NURS 163 Renal/MS Exam Questions and Answers

1. Following x-rays of an injured wrist, the patient is informed that it is badly sprained. In teaching the patient to care for the injury, the nurse tells the patient to A apply a heating pad to reduce muscle spasms. B wear an elastic compression bandage continuously. C use pillows to keep the arm elevated above the heart. D gently exercise the joint to prevent muscle shortening. - Answer- C 2. Although the characteristics of a seizure may differ from person to person, seizures are caused by which of the following? A A sudden change in how the brain cells send electrical signals to one another. B A sudden change in how the spinal cord and brain talk to each other. C A sudden change in blood flow in the brain. D A sudden change in oxygen flow in the body. - Answer- A 3. A patient is admitted to the emergency department with possible fractures of the left lower extremity. The initial action by the nurse should be to: A Splint the lower leg. B Elevate the left leg. C Check the popliteal, dorsalis pedis, and posterior tibialis pulses. D Obtain information about the patient's immunization status. - Answer- C 4. A 72 year old patient with benign prostatic hyperplasia and a history of frequent urinary tract infections (UTI) is admitted to the hospital with chills, fever, and nausea and vomiting. To determine if the patient has an upper UTI, the nurse will assess for A suprapubic pain. B foul-smelling urine. C bladder distention. D costovertebral angle (CVA) tenderness. - Answer- D 5. A patient undergoing a transurethral resection of the prostate (TURP) for BPH tells the nurse that he has delayed having surgery because he is afraid it will affect his sexual function. When responding to his concern, the nurse explains that A with this type of surgery, erectile problems are rare, but retrograde ejaculation may occur. B information about penile implants used for erectile dysfunction (ED) is available if he is interested. C there are many methods of sexual expression that can be alternatives to sexual intercourse. D sterility will not be a problem after surgery because sperm production will not be affected. - Answer- A 6. On the first postoperative day a patient with a below-the-knee amputation complains of pain in the amputated limb. An appropriate action by the nurse is to A administer the prescribed opioids to relieve the pain. B explain the reasons for phantom limb pain and that analgesics will not be required. C loosen the compression bandage to decrease incisional pressure. D remind the patient that this phantom pain will diminish over time. - Answer- A 7. A patient with an open fracture of the left tibia with soft tissue damage underwent a surgical reduction and fixation of the tibia with debridement of nonviable tissue with drain placement. When assessing the patient during the postoperative period, the nurse will be most concerned about A fever with chills and night sweats. B slight drainage from the wound. C pain on movement of the affected limb. D muscle spasms around the affected bone. - Answer- A 8. A patient has chronic osteomylitis of the left femur which is being managed at home with self-administration of IV antibiotics. On a home visit, the nurse identifies the ineffective therapeutic management regimen when the nurse finds that the patient A is unable to plantar-flex the foot on the affected side. B uses cruthches to avoid weight bearing on the affected leg. C takes and records the oral temperature twice a day. D is irritable and frustrated with the length of treatment required. - Answer- A 9. Compartment syndrome is characterized by which of the following symptoms? Select all that apply. A Pain that is distal to the injury unrelieved by narcotic analgesia. B Poor venous return for affected extremity. C Warm and pink extremity to the touch. D Numbness and tingling, with decreased pulses. E Patient can easily move the extremity. - Answer- ABD 10. A 98-year-old patient with benign prostatic hyperplasia has a markedly distended bladder and is agitated and confused. All of the following orders are received from the emergency department health care provider. Which order should the nurse act on first? A Draw blood for blood urea nitrogen (BUN) and creatinine. B Administer lorazepam (Ativan) 0.5 mg. C Insert a 16 french retention catheter. D Schedule the patient for intravenouspylogram (IVP). - Answer- C 11. When assessing a patient who has a lower urinary tract infection (UTI), the nurse will ask about A flank pain. B pain with urination C poor urine output. D nausea. - Answer- A 12. After change of shift report which patient will the nurse assess first? A A patient with a Colles' fracture who has right wrist swelling and deformity. B A patient with an instracapsular left hip fracture, whose left leg is externally rotated. C A patient with a repaired mandibular fracture who is complaining of facial pain. D A patient with a right femoral shaft fracture whose thigh is swollen and ecchymotic. - Answer- D 13. Debridement of joints such as the knee or shoulder can easily take place in the outpatient setting. Discharge instruction that is most important to include should be A weight bearing as tolerated. B managing pain to include ice and elevation. C monitor for signs of infection. D restrict excessive activity for 24-48 hours post procedure. - Answer- C 14. A patient with an intracapsular fracture of the left femur is placed in Buck's traction before surgery for a hip replacement. The patient asks why traction is necessary when surgery is planned. The nurse's response to the patient is based on the knowledge that traction A will help prevent flexion contrature of the affected hip. B is necessary to prevent displacement of the fracture. C will decrease the incidence of painful muscle spasms. D is used to maintain the leg in the external rotation position. - Answer- C 15. A patient undergoing a transurethral resection of the prostate (TURP) returns from surgery with a three-way urinary catheter with continuous bladder irrigation in place. The nurse observes that the urine output has decreased and the urine is clear red with multiple clots. The patient is complaining of painful bladder spasms. The most appropriate action by the nurse is to A administer the ordered IV morphine sulfate, 4 mg. B increase the flow rate of the continuous bladder irrigation. C give the ordered belladonna and opium suppository. D manually instill 50 mL of saline and try to remove the clots. - Answer- D 16. A patient with symptomatic BPH is scheduled for visual laser ablation of the prostate (VLAP) at an outpatient surgical center. The nurse will plan to teach the patient A that the urine will appear bloody for several days. B how to care for an indwelling urinary catheter. C to expect an immediate improvement in urinary force. D that an intraprostatic urethral stent will be placed. - Answer- B 17. To relieve the symptoms of a lower urinary tract infection (UTI) for which the patient is taking prescribed antibiotics, the nurse suggests that the patient use the over-the-counter (OTC) urinary analgesic phenazopyridine (Pyridium) but cautions the patient that this medication A contains methylene blue, which turns the urine blue or green. B should be taken on an empty stomach for maximum effect. C causes the urine to turn reddish orange and can stain underclothing. D frequently causes allergic reactions and should be stopped if a rash occurs. - Answer- C 18. A 22 year-old man tells the nurse at the health clinic that he has recently become unable to achieve an erection. When assessing for possible etiologic factors, which question should the nurse ask first? A "Have you been experiencing an unusual amount of stress?" B 'Do you have any history of an erection that has lasted for 6 hours or more?" C "Are you using any recreational drugs or drinking a lot of alcohol?" D "Do you have any chronic diseases, such as diabetes mellitus?" - Answer- C 19. A patient with a confined urinary stone in the proximal left ureter undergoes shock-wave lithotripsy. Which information is most important for the nurse to collect after lithotripsy? A Urine output B Pain level C Appearance of the site D Patient temperature - Answer- A 20. A 34 year old patient with diabetes mellitus is hospitalized with fever, anorexia, and confusion. The health care provider suspects acute pyelonephritis when the urinalysis reveals bacteriuria. An appropriate collaborative problem identified by the nurse for this patient is a potential complication: A hydronephrosis B urosepsis C acute renal failure D chronic pyelonephritis - Answer- B 21. The nurse instructs a patient seen in the outpatient clinic with symptoms of renal calculi to strain all urine and to A report the pain level when the stone is passed. B collect the stone and bring it to the clinic. C record the time that the stone is passed. D save a urine specimen to check for blood. - Answer- B 22. The composition of a patient's renal calculus is identified as uric acid. To prevent recurrence of stones, the nurse teaches the patient to avoid A spinach, chocolate, and tomatoes. B organ meats and fish with fine bones. C mild and dairy products. D legumes and dried fruits. - Answer- B 23. A patient who has been hospitalized for 3 days with a hip fracture and Buck's traction has a sudden onset of shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first? A Stay with the patient and offer reassurance. B Administer oxygen at 4 L/min by nasal cannula. C Notify the health care provider about the patient's symptoms. D Check the patient's leg for swelling or tenderness. - Answer- B 24. The nurse identifies pain related to muscle spasms for a patient with acute low back pain associated with acute lumbosacral strain. An appropriate nursing intervention for this problem is to teach the patient to A twist gently from side to side to maintain range-of-motion in the spine. B place a small pillow under the upper back to flex the lumbar spine gently. C keep the head elevated slightly and flex the knees when resting in bed. D avoid the use of cold because it will exacerbate the muscle spasms. - A