Adult Health Exam 4-Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines Review Questions & Answers latest 2020
1.	A female patient has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this patient?
A.	Bathe daily and keep the perineal region clean.
B.	Avoid voiding immediately after sexual intercourse.
C.	Drink liberal amounts of fluids.
D.	Void at least every 6 to 8 hours.
2.	A 42-year-old woman comes to the clinic complaining of occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence?
A.	Stress incontinence
B.	Reflex incontinence
C.	Overflow incontinence
D.	Functional incontinence
3.	A nurse is caring for a female patient whose urinary retention has not responded to conservative treatment. When educating this patient about self-catheterization, the nurse should encourage what practice?
A.	Assuming a supine position for self-catheterization
B.	Using clean technique at home to catheterize
C.	Inserting the catheter 1 to 2 inches into the urethra
D.	Self-catheterizing every 2 hours at home
4.	A 52-year-old patient is scheduled to undergo ileal conduit surgery. When planning this patients discharge education, what is the most plausible nursing diagnosis that the nurse should address?
A.	Impaired mobility related to limitations posed by the ileal conduit
B.	Deficient knowledge related to care of the ileal conduit
C.	Risk for deficient fluid volume related to urinary diversion
D.	Risk for autonomic dysreflexia related to disruption of the sacral plexus
5.	The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patients health education, what nutritional guidelines should the nurse provide?
A.	Restrict protein intake as ordered.
B.	Increase intake of potassium-rich foods.
C.	Follow a low-calcium diet.
D.	Encourage intake of food containing oxalates.
6.	The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. What instruction should the nurse give the patient?
A.	Limit oral fluid intake for 1 to 2 days.
B.	Report the presence of fine, sand like particles through the nephrostomy tube.
C.	Notify the physician about cloudy or foul-smelling urine.
D.	Report any pink-tinged urine within 24 hours after the procedure.
7.	A female patients most recent urinalysis results are suggestive of bacteriuria. When assessing this patient, the nurses data analysis should be informed by what principle?
A.	Most UTIs in female patients are caused by viruses and do not cause obvious symptoms.
B.	A diagnosis of bacteriuria requires three consecutive positive results.
C.	Urine contains varying levels of healthy bacterial flora.
D.	Urine samples are frequently contaminated by bacteria normally present in the urethral area.
8.	The clinic nurse is preparing a plan of care for a patient with a history of stress incontinence. What role will the nurse have in implementing a behavioral therapy approach?
A.	Provide medication teaching related to pseudoephedrine sulfate.
B.	Teach the patient to perform pelvic floor muscle exercises.
C.	Prepare the patient for an anterior vaginal repair procedure.
D.	Provide information on periurethral bulking.
9.	The nurse and urologist have both been unsuccessful in catheterizing a patient with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the physician using to drain the patients bladder?
A.	Insertion of a suprapubic catheter
B.	Scheduling the patient immediately for a prostatectomy
C.	Application of warm compresses to the perineum to assist with relaxation
D.	Medication administration to relax the bladder muscles and reattempting catheterization in 6hrs
10.	 The nurse has implemented a bladder retraining program for an older adult patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient typically has approximately 50 mL of urine remaining in her bladder after voiding. What would be the nurses best response to this finding?
A.	Perform a straight catheterization on this patient.
B.	Avoid further interventions at this time, as this is an acceptable finding.
C.	Place an indwelling urinary catheter.
D.	Press on the patients bladder in an attempt to encourage complete emptying
11.	The nurse is caring for a patient recently diagnosed with renal calculi. The nurse should instruct the patient to increase fluid intake to a level where the patient produces at least how much urine each day?
A.	1,250 mL
B.	2,000 mL
C.	2,750 mL
D.	3,500 mL
12.	A patient with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The nurse is monitoring the patients urine output hourly and notifies the physician when the hourly output is less than what?
A.	30 mL
B.	50 mL
C.	100 mL
D.	125 mL
13.	The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a patient with an indwelling catheter?
A.	Vigorously clean the meatus area daily.
B.	Apply powder to the perineal area twice daily.
C.	Empty the drainage bag at least every 8 hours.
D.	Irrigate the catheter every 8 hours with normal saline.
14.	The nurse is teaching a health class about UTIs to a group of older adults. What characteristic of UTIs should the nurse cite?
A.	Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic.
B.	The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group.
C.	Men of all ages are less prone to UTIs, but typically experience more severe symptoms.
D.	The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.
15.	A patient has been admitted to the postsurgical unit following the creation of an ileal conduit. What should the nurse measure to determine the size of the appliance needed?
A.	The circumference of the stoma
B.	The narrowest part of the stoma
C.	The widest part of the stoma
D.	Half the width of the stoma
16.	A patient being treated in the hospital has been experiencing occasional urinary retention. What nursing action should the nurse take to encourage a patient who is having difficulty voiding?
A.	Use a slipper bedpan.
B.	Apply a cold compress to the perineum.
C.	Have the patient lie in a supine position.
D.	Provide privacy for the patient.
17.	A nurses colleague has applied an incontinence pad to an older adult patient who has experienced occasional episodes of functional incontinence. What principle should guide the nurses management of urinary incontinence in older adults?
A.	Diuretics should be promptly discontinued when an older adult experiences incontinence.
B.	Restricting fluid intake is recommended for older adults experiencing incontinence.
C.	Urinary catheterization is a first-line treatment for incontinence in older adults with incontinence.
D.	Urinary incontinence is not considered a normal consequence of aging.
18.	The nurse is working with a patient who has been experiencing episodes of urinary retention. What assessment finding would suggest that the patient is experiencing retention?
A.	The patients suprapubic region is dull on percussion.
B.	The patient is uncharacteristically drowsy.
C.	The patient claims to void large amounts of urine 2 to 3 times daily.
D.	The patient takes a beta adrenergic blocker for the treatment of hypertension.
19.	A patient with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the patients post-procedure care?
A.	Strain the patients urine following the procedure.
B.	Administer a bolus of 500 mL normal saline following the procedure.
C.	Monitor the patient for fluid overload following the procedure.
D.	Insert a urinary catheter for 24 to 48 hours after the procedure.
20.	The nurse is caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurses assessment reveals that the stoma is a dark purplish color. What is the nurses most appropriate response?
A.	Document the presence of a healthy stoma.
B.	Assess the patient for further signs and symptoms of infection.
C.	Inform the primary care provider that the vascular supply may be compromised.
D.	Liaise with the wound-ostomy-continence (WOC) nurse because the ostomy appliance around the stoma may be too loose.