RN Renal Urinary and Reproductive Systems EAQ
The nurse is caring for a client with acute renal failure. The most serious
complication for this client is:
1
Anemia
2
Infection
3
Weight loss
4
Platelet dysfunction - ANSWER: 2
Infection
Infection is responsible for one third of the traumatic or surgically induced deaths of
clients with acute renal failure, as well as for medically induced acute renal failure.
A client who had a suprapubic prostatectomy returns from the post-anesthesia care
unit and accidentally pulls out the urethral catheter. What should the nurse do first?
1
Reinsert a new catheter.
2
Notify the health care provider.
3
Check for bleeding by irrigating the suprapubic tube.
4
Take no immediate action if the suprapubic tube is draining. - ANSWER: 2
Notify the health care provider.
The catheter must be reinserted by the health care provider to ensure bladder
emptying, maintain pressure at the operative site, and prevent hemorrhage. Because
of the danger of further trauma to the urethra and surgical site, the health care
provider should insert the catheter.
A client experiences difficulty in voiding after an indwelling urinary catheter is
removed. The nurse determines that this difficulty most likely is related to:
1
Fluid imbalance
2
Sedentary lifestyle
3
Interruption in previous voiding habits
4
Nervous tension following the procedure - ANSWER: 3
Interruption in previous voiding habits
,An indwelling catheter dilates the urinary sphincters, keeps the bladder empty, and
short-circuits the reflex mechanism based on bladder distention. When the catheter
is removed, the body must adapt to functioning once again.
During discharge teaching, a client with an ileal conduit asks how frequently the
urine pouch should be emptied. The best reply by the nurse is:
1
"To prevent leakage and pulling of the pouch from the skin, it should be emptied
every few hours."
2
"To prevent skin irritation, it should be emptied every hour if any urine has collected
in the bag."
3
"To reduce the risk of infection, the system should be opened as little as possible;
two times a day is adequate."
4
"To reduce the cost of drainage pouches, it should be emptied once the system is
switched to a bedside collection bag." - ANSWER: 1
"To prevent leakage and pulling of the pouch from the skin, it should be emptied
every few hours."
Before a transurethral resection of the prostate (TURP), a client asks about what to
expect postoperatively. The most appropriate response by the nurse is:
1
"You will have an abdominal incision and a dressing."
2
"Your urine will be pink and free of clots."
3
"There will be an incision between your scrotum and rectum."
4
"There will be an indwelling urinary catheter and a continuous bladder irrigation in
place." - ANSWER: 4
"There will be an indwelling urinary catheter and a continuous bladder irrigation in
place."
The presence of an indwelling urinary catheter and a continuous bladder irrigation
are routine postoperative expectations after a TURP; they provide for hemostasis
and urinary excretion. An abdominal incision and dressing are present with a
suprapubic, not transurethral, prostatectomy. After a TURP the client initially can
expect hematuria and some blood clots; the continuous bladder irrigation keeps the
bladder free of clots and the catheter patent
A client who is dehydrated is to receive an intravenous (IV) solution of normal saline
to be infused at 175 mL/hr. The drop factor of the IV set is 15 gtts/mL. At what drop
rate should the nurse adjust the flow to provide the prescribed solution? Record
your answer using a whole number. __________ gtts/min - ANSWER: 44 gtts/min is a
,correct calculation. Multiply the amount of fluid to be infused (175 mL) by the drop
factor (15) and divide this result by the amount of time in minutes (1 hr x 60 min).
A nurse teaches the signs of organ rejection to a client who had a kidney transplant.
What should be included in the education?
1
Weight loss
2
Subnormal temperature
3
Elevated blood pressure
4
Increased urinary output - ANSWER: 3
Elevated blood pressure
Hypertension is caused by hypervolemia because of the failure of the new kidney.
Weight gain, not loss, occurs with a rejection of the kidney because of fluid
retention. The client will have an elevated temperature exceeding 100° F with kidney
rejection. Urine output will be decreased or absent, depending on the degree of
kidney rejection.
A client who has repeated episodes of cystitis is scheduled for a cystoscopy to
determine the possibility of urinary tract abnormalities. The client asks the nurse to
describe the procedure. The nurse's most appropriate response is, "This procedure
is:
1
A computerized scan that outlines the bladder and surrounding tissue."
2
An x-ray film of the abdomen, kidneys, ureters, and bladder after administration of
dye."
3
The visualization of the inside of the bladder with an instrument connected to a
source of light."
4
The visualization of the urinary tract through ureteral catheterization and the use of
radiopaque material." - ANSWER: 3
The visualization of the inside of the bladder with an instrument connected to a
source of light."
A nurse is caring for a client with a diagnosis of renal calculi secondary to
hyperparathyroidism. Which type of diet should the nurse explore with the client
when providing discharge information?
1
Low purine
2
Low calcium
3
, High phosphorus
4
High alkaline ash - ANSWER: 2
Low calcium
Calcium and phosphorus are components of these stones; foods high in calcium and
phosphorus should be avoided. Low purine and high alkaline ash diets are indicated
for clients with gout. Foods high in phosphorus must be avoided.
An older client who is living in a nursing home is admitted to the hospital to be
treated with intravenous antibiotics for sepsis resulting from a urinary tract
infection. The client becomes agitated and attempts to pull out the IV. The health
care provider prescribes a stat dose of haloperidol (Haldol) 0.5 mg IM. The
haloperidol is available in a vial that states there are 2 mg/mL. How much solution
should the nurse administer? Include a leading zero if applicable. Record your
answer using two decimal places. __________ mL - ANSWER: Solve the problem by
using ratio and proportion. Desire 0.5 mg x mL
------------- = ----
Have 2 mg 1 mL
2x = 0.5
x = 0.5 ÷ 2
x = 0.25 mL
A nurse is evaluating a client's response to fluid replacement therapy. Which clinical
finding indicates adequate tissue perfusion to vital organs?
1
Urinary output of 30 mL in an hour
2
Central venous pressure reading of 2 mm Hg
3
Baseline pulse rate of 120 that decreases to 110 beats/min within a 15-minute
period
4
Baseline blood pressure of 50/30 that increases to 70/40 mm Hg within a 30-minute
period - ANSWER: 1
Urinary output of 30 mL in an hour
A urinary output rate of 30 mL/hour is considered adequate for perfusion of the
kidneys, heart, and brain.
After a successful kidney transplant for a client with end-stage kidney disease, the
nurse anticipates that laboratory studies will demonstrate:
1
Increased specific gravity
2
Correction of hypotension
3
The nurse is caring for a client with acute renal failure. The most serious
complication for this client is:
1
Anemia
2
Infection
3
Weight loss
4
Platelet dysfunction - ANSWER: 2
Infection
Infection is responsible for one third of the traumatic or surgically induced deaths of
clients with acute renal failure, as well as for medically induced acute renal failure.
A client who had a suprapubic prostatectomy returns from the post-anesthesia care
unit and accidentally pulls out the urethral catheter. What should the nurse do first?
1
Reinsert a new catheter.
2
Notify the health care provider.
3
Check for bleeding by irrigating the suprapubic tube.
4
Take no immediate action if the suprapubic tube is draining. - ANSWER: 2
Notify the health care provider.
The catheter must be reinserted by the health care provider to ensure bladder
emptying, maintain pressure at the operative site, and prevent hemorrhage. Because
of the danger of further trauma to the urethra and surgical site, the health care
provider should insert the catheter.
A client experiences difficulty in voiding after an indwelling urinary catheter is
removed. The nurse determines that this difficulty most likely is related to:
1
Fluid imbalance
2
Sedentary lifestyle
3
Interruption in previous voiding habits
4
Nervous tension following the procedure - ANSWER: 3
Interruption in previous voiding habits
,An indwelling catheter dilates the urinary sphincters, keeps the bladder empty, and
short-circuits the reflex mechanism based on bladder distention. When the catheter
is removed, the body must adapt to functioning once again.
During discharge teaching, a client with an ileal conduit asks how frequently the
urine pouch should be emptied. The best reply by the nurse is:
1
"To prevent leakage and pulling of the pouch from the skin, it should be emptied
every few hours."
2
"To prevent skin irritation, it should be emptied every hour if any urine has collected
in the bag."
3
"To reduce the risk of infection, the system should be opened as little as possible;
two times a day is adequate."
4
"To reduce the cost of drainage pouches, it should be emptied once the system is
switched to a bedside collection bag." - ANSWER: 1
"To prevent leakage and pulling of the pouch from the skin, it should be emptied
every few hours."
Before a transurethral resection of the prostate (TURP), a client asks about what to
expect postoperatively. The most appropriate response by the nurse is:
1
"You will have an abdominal incision and a dressing."
2
"Your urine will be pink and free of clots."
3
"There will be an incision between your scrotum and rectum."
4
"There will be an indwelling urinary catheter and a continuous bladder irrigation in
place." - ANSWER: 4
"There will be an indwelling urinary catheter and a continuous bladder irrigation in
place."
The presence of an indwelling urinary catheter and a continuous bladder irrigation
are routine postoperative expectations after a TURP; they provide for hemostasis
and urinary excretion. An abdominal incision and dressing are present with a
suprapubic, not transurethral, prostatectomy. After a TURP the client initially can
expect hematuria and some blood clots; the continuous bladder irrigation keeps the
bladder free of clots and the catheter patent
A client who is dehydrated is to receive an intravenous (IV) solution of normal saline
to be infused at 175 mL/hr. The drop factor of the IV set is 15 gtts/mL. At what drop
rate should the nurse adjust the flow to provide the prescribed solution? Record
your answer using a whole number. __________ gtts/min - ANSWER: 44 gtts/min is a
,correct calculation. Multiply the amount of fluid to be infused (175 mL) by the drop
factor (15) and divide this result by the amount of time in minutes (1 hr x 60 min).
A nurse teaches the signs of organ rejection to a client who had a kidney transplant.
What should be included in the education?
1
Weight loss
2
Subnormal temperature
3
Elevated blood pressure
4
Increased urinary output - ANSWER: 3
Elevated blood pressure
Hypertension is caused by hypervolemia because of the failure of the new kidney.
Weight gain, not loss, occurs with a rejection of the kidney because of fluid
retention. The client will have an elevated temperature exceeding 100° F with kidney
rejection. Urine output will be decreased or absent, depending on the degree of
kidney rejection.
A client who has repeated episodes of cystitis is scheduled for a cystoscopy to
determine the possibility of urinary tract abnormalities. The client asks the nurse to
describe the procedure. The nurse's most appropriate response is, "This procedure
is:
1
A computerized scan that outlines the bladder and surrounding tissue."
2
An x-ray film of the abdomen, kidneys, ureters, and bladder after administration of
dye."
3
The visualization of the inside of the bladder with an instrument connected to a
source of light."
4
The visualization of the urinary tract through ureteral catheterization and the use of
radiopaque material." - ANSWER: 3
The visualization of the inside of the bladder with an instrument connected to a
source of light."
A nurse is caring for a client with a diagnosis of renal calculi secondary to
hyperparathyroidism. Which type of diet should the nurse explore with the client
when providing discharge information?
1
Low purine
2
Low calcium
3
, High phosphorus
4
High alkaline ash - ANSWER: 2
Low calcium
Calcium and phosphorus are components of these stones; foods high in calcium and
phosphorus should be avoided. Low purine and high alkaline ash diets are indicated
for clients with gout. Foods high in phosphorus must be avoided.
An older client who is living in a nursing home is admitted to the hospital to be
treated with intravenous antibiotics for sepsis resulting from a urinary tract
infection. The client becomes agitated and attempts to pull out the IV. The health
care provider prescribes a stat dose of haloperidol (Haldol) 0.5 mg IM. The
haloperidol is available in a vial that states there are 2 mg/mL. How much solution
should the nurse administer? Include a leading zero if applicable. Record your
answer using two decimal places. __________ mL - ANSWER: Solve the problem by
using ratio and proportion. Desire 0.5 mg x mL
------------- = ----
Have 2 mg 1 mL
2x = 0.5
x = 0.5 ÷ 2
x = 0.25 mL
A nurse is evaluating a client's response to fluid replacement therapy. Which clinical
finding indicates adequate tissue perfusion to vital organs?
1
Urinary output of 30 mL in an hour
2
Central venous pressure reading of 2 mm Hg
3
Baseline pulse rate of 120 that decreases to 110 beats/min within a 15-minute
period
4
Baseline blood pressure of 50/30 that increases to 70/40 mm Hg within a 30-minute
period - ANSWER: 1
Urinary output of 30 mL in an hour
A urinary output rate of 30 mL/hour is considered adequate for perfusion of the
kidneys, heart, and brain.
After a successful kidney transplant for a client with end-stage kidney disease, the
nurse anticipates that laboratory studies will demonstrate:
1
Increased specific gravity
2
Correction of hypotension
3
