Chapter 41: Urologic System Introduction
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient has a nephrostomy tube that has been inserted because of an obstruction in the
ureter: What special precautions in the care of the nephrostomy tube should the nurse
implement?
a. Clamping every 2 hours to allow expansion of the kidney pelvis
b. Instilling no more than 50 mL of sterile water if sterile irrigations are ordered
c. Being certain the tube is connected, not kinked, or not clamped to ensure that it
continually drains
d. Leaving the nephrostomy site open to air
ANS: C
Because of the small capacity of the renal pelvis, drainage must be continuous;
otherwise, the urine may back up and destroy the kidney:
DIF: Cognitive Level: Application REF: p: 806 OBJ: 2
TOP: Nephrostomy Tube KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
2. Which statement by a patient on dialysis, taking gentamicin (Garamycin), should cause
the nurse the most concern?
a. “I have a horrible headache:”
b. “Speak up! I can’t hear you:”
c. “I’ve had diarrhea once or twice today:”
d. “I’m thirsty: I can’t get enough water:”
ANS: B
Garamycin is ototoxic: Indication of hearing impairment suggests drug toxicity:
DIF: Cognitive Level: Comprehension REF: p: 809 OBJ: 2
, TOP: Garamycin KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
3. Erythropoietin is a hormone produced by the kidney: What will a deficiency of
erythropoietin in a patient in chronic renal failure result in?
a. Diminished immunologic function with fewer white blood cells
b. Elevated lipid levels in the bloodstream, contributing to accelerated
atherosclerosis
c. Anemia as a result of the diminished number of red blood cells being produced
d. Hypertension as a result of the increased, concentrated blood volume
ANS: C
Erythropoietin is excreted by the kidneys and stimulates bone marrow to produce red
blood cells:
DIF: Cognitive Level: Comprehension REF: p: 797 OBJ: 1
TOP: Erythropoietin KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
4. A nurse is assessing a patient with renal impairment: Which facial characteristic is a sign
of fluid retention?
a. Broken blood vessels around the nose
b. Periorbital edema
c. Rash on cheeks and neck
d. Facial twitching
ANS: B
Periorbital edema is a sign of fluid retention: Because the patient with renal
impairment has generalized edema, this facial feature is extremely significant in
assessing edema:
DIF: Cognitive Level: Comprehension REF: p: 798 OBJ: 1
TOP: Sign of Fluid Retention KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient has a nephrostomy tube that has been inserted because of an obstruction in the
ureter: What special precautions in the care of the nephrostomy tube should the nurse
implement?
a. Clamping every 2 hours to allow expansion of the kidney pelvis
b. Instilling no more than 50 mL of sterile water if sterile irrigations are ordered
c. Being certain the tube is connected, not kinked, or not clamped to ensure that it
continually drains
d. Leaving the nephrostomy site open to air
ANS: C
Because of the small capacity of the renal pelvis, drainage must be continuous;
otherwise, the urine may back up and destroy the kidney:
DIF: Cognitive Level: Application REF: p: 806 OBJ: 2
TOP: Nephrostomy Tube KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
2. Which statement by a patient on dialysis, taking gentamicin (Garamycin), should cause
the nurse the most concern?
a. “I have a horrible headache:”
b. “Speak up! I can’t hear you:”
c. “I’ve had diarrhea once or twice today:”
d. “I’m thirsty: I can’t get enough water:”
ANS: B
Garamycin is ototoxic: Indication of hearing impairment suggests drug toxicity:
DIF: Cognitive Level: Comprehension REF: p: 809 OBJ: 2
, TOP: Garamycin KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
3. Erythropoietin is a hormone produced by the kidney: What will a deficiency of
erythropoietin in a patient in chronic renal failure result in?
a. Diminished immunologic function with fewer white blood cells
b. Elevated lipid levels in the bloodstream, contributing to accelerated
atherosclerosis
c. Anemia as a result of the diminished number of red blood cells being produced
d. Hypertension as a result of the increased, concentrated blood volume
ANS: C
Erythropoietin is excreted by the kidneys and stimulates bone marrow to produce red
blood cells:
DIF: Cognitive Level: Comprehension REF: p: 797 OBJ: 1
TOP: Erythropoietin KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
4. A nurse is assessing a patient with renal impairment: Which facial characteristic is a sign
of fluid retention?
a. Broken blood vessels around the nose
b. Periorbital edema
c. Rash on cheeks and neck
d. Facial twitching
ANS: B
Periorbital edema is a sign of fluid retention: Because the patient with renal
impairment has generalized edema, this facial feature is extremely significant in
assessing edema:
DIF: Cognitive Level: Comprehension REF: p: 798 OBJ: 1
TOP: Sign of Fluid Retention KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
