Deck 28: Urinary Elimination

Question 1

The nurse measures the urine output of a patient who requires a bedpan to void.Which action should the nurse take first? Put on gloves and:

A) Have the patient void directly into the bedpan
B) Pour the urine into a graduated container
C) Read the volume with the container on a flat surface at eye level
D) Observe the color and clarity of the urine in the bedpan

Answer 1

Have the patient void directly into the bedpan

Question 2

The nurse is caring for a patient who underwent a bowel resection 2 hours ago.His urine output for the past 2 hours totals 50 mL.Which action should the nurse take?

A) Do nothing; this is normal postoperative urine output.
B) Increase the infusion rate of the patient's IV fluids.
C) Notify the provider about the patient's oliguria.
D) Administer the patient's routine diuretic dose early.

Answer 2

Notify the provider about the patient's oliguria.

Question 3

Which urine specific gravity would be expected in a patient admitted with dehydration?

A) 1.002
B) 1.010
C) 1.021
D) 1.030

Answer 3

1.030

Question 4

Which outcome is appropriate for the patient who underwent urinary diversion surgery and creation of an ileal conduit for invasive bladder cancer?

A) Patient will resume his normal urination pattern by (target date).
B) Patient will perform urostomy self-care by (target date).
C) Patient will perform self-catheterization by (target date).
D) Patient's urine will remain clear with sufficient volume.

Question 5

Which daily urine output is within normal limits for a newborn weighing 8 pounds?

A) 288 mL
B) 180 mL
C) 36 mL
D) 18 mL

Question 6

A patient is admitted with high BUN and creatinine levels,low blood pH,and elevated serum potassium level.Based on these laboratory findings the nurse suspects which diagnosis?

A) Cystitis
B) Renal Calculi
C) Enuresis
D) Renal Failure

Question 7

Which action should the nurse take when beginning bladder training using scheduled voiding?

A) Offer the patient a bedpan every 2 hours while she is awake.
B) Increase the voiding interval by 30 to 60 minutes each week.
C) Frequently ask the patient if she has the urge to void.
D) Increase the frequency between voiding even if urine leakage occurs.

Question 8

A mother tells the nurse at an annual well child checkup that her 6-year-old son occasionally "wets himself." Which response by the nurse is appropriate?

A) Explain that occasional wetting is normal in children of this age.
B) Tell the mother to restrict her child's activities to avoid wetting.
C) Suggest "time-out" to reinforce the importance of staying dry.
D) Inform the mother that medication is commonly used to control wetting.

Question 9

The nurse identifies the nursing diagnosis Urinary Incontinence (Total)in an older adult patient admitted after a stroke.Urinary Incontinence places the patient at risk for which complication?

A) Skin breakdown
B) Urinary tract infection
C) Bowel incontinence
D) Renal calculi

Question 10

A patient who sustained a spinal cord injury will perform intermittent self-catheterization after discharge.After discharge teaching,which statement by the patient would indicate correct understanding of the procedure?

A) "I will need to replace the catheter weekly."
B) "I can use clean, rather than sterile, technique at home."
C) "I will remember to inflate the catheter balloon after insertion."
D) "I will dispose of the catheter after use and get a new one each time."

Question 11

A patient is prescribed furosemide (Lasix),a loop diuretic,for treatment of congestive heart failure.The patient is at risk for which electrolyte imbalance associated with use of this drug?

A) Hypocalcemia
B) Hypokalemia
C) Hypomagnesemia
D) Hypophosphatemia

Question 12

What position should the patient assume before the nurse inserts an indwelling urinary catheter?

A) Modified Trendelenburg
B) Prone
C) Dorsal recumbent
D) Semi-Fowler's

Question 13

The nurse instructs a woman about providing a clean-catch urine specimen.Which of the following statements indicates that the patient correctly understands the procedure?

A) "I will be sure to urinate into the 'hat' you placed on the toilet seat."
B) "I will wipe my genital area from front to back before I collect the specimen midstream."
C) "I will need to lie still while you put in a urinary catheter to obtain the specimen."
D) "I will collect my urine each time I urinate for the next 24 hours."

Question 14

Which task can the nurse safely delegate to the nursing assistive personnel?

A) Palpating the bladder of a patient who is unable to void
B) Administering a continuous bladder irrigation
C) Providing indwelling urinary catheter care
D) Obtaining the patient's history and physical assessment

Question 15

A patient complains that she passes urine whenever she sneezes or coughs.How should the nurse document this complaint in the patient's healthcare record?

A) Transient incontinence
B) Overflow incontinence
C) Urge incontinence
D) Stress incontinence

Question 16

The nurse notes that a patient's indwelling urinary catheter tubing contains sediment and crusting at the meatus.Which action should the nurse take?

A) Notify the provider immediately.
B) Flush the catheter tubing with saline solution.
C) Replace the indwelling urinary catheter.
D) Encourage fluids that increase urine acidity.

Question 17

While performing a physical assessment,the student nurse tells her instructor that she cannot palpate her patient's bladder.Which statement by the instructor is best?

A) "Try to palpate it again; it takes practice but you will locate it."
B) "Palpate the patient's bladder only when it is distended by urine."
C) "Document this abnormal finding on the patient's chart."
D) "Immediately notify the nurse assigned to the care of your patient."

Question 18

The student nurse asks the provider if she will prescribe an indwelling urinary catheter for a hospitalized patient who is incontinent.The provider explains that catheters should be utilized only when absolutely necessary because:

A) They are the leading cause of nosocomial infection
B) They are too expensive for routine use
C) They contain latex, increasing the risk for allergies
D) Insertion is painful for most patients

Question 19

Which intervention should the nurse take first to promote micturation in a patient who is having difficulty voiding?

A) Insert an indwelling urinary catheter.
B) Notify the provider immediately.
C) Insert an intermittent, straight catheter.
D) Pour warm water over the patient's perineum.

Question 20

The surgeon orders hourly urine output measurement for a patient after abdominal surgery.The patient's urine output has been greater than 60 mL/hour for the past 2 hours.Suddenly,the patient's urine output drops to almost nothing.What should the nurse do first?

A) Irrigate the catheter with 30 mL of sterile solution.
B) Replace the patient's indwelling urinary catheter.
C) Infuse 500 mL of normal saline solution IV over 1 hour.
D) Notify the surgeon immediately.

Question 21

The nurse has received a prescription to obtain a urinalysis and microscopic analysis.When is the ideal time of the day for the nurse to collect this specimen?

A) In the morning
B) In the evening before bedtime
C) Before a meal
D) After the patient drinks 1 liter of water

Question 22

The nurse educator is preparing a teaching plan on preventing urinary tract infections for a group of female college students.What information will the nurse include in the plan? Select all that apply.

A) Empty the bladder soon after sexual intercourse.
B) Urinate when you first feel the urge to void.
C) Wear appropriate underwear, including nylon or synthetic garments.
D) Wipe perineum area from back to front after voiding.
E) Use tampons instead of sanitary napkins while menstruating.

Question 23

The nurse is seeing a 20-year-old client with a urinary tract infection (UTI)at the women's health clinic.The client says to the nurse,"It seems to me more women get urinary infections than men.Why is this?" What is the best response by the nurse?

A) "Because women are usually more sexually active than men, they are at higher risk for infections."
B) "Men have a prostate gland that protects them against urinary tract infections."
C) "The female urethra is longer than a male making women more prone to infections."
D) "Hormone changes during pregnancy and pressure of the uterus on the bladder can make women more prone to UTIs."

Question 24

Which of the following statements best describes how normal voluntary urination occurs?

A) The detrusor muscle relaxes to pass urine through the urethra.
B) The external urethral sphincter contracts to force urine out of the bladder.
C) Stretch receptors send sensory impulse to the voiding reflex center.
D) Voluntary control of the internal urethral sphincter leads to bladder emptying.

Question 25

The nurse is caring for a patient with suspected kidney dysfunction.In reviewing the patient's home medication list,the nurse is most alerted to which medications? Select all that apply.

A) Aspirin
B) Gentamicin
C) Estrogen
D) Ibuprofen
E) Insulin

Question 26

Which urinary system structure is considered the functional unit responsible for filtration and water absorption?

A) Collecting duct
B) Ureter
C) Nephron
D) Tubular system

Question 27

The nurse is teaching an older female patient how to manage urge incontinence at home.What is the first-line approach to reducing involuntary leakage of urine?

A) Insertion of a pessary
B) Intermittent self-catheterization
C) Bladder training
D) Anticholinergic medication

Question 28

Which of the following are considered normal processes and changes in the urinary system that occur with aging in older adults? Select all that apply.

A) The number of functional nephrons decreases with age.
B) The volume of urine that the bladder can hold lessens with age.
C) Increased pelvic floor muscle tone contributes to incontinence.
D) Loss of bladder elasticity leads to urinary retention.
E) Prostate enlargement causes urinary incontinence.

Question 29

What type of indwelling catheter is most suitable for long-term use?

A) Silver-alloy catheter
B) Polyvinyl chloride (PVC) catheter
C) Silicone catheter
D) Triple-lumen catheter

Question 30

The nurse is preparing a young adult,female patient for intravenous pyelogram (IVP).What are the priority actions by the nurse prior to this procedure? Select all that apply.

A) Obtain an informed consent prior to the procedure.
B) Ask whether the patient has an allergy to shellfish.
C) Check laboratory results for serum BUN and creatinine.
D) Encourage increased fluid intake prior to the procedure.
E) Determine whether the patient has had a barium enema in the past 4 days.

Question 31

A patient's catheter bag is empty 2 hours after it was last drained.The nurse's first action is to:

A) Irrigate the catheter
B) Perform a bladder scan
C) Replace the catheter
D) Check for kinks or compression

Question 32

The nurse would expect which of the following signs and symptoms for a patient with a suspected urinary tract infection (UTI)? Select all that apply.

A) Urinary frequency
B) Urinary urgency
C) Polyuria
D) Abdominal pain
E) Proteinuria

Question 33

Which of the following task(s)may be delegated to a certified nursing assistant (CNA)? Select all that apply.

A) Measuring and recording intake and output
B) Performing a bedside dipstick urine test
C) Applying a condom catheter to a male patient
D) Assessing a patient's ability to collect a urine specimen
E) Determining which type of catheter to insert

Question 34

What is the best technique for obtaining a sterile urine specimen from an indwelling urinary catheter?

A) Use antiseptic wipes to cleanse the meatus prior to obtaining the sample.
B) Briefly disconnect the catheter from the drainage tube to obtain sample.
C) Withdraw urine through the port using a needleless access device.
D) Obtain the urine specimen directly from the collection bag.

Question 35

The nurse is caring for a patient who has had an indwelling urinary catheter inserted for the past 5 days.In reviewing and revising the plan of care,what is the most important nursing diagnosis for this patient?

A) Disturbed Body Image
B) Risk for Infection
C) Risk for Impaired Skin Integrity
D) Risk for Decreased Urine Output

Question 36

The nurse is planning care for a renal patient who is prescribed a diuretic medication.In planning care,what is the most appropriate time of day to administer this medication?

A) In the morning
B) In the afternoon
C) In the evening before bedtime
D) After meals

Question 37

The nurse is inserting an indwelling urinary catheter for a female patient.Upon insertion of the catheter the nurse accidently touches the patient's leg and bed sheet with the tip of the catheter.What is the most appropriate action by the nurse?

A) Cleanse the tip of the catheter with povidone iodine before proceeding with the insertion.
B) Cleanse the tip of the catheter with alcohol before proceeding with the insertion.
C) Obtain a new catheter and reinsert it using sterile technique.
D) Continue with the procedure as the nurse only lightly touched the surfaces.

Question 38

A client has just voided 50 mL,yet reports that his bladder still feels full.The nurse's next actions should include which of the following? Select all that apply.

A) Palpating the bladder height
B) Obtaining a clean-catch urine specimen
C) Performing a bladder scan
D) Asking the patient about his recent voiding history
E) Inserting a straight catheter to measure residual urine

Question 39

The nurse is teaching a female patient with stress incontinence how to perform pelvic floor muscle exercises (PFMEs).Which of the following statements indicates that the patient understands the procedure?

A) "I will practice by stopping and starting my urine flow."
B) "I will hold each contraction for 20 seconds."
C) "I will perform 30 to 45 contractions each morning."
D) "I will keep the contraction and relaxation times equal."

Question 40

Which of the following is/are an appropriate goal(s)for a patient with urinary incontinence? Select all that apply.

A) Increase the intake of citrus fruits.
B) Maintain daily oral fluids to 8 to 10 glasses per day.
C) Limit daily caffeine intake to less than 100 mg.
D) Engage in high-impact, aerobic exercise.
E) Restrict fluid intake through the day.