Nursing Care of Patients with Disorders of the
Urinary System
Nursing Care of Patients with Disorders of the Urinary System
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A patient hospitalized for orthopedic surgery had a urinary catheter inserted. The patient later develops
a urinary tract infection (UTI) and asks the nurse what caused it. What is the appropriate response by the
nurse?
a. “There was a change in the pH of your urine.”
b. “You probably did not void frequently enough.”
c. “Bacteria probably ascended the catheter, causing the infection.”
d. “There are always bacteria on your perineum that enter your urine.”
2. The nurse is reinforcing 24-hour fluid intake teaching for a patient to prevent further UTIs. Which
amount should the patient state that indicates that teaching has been effective?
a. “1000 mL.”
b. “1500 mL.”
c. “3000 mL.”
d. “5000 mL.”
3. The nurse is reviewing the history and physical of a patient who has an infection. What term should the
nurse realize describes an infection of the kidneys?
a. Cystitis
b. Hepatitis
c. Urethritis
d. Pyelonephritis
4. The nurse is reinforcing teaching provided to a patient about antibiotics prescribed for a UTI. Which pa-
,tient statement indicates teaching has been effective?
a. “I will take the antibiotics until my urine is no longer cloudy.”
b. “I will take the antibiotics whenever I feel discomfort from urinating.”
c. “I will take the antibiotics until they are gone regardless of symptoms.”
d. “I will take the antibiotics until my temperature has been normal for 3 days.”
5. The nurse is collecting data from a patient with suspected cancer of the bladder. What finding should
the nurse recognize as the most common symptom of cancer of the bladder?
a. Pain
b. Hematuria
c. Urine retention
d. Burning on urination
6. The nurse notes that the urine from a patient with an ileal conduit has mucus strands. What action
should the nurse take?
a. Notify the physician.
b. Send a urine sample to the laboratory for culture.
c. Ask the patient about a history of UTIs.
d. Nothing, as the nurse understands that this is a normal finding.
7. The nurse is reinforcing teaching provided to a patient about risk factors for the development of bladder
cancer. What risk factor should the patient state that indicates understanding of this teaching?
a. Smoking
b. Hyperlipidemia
c. Diet high in calcium
d. Recurrent UTIs
8. The nurse is caring for a patient who has renal calculi. Which action is essential for the nurse to take?
a. Strain all urine.
b. Limit fluids at night.
c. Record blood pressure.
d. Obtain a sterile urine specimen.
9. The nurse is caring for a patient who has a nephrostomy tube. What action should the nurse take to
maintain the integrity of this device?
a. Ensure tube is not kinked or clamped.
b. Limit fluids to 1000 mL per 24 hours.
c. Keep collection bag taped to abdomen.
d. Remove and clean the tube once daily.
10. A patient hourly urine output is recorded. Which output rates should be brought to the attention of the
registered nurse (RN) immediately?
a. 15 mL/hr
b. 40 mL/hr
c. 60 mL/hr
d. 80 mL/hr
11. The nurse is caring for a patient who has an acute kidney injury. Which diagnostic test result should the
, nurse identify as most supporting this diagnosis?
a. Hematocrit 20% (normal 38% to 47%)
b. Uric acid 8 ng/dL (normal 2.5 to 5.5 ng/dL)
c. 24-hour creatinine clearance 5 mL/min (normal 100 mL/min)
d. Blood urea nitrogen 20 mg/100 mL (normal 8 to 25 mg/100 mL)
12. A patient who has diabetic nephropathy asks the nurse, “Why am I using smaller doses of insulin than I
used to?” What would be the best explanation by the nurse?
a. “Insulin is now more potent than it used to be.”
b. “It would be best if you spoke with your physician about this.”
c. “You have probably decreased the amount of food you are eating.”
d. “Your kidneys are no longer breaking down the insulin as much as before.”
13. A patient with chronic kidney disease is very weak due to low hemoglobin. What should the nurse un-
derstand as the best explanation for the anemia?
a. Secretion of erythropoietin by the diseased kidney is reduced.
b. There is loss of red blood cells in the urine with kidney disease.
c. Chronic hypertension associated with chronic kidney disease suppresses the bone marrow.
d. Metabolic acidosis associated with chronic kidney disease increases red blood cell fragility.
14. The nurse is caring for a patient with chronic kidney disease. Which data collection technique is the
best one for the nurse to use to determine this patient’s fluid volume status?
a. Vital signs
b. Skin turgor
c. Daily weight
d. Intake and output
15. A patient who is on hemodialysis for chronic kidney disease is prescribed sevelamer hydrochloride (Re-
nagel) with meals. What explanation should be provided to the patient as the primary reason the medication is
being given?
a. To prevent metabolic acidosis
b. To prevent gastrointestinal ulcer formation
c. To relieve gastric irritation from excess acid production
d. To prevent damage to bones from high phosphorus levels
16. The nurse is collecting data from a patient who has returned from a dialysis session. After dialysis, the
nurse should anticipate which patient finding?
a. Weight loss
b. Hypertension
c. Increased energy
d. Distended neck veins
17. The nurse is reinforcing teaching provided to a patient with chronic kidney disease. Which patient
statement indicates the need for further teaching?
a. “I do not use salt substitute.”
b. “My fluid intake is restricted.”
c. “As long as I don’t eat protein, I’ll be okay.”
Urinary System
Nursing Care of Patients with Disorders of the Urinary System
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A patient hospitalized for orthopedic surgery had a urinary catheter inserted. The patient later develops
a urinary tract infection (UTI) and asks the nurse what caused it. What is the appropriate response by the
nurse?
a. “There was a change in the pH of your urine.”
b. “You probably did not void frequently enough.”
c. “Bacteria probably ascended the catheter, causing the infection.”
d. “There are always bacteria on your perineum that enter your urine.”
2. The nurse is reinforcing 24-hour fluid intake teaching for a patient to prevent further UTIs. Which
amount should the patient state that indicates that teaching has been effective?
a. “1000 mL.”
b. “1500 mL.”
c. “3000 mL.”
d. “5000 mL.”
3. The nurse is reviewing the history and physical of a patient who has an infection. What term should the
nurse realize describes an infection of the kidneys?
a. Cystitis
b. Hepatitis
c. Urethritis
d. Pyelonephritis
4. The nurse is reinforcing teaching provided to a patient about antibiotics prescribed for a UTI. Which pa-
,tient statement indicates teaching has been effective?
a. “I will take the antibiotics until my urine is no longer cloudy.”
b. “I will take the antibiotics whenever I feel discomfort from urinating.”
c. “I will take the antibiotics until they are gone regardless of symptoms.”
d. “I will take the antibiotics until my temperature has been normal for 3 days.”
5. The nurse is collecting data from a patient with suspected cancer of the bladder. What finding should
the nurse recognize as the most common symptom of cancer of the bladder?
a. Pain
b. Hematuria
c. Urine retention
d. Burning on urination
6. The nurse notes that the urine from a patient with an ileal conduit has mucus strands. What action
should the nurse take?
a. Notify the physician.
b. Send a urine sample to the laboratory for culture.
c. Ask the patient about a history of UTIs.
d. Nothing, as the nurse understands that this is a normal finding.
7. The nurse is reinforcing teaching provided to a patient about risk factors for the development of bladder
cancer. What risk factor should the patient state that indicates understanding of this teaching?
a. Smoking
b. Hyperlipidemia
c. Diet high in calcium
d. Recurrent UTIs
8. The nurse is caring for a patient who has renal calculi. Which action is essential for the nurse to take?
a. Strain all urine.
b. Limit fluids at night.
c. Record blood pressure.
d. Obtain a sterile urine specimen.
9. The nurse is caring for a patient who has a nephrostomy tube. What action should the nurse take to
maintain the integrity of this device?
a. Ensure tube is not kinked or clamped.
b. Limit fluids to 1000 mL per 24 hours.
c. Keep collection bag taped to abdomen.
d. Remove and clean the tube once daily.
10. A patient hourly urine output is recorded. Which output rates should be brought to the attention of the
registered nurse (RN) immediately?
a. 15 mL/hr
b. 40 mL/hr
c. 60 mL/hr
d. 80 mL/hr
11. The nurse is caring for a patient who has an acute kidney injury. Which diagnostic test result should the
, nurse identify as most supporting this diagnosis?
a. Hematocrit 20% (normal 38% to 47%)
b. Uric acid 8 ng/dL (normal 2.5 to 5.5 ng/dL)
c. 24-hour creatinine clearance 5 mL/min (normal 100 mL/min)
d. Blood urea nitrogen 20 mg/100 mL (normal 8 to 25 mg/100 mL)
12. A patient who has diabetic nephropathy asks the nurse, “Why am I using smaller doses of insulin than I
used to?” What would be the best explanation by the nurse?
a. “Insulin is now more potent than it used to be.”
b. “It would be best if you spoke with your physician about this.”
c. “You have probably decreased the amount of food you are eating.”
d. “Your kidneys are no longer breaking down the insulin as much as before.”
13. A patient with chronic kidney disease is very weak due to low hemoglobin. What should the nurse un-
derstand as the best explanation for the anemia?
a. Secretion of erythropoietin by the diseased kidney is reduced.
b. There is loss of red blood cells in the urine with kidney disease.
c. Chronic hypertension associated with chronic kidney disease suppresses the bone marrow.
d. Metabolic acidosis associated with chronic kidney disease increases red blood cell fragility.
14. The nurse is caring for a patient with chronic kidney disease. Which data collection technique is the
best one for the nurse to use to determine this patient’s fluid volume status?
a. Vital signs
b. Skin turgor
c. Daily weight
d. Intake and output
15. A patient who is on hemodialysis for chronic kidney disease is prescribed sevelamer hydrochloride (Re-
nagel) with meals. What explanation should be provided to the patient as the primary reason the medication is
being given?
a. To prevent metabolic acidosis
b. To prevent gastrointestinal ulcer formation
c. To relieve gastric irritation from excess acid production
d. To prevent damage to bones from high phosphorus levels
16. The nurse is collecting data from a patient who has returned from a dialysis session. After dialysis, the
nurse should anticipate which patient finding?
a. Weight loss
b. Hypertension
c. Increased energy
d. Distended neck veins
17. The nurse is reinforcing teaching provided to a patient with chronic kidney disease. Which patient
statement indicates the need for further teaching?
a. “I do not use salt substitute.”
b. “My fluid intake is restricted.”
c. “As long as I don’t eat protein, I’ll be okay.”
