Chapter 44: Assessment of Urinary System

Chapter 44: Assessment of Urinary System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. To assess whether there is any improvement in a patient’s dysuria, which question will the nurse ask?

a.	“Do you have to urinate at night?”
b.	“Do you have blood in your urine?”
c.	“Do you have to urinate frequently?”
d.	“Do you have pain when you urinate?”

 

 

ANS:  D

Dysuria is painful urination. The alternate responses are used to assess other urinary tract symptoms: hematuria, nocturia, and frequency.

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   1025

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

2. When a patient’s urine dipstick test indicates a small amount of protein, the nurse’s next action should be to

a.	send a urine specimen to the laboratory to test for ketones.
b.	obtain a clean-catch urine for culture and sensitivity testing.
c.	inquire about which medications the patient is currently taking.
d.	ask the patient about any family history of chronic renal failure.

 

 

ANS:  C

Normally the urinalysis will show zero to trace amounts of protein, but some medications may give false-positive readings. The other actions by the nurse may be appropriate, but checking for medications that may affect the dipstick accuracy should be done first.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   1026

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

3. A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a creatinine clearance test. Which item will the nurse need to obtain?

a.	Urinary catheter	c.	Cleansing towelettes
b.	Sterile specimen cup	d.	Large urine container

 

 

ANS:  D

Because creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes, and a sterile specimen cup are not needed for this test.

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   1031

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

4. A young adult who is employed as a hairdresser and has a 15 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for

a.	renal failure.	c.	pyelonephritis.
b.	kidney stones.	d.	bladder cancer.

 

 

ANS:  D

Exposure to the chemicals involved with working as a hairdresser and in smoking both increase the risk of bladder cancer, and the nurse should assess whether the patient understands this risk. The patient is not at increased risk for renal failure, pyelonephritis, or kidney stones.

 

DIF:    Cognitive Level: Apply (application)           REF:               1021

TOP:   Nursing Process: Planning               MSC:  NCLEX: Health Promotion and Maintenance

 

5. Which medication taken at home by a patient with decreased renal function will be of most concern to the nurse?

a.	ibuprofen (Motrin)	c.	folic acid (vitamin B9)
b.	warfarin (Coumadin)	d.	penicillin (Bicillin C-R)

 

 

ANS:  A

The nonsteroidal antiinflammatory medications (NSAIDs) are nephrotoxic and should be avoided in patients with impaired renal function. The nurse should also ask about reasons the patient is taking the other medications, but the medication of most concern is the ibuprofen.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   1020

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity