Page | 1
NSG 233 MED SURG 3 EXAM 3 2026
LATEST QUESTIONS AND ANSWERS|
ACE YOUR GRADES.
A patient presents with hematuria, urinary frequency,
and unilateral lower back pain. The nurse recognizes that
these are possible signs of:
A. Bladder cancer
B. Urinary tract infection (UTI)
C. Benign prostatic hyperplasia (BPH)
D. Renal calculi
Answer:
✔ A. Bladder cancer
Rationale:
Bladder cancer symptoms include painless hematuria (most
common), frequency, inability to urinate, nocturia, and unilateral
lower back pain due to obstruction. UTIs (B) may also cause
frequency and dysuria, but hematuria in bladder cancer is
typically painless. BPH (C) affects older men and leads to
difficulty urinating but does not typically cause hematuria. Renal
calculi (D) can cause hematuria and back pain but usually involve
severe, colicky pain.
A nurse is caring for a patient with suspected bladder
cancer. Which symptom should the nurse anticipate?
, Page | 2
A. Sudden onset of urinary retention
B. Painless hematuria
C. Severe bilateral flank pain
D. High fever and chills
Answer:
✔ B. Painless hematuria
Rationale:
Painless hematuria is the classic symptom of bladder cancer.
Urinary retention (A) is more common in conditions like BPH.
Severe bilateral flank pain (C) suggests kidney involvement, such
as renal stones. Fever and chills (D) are more indicative of an
infection, such as pyelonephriti
Which diagnostic test is most definitive for confirming
bladder cancer?
A. Urinalysis
B. Cystoscopy
C. MRI
D. Abdominal ultrasound
Answer:
✔ B. Cystoscopy
Rationale:
Cystoscopy is the gold standard for diagnosing bladder cancer, as
it allows direct visualization of the bladder and biopsy of
suspicious lesions. Urinalysis (A) may detect hematuria but is not
definitive. MRI (C) and ultrasound (D) can help evaluate tumor
spread but do not confirm diagnosis.
types of urinary diversions:
, Page | 3
Ileal conduit
•End of ileum attached to ureters
Ureterostomy
•Redirects ureters to an opening (stoma)
Vesicostomy
•Surgical opening in the bladder to outside of
the body (Lower belly
Nephrostomy
•Procedure to drain urine from kidney using a catheter
Indiana pouch
• Urinary reservoir made with right colon to form a pouch
that can hold 600ml of fluid
• No bag or device outside of body
Ostoma care: instructions for controlling odor
Controlling Odor:
• Avoid Odor-Causing Foods: Avoid foods like asparagus,
cheese, and eggs that may cause strong odors in urine.
• Vitamin C: Take Ascorbic acid (Vitamin C) to keep urine acidic,
minimizing alkaline encrustation around the stoma.
• Odor Barriers: Most ostomy appliances contain odor barriers,
but if needed, add a few drops of liquid deodorizer or diluted white
vinegar through the drain spout to reduce odors.
, Page | 4
• Proper Care of Pouch: Odor can develop if the pouch is worn
longer than recommended or not properly cared for.
Ostoma care
Managing the Ostomy Appliance:
• Empty Pouch Regularly: Empty the pouch when it is one-third
full to avoid excess weight and prevent the pouch from detaching
from the skin.
• Leg Bag Option: Some patients may prefer a leg bag connected
to the drainage apparatus.
• Uninterrupted Sleep: For sleep, use a collecting bottle and
tubing connected to the ileal appliance. Ensure some urine
remains in the bag to prevent collapsing.
• Daily Care: Rinse the tubing and bottle with cool water daily, and
use a 3:1 solution of water and white vinegar once a week.
Ostoma Cleaning and Deodorizing the Appliance:
• Rinsing the Appliance: Rinse the reusable appliance in warm
water.
• Soaking for Deodorization: Soak the appliance for 30 minutes in
a 3:1 solution of water and white vinegar or a commercial
deodorizing solution.
• Drying: After rinsing with tepid water, air-dry the appliance away
from direct sunlight. Avoid hot water or direct sunlight to prevent
cracking.
NSG 233 MED SURG 3 EXAM 3 2026
LATEST QUESTIONS AND ANSWERS|
ACE YOUR GRADES.
A patient presents with hematuria, urinary frequency,
and unilateral lower back pain. The nurse recognizes that
these are possible signs of:
A. Bladder cancer
B. Urinary tract infection (UTI)
C. Benign prostatic hyperplasia (BPH)
D. Renal calculi
Answer:
✔ A. Bladder cancer
Rationale:
Bladder cancer symptoms include painless hematuria (most
common), frequency, inability to urinate, nocturia, and unilateral
lower back pain due to obstruction. UTIs (B) may also cause
frequency and dysuria, but hematuria in bladder cancer is
typically painless. BPH (C) affects older men and leads to
difficulty urinating but does not typically cause hematuria. Renal
calculi (D) can cause hematuria and back pain but usually involve
severe, colicky pain.
A nurse is caring for a patient with suspected bladder
cancer. Which symptom should the nurse anticipate?
, Page | 2
A. Sudden onset of urinary retention
B. Painless hematuria
C. Severe bilateral flank pain
D. High fever and chills
Answer:
✔ B. Painless hematuria
Rationale:
Painless hematuria is the classic symptom of bladder cancer.
Urinary retention (A) is more common in conditions like BPH.
Severe bilateral flank pain (C) suggests kidney involvement, such
as renal stones. Fever and chills (D) are more indicative of an
infection, such as pyelonephriti
Which diagnostic test is most definitive for confirming
bladder cancer?
A. Urinalysis
B. Cystoscopy
C. MRI
D. Abdominal ultrasound
Answer:
✔ B. Cystoscopy
Rationale:
Cystoscopy is the gold standard for diagnosing bladder cancer, as
it allows direct visualization of the bladder and biopsy of
suspicious lesions. Urinalysis (A) may detect hematuria but is not
definitive. MRI (C) and ultrasound (D) can help evaluate tumor
spread but do not confirm diagnosis.
types of urinary diversions:
, Page | 3
Ileal conduit
•End of ileum attached to ureters
Ureterostomy
•Redirects ureters to an opening (stoma)
Vesicostomy
•Surgical opening in the bladder to outside of
the body (Lower belly
Nephrostomy
•Procedure to drain urine from kidney using a catheter
Indiana pouch
• Urinary reservoir made with right colon to form a pouch
that can hold 600ml of fluid
• No bag or device outside of body
Ostoma care: instructions for controlling odor
Controlling Odor:
• Avoid Odor-Causing Foods: Avoid foods like asparagus,
cheese, and eggs that may cause strong odors in urine.
• Vitamin C: Take Ascorbic acid (Vitamin C) to keep urine acidic,
minimizing alkaline encrustation around the stoma.
• Odor Barriers: Most ostomy appliances contain odor barriers,
but if needed, add a few drops of liquid deodorizer or diluted white
vinegar through the drain spout to reduce odors.
, Page | 4
• Proper Care of Pouch: Odor can develop if the pouch is worn
longer than recommended or not properly cared for.
Ostoma care
Managing the Ostomy Appliance:
• Empty Pouch Regularly: Empty the pouch when it is one-third
full to avoid excess weight and prevent the pouch from detaching
from the skin.
• Leg Bag Option: Some patients may prefer a leg bag connected
to the drainage apparatus.
• Uninterrupted Sleep: For sleep, use a collecting bottle and
tubing connected to the ileal appliance. Ensure some urine
remains in the bag to prevent collapsing.
• Daily Care: Rinse the tubing and bottle with cool water daily, and
use a 3:1 solution of water and white vinegar once a week.
Ostoma Cleaning and Deodorizing the Appliance:
• Rinsing the Appliance: Rinse the reusable appliance in warm
water.
• Soaking for Deodorization: Soak the appliance for 30 minutes in
a 3:1 solution of water and white vinegar or a commercial
deodorizing solution.
• Drying: After rinsing with tepid water, air-dry the appliance away
from direct sunlight. Avoid hot water or direct sunlight to prevent
cracking.
