NURS 2207 GU/Men's Health Quiz: Questions &
detailed Answers
When providing care for a client who had a nephrectomy secondary to renal
cancer, which factor affects the client's ability to perform his or her
postoperative deep breathing and coughing requirements?
1. Location of the client's surgical incision
2. Increased anxiety about the prognosis
3. Inflammatory process associated with surgery
4. Pulmonary congestion from preoperative medications Right Ans - 1.
Location of the client's surgical incision
Rationale:
The location of the surgical site in relation to the diaphragm increases
incisional pain when deep breathing or coughing. Anxiety about the prognosis
should not interfere with the ability to deep breathe and cough, especially
when encouraged by the nurse. Inflammatory changes will cause discomfort
in the area of any incision but are not necessarily the prime factor preventing
deep breathing after a nephrectomy. The client will need to cough and deep
breathe if there is congestion in the lungs.
The nurse writes a goal of preventing renal calculi in a care plan for a client
who has paraplegia. Which information provides the rationale for selecting
this goal?
1. High fluid volume intake
2. Increased calcium intake
3. Inadequate kidney function
4. Accelerated bone demineralization Right Ans - 4. Accelerated bone
demineralization
,Rationale:
Calcium that has left the bones as a response to prolonged inactivity enters
the blood and may precipitate in the kidneys, forming calculi. Increased fluid
intake is helpful in preventing this condition by preventing urinary stasis.
Calcium intake usually is limited to prevent the increased risk for calculi.
Calculi may develop despite adequate kidney function; kidney function may be
impaired by the presence of calculi and urinary tract infections associated
with urinary stasis or repeated catheterizations.
The laboratory values of a client with renal calculi reveal a serum calcium
within expected limits and an elevated serum purine. Which type of stone
composition is consistent with these laboratory values?
1. Cystine
2. Uric acid
3. Calcium oxalate
4. Magnesium ammonium phosphate Right Ans - 2. Uric acid
Rationale:
Purines are precursors of uric acid, which crystallizes. Cystine stones are
caused by a rare hereditary defect resulting in defective absorption of cysteine
in the gastrointestinal tract and kidneys (inborn error of cystine metabolism).
Serum purine will not be elevated if the stone is composed of calcium oxalate.
A struvite stone sometimes is called a magnesium ammonium phosphate
stone and is precipitated by recurrent urinary tract infections.
Which foods would the nurse teach a client to avoid when diagnosed with
calcium oxalate renal calculi? Select all that apply. One, some, or all responses
may be correct.
1. Milk
2. Tea
3. Liver
,4. Spinach
5. Rhubarb Right Ans - ANS: 2, 4, 5
Rationale:
Tea, rhubarb, and spinach are high in calcium oxalate. Limiting oxalate-rich
foods limits oxalate absorption and the formation of calcium oxalate calculi.
Milk is an acceptable calcium-rich protein and is avoided with calcium stones,
but not with oxalate stones. Liver is a purine-rich food and avoided with uric
acid renal calculi or gout.
Which information would the nurse include in the home care instructions for
a client being discharged post-lithotripsy for renal calculi?
1. "Increase your intake of dairy products for 5 days."
2. "Drink at least 3 L of fluid daily for 4 weeks."
3. "Do not take any medications after this treatment."
4. "Call us back immediately if you observe any blood in your urine." Right
Ans - 2. "Drink at least 3 L of fluid daily for 4 weeks."
Rationale:
Increasing fluid intake aids in the passage of fragments of the calculus that
remain after the lithotripsy. Calcium is the major component of the most
common type of calculus; the intake of dairy products, which are high in
calcium, should be limited. The client will take antibiotics after the treatment
and should complete the entire regimen. Hematuria (blood in the urine) after
lithotripsy is an expected response and does not require notification.
After an unsuccessful lithotripsy to break up renal calculi, a nephrolithotomy
was successful in removing the client's renal calculi. Which clinical indicator
would the nurse monitor during the postoperative period and report
immediately to the primary health care provider?
1. Continuous passage of pink-tinged urine
2. Pink drainage on the client's surgical dressing
, 3. Total intake volume of 2000 mL in 24 hours
4. Urinary output of 20 to 30 mL/h Right Ans - 4. Urinary output of 20 to 30
mL/h
Rationale:
The client's urinary output should be at least 30 mL/h; a decreased output
may indicate obstruction, impaired kidney function, or fluid volume deficit.
Blood, tinting the urine pink, is expected. Drainage on the surgical dressing
may be pink; the nurse would report bright red drainage. The intake of 2000
mL in 24 hours is adequate; however, a higher intake usually is preferred to
prevent fluid volume deficit (e.g., >2000-3000 mL).
Which clinical manifestations would the nurse expect the client to report
when experiencing renal calculi? Select all that apply.
1. Blood in the urine.
2. Irritability and twitching
3. Dry, itchy skin and pyuria
4. frequency and urgency of urination
5. Pain radiating from the kidney to a shoulder Right Ans - ANS: 1, 4
Rationale:
Hematuria is a common clinical manifestation of renal calculi. Frequency and
a sense of urgency may occur because of irritation caused by the calculi; the
most common expectation is sharp, severe pain. Irritability may occur because
of discomfort; twitching does not occur. Pyuria may occur when infection is
present; skin problems do not occur. Pain radiates from the flank to the groin
area.
Which instructions would the nurse give to a client with renal calculi? Select
all that apply. One, some, or all responses may be correct.
1. "Drink plenty of water."
detailed Answers
When providing care for a client who had a nephrectomy secondary to renal
cancer, which factor affects the client's ability to perform his or her
postoperative deep breathing and coughing requirements?
1. Location of the client's surgical incision
2. Increased anxiety about the prognosis
3. Inflammatory process associated with surgery
4. Pulmonary congestion from preoperative medications Right Ans - 1.
Location of the client's surgical incision
Rationale:
The location of the surgical site in relation to the diaphragm increases
incisional pain when deep breathing or coughing. Anxiety about the prognosis
should not interfere with the ability to deep breathe and cough, especially
when encouraged by the nurse. Inflammatory changes will cause discomfort
in the area of any incision but are not necessarily the prime factor preventing
deep breathing after a nephrectomy. The client will need to cough and deep
breathe if there is congestion in the lungs.
The nurse writes a goal of preventing renal calculi in a care plan for a client
who has paraplegia. Which information provides the rationale for selecting
this goal?
1. High fluid volume intake
2. Increased calcium intake
3. Inadequate kidney function
4. Accelerated bone demineralization Right Ans - 4. Accelerated bone
demineralization
,Rationale:
Calcium that has left the bones as a response to prolonged inactivity enters
the blood and may precipitate in the kidneys, forming calculi. Increased fluid
intake is helpful in preventing this condition by preventing urinary stasis.
Calcium intake usually is limited to prevent the increased risk for calculi.
Calculi may develop despite adequate kidney function; kidney function may be
impaired by the presence of calculi and urinary tract infections associated
with urinary stasis or repeated catheterizations.
The laboratory values of a client with renal calculi reveal a serum calcium
within expected limits and an elevated serum purine. Which type of stone
composition is consistent with these laboratory values?
1. Cystine
2. Uric acid
3. Calcium oxalate
4. Magnesium ammonium phosphate Right Ans - 2. Uric acid
Rationale:
Purines are precursors of uric acid, which crystallizes. Cystine stones are
caused by a rare hereditary defect resulting in defective absorption of cysteine
in the gastrointestinal tract and kidneys (inborn error of cystine metabolism).
Serum purine will not be elevated if the stone is composed of calcium oxalate.
A struvite stone sometimes is called a magnesium ammonium phosphate
stone and is precipitated by recurrent urinary tract infections.
Which foods would the nurse teach a client to avoid when diagnosed with
calcium oxalate renal calculi? Select all that apply. One, some, or all responses
may be correct.
1. Milk
2. Tea
3. Liver
,4. Spinach
5. Rhubarb Right Ans - ANS: 2, 4, 5
Rationale:
Tea, rhubarb, and spinach are high in calcium oxalate. Limiting oxalate-rich
foods limits oxalate absorption and the formation of calcium oxalate calculi.
Milk is an acceptable calcium-rich protein and is avoided with calcium stones,
but not with oxalate stones. Liver is a purine-rich food and avoided with uric
acid renal calculi or gout.
Which information would the nurse include in the home care instructions for
a client being discharged post-lithotripsy for renal calculi?
1. "Increase your intake of dairy products for 5 days."
2. "Drink at least 3 L of fluid daily for 4 weeks."
3. "Do not take any medications after this treatment."
4. "Call us back immediately if you observe any blood in your urine." Right
Ans - 2. "Drink at least 3 L of fluid daily for 4 weeks."
Rationale:
Increasing fluid intake aids in the passage of fragments of the calculus that
remain after the lithotripsy. Calcium is the major component of the most
common type of calculus; the intake of dairy products, which are high in
calcium, should be limited. The client will take antibiotics after the treatment
and should complete the entire regimen. Hematuria (blood in the urine) after
lithotripsy is an expected response and does not require notification.
After an unsuccessful lithotripsy to break up renal calculi, a nephrolithotomy
was successful in removing the client's renal calculi. Which clinical indicator
would the nurse monitor during the postoperative period and report
immediately to the primary health care provider?
1. Continuous passage of pink-tinged urine
2. Pink drainage on the client's surgical dressing
, 3. Total intake volume of 2000 mL in 24 hours
4. Urinary output of 20 to 30 mL/h Right Ans - 4. Urinary output of 20 to 30
mL/h
Rationale:
The client's urinary output should be at least 30 mL/h; a decreased output
may indicate obstruction, impaired kidney function, or fluid volume deficit.
Blood, tinting the urine pink, is expected. Drainage on the surgical dressing
may be pink; the nurse would report bright red drainage. The intake of 2000
mL in 24 hours is adequate; however, a higher intake usually is preferred to
prevent fluid volume deficit (e.g., >2000-3000 mL).
Which clinical manifestations would the nurse expect the client to report
when experiencing renal calculi? Select all that apply.
1. Blood in the urine.
2. Irritability and twitching
3. Dry, itchy skin and pyuria
4. frequency and urgency of urination
5. Pain radiating from the kidney to a shoulder Right Ans - ANS: 1, 4
Rationale:
Hematuria is a common clinical manifestation of renal calculi. Frequency and
a sense of urgency may occur because of irritation caused by the calculi; the
most common expectation is sharp, severe pain. Irritability may occur because
of discomfort; twitching does not occur. Pyuria may occur when infection is
present; skin problems do not occur. Pain radiates from the flank to the groin
area.
Which instructions would the nurse give to a client with renal calculi? Select
all that apply. One, some, or all responses may be correct.
1. "Drink plenty of water."
