NCLEX GU, Pediatric GU NCLEX, Renal GU NCLEX,
Renal & GU- NCLEX, GU NCLEX 3500, NCLEX GU –
Questions & Answers
1. When assessing the patient who has a lower urinary tract infection (UTI),
the nurse will initially ask about
a. flank pain.
b. pain with urination.
c. poor urine output.
d. nausea. - ✔️ Answer: B
Rationale: Pain with urination is a common symptom of a lower UTI. Urine
output does not decrease, but frequency may be experienced. Flank pain and
nausea are associated with an upper UTI.
Cognitive Level: Application Text Reference: p. 1157
Nursing Process: Assessment NCLEX: Physiological Integrity
2. Trimethoprim and sulfamethoxazole (Bactrim) BID for 7 days is ordered for
a patient who has a recurrent relapse of an Escherichia coli UTI. The nurse
instructs the patient to
a. take the antibiotic for the full 7 days, even if symptoms improve in a few
days.
b. return to the clinic in 3 days so that a urine culture can be done to evaluate
the effectiveness of the drug.
c. increase the effectiveness of the drug by taking it with cranberry juice to
acidify the urine.
d. take two of the pills a day for 5 days, and reserve the rest of the pills to take
if the symptoms reappear. - ✔️ Answer: A
Rationale: Although an initial infection may be treated with a shorter course
of antibiotics, the patient with a recurrent infection should take the antibiotic
for 7 days. Success of treatment is evaluated by resolution of symptoms rather
than by a repeat culture. Acidifying the urine when a patient is taking sulfa
antibiotics may lead to stone formation. The patient is instructed to take all
the antibiotics.
Cognitive Level: Application Text Reference: p. 1157
Nursing Process: Implementation NCLEX: Physiological Integrity
,3. The nurse determines that instruction regarding prevention of future UTIs
for a patient with cystitis has been effective when the patient states,
a. "I will empty my bladder every 3 to 4 hours during the day."
b. "I can use vaginal sprays to reduce bacteria."
c. "I will wash with soap and water before sexual intercourse."
d. "I will drink a quart of water or other fluids every day." - ✔️
Answer: A
Rationale: Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of
vaginal sprays is discouraged. The bladder should be emptied before and after
intercourse, but cleaning with soap and water is not necessary. A quart of
fluids is insufficient to provide adequate urine output to decrease risk for UTI.
Cognitive Level: Application Text Reference: p. 1161
Nursing Process: Evaluation
NCLEX: Health Promotion and Maintenance
4. To relieve the symptoms of a lower UTI for which the patient is taking
prescribed antibiotics, the nurse suggests that the patient use the OTC urinary
analgesic phenazopyridine (Pyridium) but cautions the patient that this
preparation
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
Rationale: Patients should be taught that Pyridium will color the urine deep
orange and stain underclothing. Urised may turn the urine blue or green. The
medication can cause gastrointestinal distress and should be taken with food.
Although an allergic reaction may occur, this is not common.
Cognitive Level: Comprehension Text Reference: p. 1158
Nursing Process: Implementation NCLEX: Physiological Integrity
5. 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 the patient is potential
complication
,a. hydronephrosis.
b. urosepsis.
c. acute renal failure.
d. chronic pyelonephritis. - ✔️ Answer: B
Rationale: Infection can easily spread from the kidney to the circulation,
causing urosepsis. A patient with a urinary tract obstruction will be at risk for
hydronephrosis. Acute renal failure is not a common complication of acute
pyelonephritis unless urosepsis and septic shock develop. Chronic
pyelonephritis may occur after recurrent upper UTIs.
Cognitive Level: Application Text Reference: p. 1161
Nursing Process: Diagnosis NCLEX: Physiological Integrity
6. A 72-year-old patient with benign prostatic hyperplasia and a history of
frequent UTIs is admitted to the hospital with chills, fever, and nausea and
vomiting. To determine whether the patient has an upper UTI, the nurse will
assess for
a. suprapubic pain.
b. foul-smelling urine.
c. bladder distension.
d. costovertebral angle (CVA) tenderness. - ✔️ Answer: D
Rationale: CVA tenderness is characteristic of pyelonephritis. The other
symptoms are characteristic of lower UTI and are likely to be present if the
patient also has an upper UTI.
Cognitive Level: Application Text Reference: p. 1161
Nursing Process: Assessment NCLEX: Physiological Integrity
7. After teaching a patient with interstitial cystitis about management of the
condition, the nurse determines that further instruction is needed when the
patient says,
a. "I will have to stop having coffee and orange juice for breakfast."
b. "I should start taking a high-potency multiple vitamin every morning."
c. "I should call the doctor about increased bladder pain or odorous urine."
d. "I will buy some calcium glycerophosphate (Prelief) at the pharmacy."
- ✔️ Answer: B
Rationale: High-potency multiple vitamins may irritate the bladder and
increase symptoms. The other patient statements indicate good
understanding of the teaching.
, Cognitive Level: Application Text Reference: p. 1164
Nursing Process: Evaluation NCLEX: Physiological Integrity
8. When admitting a patient with acute glomerulonephritis, the nurse will ask
the patient about
a. history of high blood pressure.
b. frequency of UTIs.
c. recent sore throat and fever.
d. family history of kidney disease. - ✔️ Answer: C
Rationale: Acute glomerulonephritis frequently occurs after a streptococcal
infection such as strep throat. It is not caused by hypertension, UTI, or related
to family history.
Cognitive Level: Application Text Reference: p. 1165
Nursing Process: Assessment NCLEX: Physiological Integrity
9. The nurse establishes a nursing diagnosis of excess fluid volume related to
inflammation at the glomerular basement membrane in a patient with acute
glomerulonephritis. To best evaluate whether the problem identified in the
nursing diagnosis has resolved, the nurse will monitor for
a. proteinuria.
b. elevated creatinine.
c. periorbital edema.
d. hematuria. - ✔️ Answer: C
Rationale: Resolution of the excess fluid volume is best evaluated by changes
in edema. The other data may indicate whether the glomerulonephritis is
resolving but do not provide data about fluid volume.
Cognitive Level: Application Text Reference: p. 1165
Nursing Process: Evaluation NCLEX: Physiological Integrity
10. A patient with nephrotic syndrome develops flank pain. The nurse will
anticipate treatment with
a. antibiotics.
b. antihypertensives.
c. anticoagulants.
d. corticosteroids. - ✔️ Answer: C
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