Med Surg I Exam 6 ACTUAL UPDATED
QUESTIONS AND CORRECT ANSWERS
*When a patient's urine dipstick test indicates a small amount of protein, the nurse's next
action should be to
a. send a urine specimen to the laboratory to test for ketones.
b. obtain a clean-catch urine for culture and sensitivity testing.
c. inquire about which medications the patient is currently taking.
d. ask the patient about any family history of chronic renal failure. - CORRECT
ANSWERS✅✅ANS: C
Normally the urinalysis will show zero to trace amounts of protein, but some medications
may give false-positive readings. The other actions by the nurse may be appropriate, but
checking for medications that may affect the dipstick accuracy should be done first
*Which medication taken at home by a 47-year-old patient with decreased renal function will
be of most concern to the nurse?
a. ibuprofen (Motrin)
b. warfarin (Coumadin)
c. folic acid (vitamin B9)
d. penicillin (Bicillin LA) - CORRECT ANSWERS✅✅ANS: A
The nonsteroidal antiinflammatory medications (NSAIDs) are nephrotoxic and should be
avoided in patients with impaired renal function. The nurse also should ask about reasons the
patient is taking the other medications, but the medication of most concern is the ibuprofen.
*How will the nurse assess for flank tenderness in a 30-year-old female patient with
suspected pyelonephritis?
a. Palpate along both sides of the lumbar vertebral column.
b. Strike a flat hand covering the costovertebral angle (CVA).
c. Push fingers upward into the two lowest intercostal spaces.
,d. Percuss between the iliac crest and ribs along the midaxillary line. - CORRECT
ANSWERS✅✅ANS: B
Checking for flank pain is best performed by percussion of the CVA and asking about pain.
The other techniques would not assess for flank pain
What glomerular filtration rate (GFR) would the nurse estimate for a 30-year-old patient with
a creatinine clearance result of 60 mL/min?
a. 60 mL/min
b. 90 mL/min
c. 120 mL/min
d. 180 mL/min - CORRECT ANSWERS✅✅ANS: A
The creatinine clearance approximates the GFR. The other responses are not accurate
*A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which
description of the procedure by the nurse is accurate?
a. "Your doctor will place a catheter into an artery in your groin and inject a dye that will
visualize the blood supply to the kidneys."
b. "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted
through the tube into your kidney."
c. "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the
bladder, and instill a dye that will outline your bladder on x-ray."
d. "Your doctor will inject a radioactive solution into a vein in your arm and the distribution
of the isotope in your kidneys and bladder will be checked." - CORRECT
ANSWERS✅✅ANS: C
In a cystoscope and cystogram procedure, a cystoscope is inserted into the bladder for direct
visualization, and then contrast solution is injected through the scope so that x-rays can be
taken. The response beginning, "Your doctor will place a catheter" describes a renal
arteriogram procedure. The response beginning, "Your doctor will inject a radioactive
solution" describes a nuclear scan. The response beginning, "Your doctor will insert a lighted
tube into the bladder, and little catheters will be inserted" describes a retrograde pyelogram
*The nurse caring for a patient after cystoscopy plans that the patient
, a. learns to request narcotics for pain.
b. understands to expect blood-tinged urine.
c. restricts activity to bed rest for a 4 to 6 hours.
d. remains NPO for 8 hours to prevent vomiting. - CORRECT ANSWERS✅✅ANS: B
Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination
is common, but pain that requires opioids for relief is not expected. A good fluid intake is
encouraged after this procedure. Bed rest is not required following cystoscopy
*A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch
urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will
a. have the patient empty the bladder completely, then obtain the next urine specimen that the
patient is able to void.
b. teach the patient to clean the urethral area, void a small amount into the toilet, and then
void into a sterile specimen cup.
c. insert a short sterile "mini" catheter attached to a collecting container into the urethra and
bladder to obtain the specimen.
d. clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have
the patient void into a sterile container. - CORRECT ANSWERS✅✅ANS: B
This answer describes the technique for obtaining a clean-catch specimen. The answer
beginning, "insert a short, small, 'mini' catheter attached to a collecting container" describes a
technique that would result in a sterile specimen, but a health care provider's order for a
catheterized specimen would be required. Using Betadine before obtaining the specimen is
not necessary, and might result in suppressing the growth of some bacteria. The technique
described in the answer beginning "have the patient empty the bladder completely" would not
result in a sterile specimen
*Which nursing action is essential for a patient immediately after a renal biopsy?
a. Check blood glucose to assess for hyperglycemia or hypoglycemia.
b. Insert a urinary catheter and test urine for gross or microscopic hematuria.
c. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function.
d. Apply a pressure dressing and keep the patient on the affected side for 30 minutes. -
CORRECT ANSWERS✅✅ANS: D
QUESTIONS AND CORRECT ANSWERS
*When a patient's urine dipstick test indicates a small amount of protein, the nurse's next
action should be to
a. send a urine specimen to the laboratory to test for ketones.
b. obtain a clean-catch urine for culture and sensitivity testing.
c. inquire about which medications the patient is currently taking.
d. ask the patient about any family history of chronic renal failure. - CORRECT
ANSWERS✅✅ANS: C
Normally the urinalysis will show zero to trace amounts of protein, but some medications
may give false-positive readings. The other actions by the nurse may be appropriate, but
checking for medications that may affect the dipstick accuracy should be done first
*Which medication taken at home by a 47-year-old patient with decreased renal function will
be of most concern to the nurse?
a. ibuprofen (Motrin)
b. warfarin (Coumadin)
c. folic acid (vitamin B9)
d. penicillin (Bicillin LA) - CORRECT ANSWERS✅✅ANS: A
The nonsteroidal antiinflammatory medications (NSAIDs) are nephrotoxic and should be
avoided in patients with impaired renal function. The nurse also should ask about reasons the
patient is taking the other medications, but the medication of most concern is the ibuprofen.
*How will the nurse assess for flank tenderness in a 30-year-old female patient with
suspected pyelonephritis?
a. Palpate along both sides of the lumbar vertebral column.
b. Strike a flat hand covering the costovertebral angle (CVA).
c. Push fingers upward into the two lowest intercostal spaces.
,d. Percuss between the iliac crest and ribs along the midaxillary line. - CORRECT
ANSWERS✅✅ANS: B
Checking for flank pain is best performed by percussion of the CVA and asking about pain.
The other techniques would not assess for flank pain
What glomerular filtration rate (GFR) would the nurse estimate for a 30-year-old patient with
a creatinine clearance result of 60 mL/min?
a. 60 mL/min
b. 90 mL/min
c. 120 mL/min
d. 180 mL/min - CORRECT ANSWERS✅✅ANS: A
The creatinine clearance approximates the GFR. The other responses are not accurate
*A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which
description of the procedure by the nurse is accurate?
a. "Your doctor will place a catheter into an artery in your groin and inject a dye that will
visualize the blood supply to the kidneys."
b. "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted
through the tube into your kidney."
c. "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the
bladder, and instill a dye that will outline your bladder on x-ray."
d. "Your doctor will inject a radioactive solution into a vein in your arm and the distribution
of the isotope in your kidneys and bladder will be checked." - CORRECT
ANSWERS✅✅ANS: C
In a cystoscope and cystogram procedure, a cystoscope is inserted into the bladder for direct
visualization, and then contrast solution is injected through the scope so that x-rays can be
taken. The response beginning, "Your doctor will place a catheter" describes a renal
arteriogram procedure. The response beginning, "Your doctor will inject a radioactive
solution" describes a nuclear scan. The response beginning, "Your doctor will insert a lighted
tube into the bladder, and little catheters will be inserted" describes a retrograde pyelogram
*The nurse caring for a patient after cystoscopy plans that the patient
, a. learns to request narcotics for pain.
b. understands to expect blood-tinged urine.
c. restricts activity to bed rest for a 4 to 6 hours.
d. remains NPO for 8 hours to prevent vomiting. - CORRECT ANSWERS✅✅ANS: B
Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination
is common, but pain that requires opioids for relief is not expected. A good fluid intake is
encouraged after this procedure. Bed rest is not required following cystoscopy
*A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch
urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will
a. have the patient empty the bladder completely, then obtain the next urine specimen that the
patient is able to void.
b. teach the patient to clean the urethral area, void a small amount into the toilet, and then
void into a sterile specimen cup.
c. insert a short sterile "mini" catheter attached to a collecting container into the urethra and
bladder to obtain the specimen.
d. clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have
the patient void into a sterile container. - CORRECT ANSWERS✅✅ANS: B
This answer describes the technique for obtaining a clean-catch specimen. The answer
beginning, "insert a short, small, 'mini' catheter attached to a collecting container" describes a
technique that would result in a sterile specimen, but a health care provider's order for a
catheterized specimen would be required. Using Betadine before obtaining the specimen is
not necessary, and might result in suppressing the growth of some bacteria. The technique
described in the answer beginning "have the patient empty the bladder completely" would not
result in a sterile specimen
*Which nursing action is essential for a patient immediately after a renal biopsy?
a. Check blood glucose to assess for hyperglycemia or hypoglycemia.
b. Insert a urinary catheter and test urine for gross or microscopic hematuria.
c. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function.
d. Apply a pressure dressing and keep the patient on the affected side for 30 minutes. -
CORRECT ANSWERS✅✅ANS: D
