NSG5544_Exam3_StudyGuide Questions And Verified Answers Complete b1 b1 b1 b1 b1
b1 Solutions, 100% Correct | New Update | | Complete A+ Guide
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
True or false: The most common composition of renal stones is uric acid. If
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 not true, what is the most common chemical composition of renal calculi?
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Answer: False. The most common chemical composition of renal calculi is calcium
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
oxalate (often combined with calcium phosphate).
b1 b1 b1 b1 b1 b1
Explanation: Calcium oxalate stones account for about 70–80% of all kidney stones.
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Uric acid stones are less common (5–10%). Other types include struvite (infection
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
stones) and cystine stones.
b1 b1 b1 b1
What organism is the most common cause for bladder infections? What
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 treatments would you consider (there are several to consider).
b1 b1 b1 b1 b1 b1 b1 b1
Answer: The most common organism is Escherichia coli (E. coli). Treatments include:
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
first-line antibiotics such as nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-
b1 b1 b1 b1 b1 b1 b1
SMX), fosfomycin, or pivmecillinam; also consider beta-lactams (e.g., amoxicillin-
b1 b1 b1 b1 b1 b1 b1 b1
clavulanate) as alternatives. For recurrent infections, consider post-coital prophylaxis
b1 b1 b1 b1 b1 b1 b1 b1
or continuous low-dose antibiotics, and non-pharmacologic measures like increased
b1 b1 b1 b1 b1 b1 b1 b1 b1
hydration and cranberry products.
b1 b1 b1 b1
Explanation: E. coli causes 75–95% of uncomplicated cystitis. Antibiotic choice
b1 b1 b1 b1 b1 b1 b1 b1 b1
depends on local resistance patterns, allergy, and patient factors. Nitrofurantoin is
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
often preferred for uncomplicated cystitis due to low resistance.
b1 b1 b1 b1 b1 b1 b1 b1 b1
,What diagnostic study would you order to determine if there is a urinary tract
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 infection? (that question is far too easy).
b1 b1 b1 b1 b1 b1
Answer: Urinalysis (dipstick and microscopic) and urine culture with sensitivity.
b1 b1 b1 b1 b1 b1 b1 b1 b1
Explanation: Urinalysis can show leukocyte esterase, nitrites (suggestive of
b1 b1 b1 b1 b1 b1 b1 b1
gram-negative rods), and pyuria. Urine culture (≥10^5 CFU/mL) confirms the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
diagnosis and identifies the pathogen and antibiotic susceptibility.
b1 b1 b1 b1 b1 b1 b1 b1
You have an elderly patient that is still mobile yet has functional incontinence.
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 What non-pharmacological intervention would you recommend? (this is basic
b1 b1 b1 b1 b1 b1 b1 b1
b1 nursing thinking) b1
Answer: Scheduled or timed voiding (habit training) every 2–3 hours, along with
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
ensuring easy access to a commode or bedside urinal, removing barriers (e.g., throw
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
rugs, poor lighting), and providing clothing that is easy to remove.
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Explanation: Functional incontinence occurs when a person cannot reach the toilet
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
in time despite normal bladder function. Improving the environment and
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
establishing a routine reduces accidents without medication.
b1 b1 b1 b1 b1 b1 b1
If you suspect a ureteral obstruction, what study would you anticipate?
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Answer: CT urography (or non-contrast CT of the abdomen and pelvis) is the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
preferred study. Alternatively, renal ultrasound (to assess hydronephrosis) or MR
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
urography.
b1
, Explanation: CT urography provides detailed anatomy of the ureters, identifies the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
level and cause of obstruction (e.g., stone, stricture, tumor). Ultrasound is useful to
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
detect hydronephrosis but less specific for the obstruction site.
b1 b1 b1 b1 b1 b1 b1 b1 b1
Your patient reports losing control of her bladder when coughing. What
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 anatomy is weak or deficient?
b1 b1 b1 b1
Answer: The pelvic floor muscles and/or the urethral sphincter mechanism
b1 b1 b1 b1 b1 b1 b1 b1 b1
(specifically the urethral support and intrinsic sphincter). This describes stress
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
urinary incontinence.
b1 b1
Explanation: Coughing increases intra-abdominal pressure. If the pelvic floor and
b1 b1 b1 b1 b1 b1 b1 b1 b1
sphincter are weak, they cannot maintain urethral closure pressure, leading to
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
leakage. The “hammock” theory points to deficient suburethral support.
b1 b1 b1 b1 b1 b1 b1 b1 b1
What medication can - in essence - anesthetize the lining of the bladder?
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Answer: Intravesical lidocaine (or alkalinized lidocaine) can anesthetize the bladder
b1 b1 b1 b1 b1 b1 b1 b1 b1
lining.
b1
Explanation: Lidocaine is a sodium channel blocker. When instilled directly into the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
bladder via a catheter, it numbs the urothelium, providing temporary relief for
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
painful bladder conditions (e.g., interstitial cystitis, during cystoscopy).
b1 b1 b1 b1 b1 b1 b1 b1
b1 Solutions, 100% Correct | New Update | | Complete A+ Guide
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
True or false: The most common composition of renal stones is uric acid. If
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 not true, what is the most common chemical composition of renal calculi?
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Answer: False. The most common chemical composition of renal calculi is calcium
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
oxalate (often combined with calcium phosphate).
b1 b1 b1 b1 b1 b1
Explanation: Calcium oxalate stones account for about 70–80% of all kidney stones.
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Uric acid stones are less common (5–10%). Other types include struvite (infection
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
stones) and cystine stones.
b1 b1 b1 b1
What organism is the most common cause for bladder infections? What
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 treatments would you consider (there are several to consider).
b1 b1 b1 b1 b1 b1 b1 b1
Answer: The most common organism is Escherichia coli (E. coli). Treatments include:
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
first-line antibiotics such as nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-
b1 b1 b1 b1 b1 b1 b1
SMX), fosfomycin, or pivmecillinam; also consider beta-lactams (e.g., amoxicillin-
b1 b1 b1 b1 b1 b1 b1 b1
clavulanate) as alternatives. For recurrent infections, consider post-coital prophylaxis
b1 b1 b1 b1 b1 b1 b1 b1
or continuous low-dose antibiotics, and non-pharmacologic measures like increased
b1 b1 b1 b1 b1 b1 b1 b1 b1
hydration and cranberry products.
b1 b1 b1 b1
Explanation: E. coli causes 75–95% of uncomplicated cystitis. Antibiotic choice
b1 b1 b1 b1 b1 b1 b1 b1 b1
depends on local resistance patterns, allergy, and patient factors. Nitrofurantoin is
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
often preferred for uncomplicated cystitis due to low resistance.
b1 b1 b1 b1 b1 b1 b1 b1 b1
,What diagnostic study would you order to determine if there is a urinary tract
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 infection? (that question is far too easy).
b1 b1 b1 b1 b1 b1
Answer: Urinalysis (dipstick and microscopic) and urine culture with sensitivity.
b1 b1 b1 b1 b1 b1 b1 b1 b1
Explanation: Urinalysis can show leukocyte esterase, nitrites (suggestive of
b1 b1 b1 b1 b1 b1 b1 b1
gram-negative rods), and pyuria. Urine culture (≥10^5 CFU/mL) confirms the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
diagnosis and identifies the pathogen and antibiotic susceptibility.
b1 b1 b1 b1 b1 b1 b1 b1
You have an elderly patient that is still mobile yet has functional incontinence.
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 What non-pharmacological intervention would you recommend? (this is basic
b1 b1 b1 b1 b1 b1 b1 b1
b1 nursing thinking) b1
Answer: Scheduled or timed voiding (habit training) every 2–3 hours, along with
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
ensuring easy access to a commode or bedside urinal, removing barriers (e.g., throw
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
rugs, poor lighting), and providing clothing that is easy to remove.
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Explanation: Functional incontinence occurs when a person cannot reach the toilet
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
in time despite normal bladder function. Improving the environment and
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
establishing a routine reduces accidents without medication.
b1 b1 b1 b1 b1 b1 b1
If you suspect a ureteral obstruction, what study would you anticipate?
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Answer: CT urography (or non-contrast CT of the abdomen and pelvis) is the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
preferred study. Alternatively, renal ultrasound (to assess hydronephrosis) or MR
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
urography.
b1
, Explanation: CT urography provides detailed anatomy of the ureters, identifies the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
level and cause of obstruction (e.g., stone, stricture, tumor). Ultrasound is useful to
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
detect hydronephrosis but less specific for the obstruction site.
b1 b1 b1 b1 b1 b1 b1 b1 b1
Your patient reports losing control of her bladder when coughing. What
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
b1 anatomy is weak or deficient?
b1 b1 b1 b1
Answer: The pelvic floor muscles and/or the urethral sphincter mechanism
b1 b1 b1 b1 b1 b1 b1 b1 b1
(specifically the urethral support and intrinsic sphincter). This describes stress
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
urinary incontinence.
b1 b1
Explanation: Coughing increases intra-abdominal pressure. If the pelvic floor and
b1 b1 b1 b1 b1 b1 b1 b1 b1
sphincter are weak, they cannot maintain urethral closure pressure, leading to
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
leakage. The “hammock” theory points to deficient suburethral support.
b1 b1 b1 b1 b1 b1 b1 b1 b1
What medication can - in essence - anesthetize the lining of the bladder?
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
Answer: Intravesical lidocaine (or alkalinized lidocaine) can anesthetize the bladder
b1 b1 b1 b1 b1 b1 b1 b1 b1
lining.
b1
Explanation: Lidocaine is a sodium channel blocker. When instilled directly into the
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
bladder via a catheter, it numbs the urothelium, providing temporary relief for
b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1 b1
painful bladder conditions (e.g., interstitial cystitis, during cystoscopy).
b1 b1 b1 b1 b1 b1 b1 b1
