Chapter 46: Nursing Management: Renal and Urologic Problems

Chapter 46: Nursing Management: Renal and Urologic Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim
and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take?
a. Remind the patient about the need to drink 1000 mL of fluids daily.
b. Obtain a midstream urine specimen for culture and sensitivity testing.
c. Teach the patient to take the prescribed Bactrim for at least 3 more days.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.
ANS: B
Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with
3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to
determine appropriate antibiotic therapy. Tylenol would not be as effective as other over-
the-counter (OTC) medications such as phenazopyridine (Pyridium) in treating dysuria.
The fluid intake should be increased to at least 1800 mL/day. Since the UTI has persisted
after treatment with Bactrim, the patient is likely to need a different antibiotic.
DIF: Cognitive Level: Application REF: 1123-1125 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
2. The nurse determines that instruction regarding prevention of future urinary tract
infections (UTIs) for a patient with cystitis has been effective when the patient states,
a. “I can use vaginal sprays to reduce bacteria.”
b. “I will drink a quart of water or other fluids every day.”
c. “I will wash with soap and water before sexual intercourse.”
d. “I will empty my bladder every 3 to 4 hours during the day.”
ANS: D
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal sprays is dis-
couraged. The bladder should be emptied before and after intercourse, but cleaning with
soap and water is not necessary. A quart of fluids is insufficient to provide adequate urine
output to decrease risk for UTI.
DIF: Cognitive Level: Application REF: 1125 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Health Promotion and Maintenance
3. Which information will the nurse include when teaching the patient with a urinary tract
infection (UTI) about the use of phenazopyridine (Pyridium)?
a. Take the medication for at least 7 days.
b. Use sunscreen while taking the Pyridium.
Test Bank 46-2
c. The urine may turn a reddish-orange color.
d. Use the Pyridium before sexual intercourse.
ANS: C
Patients should be taught that Pyridium will color the urine deep orange. Urinary
analgesics should only be needed for a few days until the prescribed antibiotics decrease
the bacterial count. Taking Pyridium before intercourse will not be helpful in reducing
the risk for UTI. Pyridium does not cause photosensitivity.
DIF: Cognitive Level: Application REF: 1124-1125
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital with chills,
fever, and vomiting. Which finding by the nurse will be most helpful in determining
whether the patient has an upper urinary tract infection (UTI)?
a. Suprapubic pain
b. Bladder distention
c. Foul-smelling urine
d. Costovertebral tenderness
ANS: D
Costovertebral tenderness is characteristic of pyelonephritis. The other symptoms are
characteristic of lower UTI and are likely to be present if the patient also has an upper
UTI.
DIF: Cognitive Level: Application REF: 1128
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. After teaching a patient with interstitial cystitis about management of the condition, the
nurse determines that further instruction is needed when the patient says,
a. “I will have to stop having coffee and orange juice for breakfast.”
b. “I should start taking a high potency multiple vitamin every morning.”
c. “I will buy some calcium glycerophosphate (Prelief) at the pharmacy.”
d. “I should call the doctor about increased bladder pain or odorous urine.”
ANS: B
High-potency multiple vitamins may irritate the bladder and increase symptoms. The
other patient statements indicate good understanding of the teaching.
DIF: Cognitive Level: Application REF: 1130-1131 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity