Chapter 35: Care of Patients with Disorders of the Urinary System

Medical Surgical Nursing Concepts & Practice, 2nd Edition by Susan C.

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Chapter 35: Care of Patients with Disorders of the Urinary System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. When a 90-year-old resident in a long-term care facility becomes progressively confused and irritable, the nurse should:
a. request an order for a urinalysis.
b. hold antihypertensive medications.
c. assess for fecal impaction.
d. notify the charge nurse.

 

 

ANS:  A

Sudden confusion and irritability may indicate a UTI in the older adult. There is no supportive information indicating issues with the patient’s antihypertensive medications or the presence of a fecal impaction.

 

DIF:    Cognitive Level: Application           REF:   786                OBJ:   1 (theory)

TOP:   Urinary Tract Infection (UTI) in the Older Adult

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. During the review of the medications to be administered, the nurse notes that a patient has been prescribed liquid nitrofurantoin (Furadantin). The nurse will add an intervention to the nursing care plan to:
a. give the drug on an empty stomach.
b. rinse the mouth after administration.
c. schedule a morning dose to avoid insomnia.
d. assess the urine for hematuria.

 

 

ANS:  B

The liquid form of this drug will stain the teeth. The drug causes drowsiness and should be given at night. Hematuria is not a concern.

 

DIF:    Cognitive Level: Application           REF:   787                OBJ:   1 (theory)

TOP:   Nitrofurantoin: Nursing Considerations

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

  1. When a 25-year-old woman comes to the emergency department with nonspecific urethritis, the nurse is prompted to inquire about the patient’s use of:
a. tight-fitting underwear.
b. alcohol consumption.
c. bath salts.
d. bicycle exercise.

 

 

ANS:  C

Urethritis refers to inflammation of the urethra. The use of bath salts, spermicidal jelly, body powders, and feminine hygiene sprays can cause urethritis.

 

DIF:    Cognitive Level: Application           REF:   788                OBJ:   1 (theory)

TOP:   Urethritis: Signs and Symptoms       KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A 25-year-old man comes to the college clinic with fever of 101° F and pain in the flank radiating into the thigh and genitals. He complains of nausea. The nurse recognizes these complaints as being indicative of:
a. urethritis.
b. pyelonephritis.
c. glomerulonephritis.
d. cystitis.

 

 

ANS:  B

Acute pyelonephritis is an infection of the kidneys. It is thought to occur when bacteria (such as Escherichia coli) from a bladder infection travel up the ureters to infect the kidneys. A frequent cause of pyelonephritis is an obstruction, causing stasis of urine and stones that cause irritation of the tissue. Both situations provide an environment in which bacteria can grow. When bacteria enter the renal pelvis, inflammation and infection occur. Pyelonephritis causes nausea and vomiting, flank pain, temperature elevation with chills, headache, and malaise. Urethritis and cystitis often cause dysuria. Glomerulonephritis commonly occurs about 2 to 3 weeks after a group A beta-hemolytic streptococcal infection, such as “strep throat” or impetigo. The patient with acute glomerulonephritis usually becomes suddenly ill with fever, chills, flank pain, widespread edema, puffiness about the eyes, visual disturbances, and marked hypertension.

 

DIF:    Cognitive Level: Application           REF:   788                OBJ:   1 (theory)

TOP:   Pyelonephritis: Signs and Symptoms

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse cautions a young man who is taking ciprofloxacin (Cipro) for pyelonephritis to take all the prescription as directed in order to prevent recurrence, which can cause:
a. scarring of the renal pelvis.
b. chronic pyelonephritis.
c. glomerulonephritis.
d. obstruction of the ureters.

 

 

ANS:  A

Renal scarring can be the complication of pyelonephritis, which, if not contained, can cause hypertension and renal failure in later years.

 

DIF:    Cognitive Level: Application           REF:   789                OBJ:   1 (theory)

TOP:   Pyelonephritis: Complications          KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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