occur in the case of a chronic pulmonary reaction, so the nurse need not monitor the client for this. The nurse offers fluids at regular intervals to elderly clients who develop decreased thirst sensation as an adverse reaction to the urinary tract anti-infectives.
The home health nurse reviews medications taken by the client with polycystic kidney disease. Which medication should be addressed first?
A. Lovastatin
B. Methylprednisolone
C. Furosemide
D. Ibuprofen
Correct answer:
Nephrotoxic drugs are not administered to clients with renal disease unless no other therapeutic agent is available. Ibuprofen (Motrin) is a nephrotoxic drug and nephrotoxic medications, such as nonsteroidal anti-inflammatory drugs and cephalosporin antibiotics, should be avoided in treating clients with polycystic kidney disease. Lovastatin (Mevacor) (antihyperlipidemic agent) and methylprednisolone (Depo-Medrol) (steroid) are drugs presently being reviewed for slowing the rate of disease progression in clients with polycystic kidney disease and are not considered nephrotoxic. Furosemide (Lasix) is a diuretic and has no significance in causing renal damage.
A nurse reviews the urinalysis of a client and notes the presence of glucose. Which action should the nurse take?
A. Document findings and continue to monitor the client.
B. Contact the provider and recommend a 24-hour urine test.
C. Review the clients recent dietary selections.
D. Perform a capillary artery, glucose assessment.
Correct answer:
Glucose normally is not found in the urine. The normal renal threshold for glucose is about 200 mg/dL, which means that a person whose blood glucose is less than 200 mg/dL will not have glucose in the urine. A positive finding for glucose on urinalysis indicates high blood sugar. The most appropriate action would be to perform a capillary artery glucose assessment. The client needs further evaluation for this abnormal result; therefore, documenting and continuing to monitor is not appropriate. Requesting a 24-hour urine test or reviewing the client's dietary selections will not allow the nurse to make a clinical decision related to this abnormality.
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?
A. Stress incontinence
B. Reflex incontinence
C. Overflow incontinence
D. Functional incontinence
Correct answer:
Stress incontinence is the involuntary loss of urine through an intact urethra as a result of sudden increase in intra-abdominal pressure. Reflex incontinence is loss of urine due to hyperreflexia or involuntary urethral relaxation in the absence of normal sensations usually associated with voiding. Overflow incontinence is an involuntary urine loss associated with overdistension of the bladder. Functional incontinence refers to those instances in which the function of the lower urinary tract is intact, but other factors (outside the urinary system) make it difficult or impossible for the patient to reach the toilet in time for voiding.
The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period?
A. Encourage voiding following the procedure.
B. Assess renal blood work.
C. Assess cognitive status
D. Complete a pulse assessment of the legs and feet.
Correct answer:
A renal angiography provides details about the arterial blood supply to the kidney. A catheter is passed up the femoral artery into the aorta in the area of the renal artery. After the procedure, a pressure dressing remains in place for several hours. It is essential that the nurse palpate pulses in the legs and feet at least every 1 to 2 hours for signs of arterial occlusion. Reviewing lab work is completed in the preoperative period. Voiding assessment and cognitive status provide additional data in the post-procedural period. Assessing cognitive status is completed due to the sedative that is administered in the preprocedural period.
A new graduate nurse and their preceptor must collect several urine specimens for laboratory testing. Which techniques for urine collection by the graduate nurse are performed incorrectly, requiring the preceptor to intervene?
A. Catheterizing a patient to collect a sterile urine sample for routine urinalysis
B. Collecting a clean-catch urine specimen in the morning and storing it at room temperature until an afternoon pick-up
C. Collecting a sterile urine specimen from the collection bag of a patient's indwelling catheter
D. Collecting about 3 mL of urine from a patient's indwelling catheter to send for a urine culture
E. Planning to collect a sterile specimen from a patient with a urinary diversion by catheterizing the stoma
Correct answer:
A urine culture requires about 3 mL of urine, whereas routine urinalysis requires at least 10 mL of urine. The preferred method of collecting a sterile urine specimen from a urinary diversion is to catheterize the stoma. For a 24-hour urine specimen, the nurse should discard the first voiding, then collect all urine voided for the next 24 hours. A sterile urine specimen is not required for a routine urinalysis. Urine chemistry is altered after urine stands at room temperature for a long period of time. A specimen from the collection drainage bag may not be fresh urine and could result in an inaccurate analysis.
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?
A. Oral intake
B. Pain intensity
C. Level of consciousness
D. Radiation of pain
Correct answer:
Bleeding is a major complication of kidney surgery. If undetected and untreated, this can result in hypovolemia and hemorrhagic shock. The nurses role is to observe for these complications, to report their signs and symptoms, and to administer prescribed parenteral fluids and blood and blood components. Monitoring of vital signs, skin condition, the urinary drainage system, the surgical incision, and the level of consciousness is necessary to detect evidence of bleeding, decreased circulating blood, and fluid volume and cardiac output. Bleeding is not normally evidenced by changes in pain or oral intake.
A nurse in the emergency room is teaching a patient how to collect a midstream urine specimen. What instructions will the nurse give the patient?
A. Wash your hands with soap and water.
B. Open the container and place the lid face down on the counter.
C. Separate your labia and wipe with the antiseptic towelettes in the kit.
D. Without letting go of the labia, void a small amount into the toilet or collection hat.
E. Lean the collection container against the urinary opening and void into the container.
Correct answer:
The nurse gives these instructions to collect the midstream/clean-catch urine specimen: Wash your hands with soap and water. Open the collection cup, and place the lid face up; do not touch the inside. Separate the labia and cleanse the urinary opening with soap and water or towelettes included in the kit. Void about 1 oz. (30 mL) into the toilet, then move the collection cup close to the urinary opening and void about 1 oz (no less than 2 teaspoons) into the container. Pass the remainder of the urine into the toilet. Without touching the inside of the lid, close the cup and return it to the nurse.
About these Nursing textbooks renal and urinary questions
Nursing textbooks renal and urinary practice questions for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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