NURS 6531 Final Exam 2024 Latest Brand-New Questions Included 100% with Verified Solutions Exam 2
11 views 0 purchase
Course
NURS 6531
Institution
NURS 6531
NURS 6531 Final Exam 2024 Latest Brand-New Questions Included 100% with Verified Solutions Exam 2NURS 6531 Final Exam 2024 Latest Brand-New Questions Included 100% with Verified Solutions Exam 2NURS 6531 Final Exam 2024 Latest Brand-New Questions Included 100% with Verified Solutions Exam 2NURS 653...
NURS 6531 Final Exam 2024 Latest Brand-New
Questions Included 100% with Verified Solutions Exam 2
The daughter of an elderly confused patient reports that her parent is having urinary incontinence
several times each day. What will the provider do initially?
a. Obtain a urine sample for urinalysis (UA) and possible culture
b. Order serum creatinine and blood urea nitrogen tests
c. Perform a bladder scan to determine distention and retention
d. Tell the daughter that this is expected given her mother's age and confusion - ANSWER>>>ANS: A
When incontinence occurs, UA is performed initially to exclude hematuria, pyuria, glucosuria, or
proteinuria and possible infection. Serum creatinine and BUN may be performed if renal disease is
suspected. Bladder scans may be performed if the UA is normal to evaluate physiologic causes. It is not
correct to offer reassurance without ruling out other causes.
The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid
residual (PVR) test which yields 30 mL of urine. What is the interpretation of this
result?
a. The patient may have overflow incontinence.
b. The patient probably has a urinary tract infection (UTI).
c. This is a normal result.
d. This represents incomplete emptying. - ANSWER>>>ANS: C
A PVR less than 50 mL is considered normal and this result does not indicate any abnormality.
The provider is counseling a patient who has stress incontinence about ways to minimize accidents.
What will the provider suggest initially?
a. Increasing fluid intake to dilute the urine
b. Referral to a physical therapist
c. Taking pseudoephedrine daily
d. Voiding every 2 hours during the day - ANSWER>>>ANS: D
Timed voiding is useful to help minimize stress incontinence and is used initially. Increasing fluid intake
will increase symptoms. PT referral may be done if other measures fail to help with exercises to
strengthen the pelvic floor muscles. Pseudoephedrine is useful, but not an initial therapy.
,An older male patient reports urinary frequency, back pain, and nocturia. A dipstick urinalysis reveals
hematuria. What will the provider do next to evaluate this condition?
a. Order a PSA and perform a digital rectal exam (DRE)
b. Refer for a biopsy
c. Refer the patient to a urologist
d. Schedule a transurethral ultrasound (TRUS) - ANSWER>>>ANS: A
Patients with symptoms of potential prostate cancer should be screened with PSA and DRE. Referral to a
urologist is the next step even with normal findings, since PSA is occasionally normal. The urologist may
order TRUS or biopsy.
An older male patient has a screening prostate-specific antigen (PSA) which is 12 ng/mL. What does this
value indicate?
a. A normal result
b. Benign prostatic hypertrophy
c. Early prostate cancer
d. Prostate cancer - ANSWER>>>ANS: D
A PSA greater than 10 ng/mL suggests prostate cancer. A level between 4 and 10 ng/mL may be early
prostate cancer or a benign condition. A level less than 4 ng/mL is normal.
A patient is diagnosed with prostate cancer and diagnostic testing reveals disease that has gone past the
prostatic capsule without evidence of metastasis. The patient does not wish to undergo treatment. What
will the provider tell this patient?
a. Chemotherapy is indicated to provide cure for this cancer.
b. Monitoring prostate-specific antigen (PSA) with regular digital rectal examination (DRE) is an
acceptable option.
c. Palliative radiation therapy is necessary to improve quality of life.
d. This level of disease requires intervention with hormonal therapy. - ANSWER>>>ANS: B
This patient has stage T2 prostate cancer which may be managed with watchful waiting which includes
PSA and DRE evaluation. Chemotherapy, palliative radiation therapy, and hormonal therapy are not
required.
A male patient reports nocturia and daytime urinary frequency and urgency without changes in the force
of the urine stream. What is the likely cause of this?
a. Bladder outlet obstruction
b. Lower urinary tract symptoms (LUTS)
c. Prostate cancer
,d. Urinary tract infection (UTI) - ANSWER>>>ANS: B
Lower urinary tract symptoms (LUTS) result from irritative changes in the lower tract. Bladder outlet
obstruction causes hesitancy, decreased caliber and force of the urine stream, and postvoid dribbling.
Diagnosis of prostate cancer and UTI require further testing and are less likely causes.
A 70-year-old male reports urinary hesitancy, postvoid dribbling, and a diminished urine stream. A digital
rectal exam (DRE) reveals an enlarged prostate gland that feels rubbery and smooth. Which tests will the
primary care provider order based on these findings?
a. Bladder scan for postvoid residual
b. Prostate-specific antigen (PSA) and bladder imaging
c. Urinalysis and serum creatinine
d. Urine culture and CBC with differential - ANSWER>>>ANS: C
The DRE reveals a prostate gland consistent with benign prostatic hyperplasia (BPH). The primary
provider should order a urinalysis and creatinine to evaluate possible infection and renal function. A
bladder scan is ordered at the discretion of the urologist. The prostate exam isn't consistent with
prostate cancer, so PSA and bladder imaging are not necessary. Symptoms of prostatitis would indicate a
need for evaluation of possible infection.
A patient has been taking terazosin daily at bedtime to treat benign prostatic hyperplasia (BPH) and
reports persistent daytime dizziness. What will the provider do?
a. Prescribe finasteride instead of terazosin
b. Recommend taking the medication in the morning
c. Suggest using herbal preparations
d. Switch the prescription to doxazosin - ANSWER>>>ANS: A
Patients who cannot tolerate the side effect of alpha-adrenergic antagonists, the provider may initiate
therapy with a 5a-reductase inhibitor such as finasteride. Terazosin should be given at bedtime to
minimize these adverse effects. Herbal preparations have not been proven to be safe or effective.
Doxazosin is in the same drug class as terazosin.
A pregnant woman at 30 weeks gestation presents with proteinuria. What will the provider do next?
a. Evaluate her blood pressure and discuss with OB/GYN
b. Monitor serum glucose for gestational diabetes
c. Perform a 24-hour urine collection
d. Reassure her that this normal at this stage of pregnancy - ANSWER>>>ANS: A
Proteinuria after 24 weeks gestation is usually a sign of preeclampsia, so her blood pressure should be
evaluated and discussed with the OB/GYN. Serum glucose evaluation for gestational diabetes is
, performed as part of routine screening but is not related to the finding of proteinuria. A 24-hour urine
collection is not indicated.
An older male patient reports gross hematuria but denies flank pain and fever. What will the provider do
to manage this patient?
a. Monitor blood pressure closely
b. Obtain a urine culture
c. Perform a 24-hour urine collection
d. Refer for cystoscopy and imaging - ANSWER>>>Gross hematuria in older men denotes a significant risk
of malignant disease, so cystoscopy and imaging are indicated. Proteinuria is concerning for
hypertension. The patient does not have flank pain or fever, so the likelihood of infection is lower. A 24-
hour urine collection is not indicated.
A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection.
After treatment for the urinary tract infection (UTI), what testing is indicated for this patient?
a. 24-hour urine collection to evaluate for glomerulonephritis
b. Bladder scan
c. Repeat urinalysis
d. Voiding cystourethrogram - ANSWER>>>ANS: C
After treatment has been completed, repeated urinalysis is necessary to ensure that the hematuria has
resolved. Failure to follow hematuria to resolution may result in failure to diagnose a serious condition.
Which is a prerenal cause of acute kidney injury (AKI)?
a. Hemorrhagic shock
b. Hydronephrosis
c. Hypertension
d. Renal calculi - ANSWER>>>ANS: A
Hemorrhagic shock interferes with perfusion of the kidney, which is a prerenal cause of AKI.
Hydronephrosis and renal calculi are postrenal causes leading to obstruction to renal pelvis, ureters,
bladder, or urethra. Hypertension is an intrinsic cause.
A primary care provider sees a new patient who reports having a diagnosis of chronic kidney disease for
several years. The patient is taking one medication for hypertension which has been prescribed since the
diagnosis was made. The provider orders laboratory tests to evaluate the status of this patient. Which
laboratory finding indicates a need to refer the patient to a nephrologist?
a. Albumin/creatinine ratio (ACR) of 325 mg/g
b. Blood pressure of 145/85 mm Hg
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller linokinyua. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $19.99. You're not tied to anything after your purchase.
