Chapter 45: Renal and Urologic Problems

Chapter 45: Renal and Urologic Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A 46-yr-old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole 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.	Suggest that the patient use acetaminophen (Tylenol) to relieve symptoms.
d.	Teach the patient to take the prescribed trimethoprim and sulfamethoxazole for 3 more days.

 

 

ANS:  C

Because 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. Acetaminophen would not be as effective as other over-the-counter medications such as phenazopyridine in treating dysuria. The fluid intake should be increased to at least 1800 mL/day. Because the UTI has persisted after treatment with trimethoprim and sulfamethoxazole , the patient is likely to need a different antibiotic.

 

DIF:    Cognitive Level: Apply (application)           REF:               1041

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

 

2. The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) has been effective for a 22-yr-old female patient with cystitis when the patient states which of the following?

a.	“I can use vaginal antiseptic 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 discouraged. The bladder should be emptied before and after intercourse, but cleaning with soap and water is not necessary to prevent UTI. A quart of fluids is insufficient to provide adequate urine output to decrease risk for UTI.

 

DIF:    Cognitive Level: Apply (application)           REF:               1038

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?

a.	Take phenazopyridine for at least 7 days.
b.	Phenazopyridine may cause photosensitivity
c.	Phenazopyridine may change the urine color
d.	Take phenazopyridine before sexual intercourse.

 

 

ANS:  C

Patients should be taught that phenazopyridine will color the urine deep orange. Urinary analgesics should only be needed for a few days until the prescribed antibiotics decrease the bacterial count. Phenazopyridine does not cause photosensitivity. Taking phenazopyridine before intercourse will not be helpful in reducing the risk for UTI.

 

DIF:    Cognitive Level: Apply (application)           REF:               1036

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

 

4. Which finding by the nurse will be most helpful in determining whether a 67-yr-old patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)?

a.	Bladder distention	c.	Suprapubic discomfort
b.	Foul-smelling urine	d.	Costovertebral tenderness

 

 

ANS:  D

Costovertebral tenderness is characteristic of pyelonephritis. Bladder distention, foul-smelling urine, and suprapubic discomfort are characteristic of a lower UTI and are likely to be present if the patient also has an upper UTI.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   1038

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

 

5. The nurse determines that further instruction is needed for a patient with interstitial cystitis when the patient says which of the following?

a.	“I should stop having coffee and orange juice for breakfast.”
b.	“I will buy calcium glycerophosphate (Prelief) at the pharmacy.”
c.	“I will start taking high potency multiple vitamins every morning.”
d.	“I should call the doctor about increased bladder pain or foul urine.”

 

 

ANS:  C

High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient statements indicate good understanding of the teaching.

 

DIF:    Cognitive Level: Apply (application)           REF:               1041

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