1. The nurse is aware that the following findings would be further evidence of a urethral injury in a male client during rectal examination?
a. A low-riding prostate
b. The presence of a boggy mass
c. Absent sphincter tone
d. A positive Hemoccult
2. When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members, nurse Rose teaches how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?
a. The client sets the drainage bag on the floor while sitting down.
b. The client keeps the drainage bag below the bladder at all times.
c. The client clamps the catheter drainage tubing while visiting with the family.
d. The client loops the drainage tubing below its point of entry into the drainage bag.
3. A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?
a. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
b. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
c. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
d. The human papillomavirus (HPV), which causes condylomata acuminata, can’t be transmitted during oral sex.
4. A male client with bladder cancer has had the bladder removed and an ileal conduit created for urine diversion. While changing this client’s pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should nurse Katrina conclude?
a. The skin wasn’t lubricated before the pouch was applied.
b. The pouch faceplate doesn’t fit the stoma.
c. A skin barrier was applied properly.
d. Stoma dilation wasn’t performed.
5. The nurse is aware that the following laboratory values supports a diagnosis of pyelonephritis?
d. Low white blood cell (WBC) count
6. A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, nurse Sarah knows that the client is most likely to experience:
b. weight loss.
c. increased urine output.
d. increased blood pressure.
7. Nurse Lea is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?
a. Rashes on the palms of the hands and soles of the feet
b. Cauliflower-like warts on the penis
c. Painful red papules on the shaft of the penis
d. Foul-smelling discharge from the penis
8. Nurse Agnes is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?
a. Specific gravity of 1.03
b. Urine pH of 3.0
c. Absence of protein
d. Absence of glucose
9. A male client is scheduled for a renal clearance test. Nurse Maureen should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in:
a. 1 minute.
b. 30 minutes.
c. 1 hour.
d. 24 hours.
10. A male client in the short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should:
a. keep the client’s knee on the affected side bent for 6 hours.
b. apply pressure to the puncture site for 30 minutes.
c. check the client’s pedal pulses frequently.
d. remove the dressing on the puncture site after vital signs stabilize.
11. A female client is admitted for treatment of chronic renal failure (CRF). Nurse Juliet knows that this disorder increases the client’s risk of:
a. water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
b. a decreased serum phosphate level secondary to kidney failure.
c. an increased serum calcium level secondary to kidney failure.
d. metabolic alkalosis secondary to retention of hydrogen ions.
12. Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a female client’s uremia. Which finding signals a significant problem during this procedure?
a. Potassium level of 3.5 mEq/L
b. Hematocrit (HCT) of 35%
c. Blood glucose level of 200 mg/dl
d. White blood cell (WBC) count of 20,000/mm3
13. For a male client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important?
a. Encouraging coughing and deep breathing
b. Promoting carbohydrate intake
c. Limiting fluid intake
d. Providing pain-relief measures
14. A female client requires hemodialysis. Which of the following drugs should be withheld before this procedure?
a. Phosphate binders
d. Cardiac glycosides
15. A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), Dr. Smith orders diagnostic tests of the vaginal discharge. Which STD must be reported to the public health department?
c. Genital herpes
d. Human papillomavirus infection
16. A male client with acute pyelonephritis receives a prescription for co-trimoxazole (Septra) P.O. twice daily for 10 days. Which finding best demonstrates that the client has followed the prescribed regimen?
a. Urine output increases to 2,000 ml/day.
b. Flank and abdominal discomfort decrease.
c. Bacteria are absent on urine culture.
d. The red blood cell (RBC) count is normal.
17. A 26-year-old female client seeks care for a possible infection. Her symptoms include burning on urination and frequent, urgent voiding of small amounts of urine. She’s placed on trimethoprim-sulfamethoxazole (Bactrim) to treat possible infection. Another medication is prescribed to decrease the pain and frequency. Which of the following is the most likely medication prescribed?
a. nitrofurantoin (Macrodantin)
b. ibuprofen (Motrin)
c. acetaminophen with codeine
d. phenazopyridine (Pyridium)
18. A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the nurse is aware that the functions of the three lumens include:
a. Continuous inflow and outflow of irrigation solution.
b. Intermittent inflow and continuous outflow of irrigation solution.
c. Continuous inflow and intermittent outflow of irrigation solution.
d. Intermittent flow of irrigation solution and prevention of hemorrhage.
19. Nurse Claudine is reviewing a client’s fluid intake and output record. Fluid intake and urine output should relate in which way?
a. Fluid intake should be double the urine output.
b. Fluid intake should be approximately equal to the urine output.
c. Fluid intake should be half the urine output.
d. Fluid intake should be inversely proportional to the urine output.
20. After trying to conceive for a year, a couple consults an infertility specialist. When obtaining a history from the husband, nurse Jenny inquires about childhood infectious diseases. Which childhood infectious disease most significantly affects male fertility?
d. Scarlet fever
21. A male client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region, which radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?
22. A female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes:
a. confusion, headache, and seizures.
b. acute bone pain and confusion.
c. weakness, tingling, and cardiac arrhythmias.
d. hypotension, tachycardia, and tachypnea.
23. Dr. Marquez prescribes norfloxacin (Noroxin), 400 mg P.O. twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. For an uncomplicated UTI, the usual duration of norfloxacin therapy is:
a. 3 to 5 days.
b. 7 to 10 days.
c. 12 to 14 days.
d. 10 to 21 days.
24. Nurse Joy is providing postprocedure care for a client who underwent percutaneous lithotripsy. 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. The nurse should instruct the client to:
a. limit oral fluid intake for 1 to 2 weeks.
b. report the presence of fine, sandlike particles through the nephrostomy tube.
c. notify the physician about cloudy or foul-smelling urine.
d. report bright pink urine within 24 hours after the procedure.
25. A client is frustrated and embarrassed by urinary incontinence. Which of the following measures should nurse Bea include in a bladder retraining program?
a. Establishing a predetermined fluid intake pattern for the client
b. Encouraging the client to increase the time between voidings
c. Restricting fluid intake to reduce the need to void
d. Assessing present elimination patterns
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