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1. A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?

a) Foul-smelling discharge from the penis
b) Rashes on the palms of the hands and soles of the feet
c) Painful red papules on the shaft of the penis
d) Cauliflower-like warts on the penis


2. A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?

a) Blood pressure
b) Temperature
c) Respirations
d) Pulse


3. A client is to take co-trimoxazole for a urinary tract infection. Which of the following statements indicates that the client knows how to correctly take the medication? 

a) "I should decrease my fluid intake to increase the concentration of the drug in my urine."
b) "I will take the pills until my symptoms disappear."
c) "I should take all the pills and then have the prescription renewed if I still have symptoms."
d) "I will need to get a urine culture when I am finished taking the pills."


4. 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) Noncompliance.
b) Impaired home maintenance.
c) Knowledge deficit: Chemotherapy.
d) Acute pain.


5. A nurse is teaching a client how to prevent a vaginal infection. Which activity puts the client at risk for altering the normal pH of her vagina?

a) consuming over four cups of coffee per day
b) douching unless instructed to do so by the health care provider (HCP)
c) using tampons during the menstrual cycle
d) having sexual intercourse during the menstrual cycle


6. A nurse is admitting an older female client to the gynecology surgical unit. When the nurse asks the client what medication she is taking at home, the client responds that she is taking a little red pill in the morning and a white capsule at night for her blood pressure. What action by the nurse is focused on safe, effective care of this client?

a) Consult the previous medical record from 2 years ago, and notify the health care provider (HCP) regarding medications that must be prescribed.
b) Consult the pharmacist regarding identification of the medications.
c) Show pictures to the client from the Physician's Desk Reference to identify the medications.
d) Ask a family member to bring the medications from home in the original vials for proper identification and administration times.


7. The client is on a fluid restriction of 500 ml/day plus replacement for urine output. Because the client's 24-hour urine output yesterday was 150 ml, the total fluid allotment for the next 24 hours is 650 ml. How should the nurses distribute this fluid over the next 24 hours? 

a) Given in small amounts throughout each shift.
b) Given in its entirety in the morning to minimize the client's thirst during the rest of the 24 hour period.
c) Given with meals, divided equally between breakfast and lunch. 
d) Supplemented with gelatin and ice cream.


8. A client with a urinary tract infection is to take nitrofurantoin four times each day. The client asks the nurse, "What should I do if I forget a dose?" What should the nurse tell the client?

a) "Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose."
b) "Take a lot of water with a double amount of your prescribed dose."
c) "Double the amount prescribed with your next dose."
d) "You can wait and take the next dose when it is due."


9. The client with acute renal failure is recovering and asks the nurse, "Will my kidneys ever function normally again?" The nurse's response is based on knowledge that the client's renal status will most likely:

a) improve only if the client receives a renal transplant.
b) continue to improve over a period of weeks.
c) result in end-stage renal failure.
d) result in the need for permanent hemodialysis.


10. A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instructions should the nurse include in the client's discharge teaching plan?

a) Eliminate dairy products from the diet.
b) Increase daily fluid intake to at least 2 to 3 L.
c) Strain urine at home regularly.
d) Follow measures to alkalinize the urine.


11. A female client with gonorrhea informs the nurse that she has had sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men the symptoms of gonorrhea include:

a) scrotal swelling.
b) dysuria.
c) urine retention.
d) impotence.


12. Which steps should a nurse follow to insert a straight urinary catheter?

a) Put on gloves, prepare equipment, create a sterile field, expose the urinary meatus, and insert the catheter 6″.
b) Create a sterile field, drape the client, clean the meatus, and insert the catheter 6″.
c) Prepare the client and equipment, create a sterile field, test the catheter balloon, clean the meatus, and insert the catheter until urine flows.
d) Prepare the client and equipment, create a sterile field, put on gloves, clean the urinary meatus, and insert the catheter until urine flows.


13. A woman is using progestin injections for contraception. The nurse instructs the client to return for an appointment in:

a) 6 months.
b) 1 month.
c) 4 months.
d) 3 months.


14. A sexually active male client has burning on urination and a milky discharge from the urethral meatus. What documentation should be included on the client's medical record? Select all that apply.

a) history of unprotected sex (sex without a condom)
b) names and phone numbers of all sexual contacts
c) presence of any enlarged lymph nodes on examination
d) allergies to any medications
e) length of time since symptoms presented
f) history of fever or chills


15. Which nursing measure would most likely relieve postoperative gas pains after abdominal hysterectomy?

a) offering the client a hot beverage
b) applying a snugly fitting abdominal binder
c) providing extra warmth
d) helping the client walk


16. A nurse is caring for a client with acute pyelonephritis. Which nursing intervention is the most important?

a) Increasing fluid intake to 3 L/day
b) Using an indwelling urinary catheter to measure urine output accurately
c) Encouraging the client to drink cranberry juice to acidify the urine
d) Administering a sitz bath twice per day


17. The most significant sign of acute renal failure is: 

a) Elevated body temperature.
b) Decreased urine output.
c) Increased urine specific gravity.
d) Increased blood pressure.


18. A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?

a) Prepare to remove the catheter.
b) Restrict fluids to prevent the client's bladder from becoming distended.
c) Use sterile technique when irrigating the catheter.
d) Tell the client to try to urinate around the catheter to remove blood clots.


19. A client who had a transurethral resection of the prostate (TURP) 1 day earlier has a three-way Foley catheter inserted for continuous bladder irrigation. Which of the following statements best explains why continuous irrigation is used after TURP?

a) To control bleeding in the bladder.
b) To prevent bladder distention.
c) To keep the catheter free from clot obstruction.
d) To instill antibiotics into the bladder.


20. Which clinical finding should a nurse look for in a client with chronic renal failure?

a) Metabolic alkalosis
b) Polycythemia
c) Hypotension
d) Uremia


21. Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?

a) White blood cell (WBC) count of 20,000/mm3 (0.02 L)
b) Hematocrit (HCT) of 35%
c) Blood glucose level of 200 mg/dl (11.1 mmol/L)
d) Potassium level of 3.5 mEq/L (3.5 mmol/L)


22. A client asks the nurse to explain the meaning of her abnormal Papanicolaou (Pap) smear result of atypical squamous cells. The nurse should tell the client that an atypical Pap smear means that:

a) cancer cells were found in the smear.
b) the Pap smear alone is not very important diagnostically because there are many false-positive results.
c) abnormal viral cells were found in the smear.
d) the cells could cause various conditions and help identify a problem early.


23. The nurse explains to the client the importance of drinking large quantities of fluid to prevent cystitis. The nurse should tell the client to drink:

a) at least 3,000 mL of fluids daily.
b) twice as much fluid as usual.
c) at least 1,000 mL more than usual.
d) as much water or juice as possible.


24. Which statements by a female client would indicate that she is at high risk for a recurrence of cystitis?

a) "I can usually go 8 to 10 hours without needing to empty my bladder."
b) "I wipe from front to back after voiding."
c) "I take a tub bath every evening."
d) "I work out by lifting weights 3 times a week."


25. After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?

a) Self-catheterization
b) Artificial sphincter use
c) Fluid restriction
d) Kegel exercises


26. When providing discharge teaching for a client with uric acid calculi, the nurse should include an instruction to avoid which type of diet?

a) High purine
b) High oxalate
c) Low oxalate
d) Low calcium


27. Which information would the nurse include in the teaching plan for a 32-year-old female client requesting information about using a diaphragm for family planning?

a) Diaphragms should not be used if the client develops acute cervicitis.
b) Douching with an acidic solution after intercourse is recommended.
c) The diaphragm should be washed in a weak solution of bleach and water.
d) The diaphragm should be left in place for 2 hours after intercourse.


28. Two weeks after being diagnosed with a streptococcal infection, a client develops fatigue, a low-grade fever, and shortness of breath. The nurse auscultates bilateral crackles and observes jugular vein distention. Urinalysis reveals red and white blood cells and protein. After the physician diagnoses poststreptococcal glomerulonephritis, the client is admitted to the medical-surgical unit. Which immediate action should the nurse take?

a) Monitor patient blood pressure.
b) Provide a high-protein, fluid-monitored diet.
c) Encourage activity as tolerated.
d) Place the client on a sheepskin, and monitor for increasing edema.


29. When teaching the client with a urinary tract infection about taking a prescribed antibiotic for 7 days, the nurse should tell the client to report which symptoms to the health care provider (HCP)? Select all that apply.

a) mild nausea
b) cloudy urine for the first few days
c) blood in the urine
d) urinating every 3 to 4 hours
e) fever above 100° F (37.8° C)
f) rash


30. A client with diabetes mellitus has had declining renal function over the past several years. Which diet regimen should the nurse recommend to the client on days between dialysis?

a) A low-protein diet with a prescribed amount of water
b) A high-protein diet with a prescribed amount of water
c) No protein in the diet and use of salt sparingly
d) A low-protein diet with an unlimited amount of water


31. A male client informs the urology nurse that he is embarrassed because his wife rarely has time to reach sexual satisfaction during their encounters. He says he experiences orgasm as soon as he enters the wife's vagina. What is this condition best known as?

a) Impotence.
b) Retarded ejaculation.
c) Premature ejaculation.
d) Erectile failure.


32. Which is likely to provide the most relief from the pain associated with renal colic?

a) applying moist heat to the flank area
b) maintaining complete bed rest
c) encouraging high fluid intake
d) administering meperidine


33. The nurse is caring for a client diagnosed with genitourinary tuberculosis (TB). Which statement, made by the client, about genitourinary TB demonstrates an understanding?

a) "It isn't infectious, and I can't pass it from one person to another."
b) "It's an early manifestation of an autoimmune disorder."
c) "It's a late manifestation of respiratory tuberculosis."
d) "I can't pass it sexually to my partner."


34. A client has renal colic due to renal lithiasis. What is the nurse's first priority in managing care for this client?

a) Request the central supply department to send supplies for straining urine.
b) Administer an opioid analgesic as prescribed.
c) Encourage the client to drink at least 500 mL of water each hour.
d) Do not allow the client to ingest fluids.


35. When educating a female client with gonorrhea, the nurse should emphasize that for women gonorrhea:

a) does not lead to serious complications.
b) may not cause symptoms until serious complications occur.
c) can be treated but not cured.
d) is often marked by symptoms of dysuria or vaginal bleeding.


36. A postmenopausal woman is worried about pain in the upper outer quadrant of her left breast. The nurse's best course of action is to:

a) Teach the client the correct procedure for breast self-examination (BSE).
b) Explain that pain is caused by hormonal fluctuations.
c) Do a breast examination and report the results to the physician.
d) Reassure the client that pain is not a symptom of breast cancer.


37. The nurse is teaching the client with an ileal conduit how to prevent a urinary tract infection. Which measure would be most effective?

a) Maintain a daily fluid intake of 2,000 to 3,000 mL.
b) Use sterile technique to change the appliance.
c) Avoid people with respiratory tract infections.
d) Irrigate the stoma daily.


38. A 65-year-old male client with erectile dysfunction (ED) asks the nurse, "Is all this just in my head? Am I crazy?" The best response by the nurse is based on the knowledge that:

a) more than 50% of the cases are attributed to organic causes.
b) ED is believed to be psychogenic in most cases.
c) ED is an uncommon problem among men older than age 65.
d) evaluation of nocturnal erections does not help differentiate psychogenic or organic causes.


39. A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation?

a) Specific gravity of 1.03
b) Absence of protein
c) Urine pH of 3.0
d) Absence of glucose


40. A client is scheduled for a creatinine clearance test. What should the nurse do?

a) Provide the client with a sterile urine collection container.
b) Instruct the client to force fluids to 3,000 mL/day.
c) Instruct the client about the need to collect urine for 24 hours.
d) Prepare to insert an indwelling urethral catheter.

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