Urinary System Disorders | NCLEX Quiz 110

1. A client is complaining of severe flank and abdominal pain. A flat plate of the abdomen shows urolithiasis. Which of the following interventions is important?

Strain all urine

Limit fluid intake

Enforce strict bed rest

Encourage a high calcium diet

Urine should be strained for calculi and sent to the lab for analysis.Option B: Fluid intake of three (3) to four (4) L is encouraged to flush the urinary tract and prevent further calculi formation.Option C: Ambulation is encouraged to help pass the calculi through gravity.Option D: A low-calcium diet is recommended to help prevent the formation of calcium calculi.

Explanation

Urine should be strained for calculi and sent to the lab for analysis.Option B: Fluid intake of three (3) to four (4) L is encouraged to flush the urinary tract and prevent further calculi formation.Option C: Ambulation is encouraged to help pass the calculi through gravity.Option D: A low-calcium diet is recommended to help prevent the formation of calcium calculi.

2. A client received a kidney transplant 2 months ago. He's admitted to the hospital with the diagnosis of acute rejection. Which of the following assessment findings would be expected?

Hypotension

Normal body temperature

Decreased WBC count

Elevated BUN and creatinine levels

In a client with acute renal graft rejection. evidence of deteriorating renal function is expected.Option A: The client would most likely have acute hypertension.Options B and C: The nurse would see elevated WBC counts and fever because the body is recognizing the graft as foreign and is attempting to fight it.

Explanation

In a client with acute renal graft rejection. evidence of deteriorating renal function is expected.Option A: The client would most likely have acute hypertension.Options B and C: The nurse would see elevated WBC counts and fever because the body is recognizing the graft as foreign and is attempting to fight it.

3. A client has passed a renal calculus. The nurse sends the specimen to the laboratory so it can be analyzed for which of the following factors?

Antibodies

Type of infection

Composition of calculus

Size and number of calculi

The calculus should be analyzed for the composition to determine appropriate interventions such as dietary restrictions.Options A and D: The size and number of calculi aren’t relevant. and they don’t contain antibodies.Option B: Calculi don’t result in infections.

Explanation

The calculus should be analyzed for the composition to determine appropriate interventions such as dietary restrictions.Options A and D: The size and number of calculi aren’t relevant. and they don’t contain antibodies.Option B: Calculi don’t result in infections.

4. A client had a transurethral prostatectomy for benign prostatic hypertrophy. He's currently being treated with a continuous bladder irrigation and is complaining of an increase in severity of bladder spasms. Which of the interventions should be done first?

Administer an oral analgesic

Stop the irrigation and call the physician

Administer a belladonna and opium suppository as ordered by the physician.

Check for the presence of clots. and make sure the catheter is draining properly.

Blood clots and blocked outflow if the urine can increase spasms.Option A: Oral analgesics should be given if the spasms are unrelieved by the belladonna and opium suppository.Option B: The irrigation shouldn’t be stopped as long as the catheter is draining because clots will form.Option C: A belladonna and opium suppository should be given to relieve spasms but only after assessment of the drainage.

Explanation

Blood clots and blocked outflow if the urine can increase spasms.Option A: Oral analgesics should be given if the spasms are unrelieved by the belladonna and opium suppository.Option B: The irrigation shouldn’t be stopped as long as the catheter is draining because clots will form.Option C: A belladonna and opium suppository should be given to relieve spasms but only after assessment of the drainage.

5. The client is to undergo kidney transplantation with a living donor. Which of the following preoperative assessments is important?

Urine output

Signs of graft rejection

Signs and symptoms of rejection

Client’s support system and understanding of lifestyle changes.

The client undergoing a renal transplantation will need vigilant follow-up care and must adhere to the medical regimen. The client is most likely anuric or oliguric preoperatively but postoperatively will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection. it’s most important post-op will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection. it’s most important postoperatively due to the immunosuppressant therapy. Rejection can occur postoperatively.

Explanation

The client undergoing a renal transplantation will need vigilant follow-up care and must adhere to the medical regimen. The client is most likely anuric or oliguric preoperatively but postoperatively will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection. it’s most important post-op will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection. it’s most important postoperatively due to the immunosuppressant therapy. Rejection can occur postoperatively.

6. Adverse reactions of prednisone therapy include which of the following conditions?

Acne and bleeding gums

Sodium retention and constipation

Mood swings and increased temperature

Increased blood glucose levels and decreased wound healing.

Steroid use tends to increase blood glucose levels. particularly in clients with diabetes and borderline diabetes. Steroids also contribute to poor wound healing and may cause acne. mood swings. and sodium and water retention. Steroids don’t affect thermoregulation. bleeding tendencies. or constipation.Options A. B. and C: Steroids don’t affect thermoregulation. bleeding tendencies. or constipation.

Explanation

Steroid use tends to increase blood glucose levels. particularly in clients with diabetes and borderline diabetes. Steroids also contribute to poor wound healing and may cause acne. mood swings. and sodium and water retention. Steroids don’t affect thermoregulation. bleeding tendencies. or constipation.Options A. B. and C: Steroids don’t affect thermoregulation. bleeding tendencies. or constipation.

7. A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy?

Depression

Hemorrhage

Infection

Peptic ulcer disease

Infection is the major complication to watch for in clients on cyclosporine therapy because it’s an immunosuppressive drug.Option A: Depression may occur posttransplantation but not because of cyclosporine.Option B: Hemorrhage is a complication associated with anticoagulant therapy.Option D: Peptic ulcer disease is a complication of steroid therapy.

Explanation

Infection is the major complication to watch for in clients on cyclosporine therapy because it’s an immunosuppressive drug.Option A: Depression may occur posttransplantation but not because of cyclosporine.Option B: Hemorrhage is a complication associated with anticoagulant therapy.Option D: Peptic ulcer disease is a complication of steroid therapy.

8. A client is receiving a radiation implant for the treatment of bladder cancer. Which of the following interventions is appropriate?

Flush all urine down the toilet

Restrict the client’s fluid intake

Place the client in a semi-private room

Monitor the client for signs and symptoms of cystitis

Cystitis is the most common adverse reaction of clients undergoing radiation therapy; symptoms include dysuria. frequency. urgency. and nocturia. Clients with radiation implants require a private room. Urine of clients with radiation implants for bladder cancer should be sent to the radioisotopes lab for monitoring. It is recommended that fluid intake be increased.

Explanation

Cystitis is the most common adverse reaction of clients undergoing radiation therapy; symptoms include dysuria. frequency. urgency. and nocturia. Clients with radiation implants require a private room. Urine of clients with radiation implants for bladder cancer should be sent to the radioisotopes lab for monitoring. It is recommended that fluid intake be increased.

9. A client is admitted with a diagnosis of hydronephrosis secondary to calculi. The calculi have been removed and post obstructive diuresis is occurring. Which of the following interventions should be done?

Take vital signs every 8 hours

Weigh the client every other day

Assess for urine output every shift

Monitor the client’s electrolyte levels.

Postobstructive diuresis seen in hydronephrosis can cause electrolyte imbalances; lab values must be checked so electrolytes can be replaced as needed.Option A: VS should initially be taken every 30 minutes for the first 4 hours and then every 2 hours.Option B: The client’s weight should be taken daily to assess fluid status more closely.Option C: Urine output needs to be assessed hourly.

Explanation

Postobstructive diuresis seen in hydronephrosis can cause electrolyte imbalances; lab values must be checked so electrolytes can be replaced as needed.Option A: VS should initially be taken every 30 minutes for the first 4 hours and then every 2 hours.Option B: The client’s weight should be taken daily to assess fluid status more closely.Option C: Urine output needs to be assessed hourly.

10. Which of the following symptoms indicate acute rejection of a transplanted kidney?

Edema. Nausea

Fever. Anorexia

Weight gain. pain at graft site

Increased WBC count. pain with voiding

Pain at the graft site and weight gain indicates the transplanted kidney isn’t functioning and possibly is being rejected. Transplant clients usually have edema. anorexia. fever. and nausea before transplantation. so those symptoms may not indicate rejection.

Explanation

Pain at the graft site and weight gain indicates the transplanted kidney isn’t functioning and possibly is being rejected. Transplant clients usually have edema. anorexia. fever. and nausea before transplantation. so those symptoms may not indicate rejection.