KAPLAN EXIT EXAM V1&V2 BUNDLE LATEST UPDATE 2022

KAPLAN EXIT EXAM V1&V2 BUNDLE LATEST UPDATE 2022 1. A nurse is teaching a patient about the urinary system. In which order will the nurse present the structures, following the flow of urine? **Kidney, ureters, bla ...

KAPLAN EXIT EXAM V1&V2 BUNDLE LATEST UPDATE 2022 1. A nurse is teaching a patient about the urinary system. In which order will the nurse present the structures, following the flow of urine? **Kidney, ureters, bladder, urethra 1. A nurse is reviewing urinary laboratory results. Which finding will cause the nurse to follow up? **Specific gravity of 1.036 Dehydration, reduced renal blood flow, and increase in antidiuretic hormone secretion elevate specific gravity. Normal specific gravity is 1.0053 to 1.030. An output of 30 mL/hr or less for 2 or more hours would be cause for concern; 80 mL/hr is normal. The normal pH of urine is between 4.6 and 8.0. Protein up to 8 mg/100 mL is acceptable; however, values in excess of this could indicate renal disease. 2. A patient is experiencing oliguria. Which action should the nurse perform first? **Assess for bladder distention. Oliguria is diminished urinary output in relation to fluid intake. It could be that the patient does not have adequate intake, or it could be that the bladder sphincter is not functioning and the patient is retaining water. 3. A patient requests the nurse’s help to the bedside commode and becomes frustrated when unable to void in front of the nurse. How should the nurse interpret the patient’s inability to void? **The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void 4. The patient is having lower abdominal surgery and the nurse inserts an indwelling catheter. What is the rationale for the nurse’s action? **Anesthetics can decrease bladder contractility and cause urinary retention. 5. The nurse, upon reviewing the history, discovers the patient has dysuria. Which assessment finding is consistent with dysuria? **Burning upon urination Dysuria - is burning or pain with urination. Hematuria - is blood in the urine. Urgency is an immediate and strong desire to void that is not easily deferred. Nocturia - is awakening from sleep due to urge to void. 6. An 86-year-old patient is experiencing uncontrollable leakage of urine with a strong desire to void and even leaks on the way to the toilet. Which priority nursing diagnosis will the nurse include in the patient’s plan of care? **Urge urinary incontinence Urge urinary incontinence - is the leakage of urine associated with a strong urge to void. Urinary retention - is the inability to empty the bladder. Functional urinary incontinence - is incontinence due to causes outside the urinary tract, such as mobility or cognitive impairments. 7. A patient has fallen several times in the past week when attempting to get to the bathroom. The patient gets up 3 or 4 times a night to urinate. Which recommendation by the nurse is most appropriate in correcting this urinary problem? **Limit fluid and caffeine intake before bed. Reducing fluids, especially caffeine and alcohol, before bedtime can reduce nocturia. To prevent nocturia, suggest that the patient avoid drinking fluids 2 hours before bedtime. 8. A nurse is caring for a male patient with urinary retention. Which action should the nurse take first? **Assist to a standing position. 9. Upon palpation, the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate. Which question is most appropriate? **“When was the last time you voided?” 10. A nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel? **Obtaining a midstream urine specimen 11. While receiving a shift report on a patient, the nurse is informed that the patient has urinary incontinence. Upon assessment, which finding will the nurse expect? **Reddened irritated skin on buttocks Urinary incontinence is uncontrolled urinary elimination; if the urine has prolonged contact with the skin, skin breakdown can occur. 12. A nurse is inserting a catheter into a female patient. When the nurse inserts the catheter, no urine is obtained. The nurse suspects the catheter is not in the urethra. What should the nurse do? **Leave the catheter in the vagina as a landmark for insertion of a new, sterile catheter. The catheter should be left in place until the new, sterile catheter is inserted. The balloon should not be filled since the catheter is in the vagina. The catheter must be sterile; using alcohol will not make the catheter sterile. 13. A patient asks about treatment for stress urinary incontinence. Which is the nurse’s best response? **Perform pelvic floor exercises. Poor muscle tone leads to an inability to control urine flow. The nurse should recommend pelvic muscle strengthening exercises such as Kegel exercises; this solution best addresses the patient’s problem. 14. The nurse suspects cystitis related to a lower urinary tract infection. Which clinical manifestation does the nurse expect the patient to report? **Frequency Cystitis - is inflammation of the bladder; associated symptoms include hematuria, foul-smelling cloudy urine, and urgency/frequency. Dysuria - is a common symptom of a lower urinary tract infection (bladder). Flank pain, fever, and chills are all signs of pyelonephritis (upper urinary tract). 15. Which assessment question should the nurse ask if stress incontinence is suspected? **“Do you experience urine leakage when you cough or sneeze?” Stress incontinence can be related to intraabdominal pressure causing urine leakage, as would happen during coughing or sneezing. 16. The patient has a catheter that must be irrigated. The nurse is using a needleless closed irrigation technique. In which order will the nurse perform the steps, starting with the first one? Correct Order: