N4 - test - Chap 44 Renal and Urologic Probs

1. In teaching a patient with pyelonephritis about the disorder, the nurse informs the patient that the organisms that cause pyelonephritis most commonly reach the kidneys through
A. the bloodstream.
B. the lymphatic system.
C. a descending infection.
D. an ascending infection.

2. The nurse teaches the female patient who has frequent UTIs that she should
A. urinate after sexual intercourse.
B. take tub baths with bubble bath.
C. take prophylactic sulfonamides for the rest of her life.
D. restrict fluid intake to prevent the need for frequent voiding.

3. The immunologic mechanisms involved in glomerulonephritis include
A. tubular blocking by precipitates of bacteria and antibody reactions.
B. deposition of immune complexes and complement along the GBM.
C. thickening of the GBM from autoimmune microangiopathic changes.
D. destruction of glomeruli by proteolytic enzymes contained in the GBM.

4. One of the most important roles of the nurse in relation to acute poststreptococcal glomerulonephritis is to
A. promote early diagnosis and treatment of sore throats and skin lesions.
B. encourage patients to request antibiotic therapy for all upper respiratory infections.
C. teach patients with APSGN that long-term prophylactic antibiotic therapy is necessary to prevent recurrence.
D. monitor patients for respiratory symptoms that indicate that the disease is affecting the alveolar basement membrane.

5. The edema that occurs in nephrotic syndrome is due to
A. decreased aldosterone secretion from adrenal insufficiency.
B. increased hydrostatic pressure caused by sodium retention.
C. increased fluid retention caused by decreased glomerular filtration.
D. decreased colloidal osmotic pressure caused by loss of serum albumin.

6.A patient is admitted to the hospital with severe renal colic caused by renal lithiasis. The nurse’s first priority in management of the patient is to
A. administer narcotics as prescribed.
B. obtain supplies for straining all urine.
C. encourage fluid intake of 3 to 4 L per day.
D. keep the patient NPO in preparation for surgery.

7. The nurse recommends genetic counseling for the children of a patient with
A. nephrotic syndrome.
B. chronic pyelonephritis.
C. malignant nephrosclerosis.
D. adult-onset polycystic renal disease.

8. The nurse encourages strict diabetic control in the patient prone to diabetic nephropathy knowing that the renal tissue changes that may occur in this condition include
A. uric acid calculi and nephrolithiasis.
B. renal sugar-crystal calculi and cysts.
C. lipid deposits in the glomeruli and nephrons.
D. thickening of the GBM and glomerulosclerosis.

9. The nurse identifies a risk factor for kidney and bladder cancer in a patient who relates a history of
A. aspirin use.
B. tobacco use.
C. chronic alcohol abuse.
D. use of artificial sweeteners.

10. In planning nursing interventions to increase bladder control in the patient with urinary incontinence, the nurse includes
A. restricting fluids to diminish the risk of urinary leakage.
B. counseling the patient concerning choice of incontinence containment device.
C. clamping and releasing a catheter to increase bladder tone.
D. teaching the patient biofeedback mechanisms to suppress the urge to void.

11. A patient with a ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes
A. encouraging the patient to drink fruit juices and milk.
B. forcing fluids of at least 2 to 3 L per day after nausea has subsided.
C. notifying the physician if nephrostomy tube drainage is more than 30 ml per hour.
D. irrigating the nephrostomy tube with 10 ml of normal saline solution as needed.

12. A patient has had a cystectomy and ileal conduit diversion performed. Four days postoperatively, 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 it as a normal observation.