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Med Surg Final Exam 3 Study Guide 2024/2025
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Med Surg Final Exam 3 Study GuideB
The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the
bathroom is appropriate. Fluids should be encouraged because dehydration is more common in
older patients. The information in the question does not indicate that measurement of the patient's
output is necessary or that the patient has overflow incontinence. - verified answer A 79 year old
patient has been admitted with BPH. What is most appropriate to include in the nursing plan of care
a. Limit fluid intake to no more than 1000 ml/day
b. Leave a light on in the bathroom during the night
c. Ask the patient to use a urinal so that urine can be measured
d. Pad the patients bed to accommodate overflow incontinence
B
This answer describes the technique for obtaining a clean-catch specimen. The answer beginning,
"insert a short, small, 'mini' catheter attached to a collecting container" describes a technique that
would result in a sterile specimen, but a health care provider's order for a catheterized specimen
would be required. Using Betadine before obtaining the specimen is not necessary, and might result
in suppressing the growth of some bacteria. The technique described in the answer beginning "have
the patient empty the bladder completely" would not result in a sterile specimen. - verified answer A
female patient with a suspected UTI is to provide a clean catch urine specimen for culture and
sensitivity testing. To obtain the specimen, the nurse will:
a. Have the patient empty the bladder completely, then obtain the next urine specimen that the
patient is able to void
b. Teach the patient to clean the urethral area, void a small amount into the toilet, and then void
into a sterile specimen cup
c. Insert a short sterile mini catheter attached to a collecting container into the urethra and bladder
to obtain the specimen
d. Clean the area around the meatus with a povidine-iodine (betadine) swab and then have the
patient void into a sterile container
D
The patient's elevated temperature may indicate a bladder infection, a possible complication of
cystoscopy. The health care provider should be notified so that antibiotic therapy can be started.
Pink-tinged urine is expected after a cystoscopy. The insomnia and bruising should be discussed
further with the patient but do not indicate a need to notify the health care provider. - verified
answer Which statement made by a patient who had a cystoscopy the previous day should be
reported immediately to the HCP?
,a. My urine looks pink
b. My IV site is bruised
c. My sleep was restless
d. My temperature is 101
B
Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is
not caused by kidney stones, hypertension, or urinary tract infection (UTI). - verified answer To
determine possible causes, the nurse will ask a patient admitted with acute glomerulonephritis
about:
a. Recent bladder infection
b. History of kidney stones
c. Recent sore throat and fever
d. History of high blood pres
C
Flank pain in a patient with nephrotic syndrome suggests a renal vein thrombosis, and
anticoagulation is needed. Antibiotics are used to treat a patient with flank pain caused by
pyelonephritis. Fungal pyelonephritis is uncommon and is treated with antifungals.
Antihypertensives are used if the patient has high blood pressure - verified answer The nurse will
anticipate teaching a patient with nephrotic syndrome who develops flank pain about treatment
with:
a. Antibiotics
b. Antifungals
c. Anticoagulants
d. Antihypertensive
B
Cigarette smoking is a risk factor for bladder cancer. The patient's risk for developing interstitial
cystitis, urinary tract infection (UTI), or kidney stones will not be reduced by quitting smoking. -
verified answer The nurse will plan to teach a 27 year old woman who smokes two packs a day about
the risk for:
a. Kidney stones
b. Bladder cancer
c. Bladder infection
,d. Interstitial cystitis
C
An ultrasound scanner can be used to check for residual urine after the patient voids. Because the
patient's history and clinical manifestations are consistent with overflow incontinence, it is not
appropriate to have the patient drink small amounts. Although overflow incontinence is not unusual
after surgery, the nurse should intervene to correct the physiologic problem, not just reassure the
patient. The patient may develop reflux into the renal pelvis and discomfort from a full bladder if the
nurse waits to address the problem for several hours. - verified answer Following rectal surgery, a
patient voids about 50 mL of urine every 30-60 minutes for the first 4 hours. Which nursing
intervention is most appropriate?
a. Monitor the patients intake and output overnight
b. Have the patient drink small amounts of fluid frequently
c. Use an ultrasound scanner to check the postvoid residual volume
d. Reassure the patient that this is normal after anesthesia for rectal surgery
C
Patients who are at home can use a clean technique for intermittent self-catheterization and change
the catheter every 7 days. There is no need to use a new catheter every day, to use sterile catheters,
or to take prophylactic antibiotics. - verified answer The home health nurse teaches a patient with a
neurogenic bladder how to use intermittent catheterization for bladder emptying. Which patient
statement indicates that the teaching has been effective?
a. I will buy seven new catheters weekly and use a new one everyday
b. I will use a sterile catheter and gloves for each time I self-catheterize
c. I will clean the catheter carefully before and after each catheterization
d. I will take prophylactic antibiotics to prevent any urinary tract infections
C
The Indiana pouch enables the patient to self-catheterize every 4 to 6 hours. There is no need for an
ostomy device or barrier products. Catheterization of the pouch is not painful. - verified answer A 68
year old male patient who has bladder cancer had a cystectomy with creation of an Indiana pouch.
Which topic will be included in patient teaching?
a. Application of ostomy appliances
b. Barrier products for skin protection
c. Catheterization technique and schedule
d. Analgesic use before emptying pouch
, C
Clots in the urine are not expected and require further follow-up. Voiding every 4 hours, use of
opioids for pain, and anxiety are typical after this procedure. - verified answer Which information
from a patient who had a transurethral resection with with fulguration for bladder cancer 3 days ago
is most important to report to the health care provider?
a. The patient is voiding every 4 hours
b. The patient is using opioids for pain
c. The patient has seen clots in the urine
d. The patient is anxious about the cancer
C
Because catheterization bypasses many of the protective mechanisms that prevent urinary tract
infection (UTI), avoidance of catheterization is the most effective means of reducing HAI. The other
actions will also be helpful, but are not as useful as decreasing urinary catheter use. - verified answer
Nursing staff on a hospital unit are reviewing rates of health care associated infections in the urinary
tract. Which nursing action will be most helpful in decreasing the risk for HAI in patients admitted to
the hospital?
a. Testing urine with dipstick daily for nitrates
b. Avoiding unnecessary urinary catheterization
c. Encouraging adequate oral liquid and nutritional intake
d. Providing perineal hygiene to patients daily and PRN
B
Once the patient is started on dialysis and nitrogenous wastes are removed, more protein in the diet
is encouraged. Fluids are still restricted to avoid excessive weight gain and complications such as
shortness of breath. Glucose is not lost during hemodialysis. Sodium and potassium intake continues
to be restricted to avoid the complications associated with high levels of these electrolytes. - verified
answer A patient who has had progressive chronic Kidney disease (CKD) for several years and has
just begun regular hemodialysis. Which information about diet will the nurse include in patient
teaching?
a. Increased calories are needed because glucose is lost during hemodialysis
b. More protein is allowed because urea and creatinine are removed by dialysis
c. Dietary potassium is not restricted because the level normalizes by dialysis
d. Unlimited fluids are allowed because retained fluid is removed during dialysis
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