NCLEX Review Questions – Genitourinary System Part 2

1.    After having transurethral resection of the prostate (TURP), a Mr. Locke returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client’s catheter is occluded?
a.    The urine in the drainage bag appears red to pink.
b.    The client reports bladder spasms and the urge to void.
c.    The normal saline irrigant is infusing at a rate of 50 drops/minute.
d.    About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned.

2.    Nurse Myrna is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to:
a.    initiate a stream of urine.
b.    breathe deeply.
c.    turn to the side.
d.    hold the labia or shaft of penis.

3.    A female adult client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?
a.    Blood urea nitrogen (BUN) level of 22 mg/dl
b.    Serum creatinine level of 1.2 mg/dl
c.    Serum creatinine level of 1.2 mg/dl
d.    Urine output of 400 ml/24 hours

4.    A 55-year old client with benign prostatic hyperplasia doesn’t respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, nurse Gail asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal?
a.    Transurethral resection of the prostate (TURP)
b.    Suprapubic prostatectomy
c.    Retropubic prostatectomy
d.    Transurethral laser incision of the prostate

5.    A female client with suspected renal dysfunction is scheduled for excretory urography. Nurse July reviews the history for conditions that may warrant changes in client preparation. Normally, a client should be mildly hypovolemic (fluid depleted) before excretory urography. Which history finding would call for the client to be well hydrated instead?
a.    Cystic fibrosis
b.    Multiple myeloma
c.    Gout
d.    Myasthenia gravis

6.    Nurse Kim  is caring for a client who had a cerebrovascular accident (CVA). Which nursing intervention promotes urinary continence?
a.    Encouraging intake of at least 2 L of fluid daily
b.    Giving the client a glass of soda before bedtime
c.    Taking the client to the bathroom twice per day
d.    Consulting with a dietitian

7.    When examining a female client’s genitourinary system, nurse Sally  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.    A flat sound
b.    A dull sound
c.    Hyperresonance
d.    Tympany

8.    A male client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should nurse Olivia assess first?
a.    Blood pressure
b.    Respirations
c.    Temperature
d.    Pulse

9.    Nurse Hazel is ware that the following is an appropriate nursing diagnosis for a client with renal calculi?
a.    Ineffective tissue perfusion
b.    Functional urinary incontinence
c.    Risk for infection
d.    Decreased cardiac output

10.    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 Andy suspects that the client is at risk for:
a.    cardiac arrhythmia.
b.    paresthesia.
c.    dehydration.
d.    pruritus.

11.    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 Andrew do first?
a.    Increase the I.V. flow rate.
b.    Notify the physician immediately.
c.    Assess the irrigation catheter for patency and drainage.
d.    Administer meperidine (Demerol), 50 mg I.M., as prescribed.

12.    When performing a scrotal examination, nurse Paul finds a nodule. What should the nurse do next?
a.    Notify the physician.
b.    Change the client’s position and repeat the examination.
c.    Perform a rectal examination.
d.    Transilluminate the scrotum.

13.    A male client who has been treated for chronic renal failure (CRF) is ready for discharge. Nurse Bea should reinforce which dietary instruction?
a.    “Be sure to eat meat at every meal.”
b.    “Monitor your fruit intake, and eat plenty of bananas.”
c.    “Increase your carbohydrate intake.”
d.    “Drink plenty of fluids, and use a salt substitute.”

14.    Nurse Wayne is aware that the following statements describing urinary incontinence in the elderly is true?
a.    Urinary incontinence is a normal part of aging.
b.    Urinary incontinence isn’t a disease.
c.    Urinary incontinence in the elderly can’t be treated.
d.    Urinary incontinence is a disease.

15.    The client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Nurse Yoly is aware that the following nursing interventions is appropriate?
a.    Tell the client to try to urinate around the catheter to remove blood clots.
b.    Restrict fluids to prevent the client’s bladder from becoming distended.
c.    Prepare to remove the catheter.
d.    Use aseptic technique when irrigating the catheter.

16.    A female client with a urinary tract infection is prescribed co-trimoxazole (trimethoprim-sulfamethoxazole). Nurse Don should provide which medication instruction?
a.    “Take the medication with food.”
b.    “Drink at least eight 8-oz glasses of fluid daily.”
c.    “Avoid taking antacids during co-trimoxazole therapy.”
d.    “Don’t be afraid to go out in the sun.”

17.    A male client is admitted for treatment of glomerulonephritis. On initial assessment, Nurse Rose detects one of the classic signs of acute glomerulonephritis of sudden onset. Such signs include:
a.    generalized edema, especially of the face and periorbital area.
b.    green-tinged urine.
c.    moderate to severe hypotension.
d.    polyuria.

18.    A client reports experiencing vulvar pruritus. Which assessment factor may indicate that the client has an infection caused by Candida albicans?
a.    Cottage cheese–like discharge
b.    Yellow-green discharge
c.    Gray-white discharge
d.    Discharge with a fishy odor

19.    A 24-year old female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?
a.    This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
b.    The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
c.    The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
d.    The human papillomavirus (HPV), which causes condylomata acuminata, can’t be transmitted during oral sex.

20.    Nurse Vic is monitoring the fluid intake and output of a female client recovering from an exploratory laparotomy. Which nursing intervention would help the client avoid a urinary tract infection (UTI)?
a.    Maintaining a closed indwelling urinary catheter system and securing the catheter to the leg
b.    Limiting fluid intake to 1 L/day
c.    Encouraging the client to use a feminine deodorant after bathing
d.    Encouraging the client to douche once a day after removal of the indwelling urinary catheter

21.    Nurse Eve is caring for a client who had a cerebrovascular accident (CVA). Which nursing intervention promotes urinary continence?
a.    Encouraging intake of at least 2 L of fluid daily
b.    Giving the client a glass of soda before bedtime
c.    Taking the client to the bathroom twice per day
d.    Consulting with a dietitian

22.    A female client with an indwelling urinary catheter is suspected of having a urinary tract infection. Nurse Angel should collect a urine specimen for culture and sensitivity by:
a.    disconnecting the tubing from the urinary catheter and letting the urine flow into a sterile container.
b.    wiping the self-sealing aspiration port with antiseptic solution and aspirating urine with a sterile needle.
c.    draining urine from the drainage bag into a sterile container.
d.    clamping the tubing for 60 minutes and inserting a sterile needle into the tubing above the clamp to aspirate urine.

23.    Nurse Grace is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?
a.    Rashes on the palms of the hands and soles of the feet
b.    Cauliflower-like warts on the penis
c.    Painful red papules on the shaft of the penis
d.    Foul-smelling discharge from the penis

24.    Nurse Ethel is planning to administer a sodium polystyrene sulfonate (Kayexalate) enema to a client with a potassium level of 5.9 mEq/L. Correct administration and the effects of this enema would include having the client:
a.    retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.
b.    retain the enema for 30 minutes to allow for glucose exchange; afterward, the client should have diarrhea.
c.    retain the enema for 60 minutes to allow for sodium exchange; diarrhea isn’t necessary to reduce the potassium level.
d.    retain the enema for 60 minutes to allow for glucose exchange; diarrhea isn’t necessary to reduce the potassium level.

25.    When caring for a male client with acute renal failure (ARF), Nurse Fatima expects to adjust the dosage or dosing schedule of certain drugs. Which of the following drugs would not require such adjustment?
a.    acetaminophen (Tylenol)
b.    gentamicin sulfate (Garamycin)
c.    cyclosporine (Sandimmune)
d.    ticarcillin disodium (Ticar)

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  1. alma

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