UTI EXAM SET QUESTIONS WITH
COMPLETE ANSWERS
A 98-year-old patient with benign prostatic hyperplasia has a markedly distended
bladder and is agitated and confused. All the following orders are received from the
emergency department health care provider. Which order should the nurse act on first?
a. Draw blood for blood urea nitrogen (BUN) and creatinine.
b. Administer lorazepam (Ativan) 0.5 mg.
c. Insert 16 French retention catheter.
d. Schedule for IVP. - Answer-Answer: C
Rationale: The patient's history and clinical manifestations are consistent with acute
urinary retention, and the priority action is to relieve the retention by catheterization. The
BUN and creatinine measurements can be obtained after the catheter is inserted. The
patient's agitation may resolve once the bladder distention is corrected, and sedative
drugs should be used cautiously in older patients. The IVP is an appropriate test, but
does not need to be done urgently.
A patient with a history of renal calculi is hospitalized with gross hematuria and severe
colicky left flank pain that radiates to his left testicle. In planning care for the patient, the
nurse gives the highest priority to the nursing diagnosis of
a. acute pain related to irritation by the stone.
b. deficient fluid volume related to inadequate intake.
c. risk for infection related to urinary system damage.
d. risk for nausea related to pain and renal colic. - Answer-Answer: A
Rationale: Although all the diagnoses are appropriate, the initial nursing actions should
focus on relief of the acute pain.
The nurse instructs a patient seen in the outpatient clinic with symptoms of renal calculi
to strain all urine and to
a. report the pain level when the stone passed.
b. collect the stone and bring it to the clinic.
c. record the time that the stone passed.
d. save a urine specimen to check for blood. - Answer-Answer: B
Rationale: The patient should save the stone for analysis of the stone composition,
which will help in determining treatment. Reporting the pain level and recording the time
the stone passed are not essential. Hematuria is common with urinary calculi, so it is
not necessary to test the urine for blood.
A patient with a confirmed urinary stone in the proximal left ureter undergoes
extracorporeal shock-wave lithotripsy. Which information is most important for the nurse
to collect after lithotripsy?
a. Urine output
b. Pain level
c. Appearance of the site
, d. Patient temperature - Answer-Answer: A
Rationale: Because lithotripsy breaks the stone into small sand, which could cause
obstruction, it is important to monitor the urine output. The patient may have pain as the
stones pass and bruising at the site, but these are not unexpected. Extracorporeal
shock wave lithotripsy (ESWL) is not associated with a risk for infection.
The composition of a patient's renal calculus is identified as uric acid. To prevent
recurrence of stones, the nurse teaches the patient to avoid
a. spinach, chocolate, and tomatoes.
b. organ meats and fish with fine bones.
c. milk and dairy products.
d. legumes and dried fruits. - Answer-Answer: B
Rationale: Organ meats and fish such as sardines increase purine levels and uric acid.
Spinach, chocolate, and tomatoes should be avoided in patients who have oxalate
stones. Milk, dairy products, legumes, and dried fruits may increase the incidence of
calcium-containing stones.
To prevent the recurrence of renal calculi, the nurse teaches the patient to
a. avoid all sources of dietary calcium.
b. drink diuretic fluids such as coffee.
c. drink 2000 to 3000 ml of fluid a day.
d. use a filter to strain all urine. - Answer-Answer: C
Rationale: A fluid intake of 2000 to 3000 ml daily is recommended help flush out
minerals before stones can form. Patients are not advised to avoid all calcium-
containing foods and a high calcium intake may decrease the incidence of some types
of stones. Coffee tends to increase stone recurrence. There is no need for a patient to
strain all urine routinely after a stone has passed, and this will not prevent stones.
The nurse establishes a nursing diagnosis of excess fluid volume related to
inflammation at the glomerular basement membrane in a patient with acute
glomerulonephritis. To best evaluate whether the problem identified in the nursing
diagnosis has resolved, the nurse will monitor for
a. proteinuria.
b. elevated creatinine.
c. periorbital edema.
d. hematuria. - Answer-Answer: C
Rationale: Resolution of the excess fluid volume is best evaluated by changes in
edema. The other data may indicate whether the glomerulonephritis is resolving but do
not provide data about fluid volume.
A patient with nephrotic syndrome develops flank pain. The nurse will anticipate
treatment with
a. antibiotics.
b. antihypertensives.
c. anticoagulants.
d. corticosteroids. - Answer-Answer: C
COMPLETE ANSWERS
A 98-year-old patient with benign prostatic hyperplasia has a markedly distended
bladder and is agitated and confused. All the following orders are received from the
emergency department health care provider. Which order should the nurse act on first?
a. Draw blood for blood urea nitrogen (BUN) and creatinine.
b. Administer lorazepam (Ativan) 0.5 mg.
c. Insert 16 French retention catheter.
d. Schedule for IVP. - Answer-Answer: C
Rationale: The patient's history and clinical manifestations are consistent with acute
urinary retention, and the priority action is to relieve the retention by catheterization. The
BUN and creatinine measurements can be obtained after the catheter is inserted. The
patient's agitation may resolve once the bladder distention is corrected, and sedative
drugs should be used cautiously in older patients. The IVP is an appropriate test, but
does not need to be done urgently.
A patient with a history of renal calculi is hospitalized with gross hematuria and severe
colicky left flank pain that radiates to his left testicle. In planning care for the patient, the
nurse gives the highest priority to the nursing diagnosis of
a. acute pain related to irritation by the stone.
b. deficient fluid volume related to inadequate intake.
c. risk for infection related to urinary system damage.
d. risk for nausea related to pain and renal colic. - Answer-Answer: A
Rationale: Although all the diagnoses are appropriate, the initial nursing actions should
focus on relief of the acute pain.
The nurse instructs a patient seen in the outpatient clinic with symptoms of renal calculi
to strain all urine and to
a. report the pain level when the stone passed.
b. collect the stone and bring it to the clinic.
c. record the time that the stone passed.
d. save a urine specimen to check for blood. - Answer-Answer: B
Rationale: The patient should save the stone for analysis of the stone composition,
which will help in determining treatment. Reporting the pain level and recording the time
the stone passed are not essential. Hematuria is common with urinary calculi, so it is
not necessary to test the urine for blood.
A patient with a confirmed urinary stone in the proximal left ureter undergoes
extracorporeal shock-wave lithotripsy. Which information is most important for the nurse
to collect after lithotripsy?
a. Urine output
b. Pain level
c. Appearance of the site
, d. Patient temperature - Answer-Answer: A
Rationale: Because lithotripsy breaks the stone into small sand, which could cause
obstruction, it is important to monitor the urine output. The patient may have pain as the
stones pass and bruising at the site, but these are not unexpected. Extracorporeal
shock wave lithotripsy (ESWL) is not associated with a risk for infection.
The composition of a patient's renal calculus is identified as uric acid. To prevent
recurrence of stones, the nurse teaches the patient to avoid
a. spinach, chocolate, and tomatoes.
b. organ meats and fish with fine bones.
c. milk and dairy products.
d. legumes and dried fruits. - Answer-Answer: B
Rationale: Organ meats and fish such as sardines increase purine levels and uric acid.
Spinach, chocolate, and tomatoes should be avoided in patients who have oxalate
stones. Milk, dairy products, legumes, and dried fruits may increase the incidence of
calcium-containing stones.
To prevent the recurrence of renal calculi, the nurse teaches the patient to
a. avoid all sources of dietary calcium.
b. drink diuretic fluids such as coffee.
c. drink 2000 to 3000 ml of fluid a day.
d. use a filter to strain all urine. - Answer-Answer: C
Rationale: A fluid intake of 2000 to 3000 ml daily is recommended help flush out
minerals before stones can form. Patients are not advised to avoid all calcium-
containing foods and a high calcium intake may decrease the incidence of some types
of stones. Coffee tends to increase stone recurrence. There is no need for a patient to
strain all urine routinely after a stone has passed, and this will not prevent stones.
The nurse establishes a nursing diagnosis of excess fluid volume related to
inflammation at the glomerular basement membrane in a patient with acute
glomerulonephritis. To best evaluate whether the problem identified in the nursing
diagnosis has resolved, the nurse will monitor for
a. proteinuria.
b. elevated creatinine.
c. periorbital edema.
d. hematuria. - Answer-Answer: C
Rationale: Resolution of the excess fluid volume is best evaluated by changes in
edema. The other data may indicate whether the glomerulonephritis is resolving but do
not provide data about fluid volume.
A patient with nephrotic syndrome develops flank pain. The nurse will anticipate
treatment with
a. antibiotics.
b. antihypertensives.
c. anticoagulants.
d. corticosteroids. - Answer-Answer: C
