Deck 26: Urinary Function

Question 1

A patient in a long-term care facility has incontinence.What assessment by the nurse is most important before designing interventions for this problem?

A)Cognitive status
B)Ambulatory status
C)Cardiovascular status
D)History of childbirth

Answer 1

Cognitive status

Question 2

An older patient is admitted with possible chronic renal failure (CRF).Which lab value does the nurse notify the physician about as a priority?

A)Increased calcium level
B)Increased red blood cells
C)Decreased BUN level
D)Decreased creatinine clearance level

Answer 2

Decreased creatinine clearance level

Question 3

A male patient has benign prostatic enlargement.He is at risk for what type of acute kidney injury?

A)Prerenal
B)Intrarenal
C)Postrenal
D)Combined form

Answer 3

Postrenal

Question 4

A patient is scheduled to have surgery for prostate cancer in a few weeks.What action by the nurse is most important?

A)Discuss options and their effect on sexuality.
B)Ensure the patient has advance directives.
C)Offer the patient a tour of the operating room.
D)Determine if the patient prefers outpatient surgery.

Question 5

An older adult patient reports "losing urine" when she bends over or gets out of a chair.What type of incontinence does the nurse plan interventions for?

A)Overflow
B)Urge
C)Functional
D)Stress

Question 6

A male patient reports difficulty starting a urine stream and a weak urine flow.When prompted to seek medical attention,the patient asks why,as it's "obviously" benign prostatic hypertrophy.What response by the nurse is best?

A)"You never know;it could be cancer."
B)"You should have any change checked out."
C)"Only the physician can make a diagnosis,"
D)"BPH and prostate cancer have similar symptoms."

Question 7

When assessing the patient for urinary incontinence,which patient symptom best supports the nursing diagnosis of overflow incontinence?

A)"I have small accidents ever since I developed a cystocele."
B)"It burns so badly after I urinate that I hold it as long as I can."
C)"I can't make it to the toilet when I feel the need to urinate."
D)"I lose small amounts of urine when I sneeze or laugh hard."

Question 8

A patient being treated for prostate cancer calls the clinic to report severe back pain.What action by the nurse is best?

A)Advise the patient to take his pain medication.
B)Tell the patient to come in to the clinic today.
C)Make an appointment for the patient next week.
D)Encourage the patient to rest and use moist heat.

Question 9

The nurse is admitting an older patient with benign prostate hyperplasia (BPH).The nurse's priority questioning focuses on:

A)family history of prostate disorders.
B)onset of symptoms.
C)psychosocial impact of the diagnosis.
D)typical urinary voiding patterns.

Question 10

A patient has a history of smoking and now has painless hematuria.After a workup,the patient is told the diagnosis of bladder cancer.What action by the nurse is most important?

A)Allow the patient to verbalize feelings.
B)Educate the patient on care of an ileal conduit.
C)Teach the patient how to manage nausea.
D)Offer a social work referral to complete a living will.

Question 11

When caring for older adults,the nurse expects to encounter the normal urinary age-related outcome of:

A)urinary incontinence.
B)low-grade bladder infection.
C)nocturia.
D)urinary residual volume.

Question 12

When preparing educational information regarding benign prostatic hyperplasia (BPH)for a group of older male patients,the nurse includes which of the following? (Select all that apply. )

A)Eighty percent of males experience the symptoms by age 80.
B)Diabetes mellitus is a risk factor.
C)It is only as the prostate enlarges that symptoms occur.
D)The resulting urinary retention can cause urinary tract infections.
E)Symptoms are a result of urethral obstruction.

Question 13

An older adult woman has a resistant strain of pneumonia.To best minimize her risk of developing acute renal failure,the nurse:

A)monitors the patient's serum blood urea nitrogen (BUN)levels via diagnostic laboratory work.
B)helps the patient select low-sodium foods from her daily menu.
C)measures and records the patient's urinary output.
D)chooses an analgesic other than ibuprofen (Motrin).

Question 14

What information does the nurse share with the student about normal age-related changes in the kidneys?

A)Renal mass increases.
B)The glomerular filtration rate decreases.
C)Poor renal function occurs after age 65.
D)There are no real age-related changes.

Question 15

A nurse is assessing an older patient for the possible cause of his acute urinary incontinence.Which actions by the nurse are most important? (Select all that apply. )

A)Asking when his last normal bowel movement was
B)Monitoring his intake and output
C)Determining if he has been screened for prostatic hypertrophy
D)Asking him if he awakens during the night to urinate
E)Measuring his abdominal girth

Question 16

An older adult patient is hospitalized for after an automobile crash.The nurse recognizes symptoms suggestive of an upper urinary tract (UTI)infection when the patient:

A)voids 100 mL of urine over a 3-hour period of time.
B)is not able to state where he is or what day it is.
C)has an elevated red blood cell (RBC)count.
D)reports burning when he urinates.

Question 17

A patient treats chronic kidney failure with peritoneal dialysis.The patient notes the fluid draining out of the abdomen is cloudy and foul smelling.What action by the nurse is best?

A)Assess the patient for other signs of infection.
B)Document the findings in the patient's chart.
C)Call the rapid response team immediately.
D)Request a prescription for an antibiotic.

Question 18

An 87-year-old patient has suddenly become incontinent.What should the nurse's first action be?

A)Review the patient's record for medications that may be causing urinary incontinence.
B)Seek an order for an indwelling urinary catheter to prevent skin breakdown.
C)Limit the patient's fluid intake to reduce the feeling of having to void so often.
D)Teach the patient to void every 2 hours when awake during the day or night.

Question 19

An older cognitively impaired adult patient is being discharged to a daughter's home.The nurse knows continued success of the patient's bladder training for urinary incontinence primarily rests on the:

A)patient's ability to follow instructions.
B)severity of the impairment of the urinary sphincter.
C)patient's ability to sense the need to urinate.
D)daughter's ability to support the training.

Question 20

A patient asks how elevating the legs at night will decrease nocturia.What is the nurse's best response?

A)All that fluid gets into circulation before you go to bed.
B)Decreased swelling makes it easier to ambulate at night.
C)It won't help;that's an old wives' tale you heard.
D)This measure helps dehydrate you before bedtime.

Question 21

A patient has a glomerular filtration rate (GFR)of 19 mL/min/1.73m².What assessment findings correlate with this condition? (Select all that apply. )

A)Fatigue
B)Weakness
C)Edema
D)No specific symptoms
E)Headaches

Question 22

An older adult patient's urinary incontinence is being addressed by prompted voiding.The nurse instructs all ancillary staff to do which of the following? (Select all that apply. )

A)Provide only minimal fluids after 7 PM.
B)Keep the patient on the toilet until voiding occurs.
C)Allow the patient to void at times other than those scheduled.
D)Offer toileting during the night only when the patient is awake.
E)Encourage the patient to toilet himself.

Question 23

The nurse working in the gerontology clinic understands which facts related to incontinence? (Select all that apply. )

A)It is a normal age-related change.
B)It is an independent predictor of nursing home admission.
C)It contributes to falls and injuries.
D)It can disrupt sleep.
E)It can lead to urinary tract infections.