Deck 5: Elimination

Question 1

The nurse is providing care to a client who is diagnosed with benign prostatic hyperplasia (BPH).Which items in the client's health history may have contributed to this diagnosis? Select all that apply.

A) Excessive exercise
B) Diet high in meat and fats
C) Diet high in milk
D) 70 years of age
E) African-American ethnicity

Answer 1

Diet high in meat and fats
70 years of age
African-American ethnicity

Question 2

The nurse is providing care to a client who is diagnosed with mild benign prostatic hyperplasia (BPH).Which lifestyle change is appropriate for this client?

A) Increasing caffeine intake
B) Decreasing alcohol intake
C) Urinating at first urge
D) Using over-the-counter antihistamines

Answer 2

Urinating at first urge

Question 3

A client is recovering from prostate surgery on a medical-surgical unit.The client will be ready for discharge within the next few days.Which teaching point is appropriate for this client?

A) The client should not drive for 6 weeks after surgery.
B) The client should call the healthcare provider immediately for any pain.
C) The client should increase the fiber in his diet.
D) The client should avoid heavy lifting for 2 weeks after surgery.

Answer 3

The client should increase the fiber in his diet.

Question 4

The nurse is providing care to a client at a local clinic.The nurse suspects that the client is experiencing a urinary tract infection.Which urinalysis result supports the nurse's suspicions?

A) pH 5.2
B) Negative glucose
C) WBC 10-15
D) Specific gravity 1.012

Question 5

A client presents to the urologist with complaints of getting up to urinate several times a night and difficulty starting a stream of urine.After medical testing is completed,a diagnosis of benign prostatic hyperplasia (BPH)is made.After conducting teaching regarding BPH,which statement by the client indicates the need for further education?

A) "Alpha blockers can be used to control my symptoms."
B) "I know I will get cancer of the prostate because of this."
C) "As my condition progresses, I may need to consider surgical management."
D) "There are nonsurgical treatment options available."

Question 6

The nurse is assigned to a postpartum client who had an anesthetic block during labor and delivery.When providing care for this client,which does the nurse anticipate?

A) Nocturnal enuresis
B) Risk for hyperkalemia
C) Residual urine
D) Glycosuria

Question 7

The nurse is caring for a client with a history of urinary tract infections (UTIs).Which action by the nurse would decrease the risk of the client experiencing future UTIs?

A) Instruct the client to completely empty the bladder.
B) Tell the client to increase sugar in the diet.
C) Encourage the client to take bubble baths.
D) Remind the client to wipe from back to front.

Question 8

The nurse is providing care to newborns in the nursery.When assessing the newborns urinary output,which does the nurse anticipate as normal urinary output?

A) 15-60 mL
B) 100-300 mL
C) 250-450 mL
D) 400-500 mL

Question 9

The nurse is caring for an older adult client on a medical-surgical unit.The client tells the nurse,"I don't get any sleep at night because I have to get up and use the bathroom every couple of hours!" When providing an explanation for the nocturia,which statement by the nurse is the most appropriate?

A) "As you get older, there is a decrease in number of nephrons."
B) "As you get older, there is a decrease in the blood supply to your bladder."
C) "As you get older, you may have a decrease in bladder capacity."
D) "As you get older, there is a decrease in cardiac output, which can cause your symptoms."

Question 10

The nurse is caring for a male client of Japanese descent who is experiencing urinary retention.The client asks the nurse if it is possible that he is experiencing benign prostatic hyperplasia (BPH).Which response by the nurse is the most appropriate?

A) "No, you are not old enough to have BPH."
B) "Your symptoms are not consistent with BPH."
C) "Your provider will run some tests; however, you are considered low-risk for BPH"
D) "Where did you get an idea that you might have BPH?"

Question 11

The nurse is caring for a client diagnosed with benign prostatic hyperplasia (BPH)who is experiencing an increase in symptoms.Which statement by the client would best explain the source of the increased symptoms?

A) "I have decreased oral intake at night."
B) "I recently had a vasectomy."
C) "I am using an over-the-counter cold medication for a cold."
D) "I am taking over-the-counter saw palmetto."

Question 12

The nurse is conducting education regarding urinary health at an assisted living facility.When planning topics to include in the session,which are appropriate to the nurse to consider? Select all that apply.

A) Full urinary control usually occurs at 4 or 5 years of age.
B) Because of neuromuscular immaturity, voluntary urinary control is absent.
C) The kidneys reach maximum size between 35 and 40 years of age.
D) Renal blood flow decreases because of vascular changes and a decrease in cardiac output.
E) Urinary incontinence may occur because of mobility problems or neurological impairments.

Question 13

The nurse admits a client to the medical unit for a urinary disorder.Which questions are appropriate for the nurse to include when assessing the client's voiding pattern? Select all that apply.

A) How many times do you urinate in a 24-hour period?
B) Has your pattern of urination changed recently?
C) How often do you get out of bed at night to urinate?
D) What color is your urine?
E) Does your urine have any type of odor?

Question 14

The charge nurse is observing a newly licensed nurse conduct an abdominal assessment on a client admitted with an abdominal mass that is affecting bowel elimination.Which actions by the newly licensed nurse would require the charge nurse to intervene? Select all that apply.

A) Performing palpation before auscultation
B) Performing auscultation before palpation
C) Using inspection, auscultation, percussion, and palpation during the abdominal assessment of the client
D) Using only inspection, percussion, and palpation during the abdominal assessment of the client
E) Using deep palpation during the assessment process

Question 15

A client diagnosed with high blood pressure that is not responding to medications.The nurse suspects renal stenosis.When assessing for this condition,which location will the nurse use for auscultation?

A) renal arteries
B) bladder
C) ureters
D) internal urethral sphincter

Question 16

The nurse is providing care to a client who is experiencing urinary incontinence.Which independent nursing intervention is the most appropriate for this client?

A) Encouraging increased fluid intake
B) Providing catheter care
C) Instructing on self-catheterization
D) Implementing hygiene care

Question 17

The client is experiencing urinary urgency and frequency.Which medication should the nurse anticipate may be prescribed by the healthcare provider?

A) Furosemide
B) Bumetanide
C) Oxybutynin
D) Bethanechol chloride

Question 18

The nurse is providing follow-up care for a client was recently diagnosed with benign prostatic hyperplasia (BPH).Which nursing diagnosis is the priority for the nurse to include in the client's plan of care?

A) Chronic Pain
B) Impaired Urinary Elimination
C) Constipation
D) Diarrhea

Question 19

The nurse is providing care to a client who is experiencing urinary retention.Which diagnostic tool does the nurse anticipate will be ordered for this client?

A) Ultrasonic bladder scan
B) Urinalysis
C) Intravenous pyelography (IVP)
D) Cystoscopy

Question 20

A client is recovering from minimally invasive surgery due to a diagnosis of benign prostatic hyperplasia (BPH).After assessing the client,the nurse expects which outcome for this client?

A) Bowel continence
B) Absence of pain
C) No postoperative treatment
D) Urinary continence

Question 21

The nurse is caring for a client who will be discharged with an indwelling catheter.The nurse has provided education to the client and family in regards to catheter care once the client is discharged.Which client or family action indicates a correct understanding of the information presented?

A) Hanging the drainage bag on the towel rod
B) Taking a shower each day instead of taking a tub bath
C) Restricting the amounts of fluids per day
D) Emptying the drainage bag twice a day

Question 22

The nurse is caring for a client with a history of chronic urinary tract infections.The nurse is planning care for this client based on the priority nursing diagnosis of urinary retention related to scaring.Based on this data,which prescription does the nurse anticipate from the healthcare provider?

A) Antibiotic therapy
B) An anticholinergic medication
C) Intermittent straight catheterization
D) Removal of bladder stones

Question 23

The nurse is providing care to a client who is diagnosed with benign prostatic hyperplasia (BPH).The client's primary concern is burning and difficulty when urinating.Based on this data,which nursing diagnosis is the priority for this client?

A) Fluid Volume Overload
B) Fluid Volume Deficit
C) Acute Pain
D) Deficient Knowledge

Question 24

The nurse is caring for a client with a urinary catheter.Which nursing diagnosis is a priority for this client?

A) Chronic Pain related to an obstruction
B) Risk for Impaired Skin Integrity related to incontinence
C) Risk for Infection related to catheter placement
D) Self-Care Deficit related to presence of urinary catheter

Question 25

The charge nurse is observing a newly licensed nurse catheterize an older adult client admitted with an enlarged prostate.Which action by the newly licensed nurse requires intervention from the charge nurse?

A) The newly licensed nurse injects 10 mL of 2% lidocaine gel into the client's urethra.
B) The newly licensed nurse inserts a 16 French coudé-tipped catheter.
C) The newly licensed nurse clamps the catheter after draining 500 mL.
D) The newly licensed nurse clamps the catheter after draining 800 mL.

Question 26

The nurse is attempting to place a urinary catheter for an older adult female client.The nurse is unable to visualize the client's urinary meatus.Which alternate position for catheterization may be appropriate for this client?

A) Side-lying, lifting up the buttock.
B) Supine, with the HOB elevated at 30°.
C) Supine, with the head of bed (HOB) elevated at 45°.
D) Supine, with the bed flat, legs bent and apart in stirrups.

Question 27

A client is diagnosed with benign prostatic hyperplasia (BPH).Which topics are appropriate for the nurse to include in the teaching session related to the client's condition? Select all that apply.

A) Prostate function and location
B) BPH diet
C) Surgical approaches to treatment
D) Pharmacologic approaches to treatment
E) Permanent urinary catheterization

Question 28

The nurse conducts education for a client who is experiencing urinary incontinence.Which statement by the client indicates the need for further education?

A) "Relaxation of pelvic muscles may be a factor in incontinence."
B) "Reduced urethral resistance can be a cause of incontinence."
C) "Incontinence is normal with aging."
D) "A disturbance of my bladder is a factor in the development of incontinence."

Question 29

The nurse is providing care to a client who is diagnosed with mild benign prostatic hyperplasia (BPH)who is experiencing urinary retention.Which goal is the most appropriate for this client?

A) The client will increase fluid intake to at least 2-3 liters daily.
B) The client lists over-the-counter medications to be avoided.
C) The client will voice an understanding of the importance of the use of antiembolic stockings and compression devices.
D) The client will use a T-binder or scrotal support properly.

Question 30

The nurse at a health fair is educating clients on risk factors associated with urinary incontinence.Which risk factor does the nurse include as a non-modifiable risk factor for urinary incontinence?

A) Age
B) Obesity
C) Smoking
D) Diabetes

Question 31

A client in the ambulatory care clinic tells the nurse about experiencing frequent diarrhea.The nurse inquires about the client's diet.Which statement from the client would be of greatest concern for the nurse?

A) "I like to eat a bran muffin and applesauce every morning for breakfast."
B) "I like to eat popcorn for an afternoon snack."
C) "I like to eat cottage cheese, peaches, and a turkey sandwich for lunch."
D) "I like to eat baked chicken, yeast rolls, and a small salad for dinner."

Question 32

The nurse is working in a urology clinic and is providing care for a client with urinary stress incontinence.The nurse has chosen the diagnosis of Stress Urinary Incontinence related to sphincter incompetence.Which is the desired outcome for a client with this diagnosis?

A) The client will stop the flow of urine when voiding.
B) The client will improve her incontinence within 1 month.
C) The client will empty her bladder every time she voids.
D) The client will perform 4-5 squeezes (Kegel exercises) for 10-15 seconds.

Question 33

The nurse is providing care of a client who ignores the urge to defecate when at work.The client states,"I don't like to have a bowel movement anywhere but at home." Which response by the nurse is the most appropriate?

A) "This is a common practice, and it will strengthen the reflex later."
B) "You will get the urge later, so you should not worry about it."
C) "If you continue to ignore the urge to defecate, it can lead to problems."
D) "It is better to suppress the urge than to suffer embarrassment at work."

Question 34

The nurse is providing care to a client who is diagnosed with stress incontinence.Which data would nurse expect to collect during the client's health history and physical assessment? Select all that apply.

A) Urine leakage while talking.
B) Urine leakage while coughing.
C) Urine leakage while laughing.
D) Skin breakdown on the buttock.
E) A urinary catheter.

Question 35

The nurse reviewing discharge instructions for a client diagnosed with urinary incontinence resulting from a urinary tract infection.Which statement made by the client indicates the need for further education?

A) "I should drink plenty of water to prevent damage to my kidneys while I am on the antibiotics for the infection."
B) "Drinking cranberry juice will decrease the risk for developing urinary tract infections."
C) "I will contact the healthcare provider prior to taking over-the-counter medications while on my antibiotic."
D) "I will continue to hold my urine while in public so that I do not get another infection."

Question 36

The nurse is providing care to a client in the healthcare clinic.The client's brother was recently diagnosed with benign prostatic hyperplasia (BPH)and wants to know if he is also at risk.Which item in the client's history increases the risk for BPH?

A) Increased levels of progesterone
B) Increased levels of estrogen
C) 35 years of age
D) Testicle removal due to cancer

Question 37

The client admitted with benign prostatic hyperplasia (BPH)is prescribed an alpha-adrenergic blocker.The client is prescribed prazosin (Minipress)for the treatment of BPH.When providing care to this client,which is a priority assessment related to this medication?

A) Blood pressure
B) Pain rating
C) Respiratory rate
D) Temperature

Question 38

The nurse is providing training for the clinical staff of a skilled care facility and wants to include information on functional incontinence.Which risk factors for functional incontinence will the nurse include in the training? Select all that apply.

A) Limited mobility
B) Impaired vision
C) Lack of access to facilities
D) Dementia
E) Depression

Question 39

The nurse is assessing an adult client in a urology clinic.The client reports that she has been having "accidents" and expresses frustration about this normal part of aging.Which response by the nurse is the most appropriate?

A) "Incontinence is not a normal part of aging. Tell me more about the incontinence you are experiencing."
B) "You may need to have surgery to manage this problem."
C) "I understand you are frustrated about this occurrence."
D) "Unfortunately, aging and incontinence go hand in hand."

Question 40

The nurse is caring for a client with functional incontinence.Which are factors in the development of this type of incontinence? Select all that apply.

A) Fecal impaction
B) Depression
C) Confusion
D) Prostate surgery
E) Impaired mobility

Question 41

The nurse is admitting a child who has had diarrhea for 1 week.Which goal is appropriate for this client when writing the plan of care?

A) The client will increase the amount of sugar in the diet.
B) The client will defecate regularly by discharge.
C) The client will limit fluid intake for 3 days.
D) The client will regain normal stool consistency by discharge.

Question 42

A client is admitted to the emergency department and diagnosed with urinary calculi after experiencing symptoms for 1 week.When planning care for this client,which nursing diagnosis is the most appropriate?

A) Risk for Constipation
B) Risk for Disuse Syndrome
C) Imbalanced Nutrition
D) Activity Intolerance

Question 43

A client is complaining of dull flank pain.List the order of the steps the nurse should take in conducting the physical assessment for this client.
1) Instruct the client.
2) Assess the general appearance.
3) Position the client.
4) Inspect the abdomen for color,contour,symmetry,and distention.

Question 44

The nurse providing care to a client whose medication therapy for the treatment of renal calculi has failed.Based on this data,which treatment option does the nurse anticipate for this client?

A) Lithotripsy
B) Surgical removal
C) Dietary control
D) Initiation of IV fluids

Question 45

The nurse is reviewing discharge instructions with the mother of a toddler who was hospitalized for constipation.Which statement made by the toddler's mother indicates the need for further education?

A) "I should recognize that when my child walks stiffly on his tiptoes, this could indicate withholding."
B) "Rocking and crossing the legs could be a sign of withholding."
C) "I need to make sure my child eats a low-fiber diet."
D) "Soiling could be a sign of withholding because of involuntary overflow."

Question 46

The nurse is caring for a client with a history of kidney stones.The stones have been analyzed and are all composed of calcium phosphate.Based on this data,which foods should the nurse teach the client to avoid?

A) Chicken, beef, and ham products
B) Organ meats, sardines, and seafood
C) Tomatoes, fruits, and nuts
D) Flour, milk, and ice cream

Question 47

The nurse is planning care for a newly admitted bed-bound older adult client.Which nursing diagnosis would be most appropriate for this client?

A) Risk of Bowel Incontinence
B) Disturbed Body Image
C) Risk of Diarrhea
D) Risk of Constipation

Question 48

The nurse is caring for a client who is experiencing intermittent diarrhea.The client has been advised to increase the amount of soluble fiber in the diet.Which food selections by the client indicate that teaching has been effective? Select all that apply.

A) Sunflower seeds
B) Carrot slices
C) Spinach salad
D) Corn muffins
E) Peas

Question 49

A client with urinary calculi is admitted to the hospital.When planning care for this client,which goal is most appropriate?

A) The client will lose 25 pounds in 3 months.
B) The client will ambulate three times a day.
C) The client will request pain medication at the onset of pain.
D) The client will shower independently.

Question 50

The nurse is preparing to discharge a client who underwent lithotripsy in the treatment of a kidney stone.What should the nurse teach the client to prevent further complications of urinary calculi after discharge?

A) "You will need to increase your oral fluid intake to 1L/day."
B) "It will be important that you not drive while taking pain medications."
C) "It will be important to maintain a diet high in purines."
D) "You will need to monitor for the signs and symptoms of a urinary tract infection (UTI)."

Question 51

The nurse is preparing to discharge a client with diarrhea.The healthcare provider prescribes kaolin to manage the client's diarrhea.After providing the client with information on this medication,which client statement indicates the need for further education?

A) "If my diarrhea does not get better within 2 days, I will need to call my healthcare provider for further advice."
B) "I will need to take the medication after each loose stool."
C) "I should continue to take this medication daily until my stools are firm and dry."
D) "If I start to have a fever, I need to contact my healthcare provider about continuing to take this medication."

Question 52

The nurse is providing care to a client who is experiencing constipation.The healthcare provider prescribes Metamucil,a bulk-forming laxative.Which is a nursing consideration when administering this medication to the client?

A) Offering sufficient water
B) Administering rectally
C) Using to treat acute constipation
D) Assessing for tardive dyskinesia

Question 53

The nurse is caring for a client from another culture.The client tells the nurse that he is constipated.What is the nurse's initial action?

A) Encourage the client to increase fluid intake and activity.
B) Assess the client's intake of fiber and fluids.
C) Determine what the client means by constipation.
D) Obtain an order for a laxative and an enema from the physician.

Question 54

A novice nurse is providing care to clients on a urology unit.When providing care to a group of clients,which client does the novice nurse identify as being at the greatest risk for developing urinary stones?

A) A 35-year-old female with quadriplegia from an auto accident
B) A 65-year-old male with a recent history of myocardial infarction
C) A 50-year-old male with type II diabetes mellitus
D) A 25-year-old female with several episodes of urinary infection

Question 55

The nurse is triaging a client who presents to the urgent care clinic with symptoms of severe flank pain with spasms,nausea,vomiting,and oliguria.The client states that the pain was initially intermittent and radiated from the lower back to the lower quadrants of the abdomen.Which action by the nurse is the most appropriate?

A) Complete the physical assessment.
B) Refer the client to a urologist.
C) Instruct the client to increase fluids.
D) Obtain a urine specimen for culture.

Question 56

The nurse provides education and supportive assistance for the family of a preschool-age client diagnosed with encopresis.Which statement would indicate parental understanding of appropriate care? Select all that apply.

A) "We will establish a limited schedule of activities that has many breaks to provide opportunities to use the toilet regularly."
B) "We will schedule an appointment with a play therapist to help our older child adjust to our new baby."
C) "We won't change our child's diet because we were afraid it will be stress provoking."
D) "We will work on regular elimination after morning and evening meals."
E) "We will continue to punish our child for having accidents as the behavior is learned and attention seeking."

Question 57

The home health nurse is providing care to a client with a history of constipation.The healthcare provider prescribed psyllium mucilloid (Metamucil)for the client.After providing medication teaching for this client,which statement indicate the need for further education?

A) "This medication is a lot more natural than other laxatives."
B) "I may be able to stop my Lipitor with this medication."
C) "This medication takes several days to work."
D) "I don't need to drink extra fluids while I take this medication."

Question 58

The nurse educator is speaking with a group of students about renal disorders.Which statement is appropriate for the educator to include regarding renal stones?

A) Older adult clients are particularly at risk for urolithiasis.
B) Young- or middle-adult men are at an increased risk for stones.
C) Women have a greater risk overall than men.
D) Frequency is greater in the northern United States.

Question 59

The nurse is caring for a client with chronic constipation.Which findings in the client's health history could be the cause of the current constipation? Select all that apply.

A) Bed rest
B) High-fiber foods
C) Low-fiber foods
D) Chronic laxative use
E) Depression

Question 60

The nurse is preparing to teach a class on the prevention of constipation.Which food choice with the nurse include as an example of a high-fiber food?

A) Raw fruits
B) Cooked vegetables
C) White bread
D) Cooked fruits

Question 61

A client admitted to the hospital with a diagnosis of gout has also been diagnosed with uric acid renal calculi.When planning meals for this client,which diet will the nurse anticipate?

A) Low-purine diet
B) Low-sodium diet
C) A diet high in calcium
D) A diet low in calcium

Question 62

A client admitted to the hospital with a diagnosis of inflammatory bowel disease has also been diagnosed with calcium phosphate renal calculi.When planning care for this client,which medication does the nurse anticipate based on the data?

A) Potassium citrate
B) Indomethacin
C) Morphine sulfate
D) Hydrochlorothiazide

Question 63

The nurse on the medical unit is admitting an older adult client whose primary symptoms include fatigue,pruritus,and pain in the right flank area.When conducting this client's assessment,which technique is the most appropriate?

A) Palpation over the costovertebral angles and flanks
B) Blunt percussion over the costovertebral angles and flanks
C) Palpation of the lower pole of both kidneys
D) Capturing of both kidneys

Question 64

The nurse is providing care for a client with renal calculi.Which expected outcomes will the nurse include in this client's plan of care? Select all that apply.

A) The client rates pain at a 2 on a scale of 1-10 and states that a 2 is acceptable.
B) The client is able to comfortably perform ADLs.
C) The client demonstrates a fluid intake of 800-1,000mL/day.
D) The client remains free of signs and symptoms of infection.
E) The client chooses the appropriate diet to prevent the reoccurrence of renal calculi.