REVIEWER NUR 155 Questions and Correct
Answers
When caring for the patient with interstitial cystitis, what can the nurse teach the
patient to do?*
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A. Avoid foods that make the urine more alkaline.
B. Use high-potency vitamin therapy to decrease the autoimmune effects of the
disorder.
C. Always keep a voiding diary to document pain, voiding frequency, and patterns of
nocturia.
D. Use the dietary supplement calcium glycerophosphate (Prelief) to decrease
bladder irritation.
✓ ~~~ D
Calcium glycerophosphate (Prelief) alkalinizes the urine and can help to relieve the
irritation from acidic foods. A diet low in acidic foods is recommended and if a
multivitamin is used, high-potency vitamins should be avoided because these
products may irritate the bladder. A voiding diary is useful in diagnosis but does not
need to be kept indefinitely.
A female patient reports that she is experiencing burning on urination, frequency,
and urgency. The nurse notes that a clean-voided urine specimen is markedly
cloudy. The probable cause of these symptoms and findings is:*
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A. Cystitis.
B. Hematuria.
C. Pyelonephritis.
D. Dysuria.
✓ ~~~ A
Signs and symptoms of cystitis are as follows: Abdominal or flank pain/tenderness,
frequency and urgency of urination, Pain on voiding, Nocturia, Nausea, Fever,
Cloudy urine, Hematuria, Vomiting
In cystitis to minimize experiencing nocturia, the nurse would teach the patient to:*
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A. Perform perineal hygiene after urinating.
B. Set up a toileting schedule.
C. Double void.
D. Limit fluids before bedtime.
✓ ~~~ D
With nocturia the patient has to get up during the night to urinate. Limiting fluids 2
hours before bedtime minimizes nocturia.
An older male patient states that he is having problems starting and stopping his
stream of urine and he feels the urgency to void. The best way to assist this patient
is to*
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A. Help him stand to void.
B. Place a condom catheter.
,C. Have him practice Credé's method.
D. Initiate Kegel exercises.
✓ ~~~ D
Kegel exercises strengthen pelvic floor muscles and are effective in urine control in
patients with urge incontinence and difficulty starting and stopping urination.
A 24-year-old female client comes to an ambulatory care clinic in moderate distress
with a probable diagnosis of acute cystitis. When obtaining the client's history, the
nurse should ask the client if she has had:*
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A. Fever and chills.
B. Frequency and burning on urination.
C. Flank pain and nausea.
D. Hematuria.
✓ ~~~ B
The classic symptoms of cystitis are severe burning on urination, urgency, and
frequent urination. Systemic symptoms, such as fever and nausea and vomiting, are
more likely to accompany pyelonephritis than cystitis. Hematuria may occur, but it is
not as common as frequency and burning.
A client who has been diagnosed with renal calculi reports that the pain is
intermittent and less colicky. Which of the following nursing actions is most important
at this time?*
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A. Report hematuria to the physician.
B. Strain the urine carefully.
C. Administer meperidine (Demerol) every 3 hours.
D. Apply warm compresses to the flank area.
✓ ~~~ B
Intermittent pain that is less colicky indicates that the calculi may be moving along
the urinary tract. Fluids should be encouraged to promote movement, and the urine
should be strained to detect passage of the stone. Hematuria is to be expected from
the irritation of the stone. Analgesics should be administered when the client needs
them, not routinely. Moist heat to the flank area is helpful when renal colic occurs,
but it is less necessary as pain is lessened.
The client is scheduled for an intravenous pyelogram (IVP) to determine the location
of the renal calculi. Which of the following measures would be most important for the
nurse to include in pretest preparation?*
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A. Ensuring adequate fluid intake on the day of the test.
B. Preparing the client for the possibility of bladder spasms during the test.
C. Checking the client's history for allergy to iodine.
D. Determining when the client last had a bowel movement.
✓ ~~~ C
A client scheduled for an IVP should be assessed for allergies to iodine and shellfish.
Clients with such allergies may be allergic to the IVP dye and be at risk for an
anaphylactic reaction. Adequate fluid intake is important after the examination.
Bladder spasms are not common during an IVP. Bowel preparation is important
,before an IVP to allowvisualization of the ureters and bladder, but checking for
allergies is most important.
After an intravenous pyelogram (IVP), the nurse should anticipate incorporating
which of the following measures into the client's plan of care?*
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A. Maintaining bed rest.
B. Encouraging adequate fluid intake.
C. Assessing for hematuria.
D. Administering a laxative.
✓ ~~~ B
After an IVP, the nurse should encourage fluids to decrease the risk of renal
complications caused by the contrast agent. There is no need to place the client on
bed rest or administer a laxative. An IVP would not cause hematuria.
Because a client's renal stone was found to be composed of uric acid, a low-purine,
alkaline-ash diet was ordered. Incorporation of which of the following food items into
the home diet would indicate that the client understands the necessary diet
modifications?*
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A. Milk, apples, tomatoes, and corn.
B. Eggs, spinach, dried peas, and gravy.
C. Salmon, chicken, caviar, and asparagus.
D. Grapes, corn, cereals, and liver.
✓ ~~~ A
Because a high-purine diet contributes to the formation of uric acid, a low-purine diet
is advocated. An alkaline-ash diet is also advocated because uric acid crystals are
more likely to develop in acid urine. Foods that may be eaten as desired in a low-
purine diet include milk, all fruits, tomatoes, cereals, and corn. Foods allowed on an
alkaline-ash diet include milk, fruits (except cranberries, plums, and prunes), andm
vegetables (especially legumes and green vegetables). Gravy, chicken, and liver are
high in purine.
Allopurinol (Zyloprim), 200 mg/ day, is prescribed for the client with renal calculi to
take at home. The nurse should teach the client about which of the following adverse
effects of this medication?*
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A. Retinopathy.
B. Maculopapular rash.
C. Nasal congestion.
D. Dizziness.
✓ ~~~ B
Allopurinol (Zyloprim) is used to treat renal calculi composed of uric acid. Adverse
effects of allopurinol include drowsiness, maculopapular rash, anemia, abdominal
pain, nausea, vomiting, and bone marrow depression. Clients should be instructed to
report rashes and unusual bleeding or bruising. Retinopathy, nasal congestion, and
dizziness are not adverse effects of allopurinol.
A 16-year-old sexually active female patient with a history of pelvic inflammatory
disease (PID) presents to the emergency room with complaints of sudden right-sided
, lower abdominal pain and gastrointestinal distress. She cannot recall the date of her
last menstrual period, but states she knows that she's "late." Her exam demonstrates
a unilateral, right adnexal mass. The nurse knows that this patient likely has which of
these prenatal complications?*
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A. gestational trophoblastic disease (GTD)
B. spontaneous abortion
C. ectopic pregnancy
D. premature rupture of membranes (PROM)
✓ ~~~ B
Which statement by the nurse demonstrates effective communication techniques
when initiating a discussion about sex with a 25-year-old female client?*
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A. "Do you know how to properly apply a male condom?"
B. "What questions do you have related to your sexual health?"
C. "Have you had sex with more than one partner?"
D. "Why didn't you start receiving annual Pap tests at an earlier age?"
✓ ~~~ B
While caring for a client who is being treated for severe pelvic inflammatory disease
(PID), the nurse insists on keeping her in a semi sitting position. What would be the
best possible reason for the nurse's advice?*
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A. To prevent nosocomial infections to other clients
B. To facilitate easy distraction of the client
C. To prevent movement as it increases pain
D. To facilitate pelvic drainage and to minimize the upward extension of infection
✓ ~~~ D
While caring for a patient who is being treated for severe pelvic inflammatory disease
(PID), which of the following nursing actions minimizes transmission of infection?*
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A. Keeping the patient in a sitting position
B. Performing hand hygiene when entering the room
C. Strictly adhering to the no visitation policy
D. Implementing reverse isolation precautions
✓ ~~~ B
The nurse is obtaining the history from a client who is suspected of having pelvic
inflammatory disease (PID). Which client statement would help support the suspicion
of PID?*
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A. "I haven't had sex with anyone else except my current partner."
B. "My partner and I use condoms during sexual intercourse."
C. "I was 15 years old when I first had sex."
D. "I've never had any sexually transmitted infection."
✓ ~~~ C