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NUR 402 Exam 5 (NCLEX )Test Questions And 100% Accurate Answers.

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What should the nurse expect to do to prepare a patient for an intravenous pyelogram (IVP)? A) Administer a cathartic or enema. B) Assess patient for allergies to penicillin. C) Keep the patient NPO for 4 hours preprocedure. D) Advise the patient that a metallic taste may occur during procedur...

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NUR 402 Exam 5 (NCLEX )Test
Questions And 100% Accurate Answers.
What should the nurse expect to do to prepare a patient for an intravenous pyelogram (IVP)?

A) Administer a cathartic or enema.

B) Assess patient for allergies to penicillin.

C) Keep the patient NPO for 4 hours preprocedure.

D) Advise the patient that a metallic taste may occur during procedure. - Answer A) Administer a
cathartic or enema

Nursing responsibilities in caring for a patient undergoing an IVP include administration of a cathartic or
enema to empty the colon of feces and gas. The nurse will also assess the patient for iodine sensitivity,
keep the patient NPO for 8 hours preprocedure, and advise the patient that warmth, a flushed face, and
a salty taste during injection of contrast material may occur.

In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions
important to the maintenance of homeostasis. Which physiologic processes are performed by the
kidneys (select all that apply)?

A) Production of renin

B) Activation of vitamin D

C) Carbohydrate metabolism

D) Erythropoietin production

E) Hemolysis of old red blood cells (RBCs) - Answer A) Production of renin

B) Activation of vitamin D

D) Erythropoietin production

In addition to urine formation, the kidneys release renin to maintain blood pressure, activate vitamin D
to maintain calcium levels, and produce erythropoietin to stimulate RBC production. Carbohydrate
metabolism and hemolysis of old RBCs are not physiologic functions that are performed by the kidneys.

,As a component of the head-to-toe assessment of a patient who has been recently transferred to the
clinical unit, the nurse is preparing to palpate the patient's kidneys. How should the nurse position the
patient for this assessment?

A) Prone

B) Supine

C) Seated at the edge of the bed

D) Standing, facing away from the nurse - Answer B) Supine

To palpate the right kidney, the patient is positioned supine, and the nurse's left hand is placed behind
and supports the patient's right side between the rib cage and the iliac crest. The right flank is elevated
with the left hand, and the right hand is used to palpate deeply for the right kidney. The normal-sized left
kidney is rarely palpable because the spleen lies directly on top of it.

A 70-year-old male patient has sought care because of recent difficulties in establishing and maintaining
a urine stream as well as pain that occasionally accompanies urination. How should the nurse document
this abnormal assessment finding?

A) Anuria

B) Dysuria

C) Oliguria

D) Enuresis - Answer B) Dysuria

Painful and difficult urination is characterized as dysuria. Anuria is an absence of urine production,
whereas oliguria is diminished urine production. Enuresis is involuntary nocturnal urination.

A patient with a history of recurrent urinary tract infections has been scheduled for a cystoscopy. What
teaching point should the nurse emphasize before the procedure?

A) "You might have pink-tinged urine and burning after your cystoscopy."

B) "You'll need to refrain from eating or drinking after midnight the day before the test."

C) "You'll require a urinary catheter inserted before the cystoscopy, and it will be in place for a few days."

D) "The morning of the test, the nurse will ask you to drink some water that contains a contrast
solution." - Answer A) "You might have pink-tinged urine and burning after your cystoscopy."

,Pink-tinged urine, burning, and frequency are common following a cystoscopy. The patient does not
need to be NPO prior to the test, and contrast media is not needed. A cystoscopy does not always
necessitate catheterization before or after the procedure.

Which urinalysis result should the nurse recognize as an abnormal finding?

A) pH 6.0

B) Amber yellow color

C) Specific gravity 1.025

D) White blood cells (WBCs) 9/hpf - Answer D) White blood cells (WBCs) 9/hpf

Normal WBC levels in urine are below 5/hpf, with levels exceeding this indicative of inflammation or
urinary tract infection. A urine pH of 6.0 is average; amber yellow is normal coloration, and the reference
ranges for specific gravity are 1.003 to 1.030.

When the patient reports acute, severe, renal colic pain in the lower abdomen, the nurse knows that the
patient is most likely to have an obstruction at which area?

A) Kidney

B) Urethra

C) Bladder

D) Ureterovesical junction - Answer D) Ureterovesical junction

The ureterovesical junction (UVJ) is the narrowest part of the urethra and easily obstructed by urinary
calculi. With a stone in the kidney or at the ureteropelvic junction (UPJ), the pain may be dull
costovertebral flank pain. Stones in the bladder do not cause obstruction or symptoms unless they are
staghorn stones. The urethra seldom has obstruction related to stones.

The patient in the intensive care unit is receiving gentamicin for pneumonia from Pseudomonas. What
assessment results should the nurse report to the health care provider?

A) Decreased weight

B) Increased appetite

C) Increased urinary output

D) Elevated creatinine level - Answer D) Elevated creatinine level

, Gentamicin can be toxic to the kidneys and the auditory system. The elevated creatinine level must be
reported to the physician as it probably indicates renal damage. Other factors that may occur with renal
damage would include increased weight and decreased urinary output. Many medications have side
effects of anorexia.

The patient called the clinic with manifestations of burning on urination, dysuria, and frequency. What is
the best advice for the nurse to give the patient?

A) "Drink less fluid so you don't have to void so often."

B) "Take some acetaminophen to decrease the discomfort."

C) "Come in so we can check a clean catch urine specimen."

D) "Avoid caffeine and spicy food to decrease inflammation." - Answer C) "Come in so we can check a
clean catch urine specimen."

The patient's symptoms are typical of a urinary tract infection (UTI). To verify this, a clean catch urine
specimen must be obtained for a specimen of urine to culture. Drinking less fluid will not improve the
symptoms. Acetaminophen would not decrease the discomfort; an antibiotic would be needed. Avoiding
caffeine and spicy food may decrease bladder inflammation but will not affect these symptoms.

The patient had surgery and a urinary catheter. Eight hours after catheter removal and drinking fluids,
the patient has not been able to void. What should the nurse do first to assess for urinary retention?

A) Bladder scan

B) Cystometrogram

C) Residual urine test

D) Kidneys, ureters, bladder (KUB) x-ray - Answer A) Bladder scan

If the patient is unable to void, the bladder may be palpated for distention, percussed for dullness if it is
full, or a bladder scan may be done to determine the approximate amount of urine in the bladder. A
cystometrogram visualizes the bladder and evaluates vesicoureteral reflux. A KUB x-ray delineates size,
shape, and positions of kidneys and possibly a full bladder. Neither of these would be useful in this
situation. A residual urine test requires urination before catheterizing the patient to determine the
amount of urine left in the bladder, so this assessment would not be helpful for this patient.

Which effect of aging on the urinary system is most likely to affect the action of bumetanide (Bumex)?

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