NCLEX Practice Test On Urinary System Disorders

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NCLEX Practice Test On Urinary System Disorders - Quiz

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Questions and Answers
  • 1. 

    The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of the following findings would be most important for the nurse to report to the physician?

    • A.

      Temperature. 99.8

    • B.

      Urine output. 20 ml/hour

    • C.

      Absence of bowel sounds

    • D.

      A 2×2 inch area of serous sanguineous drainage on the flank dressing.

    Correct Answer
    B. Urine output. 20 ml/hour
    Explanation
    The decrease in urinary output may indicate inadequate renal perfusion and should be reported immediately. Urine output of 30 ml/hour or greater is considered acceptable.Option A: A slight elevation in temperature is expected after surgery.Option C: Peristalsis returns gradually. usually the second or third day after surgery. Bowel sounds will be absent until then.Option D: A small amount of serous sanguineous drainage is to be expected.

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  • 2. 

    Because a client’s renal stone was found to be composed to uric acid. a low-purine. alkaline ash diet was ordered. Incorporation of which of the following food items into the home diet would indicate that the client understands the necessary diet modifications?

    • A.

      Milk. apples. tomatoes. and corn

    • B.

      Eggs. spinach. dried peas. and gravy.

    • C.

      Salmon. chicken. caviar. and asparagus

    • D.

      Grapes. corn. cereals. and liver.

    Correct Answer
    A. Milk. apples. tomatoes. and corn
    Explanation
    Because a high-purine diet contributes to the formation of uric acid. a low-purine diet is advocated. An alkaline ash diet is also advocated because uric acid crystals are more likely to develop in acid urine. Foods that may be eaten as desired in a low-purine diet include milk. all fruits. tomatoes. cereals. and corn. Food allowed on an alkaline ash diet include milk. fruits (except cranberries. plums. and prunes). and vegetables (especially legumes and green vegetables). Gravy. chicken. and liver are high in purine.

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  • 3. 

    Allopurinol (Zyloprim). 200 mg/day. is prescribed for the client with renal calculi to take home. The nurse should teach the client about which of the following side effects of this medication?

    • A.

      Retinopathy

    • B.

      Maculopapular rash

    • C.

      Nasal congestion

    • D.

      Dizziness

    Correct Answer
    B. Maculopapular rash
    Explanation
    Allopurinol is used to treat renal calculi composed of uric acid. Side effects of allopurinol include drowsiness. maculopapular rash. anemia. abdominal pain. nausea. vomiting. and bone marrow depression. Clients should be instructed to report skin rashes and any unusual bleeding or bruising.Options A. C. and D: Retinopathy. nasal congestion. and dizziness are not side effects of allopurinol.

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  • 4. 

    The client has a clinic appointment scheduled 10 days after discharge. Which laboratory finding at that time would indicate that allopurinol (Zyloprim) has had a therapeutic effect?

    • A.

      Decreased urinary alkaline phosphatase level

    • B.

      Increased urinary calcium excretion

    • C.

      Increased serum calcium level

    • D.

      Decreased serum uric acid level

    Correct Answer
    D. Decreased serum uric acid level
    Explanation
    By inhibiting uric acid synthesis. allopurinol decreases its excretion. The drug’s effectiveness is assessed by evaluating for a decreased serum uric acid concentration.Options A. B. and C: Allopurinol does not alter the level of alkaline phosphatase. not does it affect urinary calcium excretion or the serum calcium level.

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  • 5. 

    When developing a plan of care for the client with stress incontinence. the nurse should take into consideration that stress incontinence is best defined as the involuntary loss of urine associated with:

    • A.

      A strong urge to urinate

    • B.

      Overdistention of the bladder

    • C.

      Activities that increase abdominal pressure

    • D.

      Obstruction of the urethra

    Correct Answer
    C. Activities that increase abdominal pressure
    Explanation
    Stress incontinence is the involuntary loss of urine during such activities as coughing. sneezing. laughing. or physical exertion. These activities increase abdominal and detrusor pressure.Option A: A strong urge to urinate is associated with urge incontinence.Option B: Overdistention of the bladder can lead to overflow incontinence.Option D: Obstruction of the urethra can lead to urinary retention.

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  • 6. 

    Which of the following assessment data would most likely be related to a client’s current complaint of stress incontinence?

    • A.

      The client’s intake of 2 to 3 L of fluid per day.

    • B.

      The client’s history of three full-term pregnancies

    • C.

      The client’s age of 45 years

    • D.

      The client’s history of competitive swimming

    Correct Answer
    B. The client’s history of three full-term pregnancies
    Explanation
    The history of three pregnancies is most likely the cause of the client’s current episodes of stress incontinence. The client’s fluid intake. age. or history of swimming would not create an increase in intra-abdominal pressure.

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  • 7. 

    The nurse is developing a teaching plan for a client with stress incontinence. Which of the following instructions should be included?

    • A.

      Avoid activities that are stressful and upsetting

    • B.

      Avoid caffeine and alcohol

    • C.

      Do not wear a girdle

    • D.

      Limit physical exertion

    Correct Answer
    B. Avoid caffeine and alcohol
    Explanation
    Client’s with stress incontinence are encouraged to avoid substances such as caffeine and alcohol which are bladder irritants.Option A: Emotional stressors do not cause stress incontinence. It is caused most commonly be relaxed pelvic musculature.Option C: Wearing Girdles is not contraindicated.Option D: Although clients may be inclined to limit physical exertion to avoid incontinence episodes; they should be encouraged to seek treatment instead of limiting their activities.

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  • 8. 

    A client has urge incontinence. Which of the following signs and symptoms would the nurse expect to find in this client?

    • A.

      Inability to empty the bladder

    • B.

      Loss of urine when coughing

    • C.

      Involuntary urination with minimal warning

    • D.

      Frequent dribbling of urine

    Correct Answer
    C. Involuntary urination with minimal warning
    Explanation
    A characteristic of urge incontinence is involuntary urination with little or no warning. Option A: The inability to empty the bladder is urinary retention. Option B: Loss of urine when coughing occurs with stress incontinence. Option D: Frequent dribbling of urine is common in male clients after some types of prostate surgery . Option A: The inability to empty the bladder is urinary retention.Option B: Loss of urine when coughing occurs with stress incontinence.Option D: Frequent dribbling of urine is common in male clients after some types of prostate surgery or may occur in women after the development of a vesicovaginal or ureterovaginal fistula.

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  • 9. 

    A 72-year old male client is brought to the emergency room by his son. The client is extremely uncomfortable and has been unable to void for the past 12 hours. He has known for some time that he has an enlarged prostate but has wanted to avoid surgery. The best method for the nurse to use when assessing for bladder distention in a male client is to check for:

    • A.

      A rounded swelling above the pubis.

    • B.

      Dullness in the lower left quadrant

    • C.

      Rebound tenderness below the symphysis

    • D.

      Urine discharge from the urethral meatus

    Correct Answer
    A. A rounded swelling above the pubis.
    Explanation
    The best way to assess for a distended bladder in either a male or female client is to check for a rounded swelling above the pubis. The swelling represents the distended bladder rising above the pubis into the abdominal cavity.Option B: Dullness does not indicate a distended bladder.Option C: The client might experience tenderness or pressure above the symphysis.Option D: No urine discharge is expected; the urine flow is blocked by the enlarged prostate.

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  • 10. 

    During a client’s urinary bladder catheterization. the bladder is emptied gradually. The best rationale for the nurse’s action is that completely emptying an overdistended bladder at one time tends to cause:

    • A.

      Renal failure

    • B.

      Abdominal cramping

    • C.

      Possible shock

    • D.

      Atrophy of bladder musculature

    Correct Answer
    C. Possible shock
    Explanation
    Rapid emptying of an overdistended bladder may cause hypotension and shock due to the sudden change of pressure within the abdominal viscera. Previously. removing no more than 1.000 ml at one time was the standard of practice. but this is no longer thought to be necessary as long as the overdistended bladder is emptied slowly.

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