NCLEX Quiz: Trivia Questions On Urinary System Disorders

1. After undergoing transurethral resection of the prostate to treat benign prostatic hyperplasia. a male client returns to the room with continuous bladder irrigation. On the first day after surgery. the client reports bladder pain. What should Nurse Anthony do first?

Increase the I.V. flow rate.

Notify the physician immediately.

Assess the irrigation catheter for patency and drainage.

Administer meperidine (Demerol). 50 mg I.M.. as prescribed.

Although postoperative pain is expected. the nurse should make sure that other factors. such as an obstructed irrigation catheter. aren’t the cause of the pain.Option A: Increasing the I.V. flow rate may worsen the pain.Option B: Notifying the physician isn’t necessary unless the pain is severe or unrelieved by the prescribed medication.Option D: After assessing catheter patency. the nurse should administer an analgesic. such as meperidine. as prescribed.

Explanation

Although postoperative pain is expected. the nurse should make sure that other factors. such as an obstructed irrigation catheter. aren’t the cause of the pain.Option A: Increasing the I.V. flow rate may worsen the pain.Option B: Notifying the physician isn’t necessary unless the pain is severe or unrelieved by the prescribed medication.Option D: After assessing catheter patency. the nurse should administer an analgesic. such as meperidine. as prescribed.

2. The client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Nurse Yonny is aware that the following nursing interventions is appropriate?

Tell the client to try to urinate around the catheter to remove blood clots.

Restrict fluids to prevent the client’s bladder from becoming distended.

Prepare to remove the catheter.

Use aseptic technique when irrigating the catheter.

If the catheter is blocked by blood clots. it may be irrigated according to physician’s orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection.Option A: Urinating around the catheter can cause painful bladder spasms.Option B: Encourage the client to drink fluids to dilute the urine and maintain urine output.Option C: The catheter remains in place for 2 to 4 days after surgery and is only removed with a physician’s order.

Explanation

If the catheter is blocked by blood clots. it may be irrigated according to physician’s orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection.Option A: Urinating around the catheter can cause painful bladder spasms.Option B: Encourage the client to drink fluids to dilute the urine and maintain urine output.Option C: The catheter remains in place for 2 to 4 days after surgery and is only removed with a physician’s order.

3. Nurse Karen is caring for a client who had a cerebrovascular accident (CVA). Which nursing intervention promotes urinary continence?

Encouraging intake of at least 2 L of fluid daily

Giving the client a glass of soda before bedtime

Taking the client to the bathroom twice per day

Consulting with a dietitian

By encouraging a daily fluid intake of at least 2 L. the nurse helps fill the client’s bladder. thereby promoting bladder retraining by stimulating the urge to void.Option B: The nurse shouldn’t give the client soda before bedtime; soda acts as a diuretic and may make the client incontinent.Option C: The nurse should take the client to the bathroom or offer the bedpan at least every 2 hours throughout the day; twice per day is insufficient.Option D: Consultation with a dietitian won’t address the problem of urinary incontinence.

Explanation

By encouraging a daily fluid intake of at least 2 L. the nurse helps fill the client’s bladder. thereby promoting bladder retraining by stimulating the urge to void.Option B: The nurse shouldn’t give the client soda before bedtime; soda acts as a diuretic and may make the client incontinent.Option C: The nurse should take the client to the bathroom or offer the bedpan at least every 2 hours throughout the day; twice per day is insufficient.Option D: Consultation with a dietitian won’t address the problem of urinary incontinence.

4. When examining a female client's genitourinary system. Nurse Sandy assesses for tenderness at the costovertebral angle by placing the left hand over this area and striking it with the right fist. Normally. this percussion technique produces which sound?

A flat sound

A dull sound

Hyperresonance

Tympany

Percussion over the costovertebral angle normally produces a dull. thudding sound. which is soft to moderately loud with a moderate pitch and duration. This sound occurs over less dense. mostly fluid-filled matter. such as the kidneys. liver. and spleen.Option A: In contrast. a flat sound occurs over highly dense matter such as muscle.Option C: Hyperresonance occurs over the air-filled. overinflated lungs of a client with pulmonary emphysema or the lungs of a child (because of a thin chest wall).Option D: Tympany occurs over enclosed structures containing air. such as the stomach and bowel.

Explanation

Percussion over the costovertebral angle normally produces a dull. thudding sound. which is soft to moderately loud with a moderate pitch and duration. This sound occurs over less dense. mostly fluid-filled matter. such as the kidneys. liver. and spleen.Option A: In contrast. a flat sound occurs over highly dense matter such as muscle.Option C: Hyperresonance occurs over the air-filled. overinflated lungs of a client with pulmonary emphysema or the lungs of a child (because of a thin chest wall).Option D: Tympany occurs over enclosed structures containing air. such as the stomach and bowel.

5. A male client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should nurse Olivia assess first?

Blood pressure

Respirations

Temperature

Pulse

An elevated serum potassium level may lead to a life-threatening cardiac arrhythmia. which the nurse can detect immediately by palpating the pulse.Option A: The client’s blood pressure may change. but only as a result of the arrhythmia. Therefore. the nurse should assess blood pressure later.Options B and C: The nurse also can delay assessing respirations and temperature because these aren’t affected by the serum potassium level.

Explanation

An elevated serum potassium level may lead to a life-threatening cardiac arrhythmia. which the nurse can detect immediately by palpating the pulse.Option A: The client’s blood pressure may change. but only as a result of the arrhythmia. Therefore. the nurse should assess blood pressure later.Options B and C: The nurse also can delay assessing respirations and temperature because these aren’t affected by the serum potassium level.

6. A male client develops acute renal failure (ARF) after receiving I.V. therapy with a nephrotoxic antibiotic. Because the client's 24-hour urine output totals 240 ml. Nurse Billy suspects that the client is at risk for:

Cardiac arrhythmia.

Paresthesia.

Dehydration.

Pruritus.

As urine output decreases. the serum potassium level rises; if it rises sufficiently. hyperkalemia may occur. possibly triggering a cardiac arrhythmia.Option B: Hyperkalemia doesn’t cause paresthesia (sensations of numbness and tingling).Option C: Dehydration doesn’t occur during this oliguric phase of ARF. although typically it does arise during the diuretic phase.Option D: In a client with ARF. pruritus results from increased phosphates and isn’t associated with hyperkalemia.

Explanation

As urine output decreases. the serum potassium level rises; if it rises sufficiently. hyperkalemia may occur. possibly triggering a cardiac arrhythmia.Option B: Hyperkalemia doesn’t cause paresthesia (sensations of numbness and tingling).Option C: Dehydration doesn’t occur during this oliguric phase of ARF. although typically it does arise during the diuretic phase.Option D: In a client with ARF. pruritus results from increased phosphates and isn’t associated with hyperkalemia.

7. Nurse Harry is aware that the following is an appropriate nursing diagnosis for a client with renal calculi?

Ineffective tissue perfusion

Functional urinary incontinence

Risk for infection

Decreased cardiac output

Infection can occur with renal calculi from urine stasis caused by obstruction.Options A and D aren’t appropriate for this diagnosis.Option B: Retention of urine usually occurs. rather than incontinence.

Explanation

Infection can occur with renal calculi from urine stasis caused by obstruction.Options A and D aren’t appropriate for this diagnosis.Option B: Retention of urine usually occurs. rather than incontinence.

8. A male client who has been treated for chronic renal failure (CRF) is ready for discharge. Nurse Billy should reinforce which dietary instruction?

“Be sure to eat meat at every meal.”

“Monitor your fruit intake. and eat plenty of bananas.”

“Increase your carbohydrate intake.”

“Drink plenty of fluids. and use a salt substitute.”

In a client with CRF. unrestricted intake of sodium. protein. potassium. and fluid may lead to a dangerous accumulation of electrolytes and protein metabolic products. such as amino acids and ammonia. Therefore. the client must limit intake of sodium; meat. which is high in protein; bananas. which are high in potassium; and fluid. because the failing kidneys can’t secrete adequate urine.Option D: Salt substitutes are high in potassium and should be avoided. Extra carbohydrates are needed to prevent protein catabolism.

Explanation

In a client with CRF. unrestricted intake of sodium. protein. potassium. and fluid may lead to a dangerous accumulation of electrolytes and protein metabolic products. such as amino acids and ammonia. Therefore. the client must limit intake of sodium; meat. which is high in protein; bananas. which are high in potassium; and fluid. because the failing kidneys can’t secrete adequate urine.Option D: Salt substitutes are high in potassium and should be avoided. Extra carbohydrates are needed to prevent protein catabolism.

9. When performing a scrotal examination. Nurse Payne finds a nodule. What should the nurse do next?

Notify the physician.

Change the client’s position and repeat the examination.

Perform a rectal examination.

Transilluminate the scrotum.

A nurse who discovers a nodule. swelling. or other abnormal finding during a scrotal examination should transilluminate the scrotum by darkening the room and shining a flashlight through the scrotum behind the mass. A scrotum filled with serous fluid transilluminates as a red glow; a more solid lesion. such as a hematoma or mass. doesn’t transilluminate and may appear as a dark shadow.Option A: Although the nurse should notify the physician of the abnormal finding. performing transillumination first provides additional information.Options B and C: The nurse can’t uncover more information about a scrotal mass by changing the client’s position and repeating the examination or by performing a rectal examination.

Explanation

A nurse who discovers a nodule. swelling. or other abnormal finding during a scrotal examination should transilluminate the scrotum by darkening the room and shining a flashlight through the scrotum behind the mass. A scrotum filled with serous fluid transilluminates as a red glow; a more solid lesion. such as a hematoma or mass. doesn’t transilluminate and may appear as a dark shadow.Option A: Although the nurse should notify the physician of the abnormal finding. performing transillumination first provides additional information.Options B and C: The nurse can’t uncover more information about a scrotal mass by changing the client’s position and repeating the examination or by performing a rectal examination.

10. Nurse Gil is aware that the following statements describing urinary incontinence in the elderly is true?

Urinary incontinence is a normal part of aging.

Urinary incontinence isn’t a disease.

Urinary incontinence in the elderly can’t be treated.

Urinary Incontinence is a disease.

Urinary incontinence isn’t a normal part of aging nor is it a disease. It may be caused by confusion. dehydration. fecal impaction. restricted mobility. or other causes. Certain medications. including diuretics. hypnotics. sedatives. anticholinergics. and antihypertensives. may trigger urinary incontinence. Most clients with urinary incontinence can be treated; some can be cured.

Explanation

Urinary incontinence isn’t a normal part of aging nor is it a disease. It may be caused by confusion. dehydration. fecal impaction. restricted mobility. or other causes. Certain medications. including diuretics. hypnotics. sedatives. anticholinergics. and antihypertensives. may trigger urinary incontinence. Most clients with urinary incontinence can be treated; some can be cured.