NCLEX Genitourinary Disorders
The NCLEX Genitourinary Disorder is an exam taken by practitioners who have specialized in the treatment of the urinary and the genital organs. Are you in this line of duty and preparing for the exam? Use this quiz to revise.
- 1.After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an I.V. infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output?
- A.
It's a normal finding caused by blood loss during surgery.
- B.
It's a normal finding associated with the client's nothing-by-mouth status.
- C.
It's an abnormal finding that requires further assessment.
- D.
It's an abnormal finding that will correct itself when the client ambulates
- 2.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 she and her partner have sexual intercourse.
- D.
The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.
- 3.When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him 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.
- 4.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
- 5.Which statement describing urinary incontinence in an elderly client is true?
- A.
Urinary incontinence is a normal part of aging.
- B.
Urinary incontinence isn't a disease.
- C.
Urinary incontinence in the elderly population can't be treated.
- D.
Urinary incontinence is a disease.
- 6.A nurse receives her client care assignment. Following the report, she should give priority assessment to the client:
- A.
With pinkish mucus discharge in the appliance bag 2 days after an ileal conduit.
- B.
Who has a sodium level of 135 mEq/L and a potassium level of 3.7 mEq/L 7 days after a kidney transplant.
- C.
Who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.
- D.
Who is experiencing mild pain from urolithiasis.
- 7.A client receiving total parenteral nutrition is 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.
- 8.A nurse is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to:
- A.
Initiate a stream of urine.
- B.
Breathe deeply.
- C.
Turn to the side.
- D.
Hold the labia or shaft of the penis.
- 9.After undergoing transurethral resection of the prostate to treat benign prostatic hyperplasia, a client returns to the room with continuous bladder irrigation. On the first day after surgery, the client reports bladder pain. What should the nurse do first?
- A.
Increase the I.V. flow rate.
- B.
Notify the physician immediately.
- C.
Assess the irrigation catheter for patency and drainage.
- D.
Administer morphine sulfate, 2 mg I.V., as ordered.
- 10.A client is scheduled for a creatinine clearance test. The nurse 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.
- 11.Which clinical finding should a nurse look for in a client with chronic renal failure?
- A.
Hypotension
- B.
Uremia
- C.
Metabolic alkalosis
- D.
Polycythemia
- 12.A client with renal dysfunction of acute onset comes to the emergency department complaining of fatigue, oliguria, and coffee-colored urine. When obtaining the client's history to check for significant findings, the nurse should ask about:
- A.
Chronic, excessive acetaminophen use.
- B.
Recent streptococcal infection.
- C.
Childhood asthma.
- D.
Family history of pernicious anemia.
- 13.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.
- 14.Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?
- A.
Blood glucose level of 200 mg/dl
- B.
White blood cell (WBC) count of 20,000/mm3
- C.
Potassium level of 3.5 mEq/L
- D.
Hematocrit (HCT) of 35%
- 15.A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?
- A.
Kidney
- B.
Ureter
- C.
Bladder
- D.
Urethra
- 16.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.
- 17.A nurse is explaining menstruation to a class. Place the steps of the menstrual cycle listed below in the correct order. Use all options.
- 1. The level of estrogen in the blood peaks.
- 2. Peak endometrial thickening occurs.
- 3. Estrogen and progesterone levels increase.
- 4. Top layer of the endometrium breaks occurs.
- 5. Afollicle matures and ovulation occurs.
- 6. The endometrium begins thickening.
- 18.A nurse is caring for a client with acute pyelonephritis. Which nursing intervention is the most important?
- A.
Administering a sitz bath twice per day
- B.
Increasing fluid intake to 3 L/day
- C.
Using an indwelling urinary catheter to measure urine output accurately
- D.
Encouraging the client to drink cranberry juice to acidify the urine
- 19.A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to:
- A.
Assess whether the client is a good candidate for surgery.
- B.
Help the client cope with the anxiety associated with changes in body image.
- C.
Assess suicidal risk postoperatively.
- D.
Evaluate the client's need for mental health intervention.
- 20.A nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which point should the nurse include?
- A.
Limit fluid intake to reduce the need to urinate.
- B.
Take medication ordered for a UTI until the symptoms subside.
- C.
Notify the physician if urinary urgency, burning, frequency, or difficulty occurs.
- D.
Wear only nylon underwear to reduce the chance of irritation.
- 21.A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
- A.
Increased pH with decreased hydrogen ions
- B.
Increased serum levels of potassium, magnesium, and calcium
- C.
Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl
- D.
Uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75%
- 22.A registered nurse and a nursing assistant are caring for a group of clients. Which client's care may safely be delegated to the nursing assistant?
- A.
A client who underwent surgery 12 hours ago whose suprapubic catheter is draining burgundy-colored urine
- B.
A client with uncontrolled diabetes mellitus who underwent radical suprapubic prostatectomy 1 day ago and has an indwelling urinary catheter draining yellow urine with clots
- C.
A client diagnosed with renal calculi who must ambulate four times daily and drink plenty of fluids.
- D.
A client who requires neurological assessment every 4 hours after sustaining a spinal cord injury in a motor vehicle accident that left him with paraplegia
- 23.A female client reports to a nurse that she experiences a loss of urine when she jogs. The nurse's assessment reveals no nocturia, burning, discomfort when voiding, or urine leakage before reaching the bathroom. The nurse explains to the client that this type of problem is called:
- A.
Functional incontinence.
- B.
Reflex incontinence.
- C.
Stress incontinence.
- D.
Total incontinence.
- 24.When performing a scrotal examination, a nurse finds a nodule. What should the nurse do next?
- A.
Notify the physician.
- B.
Change the client's position and repeat the examination.
- C.
Perform a rectal examination.
- D.
Transilluminate the scrotum.
- 25.A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include:
- A.
Continuous inflow and outflow of irrigation solution.
- B.
Intermittent inflow and continuous outflow of irrigation solution.
- C.
Continuous inflow and intermittent outflow of irrigation solution.
- D.
Intermittent flow of irrigation solution and prevention of hemorrhage.
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