NSG 233 Med Surg 3 Final Exam 2023 Questions
and Answers (Verified Answers)
1. A 79 year old patient has been admitted with BPH. What is most
appropri- ate to include in the nursing plan of care
a. Limit fluid intake to no more than 1000 ml/day
b. Leave a light on in the bathroom during the night
c. Ask the patient to use a urinal so that urine can be measured
d. Pad the patients bed to accommodate overflow incontinence ANS : B
The patient's age and diagnosis indicate a likelihood of nocturia, so
leaving the light on in the bathroom is appropriate. Fluids should be
encouraged because dehydration is more common in older patients.
The information in the question does not indicate that measurement of
the patient's output is necessary or that the patient has overflow
incontinence.
2. A female patient with a suspected 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 povidine-iodine (betadine)
swab and then have the patient void into a sterile container 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.
3. Which statement made by a patient who had a cystoscopy the
previous day should be reported immediately to the HCP?
a. My urine looks pink
b. My IV site is bruised
c. My sleep was restless
d. My temperature is 101 ANS : D
The patient's elevated temperature may indicate a bladder
infection, a possible complication of cystoscopy. The health care
provider should be notified so that
,antibiotic therapy can be started. Pink-tinged urine is expected after a
cystoscopy. The insomnia and bruising should be discussed further
with the patient but do not indicate a need to notify the health care
provider.
4. To determine possible causes, the nurse will ask a patient admitted
with acute glomerulonephritis about:
a. Recent bladder infection
b. History of kidney stones
c. Recent sore throat and fever
d. History of high blood pres ANS : B
Acute glomerulonephritis frequently occurs after a streptococcal
infection such as strep throat. It is not caused by kidney stones,
hypertension, or urinary tract infection (UTI).
5. The nurse will anticipate teaching a patient with nephrotic syndrome
who develops flank pain about treatment with:
a. Antibiotics
b. Antifungals
c. Anticoagulants
d. Antihypertensive ANS : C
Flank pain in a patient with nephrotic syndrome suggests a renal vein
thrombosis, and anticoagulation is needed. Antibiotics are used to
treat a patient with flank pain caused by pyelonephritis. Fungal
pyelonephritis is uncommon and is treated with antifungals.
, Antihypertensives are used if the patient has high blood pressure
6. The nurse will plan to teach a 27 year old woman who smokes two
packs a day about the risk for:
a. Kidney stones
b. Bladder cancer
c. Bladder infection
d. Interstitial cystitis ANS : B
Cigarette smoking is a risk factor for bladder cancer. The patient's
risk for devel- oping interstitial cystitis, urinary tract infection (UTI),
or kidney stones will not be reduced by quitting smoking.
7. Following rectal surgery, a patient voids about 50 mL of urine every 30-
60 minutes for the first 4 hours. Which nursing intervention is most
appropriate?
a. Monitor the patients intake and output overnight
b. Have the patient drink small amounts of fluid frequently
c. Use an ultrasound scanner to check the postvoid residual volume
d. Reassure the patient that this is normal after anesthesia for rectal surgery
ANS : C
and Answers (Verified Answers)
1. A 79 year old patient has been admitted with BPH. What is most
appropri- ate to include in the nursing plan of care
a. Limit fluid intake to no more than 1000 ml/day
b. Leave a light on in the bathroom during the night
c. Ask the patient to use a urinal so that urine can be measured
d. Pad the patients bed to accommodate overflow incontinence ANS : B
The patient's age and diagnosis indicate a likelihood of nocturia, so
leaving the light on in the bathroom is appropriate. Fluids should be
encouraged because dehydration is more common in older patients.
The information in the question does not indicate that measurement of
the patient's output is necessary or that the patient has overflow
incontinence.
2. A female patient with a suspected 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 povidine-iodine (betadine)
swab and then have the patient void into a sterile container 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.
3. Which statement made by a patient who had a cystoscopy the
previous day should be reported immediately to the HCP?
a. My urine looks pink
b. My IV site is bruised
c. My sleep was restless
d. My temperature is 101 ANS : D
The patient's elevated temperature may indicate a bladder
infection, a possible complication of cystoscopy. The health care
provider should be notified so that
,antibiotic therapy can be started. Pink-tinged urine is expected after a
cystoscopy. The insomnia and bruising should be discussed further
with the patient but do not indicate a need to notify the health care
provider.
4. To determine possible causes, the nurse will ask a patient admitted
with acute glomerulonephritis about:
a. Recent bladder infection
b. History of kidney stones
c. Recent sore throat and fever
d. History of high blood pres ANS : B
Acute glomerulonephritis frequently occurs after a streptococcal
infection such as strep throat. It is not caused by kidney stones,
hypertension, or urinary tract infection (UTI).
5. The nurse will anticipate teaching a patient with nephrotic syndrome
who develops flank pain about treatment with:
a. Antibiotics
b. Antifungals
c. Anticoagulants
d. Antihypertensive ANS : C
Flank pain in a patient with nephrotic syndrome suggests a renal vein
thrombosis, and anticoagulation is needed. Antibiotics are used to
treat a patient with flank pain caused by pyelonephritis. Fungal
pyelonephritis is uncommon and is treated with antifungals.
, Antihypertensives are used if the patient has high blood pressure
6. The nurse will plan to teach a 27 year old woman who smokes two
packs a day about the risk for:
a. Kidney stones
b. Bladder cancer
c. Bladder infection
d. Interstitial cystitis ANS : B
Cigarette smoking is a risk factor for bladder cancer. The patient's
risk for devel- oping interstitial cystitis, urinary tract infection (UTI),
or kidney stones will not be reduced by quitting smoking.
7. Following rectal surgery, a patient voids about 50 mL of urine every 30-
60 minutes for the first 4 hours. Which nursing intervention is most
appropriate?
a. Monitor the patients intake and output overnight
b. Have the patient drink small amounts of fluid frequently
c. Use an ultrasound scanner to check the postvoid residual volume
d. Reassure the patient that this is normal after anesthesia for rectal surgery
ANS : C
