Urinary System Disorders | NCLEX Quiz 111

1. A client is diagnosed with prostate cancer. Which test is used to monitor progression of this disease?

Serum creatinine

Complete blood cell count (CBC)

Prostate-specific antigen (PSA)

Serum potassium

The PSA test is used to monitor prostate cancer progression; higher PSA levels indicate a greater tumor burden.Option A: Serum creatinine levels may suggest blockage from an enlarged prostate.Option B: CBC is used to diagnose anemia and polycythemia.Option D: Serum potassium levels identify hypokalemia and hyperkalemia.

Explanation

The PSA test is used to monitor prostate cancer progression; higher PSA levels indicate a greater tumor burden.Option A: Serum creatinine levels may suggest blockage from an enlarged prostate.Option B: CBC is used to diagnose anemia and polycythemia.Option D: Serum potassium levels identify hypokalemia and hyperkalemia.

2. A 27-year old client. who became paraplegic after a swimming accident. is experiencing autonomic dysreflexia. Which condition is the most common cause of autonomic dysreflexia?

Upper respiratory infection

Incontinence

Bladder distention

Diarrhea

Autonomic dysreflexia is a potentially life-threatening complication of spinal cord injury. occurring from obstruction of the urinary system or bowel.Option A: An URI could obstruct the respiratory system. but not the urinary or bowel system.Options B and D: Incontinence and diarrhea don’t result in obstruction of the urinary system or bowel. respectively.

Explanation

Autonomic dysreflexia is a potentially life-threatening complication of spinal cord injury. occurring from obstruction of the urinary system or bowel.Option A: An URI could obstruct the respiratory system. but not the urinary or bowel system.Options B and D: Incontinence and diarrhea don’t result in obstruction of the urinary system or bowel. respectively.

3. When providing discharge teaching for a client with uric acid calculi. the nurse should an instruction to avoid which type of diet?

Low-calcium

Low-oxalate

High-oxalate

High-purine

To control uric acid calculi. the client should follow a low-purine diet. which excludes high-purine foods such as organ meats.Option A: A low-calcium diet decreases the risk for oxalate renal calculi.Options B and C: Oxalate is an essential amino acid and must be included in the diet. A low-oxalate diet is used to control calcium or oxalate calculi.

Explanation

To control uric acid calculi. the client should follow a low-purine diet. which excludes high-purine foods such as organ meats.Option A: A low-calcium diet decreases the risk for oxalate renal calculi.Options B and C: Oxalate is an essential amino acid and must be included in the diet. A low-oxalate diet is used to control calcium or oxalate calculi.

4. The nurse suspects that a client with polyuria is experiencing water diuresis. Which laboratory value suggests water diuresis?

High urine specific gravity

High urine osmolarity

Normal to low urine specific gravity

Elevated urine pH

Water diuresis causes low urine specific gravity. low urine osmolarity. and a normal to elevated serum sodium level.Option A: High specific gravity indicates dehydration. Hypernatremia signals acidosis and shock.Option D: Elevated urine pH can result from potassium deficiency. a high-protein diet. or uncontrolled diabetes.

Explanation

Water diuresis causes low urine specific gravity. low urine osmolarity. and a normal to elevated serum sodium level.Option A: High specific gravity indicates dehydration. Hypernatremia signals acidosis and shock.Option D: Elevated urine pH can result from potassium deficiency. a high-protein diet. or uncontrolled diabetes.

5. The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To determine whether the client currently is experiencing difficulty. the nurse asks the client about the presence of which of the following early symptoms?

Urge incontinence

Nocturia

Decreased force in the stream of urine

Urinary retention

Decreased force in the stream of urine is an early sign of BPH. The stream later becomes weak and dribbling. The client then may develop hematuria. frequency. urgency. urge incontinence. and nocturia. If untreated. complete obstruction and urinary retention can occur.

Explanation

Decreased force in the stream of urine is an early sign of BPH. The stream later becomes weak and dribbling. The client then may develop hematuria. frequency. urgency. urge incontinence. and nocturia. If untreated. complete obstruction and urinary retention can occur.

6. The client complains of fever. perineal pain. and urinary urgency. frequency. and dysuria. To assess whether the client's problem is related to bacterial prostatitis. the nurse would look at the results of the prostate examination. which should reveal that the prostate gland is:

Tender. indurated. and warm to the touch

Soft and swollen

Tender and edematous with ecchymosis

Reddened. swollen. and boggy.

The client with prostatitis has a prostate gland that is swollen and tender. but that is also warm to the touch. firm. and indurated. Systemic symptoms include fever with chills. perineal and low back pain. and signs of urinary tract infection (which often accompany the disorder).

Explanation

The client with prostatitis has a prostate gland that is swollen and tender. but that is also warm to the touch. firm. and indurated. Systemic symptoms include fever with chills. perineal and low back pain. and signs of urinary tract infection (which often accompany the disorder).

7. The nurse is receiving in transfer from the postanesthesia care unit a client who has had a percutaneous ultrasonic lithotripsy for calculuses in the renal pelvis. The nurse anticipates that the client's care will involve monitoring which of the following?

Suprapubic tube

Urethral stent

Nephrostomy tube

Jackson-Pratt drain

A nephrostomy tube is put in place after a percutaneous ultrasonic lithotripsy to treat calculuses in the renal pelvis. The client may also have a Foley catheter to drain urine produced by the other kidney. The nurse monitors the drainage from each of these tubes and strains the urine to detect elimination of the calculus fragments.

Explanation

A nephrostomy tube is put in place after a percutaneous ultrasonic lithotripsy to treat calculuses in the renal pelvis. The client may also have a Foley catheter to drain urine produced by the other kidney. The nurse monitors the drainage from each of these tubes and strains the urine to detect elimination of the calculus fragments.

8. The client who has a cold is seen in the emergency room with inability to void. Because the client has a history of BPH. the nurse determines that the client should be questioned about the use of which of the following medications?

Diuretics

Antibiotics

Antitussives

Decongestants

In the client with BPH. episodes of urinary retention can be triggered by certain medications. such as decongestants. anticholinergics. and antidepressants. The client should be questioned about the use of these medications if the client has urinary retention. Retention can also be precipitated by other factors. such as alcoholic beverages. infection. bedrest. and becoming chilled.

Explanation

In the client with BPH. episodes of urinary retention can be triggered by certain medications. such as decongestants. anticholinergics. and antidepressants. The client should be questioned about the use of these medications if the client has urinary retention. Retention can also be precipitated by other factors. such as alcoholic beverages. infection. bedrest. and becoming chilled.

9. The client with urolithiasis has a history of chronic urinary tract infections. The nurse concludes that this client most likely has which of the following types of urinary stones?

Calcium oxalate

Uric acid

Struvite

Cystine

Struvite stones commonly are referred to as infection stones because they form in urine that is alkaline and rich in ammonia. such as with a urinary tract infection.Option A: Calcium oxalate stones result from increased calcium intake or conditions that raise serum calcium concentrations.Option B: Uric acid stones occur in clients with gout.Option D: Cystine stones are rare and occur in clients with a genetic defect that results in decreased renal absorption of the amino acid cystine.

Explanation

Struvite stones commonly are referred to as infection stones because they form in urine that is alkaline and rich in ammonia. such as with a urinary tract infection.Option A: Calcium oxalate stones result from increased calcium intake or conditions that raise serum calcium concentrations.Option B: Uric acid stones occur in clients with gout.Option D: Cystine stones are rare and occur in clients with a genetic defect that results in decreased renal absorption of the amino acid cystine.

10. The client is admitted to the ER following a MVA. The client was wearing a lap seat belt when the accident occurred. The client has hematuria and lower abdominal pain. To determine further whether the pain is due to bladder trauma. the nurse asks the client if the pain is referred to which of the following areas?

Shoulder

Umbilicus

Costovertebral angle

Hip

Bladder trauma or injury is characterized by lower abdominal pain that may radiate to one of the shoulders. Bladder injury pain does not radiate to the umbilicus. CV angle. or hip.Options B. C. and D: Bladder injury pain do not radiate to the umbilicus. CV angle. or hip.

Explanation

Bladder trauma or injury is characterized by lower abdominal pain that may radiate to one of the shoulders. Bladder injury pain does not radiate to the umbilicus. CV angle. or hip.Options B. C. and D: Bladder injury pain do not radiate to the umbilicus. CV angle. or hip.