1. A client is complaining of severe flank and abdominal pain. A flat plate of the abdomen shows urolithiasis. Which of the following interventions is important?
a. Strain all urine
b. Limit fluid intake
c. Enforce strict bed rest
d. Encourage a high calcium diet
2. A client is receiving a radiation implant for the treatment of bladder cancer. Which of the following interventions is appropriate?
a. Flush all urine down the toilet
b. Restrict the client’s fluid intake
c. Place the client in a semi-private room
d. Monitor the client for signs and symptoms of cystitis
3. A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy?
d. Peptic ulcer disease
4. A client received a kidney transplant 2 months ago. He’s admitted to the hospital with the diagnosis of acute rejection. Which of the following assessment findings would be expected?
b. Normal body temperature
c. Decreased WBC count
d. Elevated BUN and creatinine levels
5. The client is to undergo kidney transplantation with a living donor. Which of the following preoperative assessments is important?
a. Urine output
b. Signs of graft rejection
c. Signs and symptoms of rejection
d. Client’s support system and understanding of lifestyle changes.
6. A client had a transurethral prostatectomy for benign prostatic hypertrophy. He’s currently being treated with a continuous bladder irrigation and is complaining of an increase in severity of bladder spasms. Which of the interventions should be done first?
a. Administer an oral analgesic
b. Stop the irrigation and call the physician
c. Administer a belladonna and opium suppository as ordered by the physician.
d. Check for the presence of clots, and make sure the catheter is draining properly.
7. A client is admitted with a diagnosis of hydronephrosis secondary to calculi. The calculi have been removed and postobstructive diuresis is occurring. Which of the following interventions should be done?
a. Take vital signs every 8 hours
b. Weigh the client every other day
c. Assess for urine output every shift
d. Monitor the client’s electrolyte levels.
8. A client has passed a renal calculus. The nurse sends the specimen to the laboratory so it can be analyzed for which of the following factors?
b. Type of infection
c. Composition of calculus
d. Size and number of calculi
9. Which of the following symptoms indicate acute rejection of a transplanted kidney?
a. Edema, nausea
b. Fever, anorexia
c. Weight gain, pain at graft site
d. Increased WBC count, pain with voiding
10. Adverse reactions of prednisone therapy include which of the following conditions?
a. Acne and bleeding gums
b. Sodium retention and constipation
c. Mood swings and increased temperature
d. Increased blood glucose levels and decreased wound healing.
11. The nurse suspects that a client with polyuria is experiencing water diuresis. Which laboratory value suggests water diuresis?
a. High urine specific gravity
b. High urine osmolarity
c. Normal to low urine specific gravity
d. Elevated urine pH
12. A client is diagnosed with prostate cancer. Which test is used to monitor progression of this disease?
a. Serum creatinine
b. Complete blood cell count (CBC)
c. Prostate specific antigen (PSA)
d. Serum potassium
13. A 27-year old client, who became paraplegic after a swimming accident, is experiencing autonomic dysreflexia. Which condition is the most common cause of autonomic dysrelexia?
a. Upper respiratory infection
c. Bladder distention
14. When providing discharge teaching for a client with uric acid calculi, the nurse should an instruction to avoid which type of diet?
15. The client with urolithiasis has a history of chronic urinary tract infections. The nurse concludes that this client most likely has which of the following types of urinary stones?
a. Calcium oxalate
b. Uric acid
16. The nurse is receiving in transfer from the postanesthesia care unit a client who has had a percutaneous ultrasonic lithrotripsy for calculuses in the renal pelvis. The nurse anticipates that the client’s care will involve monitoring which of the following?
a. Suprapubic tube
b. Urethral stent
c. Nephrostomy tube
d. Jackson-Pratt drain
17. The client is admitted to the ER following a MVA. The client was wearing a lap seat belt when the accident occurred. The client has hematuria and lower abdominal pain. To determine further whether the pain is due to bladder trauma, the nurse asks the client if the pain is referred to which of the following areas?
c. Costovertebral angle
18. The client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client’s problem is related to bacterial prostatitis, the nurse would look at the results of the prostate examination, which should reveal that the prostate gland is:
a. Tender, indurated, and warm to the touch
b. Soft and swollen
c. Tender and edematous with ecchymosis
d. Reddened, swollen, and boggy.
19. The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To determine whether the client currently is experiencing difficulty, the nurse asks the client about the presence of which of the following early symptoms?
a. Urge incontinence
c. Decreased force in the stream of urine
d. Urinary retention
20. The client who has a cold is seen in the emergency room with inability to void. Because the client has a history of BPH, the nurse determines that the client should be questioned about the use of which of the following medications?
21. The nurse is preparing to care for the client following a renal scan. Which of the following would the nurse include in the plan of care?
a. Place the client on radiation precautions for 18 hours
b. Save all urine in a radiation safe container for 18 hours
c. Limit contact with the client to 20 minutes per hour.
d. No special precautions except to wear gloves if in contact with the client’s urine.
22. The client passes a urinary stone, and lab analysis of the stone indicates that it is composed of calcium oxalate. Based on this analysis, which of the following would the nurse specifically include in the dietary instructions?
a. Increase intake of meat, fish, plums, and cranberries
b. Avoid citrus fruits and citrus juices
c. Avoid green, leafy vegetables such as spinach.
d. Increase intake of dairy products.
23. The client returns to the nursing unit following a pyelolithotomy for removal of a kidney stone. A Penrose drain is in place. Which of the following would the nurse include on the client’s postoperative care?
a. Sterile irrigation of the Penrose drain
b. Frequent dressing changes around the Penrose drain
c. Weighing the dressings
d. Maintaining the client’s position on the affected side
24. The nurse is caring for a client following a kidney transplant. The client develops oliguria. Which of the following would the nurse anticipate to be prescribed as the treatment of oliguria?
a. Encourage fluid intake
b. Administration of diuretics
c. Irrigation of foley catheter
d. Restricting fluids
25. A week after kidney transplantation the client develops a temperature of 101, the blood pressure is elevated, and the kidney is tender. The x-ray results the transplanted kidney is enlarged. Based on these assessment findings, the nurse would suspect which of the following?
a. Acute rejection
b. Chronic rejection
c. Kidney infection
d. Kidney obstruction