Lewis’s Medical-Surgical Nursing, 11th Edition

1. Which question should the nurse ask to assess a patient’s dysuria? a. “Do you have to urinate at night?” b. “Do you have blood in your urine?” c. “Do you have to urinate frequently?” d. “Do you have pain when you urinate?” ANS: D Dysuria is painful urination. The alternate responses can be used to assess other urinary tract symptoms: hematuria, nocturia, and frequency. DIF: Cognitive Level: Understand (comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 2. What action should the nurse take first when a patient’s urine dipstick test indicates a small amount of protein? a. Send a urine specimen to the laboratory to test for ketones. b. Obtain a clean-catch urine for culture and sensitivity testing. c. Inquire about which medications the patient is currently taking. d. Ask the patient about any family history of chronic renal failure. ANS: C Normally the urinalysis will show zero to trace amounts of protein, but some medications may give false-positive readings. The other actions by the nurse may be appropriate but checking for medications that may affect the dipstick accuracy should be first. DIF: Cognitive Level: Analyze (analysis) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 3. A hospitalized patient who has possible renal insufficiency after coronary artery bypass surgery will have a creatinine clearance test. Which item will the nurse need to obtain? a. Urinary catheter b. Sterile specimen cup c. Cleansing towelettes d. Large urine container