Urinary System Disorders | NCLEX Quiz 109

1. You're preparing for urinary catheterization of a trauma patient and you observe bleeding at the urethral meatus. Which action has priority?

Irrigate and clean the meatus before catheterization

Check the discharge for occult blood before catheterization

Heavily lubricate the catheter before insertion

Delay catheterization and notify the doctor

Bleeding at the urethral meatus is evidence that the urethra is injured. Because catheterization can cause further harm. consult with the doctor.

Explanation

Bleeding at the urethral meatus is evidence that the urethra is injured. Because catheterization can cause further harm. consult with the doctor.

2. What change indicates recovery in a patient with nephritic syndrome?

Disappearance of protein from the urine

Decrease in blood pressure to normal

Increase in serum lipid levels

Gain in body weight

With nephrotic syndrome. the glomerular basement membrane of the kidney becomes more porous. leading to loss of protein in the urine. As the patient recovers. less protein is found in the urine.

Explanation

With nephrotic syndrome. the glomerular basement membrane of the kidney becomes more porous. leading to loss of protein in the urine. As the patient recovers. less protein is found in the urine.

3. Your patient returns from the operating room after abdominal aortic aneurysm repair. Which symptom is a sign of acute renal failure?

Anuria

Diarrhea

Oliguria

Vomiting

Urine output less than 50ml in 24 hours signifies oliguria. an early sign of renal failure. Anuria is uncommon except in obstructive renal disorders.

Explanation

Urine output less than 50ml in 24 hours signifies oliguria. an early sign of renal failure. Anuria is uncommon except in obstructive renal disorders.

4. Immunosuppression following Kidney transplantation is continued:

For life

24 hours after transplantation

A week after transplantation

Until the kidney is not anymore rejected

1.11E+35

Explanation

1.11E+35

5. Which criterion is required before a patient can be considered for continuous peritoneal dialysis?

The patient must be hemodynamically stable

The vascular access must have healed

The patient must be in a home setting

Hemodialysis must have failed

Hemodynamic stability must be established before continuous peritoneal dialysis can be started.

Explanation

Hemodynamic stability must be established before continuous peritoneal dialysis can be started.

6. Which cause of hypertension is the most common in acute renal failure?

Pulmonary edema

Hypervolemia

Hypovolemia

Anemia

Acute renal failure causes hypervolemia as a result of overexpansion of extracellular fluid and plasma volume with the hypersecretion of renin. Therefore. hypervolemia causes hypertension.

Explanation

Acute renal failure causes hypervolemia as a result of overexpansion of extracellular fluid and plasma volume with the hypersecretion of renin. Therefore. hypervolemia causes hypertension.

7. A patient returns from surgery with an indwelling urinary catheter in place and empty. Six hours later. the volume is 120ml. The drainage system has no obstructions. Which intervention has priority?

Give a 500 ml bolus of isotonic saline

Evaluate the patient’s circulation and vital signs

Flush the urinary catheter with sterile water or saline

Place the patient in the shock position. and notify the surgeon

A total UO of 120ml is too low. Assess the patient’s circulation and hemodynamic stability for signs of hypovolemia. A fluid bolus may be required. but only after further nursing assessment and a doctor’s order.

Explanation

A total UO of 120ml is too low. Assess the patient’s circulation and hemodynamic stability for signs of hypovolemia. A fluid bolus may be required. but only after further nursing assessment and a doctor’s order.

8. Polystyrene sulfonate (Kayexalate) is used in renal failure to:

Correct acidosis

Reduce serum phosphate levels

Exchange potassium for sodium

Prevent constipation from sorbitol use

In renal failure. patients become hyperkalemic because they can’t excrete potassium in the urine. Polystyrene sulfonate acts to excrete potassium by pulling potassium into the bowels and exchanging it for sodium.

Explanation

In renal failure. patients become hyperkalemic because they can’t excrete potassium in the urine. Polystyrene sulfonate acts to excrete potassium by pulling potassium into the bowels and exchanging it for sodium.

9. Which statement correctly distinguishes renal failure from prerenal failure?

With prerenal failure. vasoactive substances such as dopamine (Intropin) increase blood pressure

With prerenal failure. there is less response to such diuretics as furosemide (Lasix)

With prerenal failure. an IV isotonic saline infusion increases urine output

With prerenal failure. hemodialysis reduces the BUN level

Prerenal failure is caused by such conditions as hypovolemia that impairs kidney perfusion; giving isotonic fluids improves urine output. Vasoactive substances can increase blood pressure in both conditions.

Explanation

Prerenal failure is caused by such conditions as hypovolemia that impairs kidney perfusion; giving isotonic fluids improves urine output. Vasoactive substances can increase blood pressure in both conditions.

10. Your patient has complaints of severe right-sided flank pain. nausea. vomiting and restlessness. He appears slightly pale and is diaphoretic. Vital signs are BP 140/90 mmHg. Pulse 118 beats/min.. respirations 33 breaths/minute. and temperature. 98.0F. Which subjective data supports a diagnosis of renal calculi?

Pain radiating to the right upper quadrant

History of mild flu symptoms last week

Dark-colored coffee-ground emesis

Dark. scanty urine output

Patients with renal calculi commonly have blood in the urine caused by the stone’s passage through the urinary tract. The urine appears dark. tests positive for blood. and is typically scant.

Explanation

Patients with renal calculi commonly have blood in the urine caused by the stone’s passage through the urinary tract. The urine appears dark. tests positive for blood. and is typically scant.