Deck 19: Urinary Elimination

Question 1

The nurse is changing an external urinary catheter on a male patient.Which observation by the nurse requires additional attention?

A) The patient urinates at least every 4 hours.
B) The patient's urine is dark yellow and clear.
C) The skin of the penis under the catheter is dusky.
D) The patient applies the catheter independently.

Answer 1

The skin of the penis under the catheter is dusky.

Question 2

In which position would the nurse place a female patient when preparing to insert a urinary catheter?

A) Prone
B) Supine
C) High-Fowler's
D) Dorsal recumbent

Answer 2

Dorsal recumbent

Question 3

The nurse determines that the patient's urinary output from the suprapubic catheter is 150 mL for 8 hours.What does the nurse implement as a follow-up nursing intervention?

A) Encourage the patient to change positions.
B) Clamp the urinary catheter for 30 minutes.
C) Contact the health care provider for a diuretic.
D) Assess the patient's intake and catheter patency.

Answer 3

Assess the patient's intake and catheter patency.

Question 4

The patient reports a sharp stabbing pain when the nurse inflates the balloon during insertion of an indwelling urinary catheter.What would the nurse do in response to the patient report of pain?

A) Deflate the balloon.
B) Remove the catheter.
C) Advance the catheter 2 inches.
D) Reassure the patient that it will pass.

Question 5

Four hours after applying an external urinary catheter, the nurse observes no urine output in the drainage bag.Which intervention does the nurse implement first?

A) Check the catheter tubing for an obstruction.
B) Ask the patient if he or she feels the urge to void.
C) Notify the provider of inadequate urine output.
D) Increase the patient's fluid intake over the next hour.

Question 6

The nurse notes that 8 hours after removing the patient's indwelling urinary catheter, the patient has not voided.Which action would the nurse take first?

A) Run a trickle of water in the bathroom.
B) Apply a rolling motion over the bladder.
C) Ask about voiding difficulties in the past.
D) Instruct the patient to run warm water on the perineum.

Question 7

The nurse delegates the application of an external urinary catheter to nursing assistive personnel (NAP), including application of an external urinary catheter.Which aspect of applying the external catheter must the nurse perform?

A) Placing the adhesive from the kit to hold the catheter in place
B) Checking the condition of the penis and scrotum before the procedure
C) Providing perineal care before catheter placement
D) Allowing a space between the tip of the penis and the catheter

Question 8

The nurse is making patient care assignments for the staff.Which elimination activity can the nurse delegate to nursing assistive personnel (NAP) for a patient with an indwelling urinary catheter?

A) Catheterizing the patient
B) Irrigating the catheter
C) Obtaining a urine culture
D) Providing catheter care

Question 9

The nurse reviews an order for a continuous bladder irrigation after prostate surgery.Which action does the nurse take before starting the bladder irrigation?

A) Label the irrigation solution genitourinary (GU) irrigation only.
B) Change the irrigation tubing at least once every 12 hours.
C) Infuse the irrigation solution at 100 mL/hr for clear urine.
D) Ensure that the patient has a triple-lumen urinary catheter.

Question 10

The nurse assesses the patient's skin around the suprapubic catheter and observes extremely reddened skin.Which is the best nursing intervention to promote skin integrity?

A) Apply an antiseptic ointment.
B) Keep the suprapubic insertion site dry.
C) Attach a different bag to the skin.
D) Fit the stoma with a tight skin barrier.

Question 11

The nurse evaluates the effectiveness of the patient's intermittent urinary catheterization for residual urine.Which of the following requires follow-up nursing intervention?

A) The patient is passing urine in the bathroom.
B) The urine is clear yellow and without odor.
C) The bladder is nonpalpable above the pubic bone.
D) The patient reports frequency and urgency.

Question 12

The nurse infused a continuous bladder irrigation solution at 250 mL/hr for 12 hours.The total output amount measured was 3720 mL.What will the nurse record for the patient's urinary output?

A) 550 mL
B) 720 mL
C) 3000 mL
D) 3720 mL

Question 13

The nurse is preparing to insert an indwelling urinary catheter into a female patient who is having major open-heart surgery and will be in the intensive care unit after surgery.Which statement about the purpose of the catheter by the patient best indicates that teaching by the nurse was effective?

A) "An empty bladder always helps prevent bladder infections."
B) "The catheter drains residual urine in case you get a urinary obstruction."
C) "The catheter prevents urinary infections."
D) "The catheter allows us to monitor your urine output closely after surgery."

Question 14

The nurse inserts an indwelling urinary catheter into an adult patient who has been unable to void.Which assessment finding would the nurse expect?

A) The patient complains of burning.
B) The urine output exceeds 30 mL in the first hour.
C) The patient develops a fever.
D) The urine is yellow and blood tinged.

Question 15

The nurse encounters resistance during the insertion of a urinary catheter in a male patient.Which action would the nurse implement first?

A) Tell the patient to bear down.
B) Ask the patient to inhale quickly.
C) Apply force to insert the catheter.
D) Remove the catheter immediately.

Question 16

Which technique does the nurse use to cleanse the perineum of a female patient during urinary catheter insertion?

A) Rinse the perineum with warm antiseptic solution.
B) Swab the perineum 3 times from the anus to the urinary meatus.
C) Use the nondominant hand to keep the labia spread apart continuously.
D) Use the nondominant hand to cleanse from the urinary meatus to the rectum.

Question 17

A patient is going to have an indwelling catheter for the next few weeks as a result of postoperative complications.Which action does the nurse use to prevent the most common complication of an indwelling urinary catheter?

A) Maintain slight tension on the tubing.
B) Keep the collection bag several inches from the floor.
C) Empty the collection bag every 24 hours.
D) Clean the catheter from the meatus to the tubing.

Question 18

Discharge teaching for a male patient with an external urinary catheter would include which of the following instructions?

A) Retract the foreskin of the penis before applying the catheter.
B) Remove the hair at the base of the penis before applying the catheter.
C) Apply a petroleum-based skin barrier to the penis first.
D) Press the catheter adhesive to encourage adherence to the penis.

Question 19

The nurse set up the sterile field and is preparing to cleanse a male patient before inserting a urinary catheter.What step is essential for the nurse to use when cleaning the penis?

A) Keep the foreskin over the penis tip.
B) Use long strokes down the shaft of the penis.
C) Hold the penis at a right angle to the body.
D) Hold the cotton balls in the dominant hand.

Question 20

The nurse assesses a patient's suprapubic catheter.Which observation warrants further investigation by the nurse?

A) The catheter does not drain urine continuously.
B) The catheter remains in the stoma at all times.
C) The patient's urine is dark yellow and without odor.
D) The patient urinates a small volume from the urethra.

Question 21

A female patient with a hysterectomy now needs to have her bladder scanned because of difficulty voiding after back surgery.What action does the nurse take to obtain the most accurate scan?

A) Place the scanner head on the symphysis pubis using ultrasound gel.
B) Set the gender designation on the scanner as "male."
C) Place the scanner head above the symphysis pubis without ultrasound gel.
D) Set the gender designation on the scanner as "female."

Question 22

The nurse is reviewing the interventions for prevention of urinary catheter infections (CAUTIs).Which of the following interventions will help prevent infection? (Select all that apply.)

A) Maintain a closed system.
B) Perform routine perineal hygiene daily.
C) Only open the system when necessary.
D) Secure the catheter to prevent pulling on the catheter.
E) Maintain an unobstructed flow of urine.

Question 23

A male patient is having difficulty using the urinal in bed.What does the nurse do to facilitate voiding?

A) Applies an external urinary catheter.
B) Assists the patient to the upright position.
C) Encourages the patient to void every hour.
D) Instructs the patient to increase his fluid intake.

Question 24

The charge nurse is reviewing patients on the unit who have indwelling urinary catheters for appropriateness of this treatment.Which of the following have catheters for appropriate reasons? (Select all that apply.)

A) Frequently incontinent
B) On high dose steroids
C) Receiving fluid resuscitation for burns
D) Critically ill
E) On hospice, for comfort

Question 25

The nurse is providing instructions to the NAP on applying a condom catheter on a male patient.Which of the following does the nurse instruct the NAP to report? (Select all that apply.)

A) Patient reports pain at the site or when voiding.
B) Redness or irritation at the site where the condom catheter is applied.
C) Skin breakdown of the glans penis or penile shaft.
D) Inability to apply the catheter.
E) Urinary incontinence.

Question 26

The nurse is reviewing the instructions for applying a condom catheter with the NAP.Which of the following statements indicates an understanding of the procedure? (Select all that apply.)

A) "I should shave the pubic hair first."
B) "With my dominant hand, I hold the rolled condom sheath."
C) "I allow 1-2 inches of space between the tip of the penis and the end of the condom."
D) "I should not use any additional adhesive tape around the penis."
E) "I should first provide perineal care."

Question 27

A nurse is caring for an older patient who is recovering from a serious illness.The patient has an indwelling urinary catheter.The nurse notes the onset of new confusion.What action by the nurse is best?

A) Enlist a sitter to keep the patient safe.
B) Obtain an order for a urinalysis.
C) Assess the patient's intake and output.
D) Check the patient's recent lab data.