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The nurse is assisting the physician in completing a cystoscopy. In which position would the nurse place the client when preparing for the procedure?
- A. On the client's back with knees to the side
- B. On the client's back with feet in the stirrups
- C. On the client's right side with a pillow behind the back
- D. On the client's left side with a pillow behind the back
Correct Answer: B
Rationale: The client who is undergoing a cystoscopy will be positioned on the back with the feet in stirrups. The client is also to have an empty bladder and may be sedated for the procedure.
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The nurse is instructing a 3-year-old's parent regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?
- A. Dysuria
- B. Enuresis
- C. Hematuria
- D. Anuria
Correct Answer: B
Rationale: The nurse would be most correct to document that enuresis, the involuntary voiding during sleep or commonly called 'wetting the bed,' is a normal finding in a pediatric client younger than 5 years old. Dysuria (pain on urination), hematuria (red blood cell in urine), and anuria (urine output less than 50 mL/day) are all abnormal findings needing further investigation.
A client who is suspected of urinary tract infection is asked to collect a 24-hour urine specimen for culture. Which measure can the nurse suggest to the client that may help prevent the entire urine specimen from becoming contaminated?
- A. Collect the voided urine sample primarily before 5 AM.
- B. Refrigerate the specimen until it is taken to the laboratory.
- C. Use the same receptacle for voiding and defecation.
- D. Store the collected urine away from sunlight.
Correct Answer: B
Rationale: To prevent the entire urine specimen from becoming contaminated, the urine specimen should be refrigerated until it can be taken to the laboratory. The nurse should ask the client to use separate receptacles for voiding and defecation to prevent any part of the specimen from being lost or contaminated. Urinating and collecting the urine sample only before 5 AM and collecting and storing the urine away from sunlight will not help prevent the urine specimen from becoming contaminated.
The nurse is teaching a client with oliguria about the steps that occur during the process of urine formation in the order in which they occur. Place the steps in the order the nurse should review them.
- A. Entrance into the Bowman capsule
- B. Drainage from the collecting tubules
- C. Filtration of plasma by glomerulus
- D. Movement through the nephrons to be absorbed or excreted
- E. Flowing into the renal pelvis and down the ureter
- F. Drainage into the bladder then out the urethra
Correct Answer: C,A,D,B,E,F
Rationale: There are three main steps with sub-steps in the complex process of forming urine. The glomerular filtration begins with filtering of the blood plasma by the glomerulus. Next, the filtrate enters Bowman capsule and moves through the tubular system of the nephron and is either absorbed into circulation or excreted as urine. The formed urine drains from the collecting tubules into the renal pelvis and down each ureter to the bladder and out through the urethra.
The nurse is caring for a client about to undergo urologic testing. Which nursing action is best to comfort the client?
- A. Reassure the client the nurses are here to help and all will be fine.
- B. Allow for client's family to be present during testing.
- C. Provide for privacy and allow verbalization of concerns.
- D. Allow the client to determine the care to be provided.
Correct Answer: C
Rationale: Clients undergoing diagnostic testing are often anxious and worried. Clients having urologic testing may also feel embarrassed. Telling the client that all will be well dismisses the client's concerns. Provide privacy, reassurance, and information and maintain professional and empathic attitude. Allowing families to be present during testing and the client to determine care is not appropriate and may be distracting to the client.
The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?
- A. Urinary frequency
- B. Urinary urgency
- C. Urinary incontinence
- D. Urinary stasis
Correct Answer: B
Rationale: The nurse would document urinary urgency. Urinary frequency is urinating more frequently than normal often times due to inadequate emptying of the bladder. Urinary incontinence is the involuntary loss of urine. Urinary stasis is a stoppage or diminution of flow.