Chapter 55 Quiz

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Question #1

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client’s plan of care?

A Intermittent catheterizations

B Application of an ostomy pouch

C Irrigating the urinary diversion

D Exercises to promote sphincter control

Question #2

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

A Make sure to eat enough fiber to prevent constipation.”

B Try drinking coffee throughout the day.”

C Limit the number of times you urinate during the day.”

D Use scented powders to disguise any odor.”

Question #3

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?

A This medication will relieve your pain.”

B This medication will prevent re-infection.”

C This will kill the organism causing the infection.”

D This medication should be taken at bedtime.”

Question #4

The nurse is giving discharge instructions to the client with uric acid renal calculi. Which statement by the client indicates the client understands the prescribed diet?

A I should limit my intake of meat and fish.”

B I will eliminate milk and other dairy products from my diet.”

C Chocolate, spinach, and strawberries are not allowed.”

D I should avoid raw fruits and vegetables.”

Question #5

The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located?

A Over a bony prominence

B Away from skin folds

C At the belt line

D At the umbilicus

Question #6

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client’s plan of care?

A Irrigating the urinary diversion

B Application of an ostomy pouch

C Intermittent catheterizations

D Exercises to promote sphincter control

Question #7

Which of the following is classified as a upper urinary tract infection (UTI)? Select all that apply.,,

A Prostatatis

B Urethritis

C Renal abscess

D Acute pyelonephritis

Question #8

Which metabolic defects are associated with stone formation?

A Hypouricemia

B Hyperparathyroidism

C Hyperthyroidism

D Hypoparathyroidism

Question #9

Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor?

A Eat plenty of cheese and egg

B Avoid foods such as buttermilk or yogurt.

C Add a few drops of diluted white vinegar to the pouch.

D Avoid pouches with carbon filters.

Question #10

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?

A Postoperative pneumonia

B Stoma retraction

C Peritonitis

D Stoma ischemia

Question #11

Which of the following nursing actions is most important in caring for the client following lithotripsy?

A Notify the physician of hematuria.

B Strain the urine carefully for stone fragments.

C Monitor the continuous bladder irrigation.

D Administer allopurinol (Zyloprim).

Question #12

Which statement describing urinary incontinence in an older adult client is true?

A Urinary incontinence isn’t a disease.

B Urinary incontinence in the elderly population can’t be treated.

C Urinary incontinence is a disease.

D Urinary incontinence is a normal part of aging.

Question #13

A client with bladder cancer had his 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 the nurse conclude?

A The pouch faceplate doesn’t fit the stoma.

B Stoma dilation wasn’t performed.

C The skin wasn’t lubricated before the pouch was applied.

D skin barrier was applied properly.

Question #14

A woman comes to her health care provider’s office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?

A Prevent nephron destruction.

B Determine the stone type.

C Relieve the pain.

D Relieve any obstruction.

Question #15

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what?

A Interval voiding

B Prompted voiding

C Voiding at given intervals

D Bladder retraining

Question #16

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances?

A Uric acid

B Struvite

C Cystine

D Calcium

Question #17

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?

A Septra

B Pyridium

C Bactrim

D Levaquin

Question #18

A client has just undergone a urinary diversion procedure. What management issues related specifically to urinary diversion would be included in this client’s care plan? Select all that apply.

A Encourage oral intake.

B Maintain renal function.

C Observe for leakage of urine or stool from the anastomosis.

D Assess for signs and symptoms of peritonitis.

Question #19

Which medication may be ordered to relieve discomfort associated with a urinary tract infection?

A Levofloxacin

B Nitrofurantoin

C Phenazopyridine

D Ciprofloxacin

Question #20

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?

A Use a sterile technique to disconnect the catheter from the tubing to obtain urine specimens

B Use a clean technique during insertion

C Place the catheter bag on the client’s abdomen when moving the client

D Perform meticulous perineal care daily with soap and water

Question #21

A client is treated for renal calculi and suspected hydronephrosis. Therefore, the nurse should maintain a record of the kidney’s function. Which measure can the nurse take to help achieve the objective?

A Palpate for a thrill over the vascular access

B Monitor the patient’s intake and output

C Note the nail beds and mobility of the fingers

D Inspect the skin over the fistula or graft for signs of infection

Question #22

Which type of incontinence refers to involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?

A Reflex

B Overflow

C Urge

D Stress

Question #23

The nurse advises the patient with chronic pyelonephritis that he should:

A Limit his fluid intake to 1.5 L/day to minimize bladder fullness, which could cause backward pressure on the kidneys.

B Increase fluids to 3 to 4 L/24 hours to dilute the urine.

C Decrease his intake of calcium rich foods to prevent kidney stones.

D Decrease his sodium intake to prevent fluid retention.

Question #24

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?

A Hyperuricemia

B Pancreatitis

C Diabetes mellitus

D Hyperparathyroidism

Question #25

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply.,,

A Assist the patients with frequent toileting.

B Perform hand hygiene prior to patient care.

C Provide careful perineal care.

D Encourage patients to wear briefs.

E For those patients who are incontinent, insert indwelling catheters

Question #26

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

A Cipro

B Macrodantin

C Bactrim

D Septra

Question #27

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?

A The nursing assistant places the drainage bag on the client’s abdomen for transport.

B The nursing assistant holds the drainage bag while the client moves to the wheelchair

C The nursing assistant keeps the catheter and drainage bag together when moving the client.

D The nursing assistant places the drainage bag on the lower area of the wheelchair for transport.

Question #28

The nurse is caring for a client with a cystoscopy tube draining urine from the bladder. When reviewing the client’s history prior to administering care, which is of most concern?

A New diagnosis of urosepsis

B Crusted drainage around the cystoscopy tube

C A white blood count of 12,000 cells/mm3

D Diagnostic studies reporting bladder stones

Question #29

Which of the following is a cause of a calcium renal stone?

A Neurogenic bladder

B Gout

C Excessive intake of vitamin D

D Foreign bodies

Question #30

Which information is important when teaching a client how to perform self-catheterization?

A catheter is rinsed with sterile normal saline after being soaked in a cleaning solution.

B Peroxide is recommended for cleaning the urinary catheter.

C Catheterization should occur every 4 to 6 hours and before bedtime.

D The nurse uses nonsterile technique in the hospital setting.

Question #31

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

A Assessing present voiding patterns

B Restricting fluid intake to reduce the need to void

C Encouraging the client to increase the time between voidings

D Establishing a predetermined fluid intake pattern for the client

Question #32

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?

A Dysuria

B Frequency

C Incontinence

D Hematuria

Question #33

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client?

A Fruit juice midmorning

B Milk at lunch

C Ginger ale at dinner time

D Coffee in the morning

Question #34

Which of the following is a strategy to promote urinary continence?

A Use caffeine in moderation

B Take diuretics after 4 PM

C Void regularly, 5 to 8 times a day

D Implement a low fiber diet

Question #35

Sympathomimetics have which of the following effects on the body?

A Decrease of heart rate

B Relaxation of bladder wall

C Constriction of bronchioles

D Constriction of pupils

Question #36

A client comes to the clinic for a follow-up visit. During the interview, the client states, “Sometimes when I have to urinate I can’t control it, and do not reach the bathroom in time.” The nurse suspects that the client is experiencing which type of incontinence?

A Urge

B Functional

C Stress

D Overflow

Question #37

A male client who is admitted with the diagnosis of urinary calculi complains of excruciating pain. The pain is suspected to be caused by increased pressure in the renal pelvis. Which measure would be most appropriate to provide pain relief?

A Encourage frequent ambulation.

B Encourage the client to void every 2 to 3 hours

C Encourage deep-breathing exercises.

D Restrict the client’s sodium intake.

Question #38

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?

A Risk for altered urinary elimination

B Risk for infection

C Risk for fluid volume excess

D Risk for deficient knowledge: self-catherization

Question #39

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?

A Taking the client to the bathroom twice per day

B Encouraging intake of at least 2 L of fluid daily

C Consulting with a dietitian

D Giving the client a glass of soda before bedtime

Question #40

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that 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?

A Ureter

B Urethra

C Bladder

D Kidney

Question #41

A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care?

A Monitor urine output hourly and report output less than 30 mL/hr

B the patient every 2 hours around the clock

C Administer pain medication every 2 hours.

D Clean the stoma with soap and water after the patient voids.

Question #42

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?

A Be sure to take the medication with grapefruit juice.

B Take the antibiotic for 3 days as prescribed.

C Take the antibiotic as well as an antifungal for the yeast infection she will probably have.

D Understand that if the infection reoccurs, the dose will be higher next time.

Question #43

The nurse is assessing a client’s new stoma and observes that the stoma color is now dark purple. The appropriate nursing intervention is to

A remove the urinary stents.

B change the pouching system.

C contact the physician.

D apply Karaya powder.

Question #44

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?

A Shows damage to the kidneys

B risk for chronic pyelonephritis is likely

C Reveals causative microorganisms

D Detects calculi, cysts, or tumors

Question #45

Which of the following is the most common symptom of bladder cancer?

A Painless gross hematuria

B Pelvic pain

C Altered voiding

D Back pain

Question #46

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence?

A Obstruction due to fecal impaction or enlarged prostate

B Bladder irritation related to urinary tract infections

C Increased urine production due to metabolic conditions

D Decreased pelvic muscle tone due to multiple pregnancies

Question #47

Which of the following nursing actions is most important in caring for the client following lithotripsy?

A Strain the urine carefully for stone fragments.

B Notify the physician of hematuria.

C Administer allopurinol (Zyloprim

D Monitor the continuous bladder irrigation.

Question #48

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client’s care, the nurse should assign the highest priority to which nursing diagnosis?

A Impaired urinary elimination

B Impaired urinary elimination

C Acute pain

D Risk for infection

Question #49

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention?

A Empty the pouch.

B Secure or patch it with barrier paste.

C Secure or patch it with tape.

D Change the wafer and pouch.

Question #50

Which instruction would be included in a teaching plan for a client diagnosed with a UTI?

A Take tub baths as opposed to showers.

B Drink liberal amount of fluids.

C Drink coffee or tea to increase diuresis

D Void every 4 to 6 hours.

Question #51

A nurse has been asked to speak to a local women’s group about preventing cystitis. Which of the following would the nurse include in the presentation?

A Importance of urinating every 4 to 6 hours while awake

B Need to urinate after engaging in sexual intercourse

C Suggestion to take tub baths instead of showers

D to wear underwear made from synthetic material

Question #52

Which nursing intervention should the nurse caring for the client with pyelonephritis implement?

A Administer acetaminophen (Tylenol).

B Straight catheterize the client every 4 to 6 hours

C Teach client to increase fluid intake up to 3 liters per day.

D Restrict fluid intake to 1 liter per day.

Question #53

The nurse is caring for the client following surgery for a urinary diversion. The client refuses to look at the stoma or participate in its care. The nurse formulates a nursing diagnosis of:

A Situational low self esteem

B Disturbed body image

C Anticipatory grieving

D Deficient knowledge: stoma care

Question #54

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client’s report?

A How much fluid are you drinking?”

B Have you had a fever and chills?”

C When did you last urinate?”

D Do you get up at night to urinate?”

Question #55

Bladder retraining following removal of an indwelling catheter begins with

A advising the client to avoid urinating for at least 6 hours.

B encouraging the client to void immediately.

C performing straight catheterization after 4 hours.

D instructing the client to follow a 2- to 3-hour timed voiding schedule.

Question #56

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client’s care to:

A evaluate the client’s need for mental health intervention.

B assess whether the client is a good candidate for surgery.

C assess suicidal risk postoperatively.

D help the client cope with the anxiety associated with changes in body image.

Question #57

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?

A Be aware that your urine will be cherry-red for 5 to 7 days

B Take your temperature every 4 hours.”

C Apply an antibacterial dressing to the incision daily.”

D Increase your fluid intake to 2 to 3 L per day.”

Question #58

Which medication may be ordered to relieve discomfort associated with a UTI?

A Phenazopyridine

B Ciprofloxacin

C Levofloxacin

D Nitrofurantoin

Question #59

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which item should the nurse include?

A Encourage voiding immediately after catheter removal

B Perform straight catheterization every 4 hours

C Avoid drinking fluids for 6 hours

D Implement a 2- to 3-hour voiding schedule

Question #60

A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is:

A implantation of an artificial sphincter that can be inflated to prevent urine loss and deflated to allow urination.

B procedure that increases storage capacity of the bladder.

C placement of small amounts of collagen in urethral walls to aid the closing pressure

D a procedure that increases support to the bladder by tightening the vaginal wall under the urethra.

Question #61

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply.,,

A Urinary retention

B Deficient knowledge: management of urinary diversion

C Chronic pain

D Disturbed body image

E Risk for impaired skin integrity

Question #62

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

A Painless hematuria

B Fever

C Urinary retention

D Frequency

Question #63

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?

A A catheter will drain urine directly from my kidney.”

B My urine will be eliminated with my feces.”

C I will not need to worry about being incontinent of urine.”

D My urine will be eliminated through a stoma.”

Question #64

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection?

A Drink liberal amount of fluids.

B Void every 4 to 6 hours.

C Drink coffee or tea to increase diuresis.

D Use tub baths as opposed to showers

Question #65

Which type of medication may be used to inhibit bladder contraction in a client with incontinence?

A Over-the-counter decongestant

B Estrogen hormone

C Tricyclic antidepressants

D Anticholinergic agent

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