Deck 30: Urinary Elimination

Question 1

The nurse identifies the diagnosis Impaired Urinary Elimination in an older adult patient admitted after a stroke.Impaired Urinary Elimination places the patient at risk for which complication?

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

Answer 1

Skin breakdown

Question 2

Which medication class will the primary care provider most likely prescribe to increase urine output in the patient with congestive heart failure?

A) Thiazide diuretic
B) Loop diuretic
C) MAO inhibitor
D) Anticholinergic

Answer 2

Loop diuretic

Question 3

Which intervention should the nurse take first to promote micturition 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.

Answer 3

Pour warm water over the patient's perineum.

Question 4

The student nurse asks for an indwelling urinary catheter for a hospitalized patient who is incontinent.Which response should the nurse make about the use of catheters only being absolutely necessary?

A) They are the leading cause of 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 5

What is the most significant change in kidney function that occurs with aging?

A) Decreased glomerular filtration rate
B) Proliferation of micro-blood vessels to renal cortex
C) Formation of urate crystals
D) Increased renal mass

Question 6

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 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 whether she has the urge to void.
D) Increase the frequency between voiding even if urine leakage occurs.

Question 8

A patient complains that urine is passed when coughing or sneezing.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 9

A patient recovering from a bowel resection a few hours ago has a urine output of 50 mL/2 hr.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.

Question 10

The nurse notes that a patient's indwelling urinary catheter tubing contains sediment and crusting is present 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 11

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 12

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 13

The nurse instructs a woman about providing a clean-catch urine specimen.Which statement 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

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 15

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 16

A patient recovering from abdominal surgery has had a urine output greater than 60 mL/hr for the past 2 hours; however,the output suddenly drops to 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 17

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 18

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 19

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

A) 1.002
B) 1.010
C) 1.025
D) 1.030

Question 20

The nurse measures the urine output of a patient who requires a bedpan to void.Which action should the nurse take after applying gloves?

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.

Question 21

While assessing the costovertebral angle the client experiences pain.What does this finding indicate to the nurse?

A) Renal calculi
B) Kidney tumor
C) Kidney inflammation
D) Urinary tract infection

Question 22

A client asks what causes the urine to have an odor.What should the nurse respond to this client? Select all that apply.

A) Beets cause a fragrant odor.
B) Bacteria cause an ammonia odor.
C) Onions can cause a distinctive odor.
D) Spices cause a vanilla-smelling odor.
E) A congenital disorder causes a sweet odor.

Question 23

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 24

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 25

How many diapers should a healthy newborn use for urine output each day?

A) 4
B) 6
C) 10
D) 15

Question 26

The nurse prepares a teaching tool about normal urination for a group of community members.What should the nurse include in this teaching? Select all that apply.

A) Voiding can be voluntarily delayed.
B) The internal sphincter keeps urine from entering the urethra.
C) Stretch receptors in the bladder cause the detrusor muscle to relax.
D) Stretch receptors in the bladder cause the internal sphincter to constrict.
E) Stretch receptors in the bladder are activated when 200 to 450 mL of urine is present.

Question 27

A client has a history of urinary retention.Which over-the-counter medication should the nurse instruct the client to avoid taking? Select all that apply.

A) Ibuprofen
B) Ranitidine
C) Fexofenadine
D) Diphenhydramine
E) Acetaminophen

Question 28

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 the sample.
C) Withdraw urine through the port using a needleless access device.
D) Obtain the urine specimen directly from the collection bag.

Question 29

Which is an appropriate goal 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 servings per day.
C) Limit daily caffeine intake to less than 100 mg.
D) Engage in high-impact,aerobic exercise.
E) Lose weight if BMI is greater than 30.

Question 30

After completing a health history the nurse is concerned that a client is at risk for urinary tract infections.What did the nurse assess to make this clinical determination? Select all that apply.

A) Uses a spermicidal contraceptive
B) Diagnosed with kidney stones 2 years ago
C) Takes medication for type 2 diabetes mellitus
D) Treated for a urinary tract infection 6 months ago
E) Drinks 8 to 10 glasses of water a day in addition to other fluids