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A nurse is preparing a patient diagnosed with benign prostatic hypertrophy (BPH) for a lower urinary tract cystoscopic examination. The nurse informs the patient that the most common temporary complication experienced after this procedure is what?
- A. Urinary retention
- B. Bladder perforation
- C. Hemorrhage
- D. Nausea
Correct Answer: A
Rationale: After a cystoscopic examination, the patient with obstructive pathology may experience urine retention if the instruments used during the examination caused edema. The nurse will carefully monitor the patient with prostatic hyperplasia for urine retention. Post-procedure, the patient will experience some hematuria, but is not at great risk for hemorrhage. Unless the condition is associated with another disorder, nausea is not commonly associated with this diagnostic study. Bladder perforation is rare.
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The nurse is caring for a patient who is going to have an open renal biopsy. What would be an important nursing action in preparing this patient for the procedure?
- A. Discuss the patients diagnosis with the family.
- B. Bathe the patient before the procedure with antiseptic skin wash.
- C. Administer antivirals before sending the patient for the procedure.
- D. Keep the patient NPO prior to the procedure.
Correct Answer: D
Rationale: Preparation for an open biopsy is similar to that for any major abdominal surgery. When preparing the patient for an open biopsy you would keep the patient NPO. You may discuss the diagnosis with the family, but that is not a preparation for the procedure. A pre-procedure wash is not normally ordered and antivirals are not administered in anticipation of a biopsy.
A patient admitted to the medical unit with impaired renal function is complaining of severe, stabbing pain in the flank and lower abdomen. The patient is being assessed for renal calculi. The nurse recognizes that the stone is most likely in what anatomic location?
- A. Meatus
- B. Bladder
- C. Ureter
- D. Urethra
Correct Answer: C
Rationale: Ureteral pain is characterized as a dull continuous pain that may be intense with voiding. The pain may be described as sharp or stabbing if the bladder is full. This type of pain is inconsistent with a stone being present in the bladder. Stones are not normally situated in the urethra or meatus.
A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?
- A. Ultrasound
- B. X-ray
- C. Computed tomography (CT)
- D. Nuclear scan
Correct Answer: A
Rationale: Ultrasonography is a noninvasive procedure that passes sound waves into the body through a transducer to detect abnormalities of internal tissues and organs. Structures of the urinary system create characteristic ultrasonographic images. Because of its sensitivity, ultrasonography has replaced many other diagnostic tests as the initial diagnostic procedure.
Dipstick testing of an older adult patient's urine indicates the presence of protein in urine protein. Presence indicates which of the following statements is true?
- A. This finding needs to be considered in light of other forms of proteinuria testing.
- B. A finding is a risk factor for incontinence incontinence.
- C. This is is likely the result likely an aging-related change.
- D. This result confirms that it confirms diabetes diabetes mellitus.
Correct Answer: A
Rationale: The test, which detects 30 to1000,000 / \mathrm{dL}$ of protein, should only used as a screening test, as screening affects urine concentration, affects pH concentration, hematuria, and radiocontast affect materials results results. Protein is not a diagnostic of diabetes, it is not age-related, nor is a risk factor for urinary incontinence.
A geriatric nurse is performing an assessment of body systems on an 85-year-old patient. The nurse should be aware of what age-related change affecting the renal or urinary system?
- A. Increased ability to concentrate urine
- B. Increased bladder capacity
- C. Urinary incontinence
- D. Decreased glomerular filtration rate
Correct Answer: D
Rationale: Many age-related changes in the renal and urinary systems should be taken into consideration when taking a health history of the older adult. One change includes a decreased glomerular surface area resulting in a decreased glomerular filtration rate. Other changes include the decreased ability to concentrate urine and a decreased bladder capacity. It also should be understood that urinary incontinence is not a normal age-related change, but is common in older adults, especially in women because of the loss of pelvic muscle tone.