Genitourinary Disorders Nclex RN Answer and Rational

1.Answer b.
Rational: After pelvic surgery, there is an increased chance of thrombophlebitis owing to the pelvic manipulation that can interfere with circulation and promote venous stasis. Peritonitis is a potential complication of any abdominal surgery, not just pelvic surgery. Ascites is most frequently an indication of liver disease. Inguinal hernia may be caused by an increase in intra-abdominal pressure or a congenital weakness of the abdominal wall; ventral hernia occurs at the site of a previous abdominal incision.
2.Answer a.
Rational: A decreased total serum protein occurs as extensive amounts of protein are excreted from the body through the urine. Clients may develop hypocalcemia. Hyperglycemia is not a finding related to nephrotic syndrome. A decreased hematocrit is not a finding related to nephrotic syndrome.
3.Answer b
Rational: Gonorrhea must be reported to the public health department. Bacterial vaginitis, genital herpes, and HPV aren't reportable diseases.
4.Answer a.
Rational: After a renal biopsy, the client is maintained on strict bed rest in a supine position for at least 6 hours to prevent bleeding. If no bleeding occurs, the client typically resumes general activity after 24 hours. Urine output is monitored, but an indwelling catheter is not typically inserted. A pressure dressing is applied over the site, but a sandbag is not necessary. Opioids to control pain would not be anticipated; local discomfort at the biopsy site can be controlled with analgesics.
5.Answer a.
Rational:  Clients who are immunosuppressed, have diabetes mellitus, or have undergone multiple courses of antibiotic therapy are prone to bacterial, fungal, and parasitic infections.
Taking one course of antibiotic therapy or having a family history of UTIs does not make a client at high risk for development of a UTI. A predisposing factor for a UTI is ongoing problems of urinary calculi; one calculus would not place a client at high risk.
6. Answer a .
Rational: Acute pyelonephritis usually begins with a bacterial infection of the lower urinary tract via the ascending urethral route;most infections are due to gram-negative bacilli, such as E. coli, normally found in the GI tract. Thorough perineal care using soap and warm water, and cleansing from
front to back, decreases the likelihood that organisms will be introduced into the urinary
tract and ascend upward toward the kidneys. Although preventing and treating all infections are appropriate, fungal infections from the feet and bacterial infections in the throat or skin are less likely to be immediate sources of infection causing pyelonephritis.
7.Answer c.
 Rational:Managing the client’s pain is the priority nursing goal. Movement of a renal stone (calculus) along the ureter produces excruciating pain, for which narcotic analgesics are usually required. Antispasmodic medications may also be administered to relax the smooth muscle of the ureter and control spasms, but this is not the priority nursing goal. Broad-spectrum antibiotics are not prescribed unless an infection is present.Having the client lay on the left side has no effect on pain relief
8. Answer d.
 Rational: Microvascular complications result from thickening of the vessel membranes in the capillaries and arterioles in response to conditions of chronic hyperglycemia. Although microangiopathy can be found throughout the body, the areas most noticeably affected are the eyes (retinopathy), kidneys (nephropathy),
and the skin (dermopathy). Urine glucose testing is rarely used today; selfmonitoring of blood glucose is a cornerstone of diabetes management. By providing a current blood glucose reading,
self-monitoring of blood glucose enables a client to make self-management decisions regarding meal plans, activity, and medication,if required. A “no concentrated sweets”
is not a recognized meal plan by the American Diabetic Association or the American Dietetic Association. Limiting physical activity that requires lifting has no effect on the prevention of the development of acute renal failure
9.Answer c.
Rational: Water intake depends on the daily urine output. Generally, 600 ml (from insensible loss) plus an amount equal to the previous day’s urine output is allowed for the client
with chronic kidney disease who is not receiving dialysis. The fluid allotment is spaced throughout the day so the client does not become thirsty. For the client with hemodialysis, fluid intake is adjusted so that
weight gains are no more than 1 to 3 kg between dialysis. Skin has a yellow-gray discoloration and is dry and scaly because of a decrease in oil and sweat gland activity.Skin turgor is the resistance of the skin to deformation, especially to being grasped between the fingers. Sodium may be normal or low in renal failure. Because of impaired sodium excretion, sodium along with water is retained. If large quantities of body water are retained, dilutional hyponatremia occurs.
10.Answer a
Rational: Palliative care for the client with advanced cancer includes pain management, emotional support, and comfort measures. The client is in the hospital, so home maintenance doesn't apply at this time. The client has chosen palliative care, so she isn't noncompliant. The client isn't breast-feeding, so the diagnosis of Ineffective breast-feeding doesn't apply.