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Exam (elaborations) NEW MEXICO STATE UNIVERSITY NURS 515. Chapter 11. Genitourinary System(Rationale at the bottom pages)

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Chapter 11. Genitourinary System Multiple Choice Identify the choice that best completes the statement or answers the question. When performing a dipstick test on a patient’s urine sample, a positive leukocyte esterase and nitrite is indicative of: An intravenous pyelogram should not be performed if serum creatinine is: Your 55-year-old male patient presents to the emergency department with complaints of sudden development of severe right-sided, colicky lower abdominal pain. He cannot sit still on the examining table. The patient has previously been in good health. On physical examination, there are no signs of peritoneal inflammation. A urine sample reveals hematuria and crystalluria. Which is the next diagnostic test that should be done immediately? The most common complication of an untreated urinary obstruction due to a ureteral calculus is: A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is: On a physical examination for employment, a 45-year-old male shows no significant findings and takes no medications. Past medical history and surgery are unremarkable. On urinalysis, hematuria is present. The urinalysis is repeated on another day and still reveals microscopic hematuria. It is important to recognize that painless hematuria can be diagnostic of: On DRE, you note that a 45-year-old patient has a firm, smooth, non-tender but asymmetrically shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient’s PSA is within normal limits for the patient’s age. The clinician should: Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started, and nocturnal frequency of urination that is bothersome. On DRE, there is an enlarged, firm, non- tender, smooth prostate. The clinician should recognize these as symptoms of: Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream. On DRE, there is a hard, nodular, enlarged, non-tender prostate. The clinician should recognize these as symptoms of: A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy, swollen prostate. The clinician should recognize these as signs of: Your 24-year-old female patient complains of dysuria as well as frequency and urgency of urination that develops the day after she uses her diaphragm. Urine culture reveals a bacterial count of 100 CFU/mL. These signs and symptoms indicate: An 18-year-old female patient presents with repeated urinary tract infections. She has no risk factors in her history, and her physical examination is unremarkable. She also has a normal pelvic exam. Which of the following should be obtained if anatomic abnormalities are suspected? A 33-year-old female patient visits the clinic multiple times over the last year complaining of dysuria, frequency, urgency, suprapubic pain, and dyspareunia. Her physical examination, including a pelvic exam, is normal. Urinalysis and urine culture is repeatedly negative. Her intravenous pyelogram is also normal. The clinician should recognize that this presentation is consistent with symptoms of: A 65-year-old male patient complains of frequency, urgency, hesitancy, and weak urine stream. Physical examination is unremarkable except DRE reveals an enlarged, firm, non-tender prostate gland. Urine culture reveals 100 bacteria CFU/mL. The clinician should suspect: An important sign that indicates nerve compression at the cauda equina section of the spinal cord is: A 77-year-old female patient with heart failure complains of frequency and urgency of urination during the day and nocturia of 2 to 3 times a night. Which of the following medications can cause these symptoms? A 15-year-old female patient presents with complaints of constant thirst, urination up to 20 times a day, and recent unintentional weight loss of 10 pounds over the last month. It is important for the clinician to recognize these symptoms as those of: What it the normal capacity of the urinary bladder? Which of the following disorders can cause urinary incontinence? A major reason for the atrophic changes that occur in the pelvic floor muscles of the elderly woman is:

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Chapter 11. Genitourinary System

Multiple Choice
Identify the choice that best completes the statement or answers the question.

1. When performing a dipstick test on a patient’s urine sample, a positive leukocyte esterase and
nitrite is indicative of:
A. Microscopic hematuria
B. Urinary tract infection
C. Calculi in the urine
D. Possible bladder tumor
2. An intravenous pyelogram should not be performed if serum creatinine is:
A. Less than 1.5
B. Greater than 1.0
C. Greater than 1.6
D. Less than 1.0

3. Your 55-year-old male patient presents to the emergency department with complaints of sudden
development of severe right-sided, colicky lower abdominal pain. He cannot sit still on the
examining table. The patient has previously been in good health. On physical examination, there
are no signs of peritoneal inflammation. A urine sample reveals hematuria and crystalluria. Which
is the next diagnostic test that should be done immediately?
A. Ultrasound of the abdomen
B. Abdominal x-ray
C. Digital rectal examination
D. Spiral CT scan

4. The most common complication of an untreated urinary obstruction due to a ureteral calculus is:
A. Hydronephrosis
B. Renal artery stenosis
C. Ureteral rupture
D. Kidney mass

5. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right
costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is
102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most
likely condition is:
A. Lower urinary tract infection
B. Pyelonephritis
C. Nephrolithiasis
D. Hydronephrosis




T his study source was downloaded by 100000839287192 from CourseHero.com on 04 -29-2022 09:25:03 GMT -05:00


https://www.coursehero.com/file/24626339/c11rtf/

, 6. On a physical examination for employment, a 45-year-old male shows no significant findings and
takes no medications. Past medical history and surgery are unremarkable. On urinalysis, hematuria
is present. The urinalysis is repeated on another day and still reveals microscopic hematuria. It is
important to recognize that painless hematuria can be diagnostic of:
A. Urinary tract infection
B. Bladder cancer
C. Nephrolithiasis
D. Pyelonephritis
7. On DRE, you note that a 45- year-old patient has a firm, smooth, non-tender but asymmetrically
shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient’s PSA is
within normal limits for the patient’s age. The clinician should:
A. Refer the patient for transrectal ultrasound guided prostate biopsy
B. Obtain an abdominal x-ray of kidneys, ureter, and bladder
C. Recognize this as a normal finding that requires periodic follow-up
D. Obtain urine culture and sensitivity for prostatitis

8. Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started,
and nocturnal frequency of urination that is bothersome. On DRE, there is an enlarged, firm, non-
tender, smooth prostate. The clinician should recognize these as symptoms of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia

9. Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream. On
DRE, there is a hard, nodular, enlarged, non-tender prostate. The clinician should recognize these
as symptoms of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia

10. A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as
urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy,
swollen prostate. The clinician should recognize these as signs of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia
11. Your 24-year-old female patient complains of dysuria as well as frequency and urgency of
urination that develops the day after she uses her diaphragm. Urine culture reveals a bacterial
count of 100 CFU/mL. These signs and symptoms indicate:
A. Upper urinary tract infection
B. Lower urinary tract infection
C. Normal bacteriuria


T his study source was downloaded by 100000839287192 from CourseHero.com on 04 -29-2022 09:25:03 GMT -05:00


https://www.coursehero.com/file/24626339/c11rtf/

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