Deck 45: Urinary Elimination

Question 1

The nurse knows that indwelling catheters are placed before a cesarean because

A) The patient may void uncontrollably during the procedure.
B) A full bladder can cause the mother's heart rate to drop.
C) Spinal anesthetics can temporarily disable urethral sphincters.
D) The patient will not interrupt the procedure by asking to go to the bathroom.

Answer 1

Spinal anesthetics can temporarily disable urethral sphincters.

Question 2

An 86-year-old patient tells the nurse that she is experiencing uncontrollable leakage of urine.Which nursing diagnosis should the nurse include in the patient's plan of care?

A) Urinary retention
B) Hesitancy
C) Urgency
D) Urinary incontinence

Answer 2

Urinary incontinence

Question 3

A patient is experiencing oliguria.Which action should the nurse perform first?

A) Increase the patient's intravenous fluid rate.
B) Encourage the patient to drink caffeinated beverages.
C) Assess for bladder distention.
D) Request an order for diuretics.

Answer 3

Assess for bladder distention.

Question 4

Which of the following is the primary function of the kidney?

A) Metabolizing and excreting medications
B) Maintaining fluid and electrolyte balance
C) Storing and excreting urine
D) Filtering blood cells and proteins

Question 5

A patient requests the nurse's assistance to the bedside commode and becomes frustrated when unable to void in front of the nurse.The nurse understands the patient's inability to void because

A) Anxiety can make it difficult for abdominal and perineal muscles to relax enough to void.
B) The patient does not recognize the physiological signals that indicate a need to void.
C) The patient is lonely, and calling the nurse in under false pretenses is a way to get attention.
D) The patient is not drinking enough fluids to produce adequate urine output.

Question 6

Upon palpation,the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate.The nurse should follow up by asking

A) "When was the last time you voided?"
B) "Do you lose urine when you cough or sneeze?"
C) "Have you noticed any change in your urination patterns?"
D) "Do you have a fever or chills?"

Question 7

When viewing a urine specimen under a microscope,what would the nurse expect to see in a patient with a urinary tract infection?

A) Bacteria
B) Casts
C) Crystals
D) Protein

Question 8

When reviewing laboratory results,the nurse should immediately notify the health care provider about which finding?

A) Glomerular filtration rate of 20 mL/min
B) Urine output of 80 mL/hr
C) pH of 6.4
D) Protein level of 2 mg/100 mL

Question 9

When establishing a diagnosis of altered urinary elimination,the nurse should first

A) Establish normal voiding patterns for the patient.
B) Encourage the patient to flush kidneys by drinking excessive fluids.
C) Monitor patients' voiding attempts by assisting them with every attempt.
D) Discuss causes and solutions to problems related to micturition.

Question 10

When caring for a patient with urinary retention,the nurse would anticipate an order for

A) Limited fluid intake.
B) A urinary catheter.
C) Diuretic medication.
D) A renal angiogram.

Question 11

To obtain a clean-voided urine specimen for a female patient,the nurse should teach the patient to

A) Cleanse the urethral meatus from the area of most contamination to least.
B) Initiate the first part of the urine stream directly into the collection cup.
C) Hold the labia apart while voiding into the specimen cup.
D) Drink fluids 5 minutes before collecting the urine specimen.

Question 12

The nurse would expect the urine of a patient with uncontrolled diabetes mellitus to be

A) Cloudy.
B) Discolored.
C) Sweet smelling.
D) Painful.

Question 13

Which assessment question should the nurse ask if stress incontinence is suspected?

A) "Does your bladder feel distended?"
B) "Do you empty your bladder completely when you void?"
C) "Do you experience urine leakage when you cough or sneeze?"
D) "Do your symptoms increase with consumption of alcohol or caffeine?"

Question 14

If obstructed,which component of the urination system would cause peristaltic waves?

A) Kidney
B) Ureters
C) Bladder
D) Urethra

Question 15

The nurse suspects that a urinary tract infection has progressed to cystitis when the patient complains of which symptom?

A) Dysuria
B) Flank pain
C) Frequency
D) Fever and chills

Question 16

The nurse knows that urinary tract infection (UTI)is the most common health care-associated infection because

A) Catheterization procedures are performed more frequently than indicated.
B) Escherichia coli pathogens are transmitted during surgical or catheterization procedures.
C) Perineal care is often neglected by nursing staff.
D) Bedpans and urinals are not stored properly and transmit infection.

Question 17

Which nursing diagnosis related to alternations in urinary function in an older adult should be a nurse's first priority?

A) Self-care deficit related to decreased mobility
B) Risk of infection
C) Anxiety related to urinary frequency
D) Impaired self-esteem related to lack of independence

Question 18

While receiving a shift report on a patient,the nurse is informed that the patient has urinary incontinence.Upon assessment,the nurse would expect to find

A) An indwelling Foley catheter.
B) Reddened irritated skin on the buttocks.
C) Tiny blood clots in the patient's urine.
D) Foul-smelling discharge indicative of a UTI.

Question 19

A patient asks about treatment for urge urinary incontinence.The nurse's best response is to advise the patient to

A) Perform pelvic floor exercises.
B) Drink cranberry juice.
C) Avoid voiding frequently.
D) Wear an adult diaper.

Question 20

A patient has fallen several times in the past week when attempting to get to the bathroom.The patient informs the nurse that he gets up 3 or 4 times a night to urinate.Which recommendation by the nurse is most appropriate in correcting this urinary problem?

A) Clear the path to the bathroom of all obstacles before bed.
B) Leave the bathroom light on to illuminate a pathway.
C) Limit fluid and caffeine intake before bed.
D) Practice Kegel exercises to strengthen bladder muscles.

Question 21

Which statement by the patient about an upcoming computed tomography (CT)scan indicates a need for further teaching?

A) "I'm allergic to shrimp, so I should monitor myself for an allergic reaction."
B) "I will complete my bowel prep program the night before the scan."
C) "I will be anesthetized so that I lie perfectly still during the procedure."
D) "I will ask the technician to play music to ease my anxiety."

Question 22

The nurse anticipates preparing a patient who is allergic to shellfish for an arteriogram by

A) Obtaining baseline vital signs after the start of the procedure.
B) Monitoring the extremity for neurocirculatory function.
C) Keeping the patient on bed rest for the prescribed time.
D) Administering an antihistamine medication to the patient.

Question 23

When caring for a hospitalized patient with a urinary catheter,which nursing action best prevents the patient from acquiring an infection?

A) Inserting the catheter using strict clean technique
B) Performing hand hygiene before and after providing perineal care
C) Fully inflating the catheter's balloon according to the manufacturer's recommendation
D) Disconnecting and replacing the catheter drainage bag once per shift

Question 24

A nurse is caring for a patient who just underwent intravenous pyelography that revealed a renal calculus obstructing the left ureter.What is the nurse's first priority in caring for this patient?

A) Turn the patient on the right side to alleviate pressure on the left kidney.
B) Encourage the patient to increase fluid intake to flush the obstruction.
C) Administer narcotic medications to alleviate pain.
D) Monitor the patient for fever, rash, and difficulty breathing.

Question 25

Many individuals have difficulty voiding in a bedpan or urinal while lying in bed because they

A) Are embarrassed that they will urinate on the bedding.
B) Would feel more comfortable assuming a normal voiding position.
C) Feel they are losing their independence by asking the nursing staff to help.
D) Are worried about acquiring a urinary tract infection.

Question 26

Which observation by the nurse best indicates that bladder irrigation for urinary retention has been effective?

A) Recording an output that is larger than the amount instilled
B) Presence of blood clots or sediment in the drainage bag
C) Reduction in discomfort from bladder distention
D) Visualizing clear urinary catheter tubing

Question 27

A nurse notifies the provider immediately if a patient with an indwelling catheter

A) Complains of discomfort upon insertion of the catheter.
B) Places the drainage bag higher than the waist while ambulating.
C) Has not collected any urine in the drainage bag for 2 hours.
D) Is incontinent of stool and contaminates the external portion of the catheter.

Question 28

The nurse anticipates urinary diversion from the kidneys to a site other than the bladder for which patient?

A) A 12-year-old female with severe abdominal trauma
B) A 24-year-old male with severe genital warts around the urethra
C) A 50-year-old male with recent prostatectomy
D) A 75-year-old female with end-stage renal disease

Question 29

The nurse knows that which indwelling catheter procedure places the patient at greatest risk for acquiring a urinary tract infection?

A) Emptying the drainage bag every 8 hours or when half full
B) Kinking the catheter tubing to obtain a urine specimen
C) Placing the drainage bag on the side rail of the patient's bed
D) Failing to secure the catheter tubing to the patient's thigh

Question 30

The nurse would question an order to insert a urinary catheter on which patient?

A) A 26-year-old patient with a recent spinal cord injury at T₂
B) A 30-year-old patient requiring drug screening for employment
C) A 40-year-old patient undergoing bladder repair surgery
D) An 86-year-old patient requiring monitoring of urinary output for renal failure

Question 31

The nurse would anticipate inserting a Coudé catheter for which patient?

A) An 8-year-old male undergoing anesthesia for a tonsillectomy
B) A 24-year-old female who is going into labor
C) A 56-year-old male admitted for bladder irrigation
D) An 86-year-old female admitted for a urinary tract infection.

Question 32

A nurse is caring for an 8-year-old patient who is embarrassed about urinating in his bed at night.Which intervention should the nurse suggest to reduce the frequency of this occurrence?

A) "Drink your nightly glass of milk earlier in the evening."
B) "Set your alarm clock to wake you every 2 hours, so you can get up to void."
C) "Line your bedding with plastic sheets to protect your mattress."
D) "Empty your bladder completely before going to bed."

Question 33

The nurse would anticipate an order for which diagnostic test for a patient who has severe flank pain and calcium phosphate crystals revealed on urinalysis?

A) Renal ultrasound
B) Bladder scan
C) KUB x-ray
D) Intravenous pyelogram

Question 34

An 86-year-old patient asks the nurse what lifestyle changes will reduce the chance of a urinary tract infection.Which response is accurate?

A) Urinary tract infections are unavoidable in the elderly because of a weakened immune system.
B) Decreasing fluid intake will decrease the amount of urine with bacteria produced.
C) Making sure to cleanse the perineal area from back to front after voiding will reduce the chance of infection.
D) Increasing consumption of acidic foods such as cranberry juice will reduce the chance of infection.

Question 35

What signs and symptoms would the nurse expect to observe in a patient with excessive white blood cells present in the urine?

A) Fever and chills
B) Difficulty holding in urine
C) Increased blood pressure
D) Abnormal blood sugar

Question 36

A patient is having difficulty voiding in a bedpan but states that she feels her bladder is full.To stimulation micturition,which nursing intervention should the nurse try first?

A) Exiting the room and informing the patient that the nurse will return in 30 minutes to check on the patient's progress
B) Utilizing the power of suggestion by turning on the faucet and letting the water run
C) Obtaining an order for a Foley catheter
D) Administering diuretic medication

Question 37

To reduce patient discomfort during closed catheter irrigation,the nurse should

A) Use room temperature irrigation solution.
B) Administer the solution as quickly as possible.
C) Allow the solution to sit in the bladder for at least 1 hour.
D) Raise the bag of irrigation solution at least 12 inches above the bladder.

Question 38

Which nursing actions are acceptable when collecting a urine specimen?

A) Growing urine cultures for up to 12 hours
B) Labeling all specimens with date, time, and initials
C) Wearing gown, gloves, and mask for all specimen handling
D) Allowing the patient adequate time and privacy to void
E) Squeezing urine from diapers into a urine specimen cup
F) Transporting specimens to the laboratory in a timely fashion
G) Placing a plastic bag over the child's urethra to catch urine

Question 39

A nurse anticipates urodynamic testing for a patient with which symptom?

A) Involuntary urine leakage
B) Severe flank pain
C) Presence of blood in urine
D) Dysuria

Question 40

A nurse is providing education to a patient being treated for a urinary tract infection.Which of the following statements by the patient indicates an understanding?

A) "Since I'm taking medication, I do not need to worry about proper hygiene."
B) "I should drink 15 to 20 glasses of fluid a day to help flush the bacteria out."
C) "My medication may discolor my urine; this should resolve once the medication is stopped."
D) "I should not have sexual intercourse until the infection has resolved."

Question 41

The nurse understands that peritoneal dialysis and hemodialysis use which processes to clean the patient's blood?

A) Gravity
B) Osmosis
C) Diffusion
D) Filtration

Question 42

Which of the following are indications for irrigating a urinary catheter?

A) Sediment occluding within the tubing
B) Blood clots in the bladder following surgery
C) Rupture of the catheter balloon
D) Bladder infection
E) Presence of renal calculi

Question 43

Which of the following symptoms are most closely associated with uremic syndrome?

A) Fever
B) Nausea and vomiting
C) Headache
D) Altered mental status
E) Dysuria

Question 44

The nurse properly obtains a 24-hour urine specimen collection by

A) Asking the patient to void and to discard the first sample.
B) Keeping the urine collection container on ice.
C) Withholding all patient medications for the day.
D) Asking the patient to notify the staff before and after every void.