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The nurse is reviewing a patient's chart and notes that the patient has dysuria. To assess whether there is any improvement, which of the following questions should the nurse ask?
- A. Do you have any blood in your urine?
- B. Do you have to urinate very frequently?
- C. Do you have any pain when you urinate?
- D. Do you have to get up at night to urinate?
Correct Answer: C
Rationale: Dysuria is painful urination. The alternate responses are used to assess other urinary tract symptoms: hematuria, nocturia, and frequency.
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The nurse is preparing a patient for a cystoscopy. Which of the following information should the nurse include in patient teaching about the procedure?
- A. NPO for 8 hours to prevent nausea and vomiting.
- B. Strict bed rest for about 4-6 hours.
- C. Request prescribed opioids as necessary for pain.
- D. May experience blood-tinged urine and urinary frequency.
Correct Answer: D
Rationale: Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common, but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required following cystoscopy.
A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine specimen that is an orange colour. Which of the following actions should the nurse take first?
- A. Notify the patient's health care provider.
- B. Ask the patient about use of any medications.
- C. Question the patient about any UTI risk factors.
- D. Teach about the correct procedure for midstream urine collection.
Correct Answer: B
Rationale: An orange colour in the urine is normal with some medications such as sulfasalazine. The colour would not be expected with urinary tract infection, is not a sign that poor technique was used in obtaining the specimen and does not need to be communicated to the health care provider until further assessment is done.
Which of the following actions should the nurse plan to take first when admitting a patient who has a history of neurogenic bladder as a result of a spinal cord injury?
- A. Ask about the usual urinary pattern and any measures used for bladder control.
- B. Assist the patient to the toilet at scheduled times to help ensure bladder emptying.
- C. Check the patient for urinary incontinence every 2 hours to maintain skin integrity.
- D. Use intermittent catheterization on a regular schedule to avoid the risk of infection.
Correct Answer: A
Rationale: Before planning any interventions, the nurse should complete the assessment and determine the patient's normal bladder pattern and the usual measures used by the patient at home. All the other responses may be appropriate, but until the assessment is complete, an individualized plan for the patient cannot be developed.
A patient's urine dipstick indicates a small amount of protein in the urine. Which of the following actions should the nurse take next?
- A. Check which medications the patient is currently taking.
- B. Obtain a clean-catch urine specimen for culture and sensitivity testing.
- C. Ask the patient about any family history of persistent renal failure.
- D. Send a urine specimen to the laboratory to test for ketones and glucose.
Correct Answer: A
Rationale: Normally the urinalysis will show zero to trace amounts of protein, but some medications may give false-positive readings. The other actions by the nurse may be appropriate, but checking for medications that may affect the dipstick accuracy should be done first.
Which of the following techniques should the nurse use to assess the flank area of a patient with pyelonephritis for tenderness?
- A. Push gently into the two lowest intercostal spaces.
- B. Palpate along both sides of the lumbar vertebral column.
- C. Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
- D. Use two fingers to percuss the area between the iliac crest and ribs along the midaxillary line.
Correct Answer: C
Rationale: Checking for flank pain is best performed by percussion of the CVA and asking about pain. The other techniques would not assess for flank pain.