NCM 103

POST TEST
Care of Clients with Genito-Urinary Disorders
Name: _________________________________
Date: __________________________________

Year & Section: ___________________

Instructor: ___________________

Test I.Multiple Choice.

Directions: Write the letter of your answer before the each number. ERASURES and SUPERIMPOSITIONS will
invalidate your answers.
1.

Which of the following symptoms is the most common clinical finding associated with bladder cancer?
a. Suprapubic pain
b. Dysuria
c. Painless hematuria
d. Urinary retention

2.

A client is to have a cystoscopy to rule out cancer of the bladder. Which of the following symptoms would
indicate that the client has developed a complication after cystoscopy?
a. Dizziness
b. Chills
c. Pink- tinged urine
d. Bladder spasms

3.

A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively, the
nurse reinforces the clients understanding of the surgical procedure by explaining that an ileal conduit:
a. Is a temporary procedure that can be reversed later.
b. Diverts urine into the sigmoid colon, where it is expelled through the rectum.
c. Conveys urine from the ureters to a stoma opening on the abdomen.
d. Creates an opening in the bladder that allows urine to drain into an external pouch.

4.

After surgery for an ileal conduit, the nurse should closely evaluate the client for the occurrence of which of
the following complications related to pelvic surgery?
a. Peritonitis
b. Thrombophlebitis
c. Ascites
d. Inguinal hernia

5.

Which of the following solutions will be useful to help control odor in the urine collecting bag after it has been
cleaned?
a. Salt water
b. Vinegar
c. Ammonia
d. Bleach

6.

A female client who has urinary diversion tells the nurse. This urinary pouch is embarrassing. Everyone will
know that Im not normal. The most appropriate nursing diagnosis for this client is:
a. Anxiety related to the urinary diversion
b. Deficient knowledge about how to care for the urinary diversion.
c. Low- self esteem related to feelings of worthlessness.
d. Disturbed body image related to creation of a urinary diversion.

7.

A client is admitted to the hospital with diagnosis of renal calculi. She is experiencing severe flank pain and
complains of nausea. Her temperature is 100.6 F (38.1 C ). Which of the following would be a priority
outcome for this client?
a. Prevention of urinary tract complications
b. Alleviation of nausea
c. Alleviation of pain

d.

Maintenance of fluid and electrolyte balance.

8.

The client is scheduled to have a kidney, ureter and bladder (KUB) radiograph. Which of the following would
be ordered to prepare the client for this radiograph?
a. Fluid and food will be withheld the morning of the examination
b. A tranquilizer will be given before the examination
c. An enema will be given before the examination
d. No special preparation is required for the examination.

9.

The client is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi.
Which of the following measures would be most important for the nurse to include in pretest preparation?
a. Ensuring adequate fluid intake on the day of the test
b. Preparing the client for the possibility of bladder spasms during the test.
c. Checking the clients history for allergy to iodine
d. Determining when the client last had a bowel movement.

10. After an IVP, the nurse should anticipate to incorporate which of the following measures into the clients plan
of care?
a. Maintaining bed rest.
b. Encouraging adequate fluid intake.
c. Assessing for hematuria
d. Administering a laxative
11. The nurse finds a container with the clients urine specimen sitting on a corner in the bathroom. The client
states that the specimen has been sitting in the bathroom for at least 2 hours. What would be the nurses
most appropriate action?
a. Discard the urine and obtain a new specimen.
b. Send the urine to the laboratory as quickly as possible.
c. Add fresh urine to the collected specimen and send the specimen to the laboratory.
d. Refrigerate the specimen until it can be transported to the laboratory.
12. The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of
the following findings would be most important for the nurse to report to the physician?
a. Temperature, 99.8 F (37.7 C)
b. Urine output, 20 mL/hour.
c. Absence of bowel sounds.
d. A 2 x 2 inch area of serosanguinous drainage on the flank dressing.
13. Because clients renal stone was found to be composed of uric acid, a low purine, alkaline ash diet was
ordered. Incorporation of which of the following food items into the home diet would indicate that the client
understands the necessary diet modifications?
a. Milk, apples, tomatoes, and corn
b. Eggs, spinach, dried peas and gravy
c. Salmon, chicken, caviar and asparagus
d. Grapes, corn, cereals and liver
14. The client has a clinic appointment scheduled for 10 days after discharge. Which laboratory finding at that
time would indicate that Allopurinol (Zyloprim) has had a therapeutic effect?
a. Decreased urinary alkaline phosphatase level.
b. Increased urinary calcium excretion.
c. Increased serum calcium level.
d. Decreased serum uric acid level.
15. Which of the following urinary symptoms is the most common initial manifestation of acute renal failure?
a. Dysuria
b. Anuria
c. Hematuria
d. Oliguria
16. The clients serum potassium is elevated in acute renal failure, and the nurse administers Sodium
Polysterene Sulfonate (Kayexalate). The drug acts to:
a. Increase potassium excretion from the colon.

b.
c.
d.

Release hydrogen ions for sodium ions.

Increase calcium absorption in the colon.
Exchange sodium for potassium ions in the colon.

17. If the clients serum potassium continues to rise in acute renal failure, the nurse should be prepared for
which of the following emergency situations?
a. Cardiac arrest
b. Pulmonary edema
c. Circulatory collapse
d. Hemorrhage
18. In the oliguric phase of acute renal failure, the nurse should anticipate the development of which of the
following complications?
a. Pulmonary edema
b. Metabolic alkalosis
c. Hypotension
d. Hypokalemia
19. The nurse initiates the clients first hemodialysis treatment. The client develops a headache, confusion and
nausea. These symptoms indicate which of the following potential complications?
a.
Disequilibrium syndrome
b. Myocardial infraction
c. Air embolism
d. Peritonitis
20. Which of the following abnormal blood values would not be improved by dialysis treatment?
a. Elevated serum creatinine
b. Hyperkalemia
c. Decreased hemoglobin
d. Hypernatremia
21. A 24 year old female client comes to an ambulatory care clinic in moderate distress with a probable
diagnosis of acute cystitis. Which of the following symptoms would the nurse most likely expect the client to
report during assessment?
a. Fever and chills
b. Frequency and burning on urination
c. Flank pain and nausea
d. Hematuria
22. The nurse is instructing the unlicensed assistant on the correct technique for obtaining a clean catch urine
culture from a client. Which of the following statements indicates that the assistant has understood the
instructions?
a. I will have the client completely empty her bladder into the specimen cup.
b. I will have the client completely the client to get the urine specimen.
c. I will ask the client to cleanse her labia, void into the toilet, and then into the specimen cup.
d. I will obtain the specimen in the afternoon after the client has had plenty of fluids.
23. The client with cystitis is also given a prescription of Phenazopyridine Hydrochloride (Pyridium). The nurse
should teach the client that this drug is used to treat urinary tract infections by?
a. Releasing formaldehyde and providing bacteriostatic action.
b. Potentiating the action of the antibiotic.
c. Providing an analgesic effect on the bladder mucosa.
d. Preventing the crystallization that can occur with sulfa drugs.
24. Which of the following statements by the client would indicate that she is at high risk for the recurrence of
cystitis?
a. I can usually go 8 to 10 hours without needing to empty my bladder.
b. I take a tub bath every evening.
c. I wipe from front to back after voiding.
d. I drink a lot of water during the day.

25. The nurse assesses the client who has chronic renal failure and notes the following: crackles in the lung
bases, elevated blood pressure, and weight gain of 2 pounds in 1 day. Based on these data, which of the
following nursing diagnosis is appropriate?
a. Excess fluid volume related to the kidneys inability to maintain fluid balance.
b. Increased cardiac output related to fluid overload.
c. Ineffective tissue perfusion related to interrupted arterial blood flow.
d. Ineffective therapeutic regime management related to lack of knowledge about therapy.
26. The client with chronic renal failure complains of feeling nauseated at least part of every day. The nurse
should explain that the nausea is the result of:
a. Acidosis caused by the medications
b. Accumulation of waste products in the blood.
c. Chronic anemia and fatigue.
d. Excess fluid load.
27. The dialysis solution is warmed before use in peritoneal dialysis primarily to?
a. Encourage the removal of serum area.
b. Force potassium back into the cells.
c. Add extra warmth to the body.
d. Promote abdominal muscle relaxation.
28. During dialysis, the nurse observes that the flow of dialysate stops before all the solution has drained out.
The nurse should:
a. Have client to sit in a chair.
b. Turn the client from side to side.
c. Reposition the peritoneal catheter.
d. Have the client walk.
29. Which of the following nursing interventions should be included in the clients care plan during dialysis
therapy?
a. Limit the clients visitors.
b. Monitor clients blood pressure.
c. Pad the side rails of the bed.
d. Keep the client NPO.
30. What is the most potentially dangerous complication of peritoneal dialysis?
a. Abdominal pain
b. Gastrointestinal bleeding.
c. Peritonitis
d. Muscle cramps.
31. Aluminum hydroxide gel (Amphogel) is prescribed for the client with chronic renal failure to take at home.
What is the purpose of giving this drug to a client with chronic renal failure?
a. To relieve the pain of gastric hyperacidity
b. To prevent Curlings stress ulcers.
c. To bind phosphate in the intestines.
d. To reverse metabolic acidosis.
32. The client with chronic renal failure told the nurse, he takes magnesium hydroxide (milk of magnesia) at
home for constipation. The nurse suggests that the client switch to psyllium hydrophilic mucilloid (Metamucil)
because:
a. Milk of magnesia can cause magnesium intoxication
b. Milk of magnesia is too harsh on the bowel.
c. Metamucil is more palatable.
d. Milk of magnesia is high in sodium.
33. The nurse helps the client with chronic renal failure develop a home diet plan with the goal of helping the
client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a
client with chronic renal failure?
a. High carbohydrate, high protein.
b. High calcium, high potassium, high protein.

c.
d.

Low protein, low sodium, low potassium.

Low protein, high potassium.

34. Sexual problems can be troublesome to clients with chronic renal failure. Which one of the following
strategies would be most useful in helping a client cope with such a problem?
a. Help the client to accept that sexual activity will be decreased.
b. Suggest using alternative forms of sexual expression and intimacy.
c. Tell the client to plan rest periods after sexual activity.
d. Suggest that the client avoid sexual activity to prevent embarrassment.
35. Which of the following is the most significant sign of peritoneal infection?
a. Cloudy dialysate fluid
b. Swelling in the legs
c. Poor drainage of the dialysate fluid
d. Redness at the catheter insertion site.