CHAPTER 41: UROLOGIC SYSTEM
INTRODUCTION LINTON: MEDICAL-SURGICAL
NURSING, 7TH EDITION
MULTIPLE CHOICE
1. A nurse is assessing a patient with renal impairment. Which facial characteristic is
a sign of fluid retention?
a.
Broken blood vessels around the nose
b.
Periorbital edema
c.
Rash on cheeks and neck
d.
Facial twitching
ANS: B
Periorbital edema is a sign of fluid retention. Because the patient with renal
impairment has generalized edema, this facial feature is extremely significant in
assessing edema.
DIF: Cognitive Level: Comprehension REF: p. 798 OBJ: 1
TOP: Sign of Fluid Retention KEY: Nursing Process Step:
Assessment MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. What laboratory value change should indicate to a nurse that a patient with renal
failure has entered the oliguric stage?
a.
Blood urea nitrogen (BUN) level rises.
b.
Serum
c. Blood volume
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d. Urine osmolality increases.
ANS: A
In the oliguric stage of renal failure, the urine output decreases to less than 400
mL/day; the BUN, creatinine, and potassium increase; and the serum calcium
decreases. The patient becomes hypervolemic as the urine osmolality increases.
, 2
DIF: Cognitive Level: Comprehension REF: p. 799 OBJ: 1
TOP: Oliguric Stage of Renal Failure KEY: Nursing Process Step:
Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. What should nursing care focus on when caring for a patient with a ureteral
catheter in place after the removal of a kidney stone?
a.
Irrigating the catheter regularly
b.
Assessing for patency
c.
Including ureteral output with the bladder output
d.
Early ambulation
ANS: B
Patency of the ureteral catheter is essential to prevent injury to the kidney. The
patient is on bed rest until the ureteral catheter is removed. The output from the
ureteral catheter is measured and recorded separately, and irrigation, if
performed, is not done on a regular schedule and is not more than 5 mL.
DIF: Cognitive Level: Application REF: p. 806 OBJ: 2
TOP: Ureteral Catheter KEY: Nursing Process Step: Implementation
, 3
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. What is true about the urine osmolality when the kidney is adequately functioning?
a.
Equal to the osmolality of the serum
b.
Approximately half of the serum
c.
In a ratio of 10:1 with the serum
d.
Equal to the excretion of urea
ANS: A
If the blood osmolality is high, the kidneys need to dilute the blood and excrete
more concentrated urine, and the reverse is true. The osmolality of the serum
and the urine should be equal.
DIF: Cognitive Level: Comprehension REF: p. 803 OBJ: 2
TOP: Kidney Function Tests KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5. Which urine test provides the most accurate measurement of renal function?
a.
BUN
b.
Phosphates
c.
Specific gravity
d.
Creatinine
ANS: D
Creatinine is not affected by diet, hydration, or liver function and is a better
measurement of liver
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DIF: Cognitive Level: Knowledge REF: p. 803 OBJ: 2
TOP: Creatinine KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
6. A nurse is caring for a patient after urinary diversion surgery. What postoperative
nursing assessment is the priority?
a.
Level of fluid intake
b.
Position on the left side
c.
Keep the bed flat
d.
Bowel sounds
ANS: D
, 4
The bowel is manipulated during urinary diversion surgeries and frequently leads
to the patient with a paralytic ileus.
DIF: Cognitive Level: Application REF: p. 806 OBJ: 4
TOP: Urinary Diversion KEY: Nursing Process Step:
Assessment MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
7. A nurse is performing frequent catheterizations for residual urine. What causes the
greatest concern for the nurse?
a.
Introduction of pathogens into the bladder
b.
Frequent genital exposure of the patient
c.
Presence of the indwelling catheter
d.
Causing urethral erosion
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