NURS 363 FINAL EXAM QUESTIONS
WITH COMPLETE ANSWERS
structures uuof uuthe uurenal uusystem uu- uuAnswer uuKidneys
Nephrons
Ureters
Bladder
Urethra
Male uuprostate
kidney uuurine uuformation uu- uuAnswer uuGlomerular uufiltration
Tubular uureabsorption uuand uutubular uusecretion
kidney uuregulation uufunctions uu- uuAnswer uuOsmolarity uuand uuwater
uuexcretion
Electrolyte uuand uuacid/base uubalance
Blood uupressure uu(RAA uusystem)
RBC uuproduction uu(erythropoietin)
Vitamin uuD uusynthesis
Secretion uuof uuprostaglandin
Waste uuexcretion: uuend uuproducts uuof uumetabolism, uubacterial uutoxins,
uuwater-soluble uudrugs, uuand uudrug uumetabolites
Urine uustorage uu(bladder) uuand uuemptying
chief uucomplaint uu- uuAnswer uureason uufor uuseeking uucare, uuonset uuof
uuproblem, uueffect uuon uuQOL, uuassociated uuwith uufever/chills
enuresis uu- uuAnswer uubed uuwetting
renal uuphysical uuassessment uu- uuAnswer uuInspect, uuauscultate, uupercuss,
uuand uupalpitate
Areas uuof uuemphasis: uuabdomen, uusuprapubic uuregion, uugenitalia, uulower
uuback, uulower uuextremities
Kidneys uunot uuusually uupalpable
Renal uudysfunction uumay uuproduce uutenderness uuat uuthe uuCVA
Percussion uuof uuthe uubladder: uudullness uu= uuincomplete uuemptying
Edema: uufluid uuretention uu(1# uu= uu500mL)
DTRs uuand uugait: uuquality uuand uusymmetry, uusame uuperipheral uunerves
,CVA uu- uuAnswer uucostovertebral uuangle
urinalysis uuand uuurine uuculture uu- uuAnswer uuWBCs uuand uunitrates uu=
uuinfection. uuUrine uuC/S
renal uufunction uutests uu- uuAnswer uuSpecific uugravity uu(1.010-1.025)
24-hour uuurine uutest uu(aka uucreatinine uuclearance) uu*gold uustandard*
serum uurenal uutests uu- uuAnswer uuCreatinine uulevel
BUN
BUN uu: uucreatinine uuratio: uu10:1 uuand uu20:1. uuIncreases uusuggest
uudecrease uublood uuflow uu(i.e. uudehydration, uuCHF)
urine uucollection uuclean uucatch uu(midstream) uu- uuAnswer uuMale: uuvoid
uudirectly uuinto uucontainer; uufemales: uuhold uucontainer uubetween uulegs
Wash uugenitals uuand uuperineal uuarea uuwith uusoap uuand uuwater
Female uuclients: uufront uuto uuback, uuuse uueach uutowelette uuonce uu(3)
Male uuclients: uuclean uumeatus uuand uuhead uuof uupenis uuwith uucircular
uumotion, uuuse uueach uutowelette uuonce uu(3)
Instruct uuclient uuto uubeing uuvoiding, uuthen uuplace uuspecimen uucontainer
uuin uustream uuof uuurine; uucollect uu30-60mL uuof uuurine
24-hour uuurine uucollection uu- uuAnswer uuObtain uuspecimen uucontainer uuwith
uupreservative uu(lab)
Provide uuclean uureceptacle uuto uucollect uuurine uu(unless uuindwelling uuurinary
uucatheter)
Post uusigns uuin uuclient's uuroom, uuon uuchart, uuand uuin uubathroom
Have uuclient uuvoid uuand uudiscard uuthis uuurine uuat uuthe uubeginning uuof
uuthe uucollection uuperiod. uuDuring uucollection uuperiod, uusave uuall uuurine
uuin uucontainer. uuPlace uuon uuice uuand uudo uunot uucontaminate. uuInstruct
uuclient uuto uuempty uubladder uuat uuend uuof uucollection uuperiod uuand uusave
uuthis uuurine
KUB uu- uuAnswer uukidney-ureter-bladder uuradiograph uu(x-ray)
IVP uu- uuAnswer uuintravenous uupyelography uuwith uux-ray uuof uukidney uuand
uuurinary uutract uuafter uucontrast. uuUses uucontrast
cytography uu- uuAnswer uuuses uua uunuclear uutracer uuto uuassess uufor
uubladder uuinjury
renal uuangiography uu- uuAnswer uurenal uublood uuvessels uuare uuviewed;
uurenal uublood uuflow, uupre uuop uufor uurenal uutransplant, uuuses uucontrast.
uuPost uuprocedure uucare
,renal uudiagnostic uuimaging uu- uuAnswer uuKUB: uukidney-ureter-bladder
uuradiograph uu(x-ray)
US: uuultrasound uu- uuhigh uufrequency uusound uuwaves uuthrough uubody
uuand uureflect
Bladder uuscanning: uuradionuclide uuis uuinjected uuand uuobserved uupassing
CT: uugenerate uua uu3D, uucomputerized uuimage uuof uuthe uukidney
MRI: uumagnetic uuenergy uuthrough uubody
IVP: uuintravenous uupyelography uuwith uux-ray uuof uukidney uuand uuurinary
uutract uuafter uucontrast. uuUses uucontrast
Cyctography: uuuses uua uunuclear uutracer uuto uuassess uufor uubladder uuinjury
Renal uuangiography: uurenal uublood uuvessels uuare uuviewed; uurenal uublood
uuflow, uupre uuop uufor uurenal uutransplant, uuuses uucontrast. uuPost
uuprocedure uucare
urinary uuretention uu- uuAnswer uuDefinition: uuinadequate uubladder uuemptying
uu- uustasis uumay uuresult uuin uuinfection. uuUTIs uuvery uucommon
Causes: uuage, uuDM, uuprostate uuenlargement, uupregnancy, uumeds
Residual uuurine
Remains uuin uuthe uubladder uuafter uuvoiding
Can uuresult uuin uuoverflow uuincontinence
Result: uu*urinary uustasis uu→ uubacterial uugrowth
If uuuntreated: uu*UTI uuand uustone uuformation/bladder uustones
Nursing uuassessments
Nursing uuhistory
Q&A uu- uus/sx
Inspection, uupercussion, uupalpation
etiology uuof uuurinary uuretention uu- uuAnswer uuDetrusor uufunction uudeficit:
uusmooth uumuscle uufound uuin uuwall uuof uubladder uurelaxes uuand uucontracts
uuwith uuurination
Obstruction uuat uuor uubelow uubladder uuoutlet
Benign uuprostate uuhyperplasia uu(BPH): uuurine uuretention uuwhen uuhigh
uuurethral uupressure uuexceeds uubladder uupressure uuand uuprevents
uumicturition. uuKey uusymptom uuif uuacute uusuprapubic uupain
Urethral uustricture uuor uudistortion
Calculi
Fecal uuimpaction
Prostate uucarcinoma
Meds: uuanesthetics, uuopioids, uuanticholinergics, uuantidepressants... uu7 uuanti's
urinary uuretention uuinterventions uu- uuAnswer uuPrivacy
Normal uusitting uuor uustanding uuposition: uugravity uuto uuassist
Bedside uucommode uuor uutoilet: uugravity uuto uuassist
Warm uusitz
Faucet/warm uuwater
Analgesia uuafter uusurgical uuintervention
, Catheterization
*Evaluate uuoutcomes: uuspontaneous uuvoiding uuwith uucomplete uuemptying,
uuneg uuurine uuCX uuand uuno uus/sx uuof uuUTI, uuproper uuhygiene uuand
uunormal uuvoid uupatterns
urinary uuincontinence uu- uuAnswer uuDescription: uuinvoluntary uuloss uuof
uuurine
Causes: uuneurogenic uuor uucognitive
Treatments
Simple: uubehavioral
Complex
Neuromodulation: uustimulator uuthat uunormalizes uucommunication uubetween
uuthe uubrain uuand uubladder
stress uuincontinence uu- uuAnswer uuinvoluntary uuloss uuof uuurine uu(LOU)
uuthrough uuan uuintact uuurethra uuas uua uuresult uuof uusneezing, uucoughing,
uuor uulaughing
urge uuincontinence uu- uuAnswer uuinvoluntary uuLOU uuassociated uuwith uua
uustrong uuurge uuto uuvoid uuthat uucannot uube uusuppressed. uuNeed uuto
uuvoid uubut uuunable uuto uureach uuthe uutoilet. uuBladder uucontracts uuwhen
uuit uushould uunot. uuBladder uuspasms, uuoveractive uubladder
functional uuincontinence uu- uuAnswer uuinstances uuin uuwhich uulower uuurinary
uutract uufunction uuis uuintact uubut uuother uufactors, uucognitive, uumake uuit
uudifficult. uuMental uureasons uufor uugetting uuto uuthe uubathroom
iatrogenic uuincontinence uu- uuAnswer uuinvoluntary uuLOU uud/t uuextrinsic
uumedical uufactors, uuprimary uumedications uu(alpha-adrenergic uuagents)
mixed uuincontinence uu- uuAnswer uuencompasses uuseveral uutypes uuof
uuurinary uuincontinence, uuis uuinvoluntary uuleakage uuassociated uuwith
uuurgency uuand uualso uuexertion, uusneeze, uucough
urinary uuincontinence uunursing uuinterventions uu- uuAnswer uuTreat uuunderlying
uucause
Promote uubehavioral uutherapy
Kegel uuexercises
Voiding uudiary
Prompted uuvoiding
Habit uuretraining
Bladder uuretraining
Administer uumeds uuas uuordered: uuanticholinergics uuinhibit uubladder
uucontraction uuand/or uuantispasmodics
WITH COMPLETE ANSWERS
structures uuof uuthe uurenal uusystem uu- uuAnswer uuKidneys
Nephrons
Ureters
Bladder
Urethra
Male uuprostate
kidney uuurine uuformation uu- uuAnswer uuGlomerular uufiltration
Tubular uureabsorption uuand uutubular uusecretion
kidney uuregulation uufunctions uu- uuAnswer uuOsmolarity uuand uuwater
uuexcretion
Electrolyte uuand uuacid/base uubalance
Blood uupressure uu(RAA uusystem)
RBC uuproduction uu(erythropoietin)
Vitamin uuD uusynthesis
Secretion uuof uuprostaglandin
Waste uuexcretion: uuend uuproducts uuof uumetabolism, uubacterial uutoxins,
uuwater-soluble uudrugs, uuand uudrug uumetabolites
Urine uustorage uu(bladder) uuand uuemptying
chief uucomplaint uu- uuAnswer uureason uufor uuseeking uucare, uuonset uuof
uuproblem, uueffect uuon uuQOL, uuassociated uuwith uufever/chills
enuresis uu- uuAnswer uubed uuwetting
renal uuphysical uuassessment uu- uuAnswer uuInspect, uuauscultate, uupercuss,
uuand uupalpitate
Areas uuof uuemphasis: uuabdomen, uusuprapubic uuregion, uugenitalia, uulower
uuback, uulower uuextremities
Kidneys uunot uuusually uupalpable
Renal uudysfunction uumay uuproduce uutenderness uuat uuthe uuCVA
Percussion uuof uuthe uubladder: uudullness uu= uuincomplete uuemptying
Edema: uufluid uuretention uu(1# uu= uu500mL)
DTRs uuand uugait: uuquality uuand uusymmetry, uusame uuperipheral uunerves
,CVA uu- uuAnswer uucostovertebral uuangle
urinalysis uuand uuurine uuculture uu- uuAnswer uuWBCs uuand uunitrates uu=
uuinfection. uuUrine uuC/S
renal uufunction uutests uu- uuAnswer uuSpecific uugravity uu(1.010-1.025)
24-hour uuurine uutest uu(aka uucreatinine uuclearance) uu*gold uustandard*
serum uurenal uutests uu- uuAnswer uuCreatinine uulevel
BUN
BUN uu: uucreatinine uuratio: uu10:1 uuand uu20:1. uuIncreases uusuggest
uudecrease uublood uuflow uu(i.e. uudehydration, uuCHF)
urine uucollection uuclean uucatch uu(midstream) uu- uuAnswer uuMale: uuvoid
uudirectly uuinto uucontainer; uufemales: uuhold uucontainer uubetween uulegs
Wash uugenitals uuand uuperineal uuarea uuwith uusoap uuand uuwater
Female uuclients: uufront uuto uuback, uuuse uueach uutowelette uuonce uu(3)
Male uuclients: uuclean uumeatus uuand uuhead uuof uupenis uuwith uucircular
uumotion, uuuse uueach uutowelette uuonce uu(3)
Instruct uuclient uuto uubeing uuvoiding, uuthen uuplace uuspecimen uucontainer
uuin uustream uuof uuurine; uucollect uu30-60mL uuof uuurine
24-hour uuurine uucollection uu- uuAnswer uuObtain uuspecimen uucontainer uuwith
uupreservative uu(lab)
Provide uuclean uureceptacle uuto uucollect uuurine uu(unless uuindwelling uuurinary
uucatheter)
Post uusigns uuin uuclient's uuroom, uuon uuchart, uuand uuin uubathroom
Have uuclient uuvoid uuand uudiscard uuthis uuurine uuat uuthe uubeginning uuof
uuthe uucollection uuperiod. uuDuring uucollection uuperiod, uusave uuall uuurine
uuin uucontainer. uuPlace uuon uuice uuand uudo uunot uucontaminate. uuInstruct
uuclient uuto uuempty uubladder uuat uuend uuof uucollection uuperiod uuand uusave
uuthis uuurine
KUB uu- uuAnswer uukidney-ureter-bladder uuradiograph uu(x-ray)
IVP uu- uuAnswer uuintravenous uupyelography uuwith uux-ray uuof uukidney uuand
uuurinary uutract uuafter uucontrast. uuUses uucontrast
cytography uu- uuAnswer uuuses uua uunuclear uutracer uuto uuassess uufor
uubladder uuinjury
renal uuangiography uu- uuAnswer uurenal uublood uuvessels uuare uuviewed;
uurenal uublood uuflow, uupre uuop uufor uurenal uutransplant, uuuses uucontrast.
uuPost uuprocedure uucare
,renal uudiagnostic uuimaging uu- uuAnswer uuKUB: uukidney-ureter-bladder
uuradiograph uu(x-ray)
US: uuultrasound uu- uuhigh uufrequency uusound uuwaves uuthrough uubody
uuand uureflect
Bladder uuscanning: uuradionuclide uuis uuinjected uuand uuobserved uupassing
CT: uugenerate uua uu3D, uucomputerized uuimage uuof uuthe uukidney
MRI: uumagnetic uuenergy uuthrough uubody
IVP: uuintravenous uupyelography uuwith uux-ray uuof uukidney uuand uuurinary
uutract uuafter uucontrast. uuUses uucontrast
Cyctography: uuuses uua uunuclear uutracer uuto uuassess uufor uubladder uuinjury
Renal uuangiography: uurenal uublood uuvessels uuare uuviewed; uurenal uublood
uuflow, uupre uuop uufor uurenal uutransplant, uuuses uucontrast. uuPost
uuprocedure uucare
urinary uuretention uu- uuAnswer uuDefinition: uuinadequate uubladder uuemptying
uu- uustasis uumay uuresult uuin uuinfection. uuUTIs uuvery uucommon
Causes: uuage, uuDM, uuprostate uuenlargement, uupregnancy, uumeds
Residual uuurine
Remains uuin uuthe uubladder uuafter uuvoiding
Can uuresult uuin uuoverflow uuincontinence
Result: uu*urinary uustasis uu→ uubacterial uugrowth
If uuuntreated: uu*UTI uuand uustone uuformation/bladder uustones
Nursing uuassessments
Nursing uuhistory
Q&A uu- uus/sx
Inspection, uupercussion, uupalpation
etiology uuof uuurinary uuretention uu- uuAnswer uuDetrusor uufunction uudeficit:
uusmooth uumuscle uufound uuin uuwall uuof uubladder uurelaxes uuand uucontracts
uuwith uuurination
Obstruction uuat uuor uubelow uubladder uuoutlet
Benign uuprostate uuhyperplasia uu(BPH): uuurine uuretention uuwhen uuhigh
uuurethral uupressure uuexceeds uubladder uupressure uuand uuprevents
uumicturition. uuKey uusymptom uuif uuacute uusuprapubic uupain
Urethral uustricture uuor uudistortion
Calculi
Fecal uuimpaction
Prostate uucarcinoma
Meds: uuanesthetics, uuopioids, uuanticholinergics, uuantidepressants... uu7 uuanti's
urinary uuretention uuinterventions uu- uuAnswer uuPrivacy
Normal uusitting uuor uustanding uuposition: uugravity uuto uuassist
Bedside uucommode uuor uutoilet: uugravity uuto uuassist
Warm uusitz
Faucet/warm uuwater
Analgesia uuafter uusurgical uuintervention
, Catheterization
*Evaluate uuoutcomes: uuspontaneous uuvoiding uuwith uucomplete uuemptying,
uuneg uuurine uuCX uuand uuno uus/sx uuof uuUTI, uuproper uuhygiene uuand
uunormal uuvoid uupatterns
urinary uuincontinence uu- uuAnswer uuDescription: uuinvoluntary uuloss uuof
uuurine
Causes: uuneurogenic uuor uucognitive
Treatments
Simple: uubehavioral
Complex
Neuromodulation: uustimulator uuthat uunormalizes uucommunication uubetween
uuthe uubrain uuand uubladder
stress uuincontinence uu- uuAnswer uuinvoluntary uuloss uuof uuurine uu(LOU)
uuthrough uuan uuintact uuurethra uuas uua uuresult uuof uusneezing, uucoughing,
uuor uulaughing
urge uuincontinence uu- uuAnswer uuinvoluntary uuLOU uuassociated uuwith uua
uustrong uuurge uuto uuvoid uuthat uucannot uube uusuppressed. uuNeed uuto
uuvoid uubut uuunable uuto uureach uuthe uutoilet. uuBladder uucontracts uuwhen
uuit uushould uunot. uuBladder uuspasms, uuoveractive uubladder
functional uuincontinence uu- uuAnswer uuinstances uuin uuwhich uulower uuurinary
uutract uufunction uuis uuintact uubut uuother uufactors, uucognitive, uumake uuit
uudifficult. uuMental uureasons uufor uugetting uuto uuthe uubathroom
iatrogenic uuincontinence uu- uuAnswer uuinvoluntary uuLOU uud/t uuextrinsic
uumedical uufactors, uuprimary uumedications uu(alpha-adrenergic uuagents)
mixed uuincontinence uu- uuAnswer uuencompasses uuseveral uutypes uuof
uuurinary uuincontinence, uuis uuinvoluntary uuleakage uuassociated uuwith
uuurgency uuand uualso uuexertion, uusneeze, uucough
urinary uuincontinence uunursing uuinterventions uu- uuAnswer uuTreat uuunderlying
uucause
Promote uubehavioral uutherapy
Kegel uuexercises
Voiding uudiary
Prompted uuvoiding
Habit uuretraining
Bladder uuretraining
Administer uumeds uuas uuordered: uuanticholinergics uuinhibit uubladder
uucontraction uuand/or uuantispasmodics
