Chapter 45: Nursing Assessment: Urinary System

Chapter 45: Nursing Assessment: Urinary System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When reading a patient’s chart, the nurse notes that the patient has dysuria. To assess
whether there is any improvement, which question will the nurse ask?
a. “Do you have any blood in your urine?”
b. “Do you have to urinate very frequently?”
c. “Do you have any pain when you urinate?”
d. “Do you have to get up at night to urinate?”
ANS: C
Dysuria is painful urination. The alternate responses are used to assess other urinary tract
symptoms: hematuria, nocturia, and frequency.
DIF: Cognitive Level: Application REF: 1113
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A patient’s urine dipstick indicates a small amount of protein in the urine. The next action
by the nurse should be to
a. check which medications the patient is currently taking.
b. obtain a clean-catch urine for culture and sensitivity testing.
c. ask the patient about any family history of chronic renal failure.
d. send a urine specimen to the laboratory to test for ketones and glucose.
ANS: A
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: Application REF: 1114
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A creatinine clearance test is ordered for a hospitalized patient with possible renal
insufficiency. Which equipment will the nurse need to obtain?
a. Sterile specimen cup
b. Large container for urine
c. Foley catheter and drainage bag
d. Towelettes for perineal cleaning
ANS: B
Since 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.
Test Bank 45-2
DIF: Cognitive Level: Application REF: 1114
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. A 26-year-old patient who is employed as a hairdresser and has a 10 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.
b. kidney stones.
c. pyelonephritis.
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: Application REF: 1110-1111 TOP: Nursing Process:
Planning
MSC: NCLEX: Health Promotion and Maintenance
5. During assessment of a patient with decreased renal function, which of these medications
taken by the patient at home will be of most concern to the nurse?
a. ibuprofen (Motrin)
b. warfarin (Coumadin)
c. folic acid (vitamin B9)
d. penicillin (Bicillin LA)
ANS: A
The nonsteroidal anti-inflammatory medications (NSAIDs) are nephrotoxic and should
be avoided in patients with impaired renal function. The nurse also should ask about
reasons the patient is taking the other medications, but the medication of most concern is
the ibuprofen.
DIF: Cognitive Level: Application REF: 1109
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity