Urinary System Disorders | NCLEX Quiz 120

1.

The nurse is aware that the following findings would be further evidence of a urethral injury in a male client during rectal examination?
- A.
  
  A low-riding prostate
- B.
  
  The presence of a boggy mass
- C.
  
  Absent sphincter tone
- D.
  
  A positive Hemoccult
Correct Answer
B. The presence of a boggy mass

Explanation
When the urethra is ruptured. a hematoma or collection of blood separates the two sections of the urethra. This may feel like a boggy mass on rectal examination.Option A: Because of the rupture and hematoma. the prostate becomes high riding. A palpable prostate gland usually indicates a non-urethral injury.Option C: Absent sphincter tone would refer to a spinal cord injury.Option D: The presence of blood would probably correlate with GI bleeding or a colon injury.

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2.

When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members. nurse Rose teaches how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?
- A.
  
  The client sets the drainage bag on the floor while sitting down.
- B.
  
  The client keeps the drainage bag below the bladder at all times.
- C.
  
  The client clamps the catheter drainage tubing while visiting with the family.
- D.
  
  The client loops the drainage tubing below its point of entry into the drainage bag.
Correct Answer
B. The client keeps the drainage bag below the bladder at all times.

Explanation
To maintain effective drainage. the client should keep the drainage bag below the bladder; this allows the urine to flow by gravity from the bladder to the drainage bag. Option A: The client shouldn’t lay the drainage bag on the floor because it could become grossly contaminated. Option C: The client shouldn’t clamp the catheter drainage tubing because this impedes the flow of urine. Option D: To promote drainage. the client may loop the drainage tubing above — not below — its point of entry into the drainage bag.Option A: The client shouldn’t lay the drainage bag on the floor because it could become grossly contaminated.Option C: The client shouldn’t clamp the catheter drainage tubing because this impedes the flow of urine.Option D: To promote drainage. the client may loop the drainage tubing above — not below — its point of entry into the drainage bag.

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3.

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?
- A.
  
  This condition puts her at a higher risk for cervical cancer; therefore. she should have a Papanicolaou (Pap) smear annually.
- B.
  
  The most common treatment is metronidazole (Flagyl). which should eradicate the problem within 7 to 10 days.
- C.
  
  The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
- D.
  
  The human papillomavirus (HPV). which causes condylomata acuminata. can’t be transmitted during oral sex.
Correct Answer
A. This condition puts her at a higher risk for cervical cancer; therefore. she should have a Papanicolaou (Pap) smear annually.

Explanation
Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection.Option B: Because condylomata acuminata is a virus. there is no permanent cure. Option C: Because condylomata acuminata can occur on the vulva. a condom won’t protect sexual partners. Option D: HPV can be transmitted to other parts of the body. such as the mouth. oropharynx. and larynx.Option C: Because condylomata acuminata can occur on the vulva. a condom won’t protect sexual partners.Option D: HPV can be transmitted to other parts of the body. such as the mouth. oropharynx. and larynx.

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4.

A male client with bladder cancer has had the bladder removed and an ileal conduit created for urine diversion. While changing this client’s pouch. the nurse observes that the area around the stoma is red. weeping. and painful. What should Nurse Kaye conclude?
- A.
  
  The skin wasn’t lubricated before the pouch was applied.
- B.
  
  The pouch faceplate doesn’t fit the stoma.
- C.
  
  A skin barrier was applied properly.
- D.
  
  Stoma dilation wasn’t performed.
Correct Answer
B. The pouch faceplate doesn’t fit the stoma.

Explanation
If the pouch faceplate doesn’t fit the stoma properly. the skin around the stoma will be exposed to continuous urine flow from the stoma. causing excoriation and red. weeping. and painful skin.Option A: A lubricant shouldn’t be used because it would prevent the pouch from adhering to the skin.Option C: When properly applied. a skin barrier prevents skin excoriation.Option D: Stoma dilation isn’t performed with an ileal conduit. although it may be done with a colostomy if ordered.

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5.

The nurse is aware that the following laboratory values supports a diagnosis of pyelonephritis?
- A.
  
  Myoglobinuria
- B.
  
  Ketonuria
- C.
  
  Pyuria
- D.
  
  Low white blood cell (WBC) count
Correct Answer
C. Pyuria

Explanation
Pyelonephritis is diagnosed by the presence of leukocytosis. hematuria. pyuria. and bacteriuria.Option B: Ketonuria indicates a diabetic state.Option D: The client exhibits fever. chills. and flank pain. Because there is often a septic picture. the WBC count is more likely to be high rather than low.

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6.

A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis. nurse Sarah knows that the client is most likely to experience:
- A.
  
  Hematuria.
- B.
  
  Weight loss.
- C.
  
  Increased urine output.
- D.
  
  Increased blood pressure.
Correct Answer
B. Weight loss.

Explanation
Because CRF causes loss of renal function. the client with this disorder retains fluid. Hemodialysis removes this fluid. causing weight loss.Option A: Hematuria is unlikely to follow hemodialysis because the client with CRF usually forms little or no urine.Option C: Hemodialysis doesn’t increase urine output because it doesn’t correct the loss of kidney function. which severely decreases urine production in this disorder.Option D: By removing fluids. hemodialysis decreases rather than increases the blood pressure.

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7.

Nurse Lily is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?
- A.
  
  Rashes on the palms of the hands and soles of the feet
- B.
  
  Cauliflower-like warts on the penis
- C.
  
  Painful red papules on the shaft of the penis
- D.
  
  Foul-smelling discharge from the penis
Correct Answer
D. Foul-smelling discharge from the penis

Explanation
Symptoms of gonorrhea in men include purulent. foul-smelling drainage from the penis and painful urination.Option A: Rashes on the palms of the hands and soles of the feet are symptoms of the secondary stage of syphilis.Option B: Cauliflower-like warts on the penis are a sign of human papillomavirus.Option C: Painful red papules on the shaft of the penis may be a sign of the first stage of genital herpes.

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8.

Nurse Pete is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?
- A.
  
  Specific gravity of 1.03
- B.
  
  Urine pH of 3.0
- C.
  
  Absence of protein
- D.
  
  Absence of glucose
Correct Answer
B. Urine pH of 3.0

Explanation
Normal urine pH is 4.5 to 8; therefore. a urine pH of 3.0 is abnormal. Urine specific gravity normally ranges from 1.002 to 1.035. making this client’s value normal. Normally. urine contains no protein. glucose. ketones. bilirubin. bacteria. casts. or crystals. Red blood cells should measure 0 to 3 per high-power field; white blood cells. 0 to 4 per high-power field. Urine should be clear. its color ranging from pale yellow to deep amber.

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9.

A male client is scheduled for a renal clearance test. Nurse Sheldon should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in:
- A.
  
  1 minute.
- B.
  
  30 minutes.
- C.
  
  1 hour.
- D.
  
  24 hours.
Correct Answer
A. 1 minute.

Explanation
The renal clearance test determines the kidneys’ ability to remove a substance from the plasma in 1 minute. It doesn’t measure the kidneys’ ability to remove a substance over a longer period.

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10.

A male client in the short-procedure unit is recovering from renal angiography in which a femoral puncture site was useD. When providing postprocedure care. the nurse should:
- A.
  
  Keep the client’s knee on the affected side bent for 6 hours.
- B.
  
  Apply pressure to the puncture site for 30 minutes.
- C.
  
  Check the client’s pedal pulses frequently.
- D.
  
  Remove the dressing on the puncture site after vital signs stabilize.
Correct Answer
C. Check the client’s pedal pulses frequently.

Explanation
After renal angiography involving a femoral puncture site. the nurse should check the client’s pedal pulses frequently to detect reduced circulation to the feet caused by vascular injury. The nurse also should monitor vital signs for evidence of internal hemorrhage and should observe the puncture site frequently for fresh bleeding.Option A: The client should be kept on bed rest for several hours so the puncture site can seal completely. Keeping the client’s knee bent is unnecessary.Option B: By the time the client returns to the short-procedure unit. manual pressure over the puncture site is no longer needed because a pressure dressing is in place.Option D: The nurse shouldn’t remove this dressing for several hours — and only if instructed to do so.

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Urinary System Disorders | NCLEX Quiz 120

The nurse is aware that the following findings would be further evidence of a urethral injury in a male client during rectal examination?

When a female client with an indwelling urinary (Foley) catheter insists on walking to the hospital lobby to visit with family members. nurse Rose teaches how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

A male client with bladder cancer has had the bladder removed and an ileal conduit created for urine diversion. While changing this client’s pouch. the nurse observes that the area around the stoma is red. weeping. and painful. What should Nurse Kaye conclude?

The nurse is aware that the following laboratory values supports a diagnosis of pyelonephritis?

A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis. nurse Sarah knows that the client is most likely to experience:

Nurse Lily is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?

Nurse Pete is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?

A male client is scheduled for a renal clearance test. Nurse Sheldon should explain that this test is done to assess the kidneys’ ability to remove a substance from the plasma in:

A male client in the short-procedure unit is recovering from renal angiography in which a femoral puncture site was useD. When providing postprocedure care. the nurse should: