Verified Test Bank Ch.27 | Nursing Care Of Patients With - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 27 Nursing Care of Patients with Urinary Tract Disorders
1) A female patient has a history of repeated urinary tract infections (UTIs). What should the nurse include in the assessment of this patient?
1. Preferred method of birth control
2. Employment status
3. Height and weight
4. Activity status
Page Ref: 872
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
2) The nurse is caring for an older patient who is prone to developing urinary tract infections (UTIs). Which method of bladder emptying should be recommended for this patient?
1. Intermittent catheterization
2. Indwelling urinary catheterizations
3. Credé method
4. Timed intervals for taking patient to bathroom to void
Page Ref: 874
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
3) A patient is diagnosed with chronic pyelonephritis. Which health problem is this patient at risk for developing?
1. Chronic kidney disease
2. Cystitis
3. Acute renal failure
4. Renal calculi
Page Ref: 874
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
4) A patient with an indwelling urinary catheter is exhibiting signs of asymptomatic bacteriuria. What would be the best course of action for this patient?
1. Removing the catheter and beginning antibiotic therapy
2. Beginning intravenous antibiotic therapy
3. Beginning 3-day course of oral antibiotic therapy
4. Removing the catheter and monitoring for continued signs of bacteriuria
Page Ref: 873-874
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
5) A female patient asks the nurse for ways to prevent recurrent urinary tract infections. How should the nurse respond?
1. "Avoid douching."
2. "Clean the perineal area from back to front."
3. "Use feminine hygiene sprays."
4. "Wear clean nylon underpants."
Page Ref: 879
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
6) A male patient comes to the emergency department with symptoms of renal colic. Which body structure should the nurse realize is obstructed by a calculus?
1. Ureter
2. Bladder
3. Renal pelvis
4. Urethra
Page Ref: 882
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 27.2 Describe the pathophysiology and manifestations of urinary calculi, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
7) A male patient has a history of calcium calculi. Which medication should the nurse expect to be prescribed for this patient?
1. Metolazone (Zaroxolyn)
2. Penicillin (Pentids)
3. Allopurinol (Alloprim)
4. NSAIDs
Page Ref: 881
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.2 Describe the pathophysiology and manifestations of urinary calculi, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
8) A male patient is admitted for removal of a bladder papilloma. What should the nurse assess in this patient?
1. History of cigarette smoking
2. Daily fluid intake
3. Pedal pulses
4. Appetite level
Page Ref: 886
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
9) A patient is discharged after transurethral resection of a superficial bladder tumor. What should the nurse include in this patient's discharge instructions? Select all that apply.
1. Avoid constipation and continue to use stool softener.
2. Increase fluid intake.
3. Maintain bed rest.
4. Call the physician if painless hematuria develops.
5. Make a follow-up appointment in 1 year.
Page Ref: 888
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
10) A patient has had a renal stent removed. What should be included in the care of this patient?
1. Monitoring urine output
2. Encouraging ambulation
3. Ensuring adequate protein intake
4. Monitoring blood pressure
Page Ref: 890
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
11) A male patient with a urinary stoma says, "I looked at it while you were out of the room. It's not so bad." Which behavior should the nurse consider this patient is demonstrating?
1. Coping
2. Denial
3. Grief
4. Anger
Page Ref: 891
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with urinary tract disorders.
12) A middle-aged male patient comes to the clinic complaining of "frequency" and voiding "small amounts of urine at a time." Which health problem should the nurse suspect is occurring with this patient?
1. Benign prostatic hypertrophy (BPH)
2. Cystitis
3. Renal calculi
4. Bladder cancer
Page Ref: 893
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
13) A female patient is admitted with an overdistended bladder. Which diagnostic test can be done to confirm the diagnosis of urine retention?
1. Bladder scan
2. Renal scan
3. Intravenous pyelography (IVP)
4. MRI
Page Ref: 893
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
14) While being catheterized for urinary retention, a patient becomes diaphoretic and pale. What should the nurse do to help this patient?
1. The nurse should clamp the catheter after draining 500 mL of urine.
2. No action is needed, as this situation is transient.
3. The nurse should remove the urinary catheter.
4. The nurse should provide the patient with fluids.
Page Ref: 894
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
15) An older patient with diabetes is diagnosed with a flaccid bladder. What should be included in the care of this patient?
1. Instruction on the Credé method of bladder emptying
2. The importance of maintaining alkaline urine
3. Instruction on the use of anticholinergic medications
4. Reminder to restrict fluids
Page Ref: 896
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
16) A female patient with multiple medical problems experiences incontinence, regardless of the position or situation. For which type of incontinence should the nurse plan care?
1. Total
2. Urge
3. Stress
4. Overflow
Page Ref: 897
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
17) An 80-year-old female patient says to the nurse, "I can't hold my water very well so I don't leave the house much." What is an appropriate nursing response?
1. "This is not something you have to live with. Talk with your doctor about this problem."
2. "I understand."
3. "I guess it's hard getting older."
4. "Do you get enjoyment out of watching television?"
Page Ref: 897
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Therapeutic Communication
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
18) A patient who is recovering from spinal surgery had "an accident" while attempting to reach the bathroom to void. Which type of incontinence did this patient probably experience?
1. Functional
2. Urge
3. Stress
4. Total
Page Ref: 897
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
19) A patient is scheduled for a lithotripsy for renal calculi. What should the nurse explain to the patient as the purpose of a bowel preparation prior to this procedure?
1. Ensuring maximum visualization of the kidney and the stones
2. Ensuring that there is no evidence of constipation prior to the procedure
3. Increasing comfort
4. Reducing postoperative pain
Page Ref: 884
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.2 Describe the pathophysiology and manifestations of urinary calculi, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
20) A patient is participating in bladder retraining activities. Which toileting activity will reduce the patient's episodes of incontinence? Select all that apply.
1. Scheduled toileting
2. Habit training
3. Intermittent straight catheterization
4. External catheter placement at bedtime
5. Use of adult incontinence protection devices
Page Ref: 900
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
21) A patient is being instructed on how to perform Kegel exercises. What should be included in these instructions? Select all that apply.
1. While voiding, stop the flow of urine and hold for a few minutes.
2. Tighten the muscles around the anus to resist defecation.
3. Take a deep breath and hold while performing the exercise.
4. Perform these exercises at least once per day.
5. Perform these exercises for at least several months.
Page Ref: 898
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
22) A patient with a urinary diversion device is at risk for impaired skin integrity. Which intervention should the nurse perform for this patient?
1. Emptying the bag reservoir every 2 hours
2. Changing urine collection device every other day
3. Teaching self-catheterization technique
4. Monitoring for foul-smelling urine
Page Ref: 890
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
23) An older female patient asks why she is having more urinary tract infections (UTIs) now that she is older. What should the nurse explain is a contributing factor to the incidence of UTIs among older adult females?
1. Loss of tissue elasticity
2. Enhanced immune response
3. Reduced risk of urinary stasis
4. Reduced and less protective prostatic secretions
Page Ref: 872-873
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
24) A patient diagnosed with a symptomatic urinary tract infection (UTI) is prescribed phenazopyridine (Pyridium). What should the nurse instruct the patient about the color of the urine?
1. It will become orange or red.
2. It will have a green tint.
3. It will turn brown.
4. It will become clearer and pale yellow.
Page Ref: 876
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
25) The nurse is preparing to collect a urine culture specimen from a catheterized patient. What should the nurse do to safely obtain this specimen?
1. With a sterile syringe, aspirate several milliliters of urine from the sampling port using sterile technique.
2. Disconnect the catheter from the drainage tubing and allow 1-3 mL of urine to drain into a sterile specimen container.
3. With a sterile syringe and needle, aspirate 50 mL of urine from the catheter above where it is connected to the drainage tubing.
4. Empty a small volume of urine from the urine collection bag into a sterile specimen cup.
Page Ref: 874
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
26) The nurse instructs a female patient on ways to prevent urinary tract infections (UTIs). Which patient statement indicates that teaching has been effective?
1. "I should drink 2 to 2-1/2 quarts of fluid per day."
2. "I should limit my intake of water so I won't need to urinate so often."
3. "I should wear only nylon underpants."
4. "I should void every 6 hours while I am awake."
Page Ref: 877
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
27) The nurse is instructing a patient with uric acid stones on methods to prevent lithiasis. Which patient statement indicates that teaching has been effective?
1. "I should avoid organ meats and sardines in my diet."
2. "I will increase purine-rich foods in my diet."
3. "I know to avoid eating vitamin D-enriched foods."
4. "I will have to make my urine more acidic by eating cheese, cranberries, grapes, and tomatoes."
Page Ref: 881
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 27.2 Describe the pathophysiology and manifestations of urinary calculi, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
28) The nurse observes a distended bladder and no change in urine output in a patient with an indwelling urinary catheter and drainage system. What should the nurse do first?
1. Assess the catheter tubing for kinks and position it so drainage is maintained by gravity.
2. Notify the physician.
3. Flush the catheter with sterile saline using a large syringe.
4. Change the catheter.
Page Ref: 890
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
29) A patient with pyelonephritis asks the nurse to explain the condition. How should the nurse respond?
1. "It is an infection of the kidney."
2. "It is an inflammation of the bladder."
3. "It is an infection of the lower urinary tract."
4. "It is a blockage in the tube from your kidney to your bladder."
Page Ref: 874
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with urinary tract disorders.
30) A patient is diagnosed with struvite kidney stones. What interventions should the nurse anticipate being prescribed for this patient?
1. Surgical intervention and antibiotic therapy
2. Limiting foods high in calcium and taking thiazide diuretics
3. Sodium-restricted diet and taking penicillamine
4. Low-purine diet and taking potassium citrate
Page Ref: 881
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.2 Describe the pathophysiology and manifestations of urinary calculi, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
31) A patient is experiencing postoperative urinary retention. Which medication should the nurse expect to be prescribed for this patient?
1. Bethanechol chloride (Urecholine)
2. Tolterodine (Detrol)
3. Propantheline bromide (Pro-Banthine)
4. Nitrofurantoin (Macrobid)
Page Ref: 895
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
32) The nurse is caring for a patient with a urinary stoma. In which order should the nurse provide care? Place in order the steps of the process.
Choice 1. Cleanse the skin around stoma with soap and water, rinse, and pat or air-dry.
Choice 2. Assess the stoma, noting color and moisture.
Choice 3. Remove the old pouch; use warm water to loosen the seal.
Choice 4. Use the stoma guide to determine the size of the bag opening and/or protective ring. Trim as needed.
Choice 5. Apply the bag with an opening no more than 1-2 mm wider than the outside of the stoma.
Choice 6. Apply a skin barrier; allow the skin to dry, then connect the bag to the urine-collection device.
Page Ref: 890
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
33) A patient is discharged after photocoagulation for a bladder papilloma. When should this patient be instructed to return for a follow-up evaluation with the healthcare provider?
1. 3 months
2. 1 year
3. 3 years
4. If symptoms return in the year following surgery
Page Ref: 887
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
34) A patient with a history of recurrent urinary tract infections (UTIs) asks if there are any complementary approaches to reducing the risk of developing future infections. What should the nurse instruct this patient? Select all that apply.
1. Take saw palmetto.
2. Drink blueberry juice.
3. Drink cranberry juice.
4. Limit the intake of vitamin C.
5. Apply lavender over the abdomen.
Page Ref: 876
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.1 Describe the pathophysiology and manifestations of a urinary tract infection, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
35) A patient with bladder cancer is scheduled for surgery to create a continent urinary reservoir. What should the nurse include when teaching the patient about this procedure? Select all that apply.
1. Electrolytes may need to be monitored.
2. The ureters are brought to the surface.
3. Part of the bowel is used for the pouch.
4. The patient will learn how to perform self-catheterization.
5. A urinary collection device is not necessary.
Page Ref: 889
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 27.3 Describe the pathophysiology and manifestations of urinary tract tumors, and outline the interprofessional care and nursing care of patients with such disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
36) The nurse instructs a patient with spastic bladder about the prescribed medication tolterodine (Detrol). What patient statements indicate that teaching has been effective? Select all that apply.
1. "I can take this with or without food."
2. "This medication might make me drowsy."
3. "I should call my doctor if I have problems breathing."
4. "I should be careful driving while taking this medication."
5. "I can drink wine with dinner while taking this medication."
Page Ref: 895
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with urinary tract disorders.
37) The nurse is planning care for a patient recovering from bladder neck surgery. What should the nurse include in this patient's plan of care? Select all that apply.
1. Securing urinary catheters in position
2. Reporting any onset of bright red urine
3. Measuring urine output and reporting changes
4. Gently tugging on urinary catheter every shift
5. Expecting urine to be pink and gradually clear
Page Ref: 885
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.2 Describe the pathophysiology and manifestations of urinary calculi, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with urinary tract disorders.
38) The nurse provides a patient with a subcutaneous dose of bethanechol chloride (Urecholine). For which manifestation should the nurse prepare to give the patient atropine? Select all that apply.
1. Voided 250 mL
2. Audible wheezes
3. Increase in heart rate
4. Drop in blood pressure
5. New onset shortness of breath
Page Ref: 895
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 27.4 Describe the pathophysiology and manifestations of disorders of urinary elimination (urinary retention, neurogenic bladder, and urinary incontinence), and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with urinary tract disorders.
Document Information
Connected Book
Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
By LeMone, Burke, Gerene Bauldoff
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Chapter 27 Nursing Care Of Patients With Urinary Tract Disorders
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Chapter 28 Nursing Care Of Patients With Kidney Disorders
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