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.

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Genitourinary Disorders Nclex RN Practice Questions

1.After surgery for an ileal conduit, the nurse should closely assess the client for the occurrence of which of the following complications related to pelvic surgery?
a)Peritonitis.
b)Thrombophlebitis.
c)Ascites.
d)Inguinal hernia

2.Which of the following laboratory findings is present in nephrotic syndrome?
a)Decreased total serum protein.
b)Hypercalcemia.
c)Hyperglycemia.
d)Decreased hematocrit

3.A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department?
a)Bacterial vaginitis
b)Gonorrhea
c)Genital herpes
d)Human papillomavirus (HPV)

4.When caring for a client after a closed renal biopsy, the nurse should?
a)Maintain the client on strict bed rest in a supine position for 6 hours.
b)Insert an indwelling catheter to monitor urine output.
c)Apply a sandbag to the biopsy site to prevent bleeding.
d)Administer I.V. opioid medications to promote comfort

5. The nurse is planning care for a group of hospitalized clients. Which of the following clients is at high risk for a UTI?
a. Client with diabetes mellitus.
b. Client who had one course of antibiotic therapy.
c. Client with a family history of UTIs.
d. Client with a urinary calculus.

6. A client is at risk for acute pyelonephritis. The nurse should instruct the client about which of the following health promotion behaviors that will be most effective in preventing pyelonephritis?
a. Wash the perineum with warm water and soap, cleaning from front to back.
b. Treat fungal infections such as athlete’s foot immediately.
c. Have a Pneumovax immunization to prevent streptococcal infection.
d. Treat with antibiotics and cover any open skin lesions.

7. A client has a renal calculus in the left lower ureter. Which of the following is the priority nursing goal for this client?
a. Treat infection.
b. Relieve spasms.
c. Relieve pain.
d. Maintain client’s position on the left side.

8. To prevent development of acute renal failure in a client with diabetes mellitus, the nurse should emphasize which of the following care measures?
a. Conduct a urine glucose test prior to each meal and at bedtime.
b. Follow a “no concentrated sweets” meal plan.
c. Limit physical activity that requires lifting.
d. Manage daily blood glucose.

9. The most useful indicator for a nurse to assess fluid balance in a client with chronic renal failure is to:
a. Measure intake and output.
b. Assess skin turgor.
c. Measure daily weights.
d. Monitor serum sodium levels.

10.A nurse is caring for a client diagnosed with ovarian cancer. Diagnostic testing reveals that the cancer has spread outside the pelvis. The client has previously undergone a right oophorectomy and received chemotherapy. The client now wants palliative care instead of aggressive therapy. The nurse determines that the care plan's priority nursing diagnosis should be:
a)Acute pain
b)Impaired home maintenance
c)Noncompliance
d)Ineffective breast-feeding

 Answer And Rational

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