The Client with Urinary Tract Health

Problems
Lipincott REVIEW

The Client with Cancer of the

Bladder

1.

A client has undergone a cystectomy and

an ileal conduit diversion. What should the nurse
incorporate into the discharge instructions? Select
all that apply.
1. Drink at least 3,000 mL of fl uid each day.
2. Minimize daily activities.
3. Keep urine alkaline to prevent urinary tract
infections.
4. Avoid odor-producing foods, such as onions,
fi sh, eggs, and cheese.
5. Wear snug clothing over the stoma to encourage
urine fl ow into the drainage bag.

2.

A nurse is caring for a client with an ileal

conduit. When assessing the stoma, which of the
following outcomes are undesirable? Select all that
apply.
1. Dermatitis.
2. Bleeding.
3. Fungal infection.
4. Flow of adhesive solvent into the stoma.
5. Partial obstruction of the stoma from skin
cement.

3.

The nurse should assess the client with bladder

cancer for which of the following?
1. Suprapubic pain.
2. Dysuria.
3. Painless hematuria.
4. Urine retention.

4.

A client is to have a cystoscopy to rule out

cancer of the bladder. Which of the following indicate
that the client has developed a complication
after the cystoscopy?
1. Dizziness.
2. Chills.
3. Pink-tinged urine.
4. Bladder spasms.

5.

If the client develops lower abdominal pain

after a cystoscopy, the nurse should instruct the client
to do which of the following?
1. Apply an ice pack to the pubic area.
2. Massage the abdomen gently.
3. Ambulate as much as possible.
4. Sit in a tub of warm water.

6.

A client who has been diagnosed with

bladder cancer is scheduled for an ileal conduit.

Preoperatively, the nurse reinforces the clients
understanding of the surgical procedure by explaining
that an ileal conduit:
1. Is a temporary procedure that can be reversed
later.
2. Diverts urine into the sigmoid colon, where it
is expelled through the rectum.
3. Conveys urine from the ureters to a stoma
opening on the abdomen.
4. Creates an opening in the bladder that allows
urine to drain into an external pouch.

7.

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?
1. Peritonitis.
2. Thrombophlebitis.
3. Ascites.
4. Inguinal hernia.
The Client with Cancer of the Bladder
The Client with Renal Calculi
The Client with Acute Renal Failure
The Client with Urinary Tract Infection
The Client with Pyelonephritis
The Client with Chronic Renal Failure
The Client with Urinary Incontinence
Managing Care Quality and Safety
Answers, Rationales, and Test Taking Strategies

The Client with Urinary Tract Health

9
502

Problems

TEST

The Nursing Care of Adults with Medical and Surgical Health Problems

8.

The nurse is assessing the urine of a client

who has had an ileal conduit and notes that the
urine is yellow with a moderate amount of mucus.
Based on the data, the nurse should?
1. Change the appliance bag.
2. Notify the physician.
3. Obtain a urine specimen for culture.
4. Encourage a high fl uid intake.

9.

When teaching the client to care for an ileal

conduit, the nurse instructs the client to empty the
appliance frequently. Which of the following indicate
that the client is following instructions?
1. The skin around the stoma is red.
2. The urine is a deep yellow.
3. There is no odor present.
4. The seal around the stoma is intact.

10.

The nurse should teach the client with an

ileal conduit to prevent urine leakage when changing
the appliance by using which of the following

procedures?
1. Insert a gauze wick into the stoma.
2. Close the opening temporarily with a cellophane
seal.
3. Suction the stoma before changing the appliance.
4. Avoid oral fl uids for several hours before
changing the appliance.

11.

The client with an ileal conduit will be using

a reusable appliance at home. The nurse should
teach the client to clean the appliance routinely
with which product?
1. Baking soda.
2. Soap.
3. Hydrogen peroxide.
4. Alcohol.

12.

The nurse is evaluating the discharge teaching

for a client who has an ileal conduit. Which of
the following statements indicates that the client has
correctly understood the teaching? Select all that
apply.
1. If I limit my fl uid intake, I will not have to
empty my ostomy pouch as often.
2. I can place an aspirin tablet in my pouch to
decrease odor.
3. I can usually keep my ostomy pouch on for 3
to 7 days before changing it.
4. I must use a skin barrier to protect my skin
from urine.
5. I should empty my ostomy pouch of urine
when it is full.

13.

A client has an ileal conduit. Which of the

following solutions will be useful to help control
odor in the urine collecting bag after it has been
cleaned?
1. Salt water.
2. Vinegar.
3. Ammonia.
4. Bleach.

14.

A female client who has a urinary diversion

tells the nurse, This urinary pouch is embarrassing.
Everyone will know that Im not normal. I dont
see how I can go out in public anymore. The most
appropriate nursing diagnosis for this client is:
1. Anxiety related to the presence of a urinary
diversion.
2. Defi cient knowledge about how to care for the
urinary diversion.
3. Low self-esteem related to feelings of worthlessness.
4. Disturbed body image related to creation of a
urinary diversion.

15.

The nurse teaches the client with a urinary

diversion to attach the appliance to a standard urine
collection bag at night. The most important reason

for doing this is to prevent:

1. Urine refl ux into the stoma.
2. Appliance separation.
3. Urine leakage.
4. The need to restrict fl uids.

16.

The nurse teaches the client with an ileal

conduit measures to prevent a urinary tract infection.
Which of the following measures would be
most effective?
1. Avoid people with respiratory tract infections.
2. Maintain a daily fl uid intake of 2,000 to 3,000
mL.
3. Use sterile technique to change the appliance.
4. Irrigate the stoma daily.

17.

The nurse evaluates the effectiveness of the

clients postoperative plan of care. Which of the following
would be an expected outcome for a client
with an ileal conduit?
1. The client verbalizes the understanding that
his physical activity must be curtailed.
2. The client states that he will place an aspirin
in the drainage pouch to help control odor.
3. The client demonstrates how to catheterize
the stoma.
4. The client states that he will empty the drainage
pouch frequently throughout the day.
The Client with Urinary Tract Health Problems

18.

503

A nurse is planning care for a client who

underwent a percutaneous needle biopsy of the kidney.
What should the nurse plan to do immediately
after the biopsy? Select all that apply.
1. Assess the biopsy site.
2. Take vital signs every hour.
3. Assess urine for hematuria.
4. Place the client in a prone position.
5. Assess the client for chest pain.