Deck 43: Urinary Elimination

Question 1

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

Answer 1

Glomerular filtration rate of 20 mL/min

Question 2

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

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

Answer 2

Sweet smelling.

Question 3

To obtain a clean-voided urine specimen for a female patient,the nurse should teach the patient to do which of the following?

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.

Answer 3

Hold the labia apart while voiding into the specimen cup.

Question 4

Which nursing diagnosis related to alterations in urinary function in an older person should be a nurse's first priority for action?

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 5

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 distension.
D)Request an order for diuretics.

Question 6

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.

Question 7

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 with urinary elimination.
C)Increased blood pressure.
D)Abnormal blood glucose level.

Question 8

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

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

Question 9

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 which question?

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 10

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 11

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

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

Question 12

The nurse knows that urinary tract infection (UTI)is the most common health care-associated infection for which of the following reasons?

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 13

When caring for a patient with urinary retention,the nurse would anticipate an order for which of the following?

A)Limited fluid intake.
B)A urinary catheter.
C)Diuretic medication.
D)Renal angiography.

Question 14

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

A)An in-dwelling 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 15

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

A)Renal ultrasonography.
B)Bladder scan.
C)Kidney,ureter,and bladder (KUB)radiography.
D)Intravenous pyelography.

Question 16

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 17

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

A)Kidneys.
B)Ureters.
C)Bladder.
D)Urethra.

Question 18

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 three or four 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)Practise Kegel exercises to strengthen bladder muscles.

Question 19

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 20

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 that the patient is unable to void for which reason?

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 21

Which of the following are indications for irrigating a urinary catheter? (Select all that apply. )

A)Sediment occluding within the tubing.
B)Blood clots in the bladder after surgery.
C)Rupture of the catheter balloon.
D)Presence of renal calculi.

Question 22

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 23

Which nursing actions are acceptable when a urine specimen is collected? (Select all that apply. )

A)Growing urine cultures for up to 12 hours.
B)Labelling 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 manner.
G)Placing a plastic bag over the child's urethra to catch urine.

Question 24

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 older people 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 25

Which of the following symptoms are most closely associated with uremic syndrome? (Select all that apply. )

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

Question 26

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

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 30 centimetres above the bladder.

Question 27

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)"Because 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 discolour my urine;this should resolve once the medication is stopped."
D)"I should not have sexual intercourse until the infection has resolved."

Question 28

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 29

The nurse knows that which in-dwelling 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 anticipates urinary diversion from the kidneys to a site other than the bladder for which patient?

A)A 12-year-old girl with severe abdominal trauma.
B)A 24-year-old man with severe genital warts around the urethra.
C)A 50-year-old man who has recently undergone prostatectomy.
D)A 75-year-old woman with end-stage renal disease.

Question 31

Which statement by the patient about upcoming computed tomographic (CT)scanning 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 anaesthetized so that I lie perfectly still during the procedure."
D)"I will ask the technician to play music to ease my anxiety."

Question 32

Many individuals have difficulty voiding in a bedpan or urinal while lying in bed for which reason?

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

Question 33

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 34

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

A)An 8-year-old boy undergoing anaesthesia for a tonsillectomy.
B)A 24-year-old woman who is going into labour.
C)A 56-year-old man admitted for bladder irrigation.
D)An 86-year-old woman admitted for a urinary tract infection.

Question 35

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 36

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

A)An output that is larger than the amount instilled.
B)The presence of blood clots or sediment in the drainage bag.
C)Reduction in discomfort from bladder distension.
D)Visualizing clear urinary catheter tubing.

Question 37

The nurse is visiting the patient who has a nursing diagnosis of Alteration in urinary elimination,retention.On assessment,the nurse anticipates that this patient will exhibit which of the following?

A)Severe flank pain and hematuria.
B)Pain and burning on urination.
C)A loss of the urge to void.
D)A feeling of pressure and voiding of small amounts.

Question 38

A nurse notifies the provider immediately if a patient with an in-dwelling catheter does which of the following?

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 39

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 40

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 with 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 41

The nurse understands that peritoneal dialysis and hemodialysis involve which processes to clean the patient's blood? (Select all that apply. )

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