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186 Cards in this Set
- Front
- Back
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Incontinence is all of the following except:
a) involuntary loss of urine b) severe enough to cause social or hygienic problems c) a normal consequence of aging d) one of the most underreported of all health problems |
c) a normal consequence of aging
Incontinence is NOT a normal consequence of aging! |
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An involuntary loss of urine during activities that increase abdominal & detrusor pressure:
a) stress incontinince b) urge incontinence c) overflow incontinence d) mixed incontinence e) functional incontinence |
a) stress incontinince
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Transient causes of incontinence that will improve with treatment of underlying condition:
a) stress incontinince b) urge incontinence c) overflow incontinence d) mixed incontinence e) functional incontinence |
e) functional incontinence
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An involuntary loss of urine associated with a strong desire to urinate:
a) stress incontinince b) urge incontinence c) overflow incontinence d) mixed incontinence e) functional incontinence |
b) urge incontinence
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Incontinence associated with a combination of stress, urge, and overflow:
a) stress incontinince b) urge incontinence c) overflow incontinence d) mixed incontinence e) functional incontinence |
d) mixed incontinence
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A type of incontinence associated with overdistention of the bladder when the bladder has reached its capacity
a) stress incontinince b) urge incontinence c) overflow incontinence d) mixed incontinence e) functional incontinence |
c) overflow incontinence
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The most common type of incontinence is:
a) stress incontinince b) urge incontinence c) overflow incontinence d) mixed incontinence e) functional incontinence |
d) mixed incontinence
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There are 3 overall goals in nursing for patients with a UTI. Name them.
1________ 2________ 3________ |
1- will have relief from bothersome lower urinary tract symptoms
2- prevention of upper unrinary tract involvement 3- prevention of recurrence |
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There are 4 basic health promotion activities that can help to decrease the frequency of UTI's & prevent infxn. Nmae them.
1- 2- 3- 4- |
1- empty bladder regularly & completely
2- evacuating bowel regularly 3- wiping perineal area from front to back 4- drinking adequate fluids daily |
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The recommended daily liquid intake for an ambulatory patient is approximately:
a) 5 mL per lb/d b) 15 mL per lb/d c) 5 mL per kg/d d) 15 mL per kg/d |
b) 15 mL per lb/d
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Because a person weighing 150 lb's will obtain aproximately 20% of required fluids from food, the nurse would encourage the individual to drink how many 8 oz glasses of fluid to meet apx 1800 required ml's?
a) 6 glasses b) 8 glasses c) 10 glasses d) 12 glasses |
b) 8 glasses
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The nurse ide ntifies the patient w/the greatest risk for a UTI as a:
a) 37 yr old man w/renal colic associated w/kidney stones b) 26 yr old pregnant woman who has HX of UTI c) 69 yr old man who has urinary retention caused by benign prostatic hyperplasia d) 72 yr old woman hospitalized w/a stroke who has a Foley cath because of urinary incontinence |
d) 72 yr old woman hospitalized w/a stroke who has a Foley cath because of urinary incontinence
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Complete the following NDX for a patient w/a UTI:
Acute ___ RT ____ of mucosal tissue of ____ AMB pain on urination, flank pain, suprapubic pain, lower back pain, and bladder ____. |
pain
inflammation urinary tract spasms |
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Complete the following NDX for a patient w/a UTI:
____ urinary elimination RT urinary tract infection (UTI) AMB urgency, daytime voiding frequency, nocturia, hematuria, & verbalization of concern over ___ elimination pattern. |
Impaired
altered |
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Medication that will turn the urine orange:
a) Septra b) Macrodantin c) Pyridium d) Furadantin |
c) Pyridium (phenazopyridine)
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UTI's are the 2nd most common bacterial disease of which more than 100,000 are hospitalized annually &:
a) more than 5% who develop gram neg bacteremia die b) more than 15% who develop gram neg bacteremia die c) more than 20% who develop gram neg bacteremia die d) more than 25% who develop gram neg bacteremia die |
b) more than 15% who develop gram neg bacteremia die
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The most common pathogen leading to a UTI:
a) E-coli b) pseudomonas c) candida d) serratia |
a) E-coli
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Upper UTI involves all of the following except:
a) renal parenchyma b) ureters c) pelvis d) bladder e) urethra |
d) bladder
e) urethra |
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Symptoms of upper & lower urinary tract infections include dysuria, frequency, urgency, & suprapubic discomfort or pressure & bloody urine (heamaturia) or cloudy urine. Flank pain, chills, & fever indicate infxn of the:
a) bladder b) upper urinary tract c) lower urinary tract |
b) upper urinary tract
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Pyeloneephritis is:
a) disease of the upper urinary tract b) inflammation of the bladder c) inflammation of the renal parenchyma & collecting system d) infection opf the ureters |
c) inflammation of the renal parenchyma & collecting system
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Clinical manifctations of a UTI (pyelonephritis) are:
a) more common in men between 65+ yrs of age b) women 16-25 yrs of age c) commonly absent in older adults d) unoticed in upper urinary tract infections |
c) commonly absent in older adults
less likely to experience a fever too! |
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Initial diagnostic UTI test to identify presence of nitrates, WBC's & leukocyte esterase:
a) urine culture b) dipstick unrinalysis c) CBC d) imaging |
b) dipstick unrinalysis
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Reflux of urine from urethra into the bladder (constant residual of urine after voiding):
a) Ureterovesical reflux b) Vesicoureteral relux |
Ureterovesical reflux
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The patient with a uncomplicated but recurrent UTI will be on antibiotics for:
a) 1-3 days b) 3-5 days c) 5-10 days d) 3-6 months |
b) 3-5 days
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Reflux of urine from the bladder into one or both of the ureters and possibly into the renal pelvis:
a) Ureterovesical reflux b) Vesicoureteral relux |
b) Vesicoureteral relux
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The most common cause of urethritis in males is:
a) Trichomonas b) Gonorrhea c) Staphylcoccus d) Candida |
b) Gonorrhea
Purlulent discharge |
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Patients with urethritis will be instructed to do all of the following except:
a) take showers instead of baths b) take hot sitz baths c) avoid intercourse until symptoms subside d) proper perineal hygiene |
a) take showers instead of baths
Hot sitz baths may relieve discomfort! |
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Inflammation of the urinary bladder:
a) pyelonephritis b) cystitis c) urethritis |
b) cystitis
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Usually results from the invasion of bacteria into the urinary tract (most commonly E.coli) & may be noninfectious caused by chemicals or radiation:
a) pyelonephritis b) cystitis c) urethritis |
b) cystitis
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Cystitis is more commonly seen in patients who are:
a) pregnant b) multigravida c) men d) women |
d) women
10-12:1 |
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Average age of onset for cystitis is:
a) birth b) 12 yrs+ c) coital menarche d) 40 yrs+ |
d) 40 yrs+
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Condition of which etiology is unknown and no single TX to reverse or alieviate symptoms has been identified:
a) pyelonephritis b) urethritis c) cystitis d) nephrolithiasis |
c) cystitis
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Used to reduce burning pain & urinary frequency associated with cystitis:
a) Elavil or Doxepin (tricylic antidepressants) b) Pentosan (Elimron) c) Nifedipine (Procardia) |
a) Elavil or Doxepin
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May be instilled directly into the bladder to relieve symptoms of cystitis:
a) Elavil or Doxepin (tricylic antidepressants) b) Pentosan (Elimron) c) Nifedipine (Procardia) d) Heparin |
d) Heparin
Dimethyl sulfoxide & Hyaluronic acid is also used |
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Complete the following NDX for cystitis:
Altered patterns of ___ RT inflammation & irritation ___ RT inflammation & irritation High risk for infection RT _____ |
urinary elimination
pain knowledge deficit of factors that may predispoase to cystitis or TX regimen |
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Nursing assessment for patients with cystitis is focused on:
a) characterizing pain b) TX underlying cause c) nutrition d) coping |
a) characterization of pain
data collection that includes a bladder log or voiding diary for at least 3 days |
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Inflammation of the renal parenchyma & collecting system including the renal pelvis:
a) pyelonephritis b) cystitis c) glomerulonephritis d) polycystic kidney disease |
a) pyelonephritis
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The most common cause of pyelonephritis:
a) bacterial b) fungi c) protozoa d) virus |
a) bacterial (per book p. 1177)
per Fowler: reflux of infected urine (vesicoureteral) |
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A systemic infection arising from a urologic source & of which prompt diagnosis & effective TX are essential to prevent septic shock & death.
a) urosepsis b) cystitis c) glomerulonephritis d) polycystic kidney disease |
a) urosepsis
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Infection starts in the renal medulla and spreads to adjacent cortex:
a) acute pyelonephritis b) chronic pyelonephritis a) |
a) acute pyelonephritis
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Recurring episodes of pyelonephritis can lead to a scarred & poorly functioning kidney in a condition called:
a) polycystic kidney disease b) glomerulonephritis c) chronic pyelonephritis d) urosepsis |
c) chronic pyelonephritis
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The clinical manifestations of pyelonephritis usually subside within a few days, even without specific therapy, but bacteriuria & pyurea usually persist.
true/false |
true
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How long may a patient w/mild symptoms of pyelonephritis expect to be on antibiotic therapy?
a) 1-3 days b) 3-5 days c) 14-21 days d) 3-6 months |
c) 14-21 days
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A patient asks you when he can expect relief from symptoms of pyelonephritis:
a) 12-24 hours after antibiotic therapy b) 24-48 hours after antibiotic therapy c) 48-72 hours after antibiotic therapy d) 3 days to a week after antibiotic therapy |
c) 48-72 hours after antibiotic therapy
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Relapses of pyelonephritis are TX with antibiotics for:
a) 1-3 days b) 3-5 days c) 14-21 days d) 6 weeks |
d) 6 weeks
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Your overall TX for a patient with pyelonephritis include 5 goals. Name them.
1- relief from pain 2- normal ___ ___ 3- no ___ 4- normal ____ function 5- no recurrence of ___ |
1- relief from pain
2- normal body temperature 3- no complications 4- normal renal function 5- no recurrence of symptoms |
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Describes a kidney that has shrunken & lost function due to scarring & fibrosis & of which is the original diagnosis in 1/3 of patients with renal failure:
a) polycystic kidney disease b) glomerulonephritis c) pyelonephritis d) chronic pyelonephritis |
d) chronic pyelonephritis
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Complete the following NDX for patients with pyelonephritis:
1- Pain RT ___ & ___ 2- Activity intolerance RT ___ 3- ___ RT the potential development of chronic renal failure 4- High risk for ___ ___ RT knowledge deficit |
1- Pain RT INFLAMMATION & INFECTION
2- Activity intolerance RT FATIGUE 3- FEAR RT the potential development of chronic renal failure 4- High risk for INEFFECTIVE MANAGEMENT RT knowledge deficit |
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Assessment findings from urinalysis in pt's with pyelonephritis include pus, bacteria, & RBC's in urine and a culture & sensitivity (done for recurrent infxn's) will reveal a colony count of at least:
a) 1,000 colonies per cc of urine indicated infection b) 10,000 colonies per cc of urine indicated infection c) 100,000 colonies per cc of urine indicated infection d) 1,000,000 colonies per cc of urine indicated infection |
c) 100,000 colonies per cc of urine indicated infection
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Expected TX for pyelonephritis include all of the following except:
a) Broad spectrum antibiotics which may include sulfonamides such as Bactrim, Septra (ask about allergies) b) Cehpalosporins such as Duricef, Suprax c) Urinary antiseptics Nitrofurantoin: Macrobid; Marcrodantin d) Urinary analgesics such as Pyridium (teach pt this changes color of urine to a reddish-orange) |
All of these
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The first indication of pyelonephritis in the elderly may be:
a) sudden onset of incontinence (or additional problems w/incontinence) b) fever & chills c) tachycardia d) confusion |
d) confusion
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Patients with pyelonephritis with fever, chills, & tachycardia should be evaluated for:
a) polycystic kidney disease b) septicemia c) glomerulonephritis d) Wilms' Tumor |
b) septicemia
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Acute Glomerulonephritis is described by all of the following except:
a)inflammation of the kidney affecting capillary loops b) affects one kidney c) onset is usually secondary URI (beta-hemolytic strep) d) a serious condition that could lead to end-stage renal disease (ESRD) |
b) affects one kidney
AFFECTS BOTH kidneys equally !!! |
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Risk factors for acute glomerulonephritis are all of the following except:
a) Group A beta-hemolytic streptococcus infection of the throat (tonsillitis, pharyngitis) ordinarily precedes the onset by about 10 days b) may be preceded by impetigo c) most common in elderly adults, but all age groups can be affected |
c) most common in elderly adults, but all age groups can be affected
MOST common in CHILDREN !!! |
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Assessment findings for glomerulonephritis are temp, tea or cola-colored urine due to hematuria, proteinuria, decreased output, SOB, flank pain, costovertebral angle tenderness, lethargy, anorexia, & azotemia (increased urea). Name 3 others.
1- sore ___ 2- swelling of _________ 3- _____tension |
1- sore throat
2- swelling of face & lower extremities 3- hypertension (b/c of angiotension cascade) |
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Assessment questions for patients in association with glomerulonephritis would include a recent HX of skin infxn's, respiratory distress, circulatory congestion, & systemic infection. Name 3 other questions.
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1 - URI
2 - pericarditis 3 - UTI |
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Complete the following NDX for pt's w/ glomerulonephritis:
1 - Activity intolerance R/T fatigue & ______. 2- Fluid volume excess R/T decreased ____. 3- Altered ____: less than body requirements R/T loss of appetite and fatigue |
1 - fluid volume excess
2 - glomerular filtration rate 3 - nutrition |
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Diagnostic testing for glomerulonephritis includes all of the following except:
a) UA for proteinuria, increased specific gravity, hematuria, & red cell casts b) CBC (increase in H & H) c) elevated BUN & creatinine d) Positive complement studies & ASO titer |
b) CBC (increase in H & H)
will have dilution decrease in H&H |
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Wxpect patient's to receive antibiotics, diuretics, & _____.
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antihypertensives
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Dietary interventions for pt's with glomerulonephritis include all of the following except:
a) Decreased sodium intake b) Protein restriction if patient is azotemic (protein metabolizes to nitrogen) c) May need to increase potassium foods d) May see fluid restriction if urinary output is decreased |
c) May need to increase potassium foods
May need RESTRICTION of high potassium foods especially if oliguric |
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Glomerulonephritis is very SERIOUS & prevention of secondary infection is very important. Pt's will need rest & quiet, children don’t feel well & self limit activity & it is important to avoid:
a) diuretics b) lisenopril c) nephrotoxic meds d) potassium – Avoid medications that are nephrotoxic |
c) nephrotoxic meds
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Patients with glomerolonephritis should report all of the following except:
a) nausea b) fatigue c) vomiting d) increased output e) infections |
d) increased output
should report DECREASED output |
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For pt's with glomerulonephritis, it is important to teach them to avoid people with?
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respiratory infections
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With glomerulonephritis it is especially important that the patient avoid:
a) floride b) hot sitz baths c) tylenol d) cranberry juice |
c) tylenol
ALSO AVOID: guifenosyn vancomycin gentamycin ibuprofen DO NOT SELF MEDICATE |
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With glomerulonrphritis, decreased glomerular filtration results in:
a) flank pain b) hematuria c) hypotension d) edema |
d) edema
initially in low pressure tissues such as around the eyes & later involve total body as acites &/or peripheral edema in legs. Hypertension results from increased extracellular fluid volume. |
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In glomerulonephritis, bleeding in the upper respiratory tract is evidenced by:
a) blood in urine b) smokey urine c) flank pain d) oliguria |
b) smokey urine
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With glomerulonephritis it is important to maintain fluid balance by watching I&O's weigh daily, monitor renal fxn, & serum electrolytes especially:
a) sodium b) potassium c) chloride d) magnesium |
b) potassium
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Nephritic syndrome is also known as:
a) Goodpature syndrome b) polycystic kidney disease c) nephroblastoma d) chronic glomerulonephritis |
d) chronic glomerulonephritis
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Chronic Glomerulonephritis, also known as chronic nephritic syndrome, is more commonly seen in:
a) children b) adults |
b) adults
develops over a period of years (maybe 10-30) (often results in ESRD) |
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Though acute poststreptococcal glomerulonephritis is most common in children & young adults 5-21 days after strep throat or impetigo, it can also be caused by:
a) hep B b) hep C c) rubella |
All of these!
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Assessment findings in patients with glomerulonephritis are general health problems, fatigue, edema, SOB, confusion
& slurred speech. Name 3 other common manifestations. 1 - j____ 2 - skin ____ 3 - areas of ____ |
1 - jaundice
2 - skin eruptions 3 - areas of scratching |
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Nursing management of acute glomerulonephritis focuses on symptomatic relief of what 4 symptoms with interventions?
1 - f___ TX with ___ 2 - e___ TX with ___ 3 - p___ TX with ___ 4 - h___ TX with ___ |
1 - fatigue TX with rest
2 - edema TX with sodium restriction 3 - proteinuria TX with restriction of dietary protein 4 - hypertension TX with antihypertensive drugs |
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A rare autoimmune disease of which the kidney is the target organ but of which the lungs are also involved:
a) end stage renal disease b) chronic glomerulonephritis c) WIlm's disease d) Goodpasture syndrome |
d) Goodpasture syndrome
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Goodpasture syndrome is more common in:
a) young women smokers b) infants c) black males d) young male smokers |
d) young male smokers
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Identify the developmental urological disorder:
a) pyelonephritis b) urethritis c) glomerulonephritis d) polycystic kidney disease |
d) polycystic kidney disease
Pyelonephritis - infection Urethritis - inflammation Glomerulonephritis - inflammatory |
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A urological disorder that is geneticaly transmitted, leads to ERSD, cannot be prevented & of which cycts develo in the renal parenchyma:
a) pyelonephritis b) urethritis c) glomerulonephritis d) polycystic kidney disease |
d) polycystic kidney disease
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A urological disorder from which the NDX "Guilt and Altered family coping R/T genetic transmission of terminal disease" would be most appropriate:
a) pyelonephritis b) urethritis c) glomerulonephritis d) polycystic kidney disease |
d) polycystic kidney disease
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Polycystic Kidney Disease can be described as all of the following except:
a) patients need genetic counceling b) childhood form is a rare autosomal recessive disorder c) symptoms appear when cysts begin to enlarge d) there is no specific TX & major goal is to prevent infections of urinary tract loss of kidney function occurs by age of 60 |
all of these are true for polycystic kidney disease
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Nursing management of patients with Polycystic Kidney Disease are those used for patients w/ end stage renal disease which include all of the following except:
a) diet modification b) increased fluids c) drugs d) assisting Pt to accept the chronic disease process |
b) increased fluids
fluids are RESTRICTED |
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With polycystic kidneys, body image disturbance is RT:
a) pettichae b) dehydration c) jaundice d) enlargement of abdomen |
d) enlargement of abdomen
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A renal condition involving the small arteries and arterioles of the kidney:
a) pyelonephritis b) glomerulonephritis c) nephrosclerosis d) polycystic kidney disease |
c) nephrosclerosis
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A complication of hypertension characterized by a sharp increase in BP with diastolic pressure >130 mmHg and usually occuring in young males:
a) pyelonephritis b) glomerulonephritis c) renal artery stenosis d) nephrosclerosis |
d) nephrosclerosis
There are 2 types: benign - usually 30-50 years normal renal fxn in early stages accelerated - malignant HTN, rapid, young males, poor prognosis |
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Should be considered when patient experiences HTN abruptly:
a) pyelonephritis b) glomerulonephritis c) renal artery stenosis d) nephrosclerosis |
c) renal artery stenosis
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Stone in urinary tract:
a) urolithiasis b) nephrolithiasis c) urethreolithaiasis d) calculi |
a) urolithiasis
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Stone in the ureter:
a) urolithiasis b) nephrolithiasis c) urethreolithaiasis d) calculi |
c) urethreolithaiasis
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Stone in renal parenchyma:
a) urolithiasis b) nephrolithiasis c) urethreolithaiasis d) calculi |
b) nephrolithiasis
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Symptoms of calculi include pain, N&V, chills & fever, dysuria, ureteral colic, and:
H______ O______ B______ P______ |
hematuria
oliguria bladder distention previous stone |
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A program to prevent stone (calculi) recurrence always includes adequate fluid intake to produce an approximate urine output of:
a) 500 ml/day b) 1000 ml/day c) 2000 ml/day d) 4000 ml/day |
c) 2000 ml/day
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In addition to adequate fluid intake & output in patients with calculi, prevention of calculi may also involve restriction of:
a) water & cranverry juice b) citric acid & potassium c) purines & oxalates d) steroids & MAO inhibitors |
c) purines & oxalates
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The primary nursing responsibility for patients with obstructing calculi & renal colic is:
a) adequate urine output b) fluid intake of 3000-4000 ml/day c) pain & comfort management d) limitation of activities & rest |
c) pain management
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Diet management for calculi includes increased fluid intake to dilute & flush stone & may also be altered according to the makeup of the stone. Low calcium & low purines (meats) may be recommended in addition to low methionine. Low methionine would indicate the patient should avoid all of the following except:
a)meat b)milk c)eggs d)cheese |
alll of these are high in methionine
meats are also high in purines |
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A means of diverting urinary output from the bladder to an external device or by another route that is temporary:
a) nephrostomy tubes b) Ileal conduit |
a) nephrostomy tubes
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A means of diverting urinary output from the bladder to an external device or by another route that is permanent:
a) nephrostomy tubes b) Ileal conduit |
b) Ileal conduit
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In teaching the Pt w/pyelonephritis about the disorder, the nurse informs the Pt the organisms that cause this condition most commonly reach the kidneys through:
a) bloodstream b) lymphatic system c) a descending infxn d) an ascending infxn |
d) an ascending infxn
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The immunologic mechanisms involved in glomerulonephritis include:
a) tubular blocking by precipitates of bacteria & antibody reactions b) deposition of immune complexes & complement along the GBM c) thickening of the GBM from autoimmune microangiopathic changes d) destruction of glomeruli by proteolytic enzymes contained in the GBM |
b) deposition of immune complexes & complement along the GBM
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One of the most important roles of the nurse in relation to acute poststreptococcal glomerulonephritis is to:
a) promote early diagnosis & Tx of sore throats & skin lesions b) encourage Pt's to request antibiotic therapy for all upper respiratory infxns c) teach Pt's w/APSGN that long term prophylactic antibiotic therapy is necessary to prevent recurrence d) monitor Pt's for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane |
d) monitor Pt's for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane
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A Pt is admitted to the jospital w/severe renal colic cause dby renal lithiasis. The 1st priority in management of the Pt is to:
a) administer narcotics as prescribed b) obtainn supplies for straining all urine c) encourage fluid intake of 4-5 l/day d) keep Pt NPO in preparation for surgery |
a) administer narcotics as prescribed
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The nurse recommends genetic counceling for the children of a Pt w/:
a) nephrotic syndrome b) chronic pyelonephritis c) malignant nephrosclerosis d) adult-onset polycystic renal disease |
d) adult-onset polycystic renal disease
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The nurse encourages strict diabetic control in the Pt prone to diabetic nephropathy knowing that the renal tissue changes that may occur in this condition include:
a) uric acid calculi & nephrolithiasis b) renal sugar-crystal calculi & cysts c) lipid deposits in the glomeruli & nephrons d) thickening of the GBM & glomerulosclerosis |
d) thickening of the GBM & glomerulosclerosis
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The nurse identifies a risk factor for kidney & bladder cancer in a Pt who relates a Hx of:
a) aspirin use b) tobacco use c) chronic alcohol abuse d) artificial sweetener use |
b) tobacco use
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In planning nursing interventions to increase bladder control in the Pt w/urinary incontinence, the nurse includes:
a) restricting fluids to diminish the risk of urinary leakage b) counceling the Pt concerning choice of continence containment device c) clamoping & releasing a catheter to increase bladder tone d) teaching the Pt biofeedback mechanisms to supress the urge to void |
a) restricting fluids to diminish the risk of urinary leakage
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A Pt /a ureterlithotomy returns from surgery w/a nephrostomy tube in place. Postoperative nursing care of the Pt includes:
a) encouraging the Pt to drink fruit juices & milk b) forcing fluids of at least 2-3 L per day after nausea has subsided c) notify physician if nephrostomy tube drainage is more than 30 mL/hour d) irrigating the nephrostomy tube w/10mL of NS as needed |
b) forcing fluids of at least 2-3 L per day after nausea has subsided
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A Pt has had a cystectomy & ileal conduit diversion performed. 4 days postoperativly, mucous shreds are seen in the drainage bag. The nurse should:
a) notify the physician b) notify the charge nurse c) irrigate the drainage tube d) chart as a normal observation |
d) chart as a normal observation
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Occurs in a otherwise normal urinary tract:
a) Upper UTI b) Lower UTI c) Complicated UTI d) Uncomplicated UTI |
d) Uncomplicated UTI
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Initially resistant to antibiotics:
a) Complicated UTI b) Recurrent UTI c) Unresolved bacteriuria d) Bacterial resistance |
c) Unresolved bacteriuria
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Complicated UTI:
a) initially resistant to antibiotics b) exists in the presence of obstruction or stones c) continuing infxn because of development resistance d) asymptomatic of resistance bacteriuria |
b) exists in the presence of obstruction or stones
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Upper UTI:
a) initially resistant to antibiotics b) continuing infxn because of development resistance c) infection of kidney &/or kidney pelvis d) asymptomatic of resistance bacteriuria |
c) infection of kidney &/or kidney pelvis
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Teaching plan developed by nurse for Pt w/new ileal conduit or ureterostomy stoma includes instructions to:
a) clean skin around stoma w/alcohol everyday b) use a wick to keep the skin dry during appliance changes c) use sterile supplies & technique during care of the stoma d) change the appliance every day & wash it w/warm soap & water |
b) use a wick to keep the skin dry during appliance changes
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A Pt w/bladder cancer undergoes cystectomy w/formation of an ileal conduit. During the Pt's 1st postop day the nurse plans to:
a) measure & fit the stoma for a permanenet appliance b) teach Pt to self cath stoma q6h c) encourage high oral intake to flush mucous from conduit d) empty drainage bag q2-3hrs & measure urinary output |
d) empty drainage bag q2-3hrs & measure urinary output
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Continent diversion created by formation of ileal pouch w/stoma requiring cathetarization:
a) Ileal conduit b) Cutaneous ureterostomy c) Kock pouch d) Ureteriliosigmoidostomy |
c) Kock pouch
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Abdominal stoma formed from resected ileum into which ureters are implanted:
a) Ileal conduit b) Cutaneous ureterostomy c) Kock pouch d) Ureteriliosigmoidostomy |
a) Ileal conduit
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Stoma created from ureter(s) brought to ABD wall
a) Ileal conduit b) Cutaneous ureterostomy c) Kock pouch d) Ureteriliosigmoidostomy |
b) Cutaneous ureterostomy
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Continent diversion in which ureters are attached to resected segment of ileum inplanted into sigmoid colon:
a) Ileal conduit b) Cutaneous ureterostomy c) Kock pouch d) Ureteriliosigmoidostomy |
d) Ureteriliosigmoidostomy
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During the assessment of Pt who had a nephrectomy, the nurse would expect to find:
a) shallow, slow respirations b) clear breath sounds in all lung fields c) decreased breath sounds in the lower left lobe d) decreased breath sounds in the right & left lower lobes |
b) clear breath sounds in all lung fields
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A Pt has a right uretal catheter placed following a lthotripsy for a stone in the ureter. In caring for the Pt after the procedure, the nurse:
a) milks or strips the cat q2h b) measures uretal urinary drainage q1-2hrs c) irrigates w/catheter w/30mL sterile saline q4h d) encourages ambulation to promote urinary peristaltic action |
b) measures uretal urinary drainage q1-2hrs
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Nursing care that applies to the management of all urinary catheters in hospitalized Pt's includes:
a) measuring urine output q1-2hrs to ensure patency b) turning the Pt frequently from side to side to promote drainage c) using strict sterile technique during irrigation or opening of the collecting system d) daily cleaning of the catheter insertion site w/soap & water & application of an antimicrobial ointment |
c) using strict sterile technique during irrigation or opening of the collecting system
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To assist the Pt w/stress incontinence, the nurse teaches the Pt to:
a) void q2h tp prevent leakage b) use absorptive perineal pads to contain urine c) perform pelvic floor muscle exercises 4-5 time daily d) increase intraabdominal pressure during voiding to fully empty the bladder |
c) perform pelvic floor muscle exercises 4-5 time daily
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Used for stress incontinence; increases urethral tone & resistance:
a) estrogen replacements b) anticholenergics c) alpha-adrenergic blockers d) alpha-adrenergic agomists |
d) alpha-adrenergic agomists
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Prescribed for urge incontinence; relaxes bladder tone & increases sphincter tone; decreases unwanted contractions:
a) estrogen replacements b) anticholenergics c) alpha-adrenergic blockers d) alpha-adrenergic agomists |
b) anticholenergics
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Prescribed for overflow & reflex incontinence; relaxes spastic bladder neck; prevents retention:
a) estrogen replacements b) anticholenergics c) alpha-adrenergic blockers d) alpha-adrenergic agomists |
c) alpha-adrenergic blockers
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Prescribed for stress & urge incontinence; increases urethral tone & suppleness:
a) estrogen replacements b) anticholenergics c) alpha-adrenergic blockers d) alpha-adrenergic agomists |
a) estrogen replacements
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Caused by overactivity of the detrusor muscle:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
b) urge incontinence
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Found following prostatectomy:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
a) stress incontinence
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Tx with Kegal exercises:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
a) stress incontinence
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Occurs w/spinal cord lesions above S2:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
d) reflex incontinence
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Involuntary urination w/minimal warning:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
b) urge incontinence
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Common in postmenopausal women:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
a) stress incontinence
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Loss of urine caused by problems of mobility:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
e) functional incontinence
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Coused by outlet obstruction:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
c) overflow incontinence
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Occurs without warning or stress equally during the day & night:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
d) reflex incontinence
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Bladder contracts reflexly, overriding central inhibition:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
b) urge incontinence
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Leakage of urine from overfull bladder:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
c) overflow incontinence
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Involuntary urination with increased intraabdominal pressure:
a) stress incontinence b) urge incontinence c) overflow incontinence d) reflex incontinence e) functional incontinence |
a) stress incontinence
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Connective tissue changes affecting the glomerulus:
a) diabetes mellitus b) gout c) amyloidosis d) systemic lupus erythematosus e) scleroderma |
d) systemic lupus erythematosus
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Diffuse & nodular glomerulosclerosis:
a) diabetes mellitus b) gout c) amyloidosis d) systemic lupus erythematosus e) scleroderma |
a) diabetes mellitus
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Deposition of sodium urate crystals in interstitium & tubules:
a) diabetes mellitus b) gout c) amyloidosis d) systemic lupus erythematosus e) scleroderma |
b) gout
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Vscular lesions w/fibrosis:
a) diabetes mellitus b) gout c) amyloidosis d) systemic lupus erythematosus e) scleroderma |
e) scleroderma
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Deostion of hyaline substance in kidney:
a) diabetes mellitus b) gout c) amyloidosis d) systemic lupus erythematosus e) scleroderma |
c) amyloidosis
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The 5-year survival rate for cancer of the kidney is usually low primarily because:
a) the only Tx for the disease is palliative b) diagnostic tests are not available to detect tumors before they metastasize c) the classic symptoms of hematuria & palpable mass do not occur until the disease is advanced d) early metastasis to the brain impairs Pt's ability to recognize symptoms |
c) the classic symptoms of hematuria & palpable mass do not occur until the disease is advanced
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A 60-year old man w/cancer of bladder has laser photocoagulation for Tx of the tomor. Following the procedure, the nurse plans to:
a) assess the Pt for symptoms of cystitis b) encourage Pt to take warm sitz baths c) monitor Pt for iritative bladder symptoms d) monitor urine output from the urinary catheter for hematuria |
b) encourage Pt to take warm sitz baths
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I providing care for Pt w/adult-onset polycystic kidney disease, the nurse:
a) helps Pt cope w/rapid progression of the disease b) suggests genetic counceling resources for the children of the Pt c) expects the Pt to have polyuria & poor concentration ability of the kidneys d) implements appropriate measures for the Pt's deafness & blindness in addition to the renal problems |
b) suggests genetic counceling resources for the children of the Pt
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When a patient suffering from a sports injury has gross hematuria, which of the following should be suspected?
a) uurithritis b) cystitis c) kidney injury d) glomerulonephritis |
c) kidney injury
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The most common manifestation of reanl artery stenosis is:
a) flank pain b) hematuria c) HTN d) suprapubic pain |
c) HTN
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Benign & accelerated nephrosclerosis is Tx with:
a) hormones (estrogen) b) antibiotics c) corticosteroids d) antihypertensives |
d) antihypertensives
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Renal vein thrombosis is most commonly Tx w/:
a) surgical revascularization b) corticosteroids c) anticoagulants d) sulfonimides |
c) anticoagulants
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Following lithrotripsy for Tx of renal calculi, the Pt has a NDX of risk for infxn RT introduction of bacteria floowing manipulation of the urinary tract. An appropriate nursing intervention is to:
a) monitor for hematuria b) encourage high fluid intake c) apply moist heat to flank area d) strain all urine |
b) encourage high fluid intake
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Prevention od calcium oxalate stones would include dietary restriction of:
a) milk & milk products b) dried beans & dried fruits c) liver, kidney, & sweetbreads d) spinach, cabbage & tomatoes |
d) spinach, cabbage & tomatoes
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On assment of Pt w/renal calculi passing down the ureter, the nurse would expect the Pt to report:
a) dull, costovertebral flank pain b) Hx of chronic urinary tract ifxn's c) severe, colicky back pain radiating to the groin d) feeling of bladder fullness w/urgency & frequency |
c) severe, colicky back pain radiating to the groin
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Calculi that is more common in women:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
c) struvite
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Calculi resulting from genetic autosomal recessive defect:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
e) cystine
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Often mixed w/struvite & oxalate stones:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
b) calcium phosphate
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Calculi that frequently obstructs the ureter:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
a) calcium oxalate
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Calculi that is always associated w/UTI & urea-splitting bacterias:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
c) struvite
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Calculi associated with gout:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
d) uric acid
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Calculi resulting from defective GI & kidney absorption:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
e) cystine
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Most common type of stone:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
a) calcium oxalate
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Often staghorn calculi formation in kidney pelvis:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
c) struvite
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Most common calculi in Jewish men:
a) calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine |
d) uric acid
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Pt's at risk for renal lithiasis can prevent the stones in many cases by:
a) leading an active lifestyle b) limiting protein & acid foods in the diet c) drinking enough fluids to produce 2 L urine output a day d) taking prophylactic antibiotics to control UTI's |
c) drinking enough fluids to produce 2 L urine output a day
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The edema associated w/nephrotic syndrome occurs as a result of:
a) hypercoaguability b) hyperalbuminemia c) decreased plasma oncotic pressure d) decreased glomerular filtration rate |
c) decreased plasma oncotic pressure
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Care plans for Pt's w/ acute poststreptococcal glomerulonephritis (APSGN) is based on the knowledge that:
a) most recover completely or rapidly inmprove w/conservative management b) chronic glomerulonephritis leading to renal failure is a common sequela to acute glomerulonephritis c) pulmonary hemmorhage may occur as a result of antibodies also attacking the alveolar basement membrane d) a large percentage of Pt's w/APSGN develop rapidly progressive glomerulonephritis resulting in kidney failure |
a) most recover completely or rapidly inmprove
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Restricting dietary protein may be indicated in management of acute poststreptococcal glomerulonephritis when the Pt has:
a) hematuria b) proteinuria c) hypertension d) elevated BUN |
d) elevated BUN
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Manifestations of periorbital edema:
a) decreased glomerular filtration rate b) injury to the glomerular basement membrane |
a) decreased glomerular filtration rate
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Smokey urine:
a) decreased glomerular filtration rate b) injury to the glomerular basement membrane |
b) injury to the glomerular basement membrane
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Protenuria:
a) decreased glomerular filtration rate b) injury to the glomerular basement membrane |
b) injury to the glomerular basement membrane
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Hypertension:
a) decreased glomerular filtration rate b) injury to the glomerular basement membrane |
a) decreased glomerular filtration rate
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Increased BUN & Creatinine:
a) decreased glomerular filtration rate b) injury to the glomerular basement membrane |
a) decreased glomerular filtration rate
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Oliguria:
a) decreased glomerular filtration rate b) injury to the glomerular basement membrane |
a) decreased glomerular filtration rate
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Glomerulonephritis is characterized by glomerular damage caused by:
a) growthof microorganisms in the gloeruli b) release of bacteial substances toxic to the glomeruli c) hemolysis of RBC circulating through the glomeruli d) accumulation of immune complexes & compliment in the glomeruli |
d) accumulation of immune complexes & compliment in the glomeruli
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When caring for Pt w/cystitis, the nurse teaches the Pt:
a) avoid foods that make the urine more alkaline b) use the dietary suppliment calcium glycerophosphate (prereleif) to decrease bladder irritation c) always keep a voiding diary to documetn pain, voiding frequencies, & patterns of nocturia d) use high-potency vitamin therapy to decrease the autoimmune effects of the bladder |
b) use the dietary suppliment calcium glycerophosphate (prereleif) to decrease bladder irritation
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A Pt w/suprapubic pain & sypmtoms of urinary frequency & urgency has 2 neg urine cultures. One assessment finding that would indicate cystitis is:
a) a residual urine of greater than 200 mL b) a large, atonic bladder on urodynamic testing c) a voiding pattern that indicates psychogenic urinary retention d) pain w/bladder filling that is transiently relieved by urination |
d) pain w/bladder filling that is transiently relieved by urination
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Diagnosis of acute pyelonephritis always requires:
a) Serum protein b) BUN c) urine culture d) urine sensitivity test |
Both ...
c) urine culture d) urine sensitivity test |
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The Pt w/acute pyelonephritis is more likely than the Pt w/a lower UTI to have a NDX of:
a) hyperthermia RT to infxn b) acute pain RT dysuria & bladder spasms c) impaired urinary elimination RT ifxn d) risk for ifxn RT lack of knowledge regarding prevention of recurrence |
a) hyperthermia RT to infxn
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Nurse identifies Pt w/greatest risk for a UTI as:
a) 37-yr old man w/renal colic associated w/kidney stones b) 26-yr old pregnant woman w/Hx of UTI's c) 69-yr old man who has urinary retention caused by benign prostatic hyperplasia d) 72-yr old woman hospitalized w/stroke who has a Foley cath because of urinary incontinence |
d) 72-yr old woman hospitalized w/stroke who has a Foley cath because of urinary incontinence
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While caring for 77-yr old woman who has a Foley cath, the nurse monitors the Pt for the development of a UTI. The clinical manifestations the Pt is most likely to experience include:
a) cloudy urine & fever b) urethral burning & bloody urine c) vague abd pain & disorientation d) superpubic pain & slight decline in body temp |
c) vague abd pain & disorientation
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A woman with no Hx of UTI's who is experiencing urgency, fequency, & dysuria comes to clinic where a dipstick & microscopic urinalysis indicates bacteruria. The nurse anticipates the Pt will:
a) need to have bllod specimen drawn for a CBC & kidney FXN test b) not be Tx w/medication unless she develops fever, chills, & flank pain c) be requested to obtain a clean catch midstream urine specimen for culture & sensitivity d) be Tx empirically w/trimethoprim-sulfamethasoxazole for 3 days |
d) be Tx empirically w/trimethoprim-sulfamethasoxazole for 3 days
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Among newborns, most UTI's occur in:
a) males b) females |
a) males
usually assoc. w/structural defects higher in girls when older infants due to a shorter urethra |
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Child makes known the need to void:
a) 2 years b) 2 1/2 years c) 3 years d) 4 years |
b) 2 1/2 years
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Child goes to bathroom by self:
a) 2 years b) 2 1/2 years c) 3 years d) 4 years |
c) 3 years
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Nephroblastoma (Wilms tumor)occurs most frequently in children between:
a) newborn -1 year b) 1-3 years c) 2-5 years d) 12-16 years |
c) 2-5 years
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Associated with congenital anomolies such as abnormal growth of 1/2 of the body, absence of the iris, and benign nodulike growths:
a) glomeruloephritis b) nephroblastoma c) nephrotic syndrome d) polycystic disease |
b) nephroblastoma
WILMS TUMOR |
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Wilms tumor grows:
a) very slowly resulting in extensive damage before detection b) very slowly with rapid metastasis c) very rapidly d) doubles in size in 11-13 days |
d) doubles in size in 11-13 days
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Prognosis for Wilms tumor is:
a) responsive to chemotherapy b) poor response to chemotherapy |
a) responsive to chemotherapy
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Nursing assessment of Wilms tumor includes all of the following except:
a) baseline assessment b) assess for hypertension c) palpation of mass d) place sign on bed to alert others not to palpate abd |
c) palpation of mass
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Drugs used to Tx Wilms Tumor (nephroblastoma) are all of the following except:
a) Vincristine b) Actinomycin D c) Doxorubicin d) Cyclophosphamide |
All of these
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Desired outcomes for nursing care of child with Wilms Tumor include:
1- Balanced ____&____ 2- Normal ____ 3- ____ from surgery 4- successful ____ management |
1- Balanced input & output
2- Normal vital signs 3- Recovery from surgery 4- Successful family management of postsurgical care & ongoing Tx |
