ANSWER RATIONALE

1. D Calcium glycerophosphate (Prelief) alkalinizes the urine and can help to relieve the irritation from acidic
foods. A diet low in acidic foods is recommended and if a multivitamin is used, high-potency vitamins should
be avoided because these products may irritate the bladder. Avoiding diary is useful in diagnosis but does not
need to be kept indefinitely.

2. A Urine is cloudy in cystitis because of bacterial and white cells.

3. D With nocturia the patient has to get up during the night to urinate. Limiting fluids 2 hours before bedtime
minimizes nocturia.

4. D Kegel exercises strengthen pelvic floor muscles and are effective in urine control in patients with urge
incontinence and difficulty starting and stopping urination.

5. B The classic symptoms of cystitis are severe burning on urination, urgency, and frequent urination. Systemic
symptoms, such as fever and nausea and vomiting, are more likely to accompany pyelonephritis than cystitis.
Hematuria may occur, but it is not as common as frequency and burning.

6. B Intermittent pain that is less colicky indicates that the calculi may be moving along the urinary tract. Fluids
should be encouraged to promote movement, and the urine should be strained to detect passage of the
stone. Hematuria is to be expected from the irritation of the stone.

7. C A client scheduled for an IVP should be assessed for allergies to iodine and shellfish. Clients with such
allergies may be allergic to the IVP dye and be at risk for an anaphylactic reaction. Adequate fluid intake is
important after the examination.

8. B After an IVP, the nurse should encourage fluids to decrease the risk of renal complications caused by the
contrast agent. There is no need to place the client on bed rest or administer a laxative. An IVP would not
cause hematuria.

9. A Because a high-purine diet contributes to the formation of uric acid, a low-purine diet is advocated. An
alkaline-ash diet is also advocated because uric acid crystals are more likely to develop in acid urine. Foods
that may be eaten as desired in a low-purine diet include milk, all fruits, tomatoes, cereals, and corn. Foods
allowed on an alkaline-ash diet include milk, fruits (except cranberries, plums, and prunes), and vegetables
(especially legumes and green vegetables). Gravy, chicken, and liver are high in purine.

10. B Allopurinol (Zyloprim) is used to treat renal calculi composed of uric acid. Adverse effects of allopurinol
include drowsiness, maculopapular rash, anemia, abdominal pain, nausea, vomiting, and bone marrow
depression. Clients should be instructed to report rashes and unusual bleeding or bruising. Retinopathy, nasal
congestion, and dizziness are not adverse effects of allopurinol.