NEW
Font size
WorksheetsGENITOURINARY TRACT (GUT) ⏐ 𝙲𝙰 𝟷
Total questions: 50
Worksheet time: 38mins
Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis?
Costovertebral angle tenderness and chills.
Jaundice and flank pain.
Burning sensation on urination.
Polyuria and nocturia.
You have a patient that might have a urinary tract infection (UTI). Which statement by the patient suggests that a UTI is likely?
“It burns when I pee.”
“I pee a lot.”
“I go hours without the urge to pee.”
“My pee smells sweet.”
Which instructions do you include in the teaching care plan for a patient with cystitis receiving phenazopyridine (Pyridium)?
After painful urination is relieved, stop taking phenazopyridine.
If the urine turns orange-red, call the doctor.
Take phenazopyridine just before urination to relieve pain.
Once painful urination is relieved, discontinue prescribed antibiotics.
Which patient is at greatest risk for developing a urinary tract infection (UTI)?
50 y.o. postmenopausal woman.
35 y.o. woman with a fractured wrist.
20 y.o. woman with asthma.
28 y.o. with angina.
You have a patient that is receiving peritoneal dialysis. What should you do when you notice the return fluid is slowly draining?
Check for kinks in the outflow tubing.
Raise the drainage bag above the level of the abdomen.
Place the patient in a reverse Trendelenburg position.
Ask the patient to cough.
What is the appropriate infusion time for the dialysate in your 38 y.o. patient with chronic renal failure undergoing peritoneal dialysis?
15 minutes.
30 minutes.
1 hour.
2-3 hours.
A 30 y.o. female patient is undergoing hemodialysis with an internal arteriovenous fistula in place. What do you do to prevent complications associated with this device?
Avoid taking blood pressures in the arm with the fistula.
Insert I.V. lines above the fistula.
Palpate pulses above the fistula.
Report a bruit or thrill over the fistula to the doctor.
Your patient becomes restless and tells you she has a headache and feels nauseous during hemodialysis. Which complication do you suspect?
Disequilibrium syndrome.
Infection.
Air embolism.
Acute hemolysis.
Your patient is complaining of muscle cramps while undergoing hemodialysis. Which intervention is effective in relieving muscle cramps?
Infuse normal saline solution.
Increase the rate of dialysis.
Administer a 5% dextrose solution.
Encourage active ROM exercises.
Your patient with chronic renal failure reports pruritus. Which instruction should you include in this patient’s teaching plan?
Keep fingernails short and clean.
Rub the skin vigorously with a towel.
Take frequent baths.
Apply alcohol-based emollients to the skin.
Which intervention do you plan to include with a patient who has renal calculi?
Strain all urine.
Maintain bed rest.
Increase dietary purines.
Restrict fluids.
An 18 y.o. student is admitted with dark urine, fever, and flank pain and is diagnosed with acute glomerulonephritis. Which would most likely be in this student’s health history?
Recent sore throat.
Renal calculi.
Renal trauma.
Family history of acute glomerulonephritis.
Which drug is indicated for pain related to acute renal calculi?
Narcotic analgesics.
Nonsteroidal anti-inflammatory drugs (NSAIDS).
Muscle relaxants.
Salicylates.
Which of the following causes the majority of UTI’s in hospitalized patients?
Invasive procedures.
Lack of fluid intake.
Inadequate perineal care.
Immunosuppression.
Clinical manifestations of acute glomerulonephritis include which of the following?
Hematuria and proteinuria.
Chills and flank pain.
Oliguria and generalized edema.
Dysuria and hypotension.
You expect a patient in the oliguric phase of renal failure to have a 24 hour urine output less than:
400ml.
200ml.
800ml.
1000ml.
The most common early sign of kidney disease is:
Elevated BUN level.
Sodium retention.
Development of metabolic acidosis.
Inability to dilute or concentrate urine.
A patient is experiencing which type of incontinence if she experiences leaking urine when she coughs, sneezes, or lifts heavy objects?
Stress.
Reflex.
Overflow.
Urge.
Immediately post-op after a prostatectomy, which complications require priority assessment of your patient?
Hemorrhage.
Pneumonia.
Urine retention.
Deep vein thrombosis.
The most indicative test for prostate cancer is:
Prostate-specific antigen.
A thorough digital rectal examination.
Magnetic resonance imaging (MRI).
Excretory urography.
A 22 y.o. patient with diabetic nephropathy says, “I have two kidneys and I’m still young. If I stick to my insulin schedule, I don’t have to worry about kidney damage, right?” Which of the following statements is the best response?
“Even with insulin, kidney damage is still a concern.”
“You have little to worry about as long as your kidneys keep making urine.”
“You should talk to your doctor because statistics show that you’re being unrealistic.”
“You would be correct if your diabetes could be managed with insulin.”
A patient diagnosed with sepsis from a UTI is being discharged. What do you plan to include in her discharge teaching?
Drink 8 to 10 eight-oz glasses of water daily.
Take cool baths.
Avoid tampon use.
Avoid sexual activity.
You’re planning your medication teaching for your patient with a UTI prescribed Phenazopyridine Hydrochloride (Pyridium). What do you include?
“Your urine might turn bright orange.”
“Take this drug between meals and at bedtime.”
“You need to take this antibiotic for 7 days.”
“Don’t take this drug if you’re allergic to penicillin.”
Which finding leads you to suspect acute glomerulonephritis in your 32 y.o. patient?
Hypertension, oliguria, and fatigue.
Dysuria, frequency, and urgency.
Back pain, nausea, and vomiting.
Fever, chills, and right upper quadrant pain radiating to the back.
What is the priority nursing diagnosis with your patient diagnosed with end-stage renal disease?
Fluid volume excess.
Activity intolerance.
Knowledge deficit.
Pain.
A patient with ESRD has an arteriovenous fistula in the left arm for hemodialysis. Which intervention do you include in his plan of care?
Apply pressure to the needle site upon discontinuing hemodialysis.
Keep the head of the bed elevated 45 degrees.
Place the left arm on an arm board for at least 30 minutes.
Keep the left arm dry.
Your 60 y.o. patient with pyelonephritis and possible septicemia has had five UTIs over the past two years. She is fatigued from lack of sleep, has lost weight, and urinates frequently even in the night. Her labs show: sodium, 154 mEq/L; osmolarity 340 mOsm/L; glucose, 127 mg/dl; and potassium, 3.9 mEq/L. Which nursing diagnosis is a priority?
Fluid volume deficit related to inability to conserve water.
Fluid volume deficit related to osmotic diuresis induced by hyponatremia.
Altered nutrition: Less than body requirements related to hypermetabolic state.
Altered nutrition: Less than body requirements related to catabolic effects of insulin deficiency.
Which sign indicates the second phase of acute renal failure?
Daily doubling of urine output (4 to 5 L/day).
Urine output less than 400 ml/day.
Urine output less than 100 ml/day.
Stabilization of renal function.
Your patient had surgery to form an arteriovenous fistula for hemodialysis. Which information is important for providing care for the patient?
Taking a blood pressure reading on the affected arm can cause clotting of the fistula.
The patient shouldn’t feel pain during initiation of dialysis.
The patient feels best immediately after the dialysis treatment.
Using a stethoscope for auscultating the fistula is contraindicated.
A patient with diabetes mellitus and renal failure begins hemodialysis. Which diet is best on days between dialysis treatments?
Low-protein diet with a prescribed amount of water.
Low-protein diet with unlimited amounts of water.
No protein in the diet and use of a salt substitute
No restrictions.
After the first hemodialysis treatment, your patient develops a headache, hypertension, restlessness, mental confusion, nausea, and vomiting. Which condition is indicated?
Disequilibrium syndrome.
Respiratory distress.
Hypervolemia.
Peritonitis.
Which action is most important during bladder training in a patient with a neurogenic bladder?
Set up specific times to empty the bladder.
Encourage the use of an indwelling urinary catheter.
Encourage Kegel exercises.
Force fluids.
A patient with diabetes has had many renal calculi over the past 20 years and now has chronic renal failure. Which substance must be reduced in this patient’s diet?
Proteins.
Carbohydrates.
Fats.
Vitamin C.
What is the best way to check for patency of the arteriovenous fistula for hemodialysis?
Palpate the fistula throughout its length to assess for a thrill.
Pinch the fistula and note the speed of filling on release.
Use a needle and syringe to aspirate blood from the fistula.
Check for capillary refill of the nail beds on that extremity.
You have a paraplegic patient with renal calculi. Which factor contributes to the development of calculi?
Increased calcium loss from the bones.
Decreased kidney function.
Decreased calcium intake.
High fluid intake.
What is the most important nursing diagnosis for a patient in end-stage renal disease?
Fluid volume excess.
Risk for injury.
Altered nutrition: less than body requirements.
Activity intolerance.
Frequent PVCs are noted on the cardiac monitor of a patient with end-stage renal disease. The priority intervention is:
Check the patient’s latest potassium level.
Call the doctor immediately.
Give the patient IV lidocaine (Xylocaine).
Prepare to defibrillate the patient.
A patient who received a kidney transplant returns for a follow-up visit to the outpatient clinic and reports a lump in her breast. Transplant recipients are:
At increased risk for cancer due to immunosuppression caused by Cyclosporine (Neoral).
Consumed with fear after the life-threatening experience of having a transplant.
At increased risk for tumors because of the kidney transplant.
At decreased risk for cancer, so the lump is most likely benign
You’re developing a care plan with the nursing diagnosis risk for infection for your patient that received a kidney transplant. A goal for this patient is to:
Remain afebrile and have negative cultures.
Resume normal fluid intake within 2 to 3 days.
Resume the patient’s normal job within 2 to 3 weeks.
Try to discontinue Cyclosporine (Neoral) as quickly as possible.
You suspect kidney transplant rejection when the patient shows which symptoms?
Fever, weight gain, and diminished urine output.
Pain in the incision, general malaise, and hypotension.
Pain in the incision, general malaise, and depression.
D. Diminished urine output and hypotension.
Your patient returns from the operating room after abdominal aortic aneurysm repair. Which symptom is a sign of acute renal failure?
Oliguria
Anuria
Diarrhea
Vomiting
Which cause of hypertension is the most common in acute renal failure?
Hypervolemia
Hypovolemia
Pulmonary edema
Anemia
A patient returns from surgery with an indwelling urinary catheter in place and empty. Six hours later, the volume is 120ml. The drainage system has no obstructions. Which intervention has priority?
Evaluate the patient’s circulation and vital signs.
Give a 500 ml bolus of isotonic saline.
Flush the urinary catheter with sterile water or saline.
Place the patient in the shock position and notify the surgeon.
You’re preparing for urinary catheterization of a trauma patient and you observe bleeding at the urethral meatus. Which action has priority?
Delay catheterization and notify the doctor.
Irrigate and clean the meatus before catheterization.
Check the discharge for occult blood before catheterization.
Heavily lubricate the catheter before insertion.
What change indicates recovery in a patient with nephrotic syndrome?
Disappearance of protein from the urine.
Decrease in blood pressure to normal.
Increase in serum lipid levels.
Gain in body weight.
Which statement correctly distinguishes renal failure from prerenal failure?
With prerenal failure, an IV isotonic saline infusion increases urine output.
With prerenal failure, vasoactive substances such as Dopamine (Intropin) increase blood pressure.
With prerenal failure, there is less response to such diuretics as Furosemide (Lasix).
With prerenal failure, hemodialysis reduces the BUN level.
Which criterion is required before a patient can be considered for continuous peritoneal dialysis?
The patient must be hemodynamically stable.
The vascular access must have healed.
The patient must be in a home setting.
Hemodialysis must have failed.
Polystyrene sulfonate (Kayexalate) is used in renal failure to:
Exchange potassium for sodium.
Correct acidosis.
Reduce serum phosphate levels.
Prevent constipation from sorbitol use.
Your patient has complaints of severe right-sided flank pain, nausea, vomiting, and restlessness. He appears slightly pale and is diaphoretic. Vital signs are BP 140/90 mmHg, Pulse 118 beats/min., respirations 33 breaths/minute, and temperature, 98.0F. Which subjective data supports a diagnosis of renal calculi?
Pain radiating to the right upper quadrant.
History of mild flu symptoms last week.
Dark-colored coffee-ground emesis.
Dark, scanty urine output.
Immunosuppression following kidney transplantation is continued:
For life
24 hours after transplantation
A week after transplantation
Until the kidney is not anymore rejected
