Urinary System Disorders | NCLEX Quiz 105

1. You have a patient that might have a urinary tract infection (UTI). Which statement by the patient suggests that a UTI is likely?

“I pee a lot.”

“It burns when I pee.”

“I go hours without the urge to pee.”

“My pee smells sweet.”

A common symptom of a UTI is dysuria. A patient with a UTI often reports frequent voiding of small amounts and the urgency to void.Option D: Urine that smells sweet is often associated with diabetic ketoacidosis.

Explanation

A common symptom of a UTI is dysuria. A patient with a UTI often reports frequent voiding of small amounts and the urgency to void.Option D: Urine that smells sweet is often associated with diabetic ketoacidosis.

2. Which patient is at greatest risk for developing a urinary tract infection (UTI)?

A 35 y.o. woman with a fractured wrist

A 20 y.o. woman with asthma

A 50 y.o. postmenopausal woman

A 28 y.o. with angina

Women are more prone to UTI’s after menopause due to reduced estrogen levels. Reduced estrogen levels lead to reduced levels of vaginal Lactobacilli bacteria. which protect against infection.Options B. C. and D: Angina. asthma and fractures don’t increase the risk of UTI.

Explanation

Women are more prone to UTI’s after menopause due to reduced estrogen levels. Reduced estrogen levels lead to reduced levels of vaginal Lactobacilli bacteria. which protect against infection.Options B. C. and D: Angina. asthma and fractures don’t increase the risk of UTI.

3. A 30 y.o. female patient is undergoing hemodialysis with an internal arteriovenous fistula in place. What do you do to prevent complications associated with this device?

Insert I.V. lines above the fistula.

Avoid taking blood pressures in the arm with the fistula.

Palpate pulses above the fistula.

Report a bruit or thrill over the fistula to the doctor.

Don’t take blood pressure readings in the arm with the fistula because the compression could damage the fistula.Option A: IV lines shouldn’t be inserted in the arm used for hemodialysis.Option C: Palpate pulses below the fistula.Option D: Lack of bruit or thrill should be reported to the doctor.

Explanation

Don’t take blood pressure readings in the arm with the fistula because the compression could damage the fistula.Option A: IV lines shouldn’t be inserted in the arm used for hemodialysis.Option C: Palpate pulses below the fistula.Option D: Lack of bruit or thrill should be reported to the doctor.

4. You have a patient that is receiving peritoneal dialysis. What should you do when you notice the return fluid is slowly draining?

Check for kinks in the outflow tubing.

Raise the drainage bag above the level of the abdomen.

Place the patient in a reverse Trendelenburg position.

Ask the patient to cough.

Tubing problems are a common cause of outflow difficulties. check the tubing for kinks and ensure that all clamps are open. Other measures include having the patient change positions (moving side to side or sitting up). applying gentle pressure over the abdomen. or having a bowel movement.

Explanation

Tubing problems are a common cause of outflow difficulties. check the tubing for kinks and ensure that all clamps are open. Other measures include having the patient change positions (moving side to side or sitting up). applying gentle pressure over the abdomen. or having a bowel movement.

5. Your patient becomes restless and tells you she has a headache and feels nauseous during hemodialysis. Which complication do you suspect?

Infection

Disequilibrium syndrome

Air embolus

Acute hemolysis

Disequilibrium syndrome is caused by a rapid reduction in urea. sodium. and other solutes from the blood. This can lead to cerebral edema and increased intracranial pressure (ICP). Signs and symptoms include headache. nausea. restlessness. vomiting. confusion. twitching. and seizures.

Explanation

Disequilibrium syndrome is caused by a rapid reduction in urea. sodium. and other solutes from the blood. This can lead to cerebral edema and increased intracranial pressure (ICP). Signs and symptoms include headache. nausea. restlessness. vomiting. confusion. twitching. and seizures.

6. Your patient with chronic renal failure reports pruritus. Which instruction should you include in this patient's teaching plan?

Rub the skin vigorously with a towel

Take frequent baths

Apply alcohol-based emollients to the skin

Keep fingernails short and clean

Calcium-phosphate deposits in the skin may cause pruritus. Scratching leads to excoriation and breaks in the skin that increase the patient’s risk of infection. Keeping fingernails short and clean helps reduce the risk of infection.

Explanation

Calcium-phosphate deposits in the skin may cause pruritus. Scratching leads to excoriation and breaks in the skin that increase the patient’s risk of infection. Keeping fingernails short and clean helps reduce the risk of infection.

7. Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis?

Jaundice and flank pain

Costovertebral angle tenderness and chills

Burning sensation on urination

Polyuria and nocturia

Costovertebral angle tenderness. flank pain. and chills are symptoms of acute pyelonephritis.Option A: Jaundice indicates gallbladder or liver obstruction.Option C: A burning sensation on urination is a sign of lower urinary tract infection.

Explanation

Costovertebral angle tenderness. flank pain. and chills are symptoms of acute pyelonephritis.Option A: Jaundice indicates gallbladder or liver obstruction.Option C: A burning sensation on urination is a sign of lower urinary tract infection.

8. Your patient is complaining of muscle cramps while undergoing hemodialysis. Which intervention is effective in relieving muscle cramps?

Increase the rate of dialysis

Infuse normal saline solution

Administer a 5% dextrose solution

Encourage active ROM exercises

Treatment includes administering normal saline or hypertonic normal saline solution because muscle cramps can occur when the sodium and water are removed to quickly during dialysis. Reducing the rate of dialysis. not increasing it. may alleviate muscle cramps.

Explanation

Treatment includes administering normal saline or hypertonic normal saline solution because muscle cramps can occur when the sodium and water are removed to quickly during dialysis. Reducing the rate of dialysis. not increasing it. may alleviate muscle cramps.

9. Which instructions do you include in the teaching care plan for a patient with cystitis receiving phenazopyridine (Pyridium).

If the urine turns orange-red. call the doctor.

Take phenazopyridine just before urination to relieve pain.

Once painful urination is relieved. discontinue prescribed antibiotics.

After painful urination is relieved. stop taking phenazopyridine.

Pyridium is taken to relieve dysuria because is provides an analgesic and anesthetic effect on the urinary tract mucosa. The patient can stop taking it after the dysuria is relieved.Option A: The urine may temporarily turn red or orange due to the dye in the drug.Option B: The drug isn’t taken before voiding. and is usually taken 3 times a day for 2 days.

Explanation

Pyridium is taken to relieve dysuria because is provides an analgesic and anesthetic effect on the urinary tract mucosa. The patient can stop taking it after the dysuria is relieved.Option A: The urine may temporarily turn red or orange due to the dye in the drug.Option B: The drug isn’t taken before voiding. and is usually taken 3 times a day for 2 days.

10. What is the appropriate infusion time for the dialysate in your 38 y.o. patient with chronic renal failure?

15 minutes

30 minutes

1 hour

2 to 3 hours

Dialysate should be infused quickly. The dialysate should be infused over 15 minutes or less when performing peritoneal dialysis. The fluid exchange takes place over a period ranging from 30 minutes to several hours.

Explanation

Dialysate should be infused quickly. The dialysate should be infused over 15 minutes or less when performing peritoneal dialysis. The fluid exchange takes place over a period ranging from 30 minutes to several hours.