Chapter 46: Nursing Management: Renal
and Urologic Problems EXAM Q and A
Graded A+
A 46-year-old female patient returns to the clinic with recurrent dysuria after being
treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will
the nurse plan to take?
a. Teach the patient to take the prescribed Bactrim for 3 more days.
b. Remind the patient about the need to drink 1000 mL of fluids daily.
c. Obtain a midstream urine specimen for culture and sensitivity testing.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.
ANSWERS-ANS: C
Because uncomplicated urinary tract infections (UTIs) are usually successfully treated
with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to
determine appropriate antibiotic therapy. Acetaminophen would not be as effective as
other over-the-counter (OTC) medications such as phenazopyridine (Pyridium) in
treating dysuria. The fluid intake should be increased to at least 1800 mL/day. Because
the UTI has persisted after treatment with Bactrim, the patient is likely to need a
different antibiotic
The nurse determines that instruction regarding prevention of future urinary tract
infections (UTIs) has been effective for a 22-year-old female patient with cystitis when
the patient states which of the following?
a. "I can use vaginal antiseptic sprays to reduce bacteria."
b. "I will drink a quart of water or other fluids every day."
c. "I will wash with soap and water before sexual intercourse."
d. "I will empty my bladder every 3 to 4 hours during the day." ANSWERS-ANS: D
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal sprays is
discouraged. The bladder should be emptied before and after intercourse, but cleaning
with soap and water is not necessary. A quart of fluids is insufficient to provide
adequate urine output to decrease risk for UTI.
Which information will the nurse include when teaching the patient with a urinary tract
infection (UTI) about the use of phenazopyridine (Pyridium)?
a. Pyridium may cause photosensitivity
b. Pyridium may change the urine color.
c. Take the Pyridium for at least 7 days.
d. Take Pyridium before sexual intercourse. ANSWERS-ANS: B
Patients should be taught that Pyridium will color the urine deep orange. Urinary
analgesics should only be needed for a few days until the prescribed antibiotics
decrease the bacterial count. Pyridium does not cause photosensitivity. Taking Pyridium
before intercourse will not be helpful in reducing the risk for UTI.
, Which finding by the nurse will be most helpful in determining whether a 67-year-old
patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)?
a. Bladder distention
b. Foul-smelling urine
c. Suprapubic discomfort
d. Costovertebral tenderness ANSWERS-ANS: D
Costovertebral tenderness is characteristic of pyelonephritis. Bladder distention, foul-
smelling urine, and suprapubic discomfort are characteristic of lower UTI and are likely
to be present if the patient also has an upper UTI.
The nurse determines that further instruction is needed for a patient with interstitial
cystitis when the patient says which of the following?
a. "I should stop having coffee and orange juice for breakfast."
b. "I will buy calcium glycerophosphate (Prelief) at the pharmacy."
c. "I will start taking high potency multiple vitamins every morning."
d. "I should call the doctor about increased bladder pain or odorous urine." ANSWERS-
ANS: C
High-potency multiple vitamins may irritate the bladder and increase symptoms. The
other patient statements indicate good understanding of the teaching.
It is most important that the nurse ask a patient admitted with acute glomerulonephritis
about
a. history of kidney stones.
b. recent sore throat and fever.
c. history of high blood pressure.
d. frequency of bladder infections. ANSWERS-ANS: 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).
Which finding for a patient admitted with glomerulonephritis indicates to the nurse that
treatment has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. The antistreptolysin-O (ASO) titer is decreased.
d. The periorbital and peripheral edema is resolved. ANSWERS-ANS: D
Because edema is a common clinical manifestation of glomerulonephritis, resolution of
the edema indicates that the prescribed therapies have been effective. Nitrites will be
negative and the patient will not experience dysuria because the patient does not have
a urinary tract infection. Antibodies to streptococcus will persist after a streptococcal
infection.
The nurse will anticipate teaching a patient with nephrotic syndrome who develops flank
pain about treatment with
a. antibiotics.
b. antifungals.
and Urologic Problems EXAM Q and A
Graded A+
A 46-year-old female patient returns to the clinic with recurrent dysuria after being
treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will
the nurse plan to take?
a. Teach the patient to take the prescribed Bactrim for 3 more days.
b. Remind the patient about the need to drink 1000 mL of fluids daily.
c. Obtain a midstream urine specimen for culture and sensitivity testing.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.
ANSWERS-ANS: C
Because uncomplicated urinary tract infections (UTIs) are usually successfully treated
with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to
determine appropriate antibiotic therapy. Acetaminophen would not be as effective as
other over-the-counter (OTC) medications such as phenazopyridine (Pyridium) in
treating dysuria. The fluid intake should be increased to at least 1800 mL/day. Because
the UTI has persisted after treatment with Bactrim, the patient is likely to need a
different antibiotic
The nurse determines that instruction regarding prevention of future urinary tract
infections (UTIs) has been effective for a 22-year-old female patient with cystitis when
the patient states which of the following?
a. "I can use vaginal antiseptic sprays to reduce bacteria."
b. "I will drink a quart of water or other fluids every day."
c. "I will wash with soap and water before sexual intercourse."
d. "I will empty my bladder every 3 to 4 hours during the day." ANSWERS-ANS: D
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal sprays is
discouraged. The bladder should be emptied before and after intercourse, but cleaning
with soap and water is not necessary. A quart of fluids is insufficient to provide
adequate urine output to decrease risk for UTI.
Which information will the nurse include when teaching the patient with a urinary tract
infection (UTI) about the use of phenazopyridine (Pyridium)?
a. Pyridium may cause photosensitivity
b. Pyridium may change the urine color.
c. Take the Pyridium for at least 7 days.
d. Take Pyridium before sexual intercourse. ANSWERS-ANS: B
Patients should be taught that Pyridium will color the urine deep orange. Urinary
analgesics should only be needed for a few days until the prescribed antibiotics
decrease the bacterial count. Pyridium does not cause photosensitivity. Taking Pyridium
before intercourse will not be helpful in reducing the risk for UTI.
, Which finding by the nurse will be most helpful in determining whether a 67-year-old
patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)?
a. Bladder distention
b. Foul-smelling urine
c. Suprapubic discomfort
d. Costovertebral tenderness ANSWERS-ANS: D
Costovertebral tenderness is characteristic of pyelonephritis. Bladder distention, foul-
smelling urine, and suprapubic discomfort are characteristic of lower UTI and are likely
to be present if the patient also has an upper UTI.
The nurse determines that further instruction is needed for a patient with interstitial
cystitis when the patient says which of the following?
a. "I should stop having coffee and orange juice for breakfast."
b. "I will buy calcium glycerophosphate (Prelief) at the pharmacy."
c. "I will start taking high potency multiple vitamins every morning."
d. "I should call the doctor about increased bladder pain or odorous urine." ANSWERS-
ANS: C
High-potency multiple vitamins may irritate the bladder and increase symptoms. The
other patient statements indicate good understanding of the teaching.
It is most important that the nurse ask a patient admitted with acute glomerulonephritis
about
a. history of kidney stones.
b. recent sore throat and fever.
c. history of high blood pressure.
d. frequency of bladder infections. ANSWERS-ANS: 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).
Which finding for a patient admitted with glomerulonephritis indicates to the nurse that
treatment has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. The antistreptolysin-O (ASO) titer is decreased.
d. The periorbital and peripheral edema is resolved. ANSWERS-ANS: D
Because edema is a common clinical manifestation of glomerulonephritis, resolution of
the edema indicates that the prescribed therapies have been effective. Nitrites will be
negative and the patient will not experience dysuria because the patient does not have
a urinary tract infection. Antibodies to streptococcus will persist after a streptococcal
infection.
The nurse will anticipate teaching a patient with nephrotic syndrome who develops flank
pain about treatment with
a. antibiotics.
b. antifungals.
