NUR 224- Pre-lecture Quiz on Renal and Endocrine System Exam Questions and Answers New Update 2022/2023

Renal System • A 55-year old client with benign prostatic hyperplasia doesn’t respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, nurse Gail asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal? a. Transurethral resection of the prostate (TURP) b. Suprapubic prostatectomy c. Retropubic prostatectomy d. Transurethral laser incision of the prostate Rationale: TURP is the most widely used procedure for prostate gland removal. Because it requires no incision, TURP is especially suitable for men with relatively minor prostatic enlargements and for those who are poor surgical risks. Suprapubic prostatectomy, retropubic prostatectomy, and transurethral laser incision of the prostate are less common procedures; they all require an incision. • A female client with suspected renal dysfunction is scheduled for excretory urography. Nurse July reviews the history for conditions that may warrant changes in client preparation. Normally, a client should be mildly hypovolemic (fluid depleted) before excretory urography. Which history finding would call for the client to be well hydrated instead? a. Cystic fibrosis b. Multiple myeloma c. Gout d. Myasthenia gravis Rationale: Fluid depletion before excretory urography is contraindicated in clients with multiple myeloma, severe diabetes mellitus, and uric acid nephropathy — conditions that can seriously compromise renal function in fluid-depleted clients with reduced renal perfusion. If these clients must undergo excretory urography, they should be well hydrated before the test. Cystic fibrosis, gout, and myasthenia gravis don't necessitate changes in client preparation for excretory urography. • Nurse Kim is caring for a client who had a cerebrovascular accident (CVA). Which nursing intervention promotes urinary continence? a. Encouraging intake of at least 2 L of fluid daily b. Giving the client a glass of soda before bedtime c. Taking the client to the bathroom twice per day d. Consulting with a dietitian Rationale: By encouraging a daily fluid intake of at least 2 L, the nurse helps fill the client's bladder, thereby promoting bladder retraining by stimulating the urge to void. The nurse shouldn't give the client soda before bedtime; soda acts as a diuretic and may make the client incontinent. The nurse should take the client to the bathroom or offer the bedpan at least every 2 hours throughout the day; twice per day is insufficient. Consultation with a dietitian won't address the problem of urinary incontinence. • When examining a female client’s genitourinary system, nurse Sally assesses for tenderness at the costovertebral angle by placing the left hand over this area and striking it with the right fist. Normally, this percussion technique produces which sound? a. A flat sound b. A dull sound c. Hyperresonance d. Tympany Rationale: Percussion over the costovertebral angle normally produces a dull, thudding sound, which is soft to moderately loud with a moderate pitch and duration. This sound occurs over less dense, mostly fluid-filled matter, such as the kidneys, liver, and spleen. In contrast, a flat sound occurs over highly dense matter such as muscle; hyperresonance occurs over the air-filled, overinflated lungs of a client with pulmonary emphysema or the lungs of a child (because of a thin chest wall); and tympany occurs over enclosed structures containing air, such as the stomach and bowel. • A male client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should nurse Olivia assess first? a. Blood pressure b. Respirations c. Temperature d. Pulse Rationale: An elevated serum potassium level may lead to a life-threatening cardiac arrhythmia, which the nurse can detect immediately by palpating the pulse. The client's blood pressure may change, but only as a result of the arrhythmia. Therefore, the nurse should assess blood pressure later. The nurse also can delay assessing respirations and temperature because these aren't affected by the serum potassium level. • Nurse Hazel is ware that the following is an appropriate nursing diagnosis for a client with renal calculi? a. Ineffective tissue perfusion b. Functional urinary incontinence c. Risk for infection d. Decreased cardiac output Rationale: Infection can occur with renal calculi from urine stasis caused by obstruction. Options A and D aren't appropriate for this diagnosis, and retention of urine usually occurs, rather than incontinence. • After having transurethral resection of the prostate (TURP), a Mr. Locke returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client’s catheter is occluded? a. The urine in the drainage bag appears red to pink. b. The client reports bladder spasms and the urge to void. c. The normal saline irrigant is infusing at a rate of 50 drops/minute. d. About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned. Rationale: Reports of bladder spasms and the urge to void suggest that a blood clot may be occluding the catheter. After TURP, urine normally appears red to pink, and normal saline irrigant usually is infused at a rate of 40 to 60 drops/minute or according to facility protocol. The amount of returned fluid (1,200 ml) should correspond to the amount of instilled fluid, plus the client's urine output (1,000 ml + 200 ml), which reflects catheter patency. • Nurse Myrna is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to: a. initiate a stream of urine. b. breathe deeply. c. turn to the side. d. hold the labia or shaft of penis. Rationale: When inserting a urinary catheter, facilitate insertion by asking the client to breathe deeply. Doing this will relax the urinary sphincter. Initiating a stream of urine isn't recommended during catheter insertion. Turning to the side or holding the labia or penis won't ease insertion, and doing so may contaminate the sterile field. • A female adult client admitted with a