Deck 28: Urinary Elimination

Question 1

The nurse instructs a woman about providing a clean-catch urine specimen. Which statement indicates the patient correctly understands the procedure?
1)"I will be sure to urinate into the 'hat' you placed on the toilet seat."
2)"I will wipe my genital area from front to back before I collect the specimen midstream."
3)"I will need to lie still while you put in a urinary catheter to obtain the specimen."
4)"I will collect my urine each time I urinate for the next 24 hours."

Answer 1

2

Question 2

A female patient complains that she passes urine whenever she sneezes or coughs. How should the nurse document this finding in the patient's healthcare record?
1)Transient incontinence
2)Overflow incontinence
3)Urge incontinence
4)Stress incontinence

Answer 2

4

Question 3

A patient is admitted with high blood urea nitrogen (BUN) and creatinine levels, and anuria. Based on these findings, the nurse suspects which diagnosis?
1)Urinary tract infection
2)Renal calculi
3)Enuresis
4)Renal failure

Answer 3

4

Question 4

Which action should the nurse take when beginning bladder training using scheduled voiding?
1)Offer the patient a bedpan every 2 hours while awake.
2)Increase the voiding interval by 30 to 60 minutes each week.
3)Frequently ask the patient if he or she has the urge to void.
4)Lengthen the time between voidings even if urine leakage occurs.

Question 5

The nurse is caring for a patient who underwent a bowel resection 2 hours ago. The urine output for the past 2 hours totals 50 mL. Which action should the nurse take?
1)Do nothing; this is normal postoperative urine output.
2)Increase the infusion rate of the patient's intravenous (IV) fluids.
3)Notify the provider about the patient's oliguria.
4)Administer the patient's routine diuretic dose early.

Question 6

While performing a physical assessment, the female student nurse tells the instructor that she cannot palpate the patient's bladder. Which statement by the instructor is best?
1)"Try to palpate it again; it takes practice but you will locate it."
2)"Palpate the patient's bladder only when it is distended by urine."
3)"Document this abnormal finding on the patient's chart."
4)"Notify the nurse assigned to the care of your patient."

Question 7

Which urine specific gravity would be expected in a patient admitted with dehydration?
1)1.002
2)1.010
3)1.021
4)1.033

Question 8

Which outcome is appropriate for the patient who underwent urinary diversion surgery and creation of an ileal conduit (conventional urostomy) for invasive bladder cancer?
1)Patient will resume normal urination pattern by (target date).
2)Patient will perform urostomy self-care by (target date).
3)Patient will perform self-catheterization by (target date).
4)Patient's urine will remain clear with sufficient volume.

Question 9

A patient is prescribed furosemide, a loop diuretic, for treatment of congestive heart failure. The nurse will monitor for which electrolyte loss?
1)Calcium
2)Potassium
3)Magnesium
4)Phosphorus

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?
1)"I will need to replace the catheter monthly."
2)"I will use clean, rather than sterile, technique at home."
3)"I will remember to inflate the catheter balloon after insertion."
4)"I will dispose of the catheter after use and get a new one each time."

Question 11

The nurse notes that a patient's indwelling urinary catheter tubing contains sediment and crusting at the meatus. Which action should the nurse take?
1)Notify the healthcare provider immediately.
2)Flush the catheter tubing with saline solution.
3)Replace the indwelling urinary catheter.
4)Encourage fluids that increase urine acidity.

Question 12

Which intervention should the nurse take first to promote micturition in a patient who is having difficulty voiding?
1)Insert an indwelling urinary catheter.
2)Notify the healthcare provider immediately.
3)Obtain an intermittent, straight catheter.
4)Pour warm water over the patient's perineum.

Question 13

A mother tells the nurse at an annual well-child checkup that her 6-year-old son occasionally "wets himself" during the day. Which response by the nurse is appropriate?
1)Explain that occasional wetting is normal in children of this age.
2)Tell the mother to restrict her child's activities to avoid wetting.
3)Suggest "time-out" to reinforce the importance of staying dry.
4)Inform the mother that medication is commonly used to control wetting.

Question 14

The nurse is calculating the intake and output (I&O) for a patient. On the I&O record, the following information is noted: milk 140 mL at breakfast, voided 240 mL after breakfast, 120 mL of coffee at 1000, and urinated 300 mL at 1100. Which amount will the nurse document for the total urine output?
1)240 mL
2)540 mL
3)380 mL
4)300 mL

Question 15

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:
1)Have the patient void directly into the bedpan.
2)Pour the urine into a graduated container.
3)Read the volume with the container on a flat surface at eye level.
4)Observe the color and clarity of the urine in the bedpan.

Question 16

What position should the female patient assume before the nurse inserts an indwelling urinary catheter?
1)Modified Trendelenburg
2)Prone
3)Dorsal recumbent
4)Semi-Fowler's

Question 17

The nurse identifies the nursing diagnosis Urinary Incontinence in an older adult patient admitted after a stroke. Urinary Incontinence places the patient at risk for which complication?
1)Skin breakdown
2)Urinary tract infection
3)Bowel incontinence
4)Renal calculi

Question 18

The nurse meets resistance when irrigating a patient's urinary catheter. Which action would the nurse perform first?
1)Slightly turn the patient.
2)Replace the patient's indwelling urinary catheter.
3)Force the fluid through the catheter tubing.
4)Notify the healthcare provider.

Question 19

The nurse is making assignments for the shift. Which assignment would the nurse delegate to the unlicensed assistive personnel (UAP)?
1)Teaching the patient to perform the Credé's maneuver
2)Irrigating an indwelling catheter
3)Applying a condom catheter
4)Obtaining the patient's urinary history and physical assessment

Question 20

The student nurse asks the healthcare provider if an indwelling urinary catheter will be prescribed for a hospitalized patient who is incontinent. The healthcare provider explains that catheters should be utilized only when absolutely necessary because:
1)They are the leading cause of healthcare-associated infections.
2)They are too expensive for routine use.
3)They contain latex, increasing the risk for allergies.
4)They are painful upon insertion for most patients.

Question 21

The nurse educator is preparing a teaching plan on preventing urinary tract infections (UTIs) for a group of female college students. Which information will the nurse include in the plan?
Select all that apply.
1)Empty the bladder soon after sexual intercourse.
2)Urinate when you first feel the urge to void.
3)Wear appropriate underwear, including nylon or synthetic garments.
4)Wipe perineum area from back to front after voiding.
5)Avoid tight-fitting clothes over the groin area.

Question 22

The nurse is checking for costovertebral angle tenderness. Which technique would the nurse use?
1)Place one palm flat on the 12th rib and spine, on the back.
2)Apply the scanner above the symphysis pubis.
3)Gently percuss the bladder midline abdomen.
4)Calibrate the refractometer before using.

Question 23

What is the best technique for obtaining a sterile urine specimen from an indwelling urinary catheter?
1)Use antiseptic wipes to cleanse the meatus prior to obtaining the sample.
2)Briefly disconnect the catheter from the drainage tube to obtain sample.
3)Withdraw urine through the port using a needleless access device.
4)Obtain the urine specimen directly from the collection bag.

Question 24

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?
1)In the morning
2)In the afternoon
3)In the evening before bedtime
4)After meals

Question 25

Which statement best describes how normal voluntary urination occurs?
1)The detrusor muscle relaxes to pass urine through the urethra.
2)The external urethral sphincter contracts to force urine out of the bladder.
3)Stretch receptors send sensory impulse to the voiding reflex center.
4)Voluntary control of the internal urethral sphincter leads to bladder emptying.

Question 26

A client has just voided 50 mL and yet reports that the bladder still feels full. The nurse's next actions should include which of the following? Select all that apply.
1)Palpating the bladder height
2)Obtaining a clean-catch urine specimen
3)Performing a bladder scan
4)Applying a heating pad to the lower abdomen
5)Inserting an incontinence pessary

Question 27

The nurse is inserting an indwelling urinary catheter for a female patient. Upon insertion of the catheter, the nurse accidentally touches the patient's leg and bed sheet with the tip of the catheter. What is the most appropriate action by the nurse?
1)Wipe the tip of the catheter with povidone iodine before proceeding with the insertion.
2)Cleanse the tip of the catheter with alcohol before proceeding with the insertion.
3)Obtain a new catheter and reinsert it using sterile technique.
4)Apply more lubricant and continue to insert the catheter.

Question 28

The nurse is caring for a patient who has a neobladder. Which action should the nurse take?
1)Insert an indwelling catheter.
2)Replace the collection device, as needed.
3)Inspect the color of the stoma.
4)Encourage performing Kegel exercises.

Question 29

Which age-related changes are considered normal processes in the urinary system that occur in older adults? Select all that apply.
1)The number of functional nephrons decreases with age.
2)The size of the kidney shrinks.
3)Increased bladder muscle tone contributes to incontinence.
4)Loss of bladder elasticity occurs.
5)Prostate enlargement causes urinary incontinence.

Question 30

The nurse is preparing a client for a computerized tomography with contrast media. Which instruction will the nurse share with the client?
1)"You will have a pressure probe inserted into your rectum."
2)"You will wear your rings and eyeglasses into the procedure room."
3)"You will need to let me know if you are allergic to shellfish."
4)"You will drink 5 to 6 glasses of fluid 90 minutes before the test."

Question 31

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?
1)Disturbed Body Image
2)Risk for Infection
3)Risk for Impaired Skin Integrity
4)Risk for Decreased Urine Output

Question 32

A patient's catheter bag is empty 2 hours after it was last drained. The nurse's first action is to:
1)Irrigate the catheter
2)Perform a bladder scan
3)Replace the catheter
4)Check for kinks or compression

Question 33

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.
1)Aspirin
2)Gentamicin
3)Estrogen
4)Ibuprofen
5)Insulin

Question 34

What type of indwelling catheter is most suitable for long-term use?
1)Silver-alloy catheter
2)Polyvinyl chloride (PVC) catheter
3)Silicone catheter
4)Triple-lumen catheter

Question 35

Which interventions are appropriate for an older adult patient with urinary incontinence? Select all that apply.
1)Increase the intake of citrus fruits.
2)Consume high-fiber foods regularly.
3)Limit daily caffeine intake to less than 100 mg.
4)Engage in high-impact, aerobic exercise.
5)Keep fluid intake extremely low.

Question 36

The nurse is teaching a female patient with stress incontinence how to perform pelvic floor muscle exercises (PFMEs). Which statement indicates the patient understands the procedure?
1)"I will practice by stopping and starting my urine flow."
2)"I will hold each contraction for 20 seconds."
3)"I will perform 30 to 45 contractions each morning."
4)"I will keep the contraction and relaxation times equal."

Question 37

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.
1)Obtain an informed consent prior to the procedure.
2)Ask whether the patient has an allergy to iodine.
3)Check laboratory results for serum blood urea nitrogen (BUN) and creatinine.
4)Encourage increased fluid intake prior to the procedure.
5)Determine whether the patient has had a barium enema in the past 4 days.

Question 38

The nurse would expect which signs and symptoms for a patient with a suspected urinary tract infection (UTI)? Select all that apply.
1)Urinary frequency
2)Dysuria
3)Polyuria
4)Upper abdominal pain
5)Foul-smelling urine

Question 39

Which tasks may be delegated to an unlicensed assistive personnel (UAP)? Select all that apply.
1)Measuring and recording intake and output
2)Performing a bedside dipstick urine test
3)Irrigating a triple lumen catheter
4)Assessing a patient's ability to collect a urine specimen
5)Determining which type of catheter to insert

Question 40

Which urinary system structure is considered the functional unit responsible for filtration and water absorption?
1)Collecting duct
2)Ureter
3)Nephron
4)Tubular system