Urinary System Disorders | NCLEX Quiz 115

1.

The primary reason for taping an indwelling catheter laterally to the thigh of a male client is to:
- A.
  
  Eliminate pressure at the penoscrotal angle
- B.
  
  Prevent the catheter from kinking in the urethra
- C.
  
  Prevent accidental catheter removal
- D.
  
  Allow the client to turn without kinking the catheter
Correct Answer
A. Eliminate pressure at the penoscrotal angle

Explanation
The primary reason for taping an indwelling catheter to a male client soothe penis is held in a lateral position to prevent pressure at the penoscrotal angle. Prolonged pressure at the penoscrotal angle can cause a ureterocutaneous fistula.

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2.

The primary function of the prostate gland is:
- A.
  
  To store underdeveloped sperm before ejaculation
- B.
  
  To regulate the acidity and alkalinity of the environment for proper sperm development.
- C.
  
  To produce a secretion that aids in the nourishment and passage of sperm
- D.
  
  To secrete a hormone that stimulates the production and maturation of sperm
Correct Answer
C. To produce a secretion that aids in the nourishment and passage of sperm

Explanation
The prostate gland is located below the bladder and surrounds the urethra. It serves one primary purpose: to produce a secretion that aids in the nourishment and passage of sperm.

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3.

The nurse is reviewing a medication history of a client with BPH. Which medication should be recognized as likely to aggravate BPH?
- A.
  
  Metformin (Glucophage)
- B.
  
  Buspirone (BuSpar)
- C.
  
  Inhaled ipratropium (Atrovent)
- D.
  
  Ophthalmic timolol (Timoptic)
Correct Answer
C. Inhaled ipratropium (Atrovent)

Explanation
Atrovent is a bronchodilator. and its anticholinergic effects can aggravate urinary retention.Options A and B: Glucophage and BuSpar do not affect the urinary system.Option D: Timolol does not have a systemic effect.

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4.

A client is scheduled to undergo a transurethral resection of the prostate gland (TURP). The procedure is to be done under spinal anesthesia. Postoperatively. the nurse should be particularly alert for early signs of:
- A.
  
  Convulsions
- B.
  
  Cardiac arrest
- C.
  
  Renal shutdown
- D.
  
  Respiratory paralysis
Correct Answer
D. Respiratory paralysis

Explanation
If paralysis of vasomotor nerves in the upper spinal cord occurs when spinal anesthesia is used. the client is likely to develop respiratory paralysis. Artificial ventilation is required until the effects of the anesthesia subside.Options A. B. and C: Convulsions. cardiac arrest. and renal shutdown are not likely results of spinal anesthesia.

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5.

A client with BPH is being treated with terazosin (Hytrin) 2 mg at bedtime. The nurse should monitor the client’s:
- A.
  
  Urinary nitrites
- B.
  
  White blood cell count
- C.
  
  Blood pressure
- D.
  
  Pulse
Correct Answer
C. Blood pressure

Explanation
Terazosin (Hytrin) is an antihypertensive drug that is also used in the treatment of BPH. Blood pressure must be monitored to ensure that the client does not develop hypotension. syncope. or postural hypotension. The client should be instructed to change positions slowly.Options A. B. and D: Urinary nitrites. white blood cell count. and pulse rate are not affected by terazosin.

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6.

A client underwent a TURP. and a large three-way catheter was inserted into the bladder with continuous bladder irrigation. In which of the following circumstances would the nurse increase the flow rate of the continuous bladder irrigation?
- A.
  
  When the drainage is continuous but slow
- B.
  
  When the drainage appears cloudy and dark yellow
- C.
  
  When the drainage becomes bright red
- D.
  
  When there is no drainage of urine and irrigating solution
Correct Answer
C. When the drainage becomes bright red

Explanation
The decision made by the surgeon to insert a catheter after a TURP or prostatectomy depends on the amount of bleeding that is expected after the procedure. During continuous bladder irrigation after a TURP or prostatectomy. the rate at which the solution enters the bladder should be increased when the drainage becomes brighter red. The color indicates the presence of blood. Increasing the flow of irrigating solution helps flush the catheter well so clots do not plug it.Option B: There would be no reason to increase the flow rate when the return is continuous or when the return appears cloudy and dark yellow.Option D: Increasing the flow would be contraindicated when there is no return of urine and irrigating solution.

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7.

A priority nursing diagnosis for the client who is being discharged t home 3 days after a TURP would be:
- A.
  
  Deficient fluid volume
- B.
  
  Imbalanced Nutrition: Less than Body Requirements
- C.
  
  Impaired Tissue Integrity
- D.
  
  Ineffective Airway Clearance
Correct Answer
A. Deficient fluid volume

Explanation
Deficient Fluid Volume is a priority diagnosis because the client needs to drink a large amount of fluid to keep the urine clear. The urine should be almost without color. About two (2) weeks after a TURP. when desiccated tissue is sloughed out. a secondary hemorrhage could occur. The client should be instructed to call the surgeon or go to the ED if at any time the urine turns bright red.Option B: The client is not specifically at risk for nutritional problems after a TURP. The client is not specifically at risk for nutritional problems after a TURP.Option C: The client is not specifically at risk for impaired tissue integrity because there is no external incision.Option D: The client is not specifically at risk for airway problems because the procedure is done after spinal anesthesia.

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8.

If a client’s prostate enlargement is caused by a malignancy. which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred?
- A.
  
  Serum creatinine level
- B.
  
  Serum acid phosphatase level
- C.
  
  Total nonprotein nitrogen level
- D.
  
  Endogenous creatinine clearance time
Correct Answer
B. Serum acid phosphatase level

Explanation
The most specific examination to determine whether a malignancy extends outside of the prostatic capsule is a study of the serum acid phosphatase level. The level increases when a malignancy has metastasized. The prostate-specific antigen (PSA) determination and a digital rectal examination are done when screening for prostate cancer. Serum creatinine level. total nonprotein nitrogen level. and endogenous creatinine clearance time give information about kidney function.Options A. C. and D: Serum creatinine level. total nonprotein nitrogen level. and endogenous creatinine clearance time give information about kidney function. not prostate malignancy.

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9.

Steroids. if used following kidney transplantation would cause which of the following side effects?
- A.
  
  Alopecia
- B.
  
  Increase Cholesterol Level
- C.
  
  Orthostatic Hypotension
- D.
  
  Increase Blood Glucose Level
Correct Answer
D. Increase Blood Glucose Level

Explanation
Steroids, when used following kidney transplantation, can cause an increase in blood glucose levels. This is because steroids can impair the body's ability to regulate blood sugar levels, leading to elevated glucose levels. This side effect is particularly important to monitor in transplant patients, as high blood glucose levels can increase the risk of complications such as infections and delayed wound healing.

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10.

Mr. Roberto was readmitted to the hospital with acute graft rejection. Which of the following assessment finding would be expected?
- A.
  
  Hypotension
- B.
  
  Normal Body Temperature
- C.
  
  Decreased WBC
- D.
  
  Elevated BUN and Creatinine
Correct Answer
D. Elevated BUN and Creatinine

Explanation
Elevated BUN (blood urea nitrogen) and creatinine levels would be expected as assessment findings in a patient with acute graft rejection. Graft rejection occurs when the body's immune system recognizes the transplanted organ as foreign and attacks it. This immune response can cause damage to the transplanted organ, leading to impaired kidney function. Elevated BUN and creatinine levels are indicators of kidney dysfunction and impaired renal function. Hypotension, normal body temperature, and decreased WBC (white blood cell) count are not typically associated with acute graft rejection.

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Urinary System Disorders | NCLEX Quiz 115

The primary reason for taping an indwelling catheter laterally to the thigh of a male client is to:

The primary function of the prostate gland is:

The nurse is reviewing a medication history of a client with BPH. Which medication should be recognized as likely to aggravate BPH?

A client is scheduled to undergo a transurethral resection of the prostate gland (TURP). The procedure is to be done under spinal anesthesia. Postoperatively. the nurse should be particularly alert for early signs of:

A client with BPH is being treated with terazosin (Hytrin) 2 mg at bedtime. The nurse should monitor the client’s:

A client underwent a TURP. and a large three-way catheter was inserted into the bladder with continuous bladder irrigation. In which of the following circumstances would the nurse increase the flow rate of the continuous bladder irrigation?

A priority nursing diagnosis for the client who is being discharged t home 3 days after a TURP would be:

If a client’s prostate enlargement is caused by a malignancy. which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred?

Steroids. if used following kidney transplantation would cause which of the following side effects?

Mr. Roberto was readmitted to the hospital with acute graft rejection. Which of the following assessment finding would be expected?