Urinary NCLEX RN Questions Related

The following scenario applies to the next 1 items
The student nurse is assisting the nurse in caring for a 31-year-old female in the outpatient clinic.
Item 1 of 1
Nurses' Note
1415: The client requested her annual physical be moved up because of urinary symptoms that started nine months ago. She states that she has managed so far with them, but she is starting a new traveling job and would like to get any necessary treatment. She states that every time she laughs or sneezes, she leaks a small amount of urine. She reports that this also occurs while performing intense physical exercise. The symptoms occur daily. She denies increased frequency, urgency, and burning upon urination. She denies having any vaginal discharge. She was treated for a urinary tract infection two months ago with antibiotics.

Diagnostic Results
1500:
Bladder scan - post-void residual
20 mL

Medical History
• Chronic low back pain following a motor vehicle crash
• Obstetric history - G = 2, T = 2 (vaginal deliveries), P = 0, A = 0, L = 2

The nurse reviews the concept of urinary incontinence, its causes, and symptoms with the student nurse. Click to specify if the causes or symptoms are consistent with the disease process of stress incontinence, overflow incontinence, or urge incontinence.

• A. Urine loss with physical exertion, cough, sneeze, or exercise
• B. Palpable bladder during assessment
• C. Caused by neurologic disorders, such as multiple sclerosis or spinal cord damage
• D. Caused by vaginal prolapse from vaginal birth or aging
• E. Caused by bladder irritants, such as artificial sweeteners, caffeine, alcohol
• F. Caused by constipation
• G. Loss of large amounts of urine with each occurrence

Intravenous therapies often consist of electrolyte replacement therapies. Select the electrolyte that is accurately paired with one of its functions.

• A. Sodium: The control and management of circulating blood volume.
• B. Bicarbonate: The regulation of extracellular fluid.
• C. Chloride: The regulation of plasma protein.
• D. Calcium: The metabolism of fats, carbohydrates, and proteins.

The nurse is assessing a client who was admitted four hours ago with hypomagnesemia. Which of the following findings should the nurse recognize as a common cause of hypomagnesemia? Select all that apply.

• A. Renal failure
• B. Alcoholism
• C. Anorexia nervosa
• D. Diarrhea
• E. Hypothyroidism

The nurse cares for a client with a serum sodium level of 152 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]. Which of the following assessment findings would be expected? Select all that apply.

• A. Lethargy
• B. Dry mucous membranes
• C. Tachypnea
• D. Cyanosis
• E. Excessive thirst

The nurse in the emergency department (ED) is caring for a 57-year-old male client.
Item 4 of 6
History and Physical
A 57-year-old male client with stage three small cell lung cancer. The client had suddenly become disoriented and did not recognize his family members and relatives. He reports severe lower extremity weakness and has had three episodes of diarrhea in the past four hours. The client is undergoing 6 cycles of chemotherapy with cisplatin and etoposide. He is currently taking a 14-day course of 15 mg of prednisone. He is on his third day of steroid treatment. He has a medical history of dyslipidemia and advanced chronic obstructive pulmonary disease.

Laboratory Results
• Hemoglobin 14 g/dL [14-18 g/dL (140–180 g/L)]
• Hematocrit 42% (0.42) [42-52% (0.42-0.52)]
• White Blood Cell 11,000 mm3 [5-10 mm3]
• Platelet Count 140,000 mm3 [150-400 mm3 (150–400 × 109/L)]
• Glucose 139 mg/dL (7.72 mmol/L) [70–110 mg/dL (4-6 mmol/L)]
• Sodium 116 mEq/L [136–145 mEq/L (mmol/L)]
• Potassium 3.3 mEq/L [3.5–5.0 mEq/L (mmol/L)]
• Creatinine 0.7 mg/dL (61.88 mmol/L) [0.6–1.2 mg/dL (53–106 mmol/L)]
• Blood Urea Nitrogen 8 mg/dL (2.86 mmol/L) [10–20 mg/dL (3.6–7.1 mmol/L)]
• Serum Osmolality 277 mOsm/kg [285-295 mOsm/kg (285–295 mmol/kg)]

Nurses' Notes
0759: Client is completely disoriented and required maximum assistance to the stretcher because of unsteady gait. Lung sounds clear bilaterally. Alopecia noted. Skin is warm and dry and normal for ethnicity. Peripheral pulses 2+. No skin tenting. Hyperactive bowel sounds in all quadrants. 20-gauge peripheral vascular access device placed in the left antecubital space. T 97.8° F (36.6° C) P 88 RR 21 BP 123/68 Pulse oximetry reading 91% on room air.
0850: Verbal order was received from physician to insert indwelling urethral catheter.
0910: Urinary catheter inserted with sterile technique. 40 mL of dark yellow urine returned.

The physician diagnoses the client with syndrome of inappropriate antidiuretic hormone. The nurse updates the nurses' notes. For each potential order, click to specify whether the potential order is indicated or not indicated for the client.

• A. thiazide diuretic
• B. continuous cardiac monitoring
• C. seizure precautions
• D. intravenous hypotonic fluids
• E. urology consultation
• F. desmopressin {DDAVP}