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The nurse is assessing a male patient with symptoms of a feeling of incomplete bladder emptying and a split, spraying urine stream. Which of the following conditions should the nurse question the patient about when taking a health history?
- A. Bladder infection
- B. Recent kidney trauma
- C. Gonococcal urethritis
- D. Benign prostatic hyperplasia
Correct Answer: C
Rationale: The patient's clinical manifestations are consistent with urethral strictures, a possible complication of gonococcal urethritis. These symptoms are not consistent with benign prostatic hyperplasia, kidney trauma, or bladder infection.
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The nurse is assessing a patient who has a history of a bladder infection. Which of the following findings indicates that the bladder infection has extended into the upper urinary tract?
- A. Dysuria
- B. Urinary frequency
- C. Flank pain
- D. Urinary urgency
Correct Answer: C
Rationale: Flank pain indicates that the patient may have developed pyelonephritis as a complication of the bladder infection. The other clinical manifestations are consistent with a lower urinary tract infection (UTI).
The nurse is caring for a patient who has had a segmental cystectomy. Which of the following information should the nurse include in the postoperative teaching for the patient?
- A. Limit fluid intake for at least 7 days.
- B. Urine should be amber and not contain blood clots.
- C. In about one week urine will have rust-coloured flecks.
- D. Avoid sitz baths for a week after surgery.
Correct Answer: C
Rationale: Approximately 7-10 days following tumour resection or ablation, the patient may observe dark red or rust-coloured flecks in the urine. These are anticipated and represent scabs from the healing tumour resection sites. Other postoperative instructions for a segmental cystectomy include to drink a large volume of fluid each day for the first week following the procedure and to avoid intake of alcoholic beverages. Urine is anticipated to be pink during the first several days after the procedure, but it should not be bright red or contain blood clots. The patient can be encouraged to take a 15-20-minute sitz bath two to three times a day to promote muscle relaxation and to reduce the risk of urinary retention.
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider?
- A. Foul-smelling urine
- B. Complaint of flank pain
- C. Blood pressure 88/45 mm Hg
- D. Temperature 37.8°C (100°F)
Correct Answer: C
Rationale: Low blood pressure (88/45 mm Hg) indicates potential septic shock, a life-threatening complication of pyelonephritis, requiring urgent intervention. Foul-smelling urine, flank pain, and a mild fever are common findings in pyelonephritis but are less critical unless accompanied by systemic signs like hypotension.
The nurse is caring for a patient who has had left-sided extracorporeal shock wave lithotripsy. Which of the following findings is most important to report?
- A. Blood in urine
- B. Left flank pain
- C. Left flank bruising
- D. Drop in urine output
Correct Answer: D
Rationale: A drop in urine output after lithotripsy may indicate obstruction or renal damage, which is a critical complication requiring immediate reporting. Hematuria, left flank pain, and bruising are common post-lithotripsy findings and are less urgent unless severe or persistent.
The home health nurse is teaching a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying. Which of the following patient statements indicates that the teaching has been effective?
- A. I will use a sterile catheter and gloves for each time I self-catheterize.
- B. I will clean the catheter carefully before and after each catheterization.
- C. I will need to buy seven new catheters weekly and use a new one every day.
- D. I will need to take prophylactic antibiotics to prevent any urinary tract infections.
Correct Answer: B
Rationale: Patients who are at home can use a clean technique for intermittent self-catheterization and change the catheter every 7 days. There is no need to use a new catheter every day, to use sterile catheters, or to take prophylactic antibiotics.