NCLEX PRACTICE QUESTIONS » URINARY DISORDERS NCLEX PRACTICE QUIZ (150 QUESTIONS) Urinary Disorders NCLEX Practice Quiz (150 Questions UPDATED ON MARCH 19, 2022 BY MATT VERA, BSN, R.N. 1. Question... Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis? A. Jaundice and flank pain B. Costovertebral angle tenderness and chills C. Burning sensation on urination D. Polyuria and nocturia Correct Answer: B. Costovertebral angle tenderness and chills Costovertebral angle tenderness, flank pain, and chills are symptoms of acute pyelonephritis. Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys. Pyelonephritis occurs as a complication of an ascending urinary tract infection which spreads from the bladder to the kidneys. Symptoms usually include fever, flank pain, nausea, vomiting, burning with urination, increased frequency, and urgency. o Option A: Jaundice indicates gallbladder or liver obstruction. Dysfunction in prehepatic phase results in elevated serum levels of unconjugated bilirubin while insult in post hepatic phase marks elevated conjugated bilirubin. Hepatic phase impairment can elevate both unconjugated and conjugated bilirubin. o Option C: A burning sensation on urination is a sign of lower urinary tract infection. Symptoms of uncomplicated UTI are pain on urination (dysuria), frequent urination (frequency), inability to start the urine stream (hesitation), sudden onset of the need to urinate (urgency), and blood in the urine (hematuria). Usually, patients with uncomplicated UTI do not have fever, chills, nausea, vomiting, or back pain, which are signs of kidney involvement or upper tract disease/pyelonephritis. o Option D: Nocturnal polyuria as a cause of nocturia is more prevalent in older patients, while in younger patients, a decreasednocturnal bladder capacity is the more common etiology. Caffeine and excessive oral fluid intake in the evenings, as well as alcoholism, can contribute significantly to this disorder. It is also associated with congestive heart failure, obstructive sleep apnea, evening use of diuretics, peripheral edema, high dietary salt intake, and chronic venous insufficiency of the lower extremities. 2. Question You have a patient that might have a urinary tract infection (UTI). Which statement by the patient suggests that a UTI is likely? o A. “I pee a lot.” o B. “It burns when I pee.” o C. “I go hours without the urge to pee.” o D. “My pee smells sweet.” Correct Answer: B. “It burns when I pee.” A common symptom of a UTI is dysuria. A patient with a UTI often reports frequent voiding of small amounts and the urgency to void. Symptoms of uncomplicated UTI are pain on urination (dysuria), frequent urination (frequency), inability to start the urine stream (hesitation), sudden onset of the need to urinate (urgency), and blood in the urine (hematuria). Usually, patients with uncomplicated UTI do not have fever, chills, nausea, vomiting, or back pain, which are signs of kidney involvement or upper tract disease/pyelonephritis. o Option A: High amounts of solutes within the renal tubules cause a passive osmotic diuresis (solute diuresis) and thus an increase in urine volume. The classic example of this process is the glucoseinduced osmotic diuresis in uncontrolled diabetes mellitus, when high urinary glucose levels (> 250 mg/dL [13.88 mmol/L]) exceed tubular reabsorption capacity, leading to high glucose levels in the renal tubules; water follows passively, resulting in glucosuria and increased urine volume. o Option C: Oliguria can be the result of various causes that can be apparent or subclinical. Oliguria can arise as a result of the normal physiological response of the body or due to an underlying pathology affecting the kidney or urinary tract. The most commonprerenal cause is reduced blood flow to the kidney secondary to intravascular volume depletion, heart failure, sepsis, or as a side effect of medication. o Option D: Urine that smells sweet is often associated with diabetic ketoacidosis. Commonly accepted criteria for diabetic ketoacidosis are blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum bicarbonate less than 15 mEq/l, and the presence of ketonemia or ketonuria. 3. Question Which instructions do you include in the teaching care plan for a patient with cystitis receiving phenazopyridine (Pyridium)? o A. If the urine turns orange-red, call the doctor. o B. Take phenazopyridine just before urination to relieve pain. o C. Once painful urination is relieved, discontinue prescribed antibiotics. o D. After painful urination is relieved, stop taking phenazopyridine. Correct Answer: D. After painful urination is relieved, stop taking phenazopyridine. Pyridium is taken to relieve dysuria because it provides an analgesic and anesthetic effect on the urinary tract mucosa. The patient can stop taking it after the dysuria is relieved. Symptomatic treatment with analgesics may be used in patients who present with severe dysuria. Phenazopyridine is a urinary analgesic used in short-term treatment of urinary dysuria or discomfort. o Option A: The urine may temporarily turn red or orange due to the dye in the drug. Patients should be informed that Phenazopyridine HCl produces a reddish-orange discoloration of the urine and may stain fabric. Staining of contact lenses has been reported. o Option B: The drug isn’t taken before voiding, and is usually taken 3 times a day for 2 days. Treatment of a urinary tract infection with Phenazopyridine HCl should not exceed two days because there is a lack of evidence that the combined administration ofPhenazopyridine HCl and an antibacterial provides greater benefit than administration of the antibacterial alone after two days. o Option C: Antibiotics should not be discontinued without indication from the physician. The analgesic action may reduce or eliminate the need for systemic analgesics or narcotics. It is, however, compatible with antibacterial therapy and can help to relieve pain and discomfort during the interval before antibacterial therapy controls the infection. 4. Question Which patient is at greatest risk for developing a urinary tract infection (UTI)? o A. A 35 y.o. woman with a fractured wrist o B. A 20 y.o. woman with asthma o C. A 50 y.o. postmenopausal woman o D. A 28 y.o. with angina Correct Answer: C. A 50 y.o. postmenopausal woman Women are more prone to UTIs after menopause due to reduced estrogen levels. Reduced estrogen levels lead to reduced levels of vaginal Lactobacilli bacteria, which protect against infection. Premenopausal women have large concentrations of lactobacilli in the vagina and prevent the colonization of uropathogens. However, the use of antibiotics can erase this protective effect. o Option A: An uncomplicated UTI usually only involves the bladder. When the bacteria invade the bladder mucosal wall, cystitis is produced. The majority of organisms causing a UTI are enteric coliforms that usually inhabit the periurethral vaginal introitus. These organisms ascend into the bladder and cause a UTI. o Option B: Sexual intercourse is a common cause of a UTI as it promotes the migration of bacteria into the bladder. People who frequently void and empty the bladder have a much lower risk of a UTI. Pathogenic bacteria ascend from the perineum, causing UTI. Women have shorter urethras than men and therefore are more susceptible to UTI. Very few uncomplicated UTIs are caused by blood-borne bacteria. Escherichia coli is the most common organism in uncomplicated UTI by a large margin. [Show More]
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