GENITOURINARY QUIZ (Answers in bold)
Nursing II
September 28, 2006
Mrs. Griffin’s comments in blue.
1. Which of the following would not be included by the nurse who is teaching a client how to avoid future bouts of cystitis?
a. avoid bubble baths
b. urinate before and after intercourse
c. void approximately every 4 hours
d. avoid artificial vaginal lubricants during sexual activity
(Remember to teach client oil-based lubricants can damage condoms.)
2. What is the priority for the nurse to monitor while a patient is undergoing lithotripsy?
a. continuous EKG for dysrhythmias
b. temperature
c. blood pressure (one could argue this is important, also!)
d. color and smell of urine
3. Which specific test will (most likely) detect cancer of the prostate?
a. DRE
b. CT scan
c. PSA
d. MRI
4. Which of the following would be at greater risk for prostate cancer?
a. 25 y/o Chinese male
b. 55 y/o African-American male
c. 35 y/o Caucasian male
d. 45 y/o Hispanic male
(The age gave this one away!)
5. A patient demonstrates understanding of a TURP when he says:
a. “The surgeon will approach the prostate gland through the urinary bladder.”
b. “the surgeon removes the prostate tissue through an abdominal incision.”
c. “The surgeon will insert a resectoscope through the urethra and remove tissue from the prostate gland.”
d. “The surgeon will make an incision between the scrotum and rectom to remove prostate tissue.”
6. A patient with benign prostatic hypertrophy (BPH) will show which of the following signs and symptoms?
a. nocturia, hesitancy, hematuria
b. gross hematuria, flank pain, weight loss
c. hematuria, dull pain, sweating
d. headache, n&v, painful urination
7. The greatest risk for bladder cancer is which of the following?
a. alcohol use
b. excessive drug use (do you mean illegal drugs?)
c. smoking
d. exposure to toxins
8. If a patient has bladder cancer limited to the lining of the bladder, which would be the treatment of choice?
a. lithotripsy
b. instillation of BCG compound
c. radiation therapy
d. cystectomy
(Note, generally the small areas of cancer are surgically removed before the BCG treatment.)
9. A 60 year old male is admitted to the Emergency Department with complaint of not being able to empty his bladder completetly. What is the nurse’s first action?
a. send a specimen for urinalysis
b. assess patient for distention
c. ask the tech to insert a Coudé catheter
(Assess is always the first step!)
10. Which of the following lab tests are the best indicators of testicular cancer?
a. alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG)
b. KUB, creatinine, urinalysis
c. urinalysis and complete blood count
d. PSA and digital rectal exam
11. A client is admitted to a walk-in clinic with dehiscence of his incision following orchiectomy for testicular cancer. What is the nurse’s priority action?
a. cover the wound with a sterile dressing
b. notify the physician
c. administer pain medication
d. assess vital signs
12. Which statement by the client with BPH indicates the need for further teaching?
a. “If I need a catheter, my doctor may need to use a special type.”
b. “It is difficult for me to start urinating sometimes, but the doctor says that is common with my condition.”
c. ”Because I retain urine, I should reduce my daily fluid intake.”
c. “I may retain urine sometimes because my bladder can’t empty all the way.”
13. Which medication will help alleviate symptoms of BPH by reducing overall testosterone?
a. Hytrin
b. Proscar
c. Flomax
d. Cardura
14. What is the cause of urinary retention in BPH?
a. inflammation of the urinary bladder
b. obstruction between the kidney and the ureter
c. necrosis of the bladder
d. enlarged prostate obstructs the bladder neck
15. Which of the following is not a nursing intervention for urinary retention related to BPH?
a. monitor intake and output
b. use power of suggestion by running water or flushing toilet.
c. encourage ambulation
d. insert urinary catheter as appropriate
16. Which of the following medications would be used to shrink the prostate gland to improve urine flow in the patient with BPH?
a. Flomax
b. Procrit
c. Proscar
d. Cardura
17. A 64 y/o male complains of nocturia and hesitancy when trying to urinate. What other symptoms might be present if BPH is suspected by his doctor?
a. strong stream and urinary retention
b. hematuria, weak stream, and UTI symptoms
c. clear urine, hematuria, bladder distention
d. cloudy urine, ease of urination
18. Six hours after a TURP, the nurse notes blood clots in the foley drainage of the continuous bladder irrigation system. What is the priority action?
a. call the physician immediately
b. adjust the irrigation fluid rate to maintain light pink drainage
c. instruct the client to increase fluid intake to 2500 mL per day
d. administer Proscar every four hours.
19. Which of the following is not a clinical manifestation of BPH?
a. nocturia
b. post-void dribbling
c. bladder distention
d. fever(actually, this might be present with infection related to untreated UTI secondary to BPH)
20. Discharge teaching for a client who had bilateral orchiectomy for testicular cancer includes all of the following (or at least three years) except:
a. regularly scheduled tests for urinary and serum levels of tumor markers
b. regularly scheduled CT scans
c. regularly scheduled MRIs
d. regular testicular self-exams(testicles have been removed. Note: if the client had only one testicle removed, he still needs to examine the other testicle monthly!)
21. Which of the following client statements indicates more teaching is needed when the nurse is teaching about sperm-banking?
a. “not all sperm will live, but there is a good chance of pregnancy if the sperm is used within 10 years.”
b. “I need to check with the local sperm bank regarding storage expenses.”
c. “ I can have my sperm frozen so that when I am ready to have children, I can use the sperm for in vitro fertilization.”
d. “The hospital will store the sperm for me at little to no charge.”
22. Which of the following blood tests is used to screen for prostate cancer?
a. creatinine
b. testosterone level
c. PSA
d. BUN
23. What hormone may be used in the treatment of prostate cancer?
a. anti-diuretic hormone
b. growth hormone
c. testosterone
d. estrogen
24. Only 5-10% of clients with renal cancer have which of the following symptoms?
a. sharp flank pain, bladder distention, jaundice
b. jaundice, fever, high blood pressure
c. flank pain, gross hematuria, palpable renal mass
d. weight loss, anemia, gross hematuria
25. Which of the following describes a surgically-created pouch which functions as a bladder after cystectomy?
a. ileal (Bricker’s) conduit
b. colon conduit
c. ureterosigmoidostomy
d. continent internal ileal reservoir (Kock’s pouch)
26. Which of the following is at highest risk for developing bladder cancer?
a. a hair dresser
b. a smoker
c. a chemist
d. a painter
27. A female presents to the ED with c/o painful urination, urgency, and frequency. What is the priority assessment by the nurse?
a. urinalysis
b. pelvic exam
c. obtain history
d. prescribe antibiotics
28. Which of the following statements indicates a client understands teaching about prevention of urinary tract infections?
a. “ I should drink plenty of fluids and empty my bladder every 3 – 4 hours.”
b. “I do not need to void before having sexual intercourse.”
c. “I always cleanse with peri-sprays.”
d. Because of my diabetes, I am less susceptible to bladder infections.”
29. During lithotripsy, which of the following is monitored continuously?
a. respiratory rate
b. blood pressure
c. EKG
d. all of the above
(Actually, “d” would be a good choice also. We normally do not create “all of the above” questions.)
30. During percutaneous ureterolithotomy, in what position is the client placed?
a. prone position
b. lateral position
c. a or b
d. none of the above.
31. What would be a priority nursing diagnosis for a patient with a kidney stone passing through the ureter?
a. risk for infection r/t trauma to the urethra lining
b. kidney stones r/t presence of urinary tract infection
c. acute pain r/t the presence of kidney stone in the ureter
32. Which of the following component is found in 75% of kidney stones?
a. struvite
b. calcium
c. uric acid
d. phosphate
33. Which of the following instructions would be included for clients who have either calcium oxalate or calcium phosphate kidney stones?
a. decrease calcium intake
b. decrease fluids
c. decrease sodium intake
d. reduce uric acid from food sources