Genitourinary Disorders
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- 1.A nurse is caring for a client who's ordered continuous ambulatory peritoneal dialysis (CAPD). Which finding should lead the nurse to question the client's suitability for CAPD?
- A.
The client is blind in his right eye.
- B.
The client has a history of severe anemia during hemodialysis.
- C.
The client has a history of diverticulitis.
- D.
The client is on the kidney transplant waiting list.
- 2.
- 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 she and her partner have sexual intercourse.
- D.
The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.
- 3.A client with heart failureis admitted to an acute care facility and is found to have a cystocele. When planning care for this client, the nurse is most likely to formulate which nursing diagnosis?
- A.
Total urinary incontinence
- B.
Functional urinary incontinence
- C.
Reflex urinary incontinence
- D.
Stress urinary incontinence
- 4.After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching?
- A.
"I'll have to wear an external collection pouch for the rest of my life."
- B.
"I should eat foods from all the food groups."
- C.
"I'll need to drink at least eight glasses of water a day."
- D.
"I'll have to catheterize my pouch every 2 hours."
- 5.Which nursing diagnosis is appropriate for a client with renal calculi?
- A.
Ineffective tissue perfusion (renal)
- B.
Functional urinary incontinence
- C.
Risk for infection
- D.
Decreased cardiac output
- 6.A nurse is caring for a client in acute renal failure. The nurse should expect hypertonicglucose, insulin infusions, and sodium bicarbonate to be used to treat:
- A.
Hypernatremia.
- B.
Hypokalemia.
- C.
Hyperkalemia.
- D.
Hypercalcemia.
- 7.Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blockergiven to a client with benign prostatic hyperplasia (BPH)?
- A.
Voiding pattern
- B.
Size of the prostate
- C.
Creatinine clearance
- D.
Serum testosterone level
- 8.A client with suspected renal dysfunction is scheduled for excretory urography. The nurse reviews his history for conditions that may warrant changes in client preparation. Normally, the client should be mildly hypovolemic (fluid depleted) before excretory urography. Which history finding calls for the client to be well hydrated?
- A.
Cystic fibrosis
- B.
Multiple myeloma
- C.
Gout
- D.
Myasthenia gravis
- 9.
- A.
Poor perfusion to the kidneys
- B.
Damage to cells in the adrenal cortex
- C.
Obstruction of the urinary collecting system
- D.
Nephrotoxic injury secondary to use of contrast media
- 10.A client who has cervical cancer is scheduled to undergo internal radiation. In teaching the client about the procedure, the nurse should tell the client that:
- A.
She will be in a private room with unrestricted activities.
- B.
A bowel-cleansing procedure will precede radioactive implantation.
- C.
She will be expected to use a bedpan for urination.
- D.
The preferred position in bed will be semi-Fowler's.
- 11.After trying for a year to conceive, a couple consults an infertility specialist. When obtaining a history from the husband, the nurse asks about childhood infectious diseases. Which childhood infectious disease most significantly affects male fertility?
- A.
Chickenpox
- B.
Measles
- C.
Mumps
- D.
Scarlet fever
- 12.A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department?
- A.
Bacterial vaginitis
- B.
Gonorrhea
- C.
Genital herpes
- D.
Human papillomavirus (HPV)
- 13.A nurse is teaching a client about peritoneal dialysis. The nurse should tell the client the dwell time is:
- A.
10 minutes
- B.
20 minutes
- C.
30 minutes
- D.
60 minutes
- 14.A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?
- A.
Encouraging intake of at least 2 L of fluid daily
- B.
Giving the client a glass of soda before bedtime
- C.
Taking the client to the bathroom twice per day
- D.
Consulting with a dietitian
- 15.A client with an indwelling urinary catheter is suspected of having a urinary tract infection. The nurse should collect a urine specimen for culture and sensitivity by:
- A.
Disconnecting the tubing from the urinary catheter and letting the urine flow into a sterile container.
- B.
Wiping the self-sealing aspiration port with antiseptic solution and aspirating urine with a sterile needle.
- C.
Draining urine from the drainage bag into a sterile container.
- D.
Clamping the tubing for 60 minutes and inserting a sterile needle into the tubing above the clamp to aspirate urine.
- 16.A nurse is caring for a client with chronic renal failure. The laboratory results indicate hypocalcemia and hyperphosphatemia. When assessing the client, the nurse should be alert for which signs and symptoms? Select all that apply.
- A.
Trousseau's sign
- B.
Cardiac arrhythmias
- C.
Constipation
- D.
Decreased clotting time
- E.
Drowsiness and lethargy
- F.
Fractures
- 17.A nurse is collecting a health history on a client who's to undergo a renal angiography. Which statement by the client should be the priority for the nurse to address?
- A.
"I've had diabetes for 4 years."
- B.
"I'm allergic to shellfish."
- C.
"I haven't eaten since midnight."
- D.
"My physician diagnosed me with hypertension 3 months ago."
- 18.A client receiving total parenteral nutritionis ordered a 24-hour urine test. When initiating a 24-hour urine specimen, the collection time should:
- A.
Start with the first voiding.
- B.
Start after a known voiding.
- C.
Always be with the first morning urine.
- D.
Always be the evening's last void as the last sample.
- 19.A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged I.V. pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow?
- A.
Evaluating patency of the drainage lumen
- B.
Counter-balancing the I.V. pole
- C.
Attaching the infusion set to an infusion pump
- D.
Collecting a urine specimen before beginning irrigation
- 20.Which statement best describes the therapeutic action of loop diuretics?
- A.
They block reabsorption of potassium on the collecting tubule.
- B.
They promote sodium secretion into the distal tubule.
- C.
They block sodium reabsorption in the ascending loop and dilate renal vessels.
- D.
They promote potassium secretion into the distal tubule and constrict renal vessels.
- 21.
- A.
Retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.
- B.
Retain the enema for 30 minutes to allow for glucose exchange; afterward, the client should have diarrhea.
- C.
Retain the enema for 60 minutes to allow for sodium exchange; diarrhea isn't necessary to reduce the potassium level.
- D.
Retain the enema for 60 minutes to allow for glucose exchange; diarrhea isn't necessary to reduce the potassium level.
- 22.A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:
- A.
Water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
- B.
A decreased serum phosphate level secondary to kidney failure.
- C.
An increased serum calcium level secondary to kidney failure.
- D.
Metabolic alkalosis secondary to retention of hydrogen ions.
- 23.
- A.
Limit oral fluid intake for 1 to 2 weeks.
- B.
Report the presence of fine, sandlike particles through the nephrostomy tube.
- C.
Notify the physician about cloudy or foul-smelling urine.
- D.
Report bright pink urine within 24 hours after the procedure.
- 24.A nurse is caring for a client diagnosed with ovarian cancer. Diagnostic testing reveals that the cancer has spread outside the pelvis. The client has previously undergone a right oophorectomyand receivedchemotherapy. The client now wants palliative care instead of aggressive therapy. The nurse determines that the care plan's priority nursing diagnosis should be:
- A.
Acute pain
- B.
Impaired home maintenance
- C.
Noncompliance
- D.
Ineffective breast-feeding
- 25.A client develops acute renal failure (ARF) after receiving I.V. therapy with a nephrotoxic antibiotic. Because the client's 24-hour urine output totals 240 ml, the nurse suspects that the client is at risk for:
- A.
Cardiac arrhythmia.
- B.
Paresthesia.
- C.
Dehydration.
- D.
Pruritus.
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