Question 1

The home-care nurse is visiting a client who performs self-catheterization.The nurse observes the client's technique as a plan to decrease the possibility of urinary tract infection (UTI).Which observation of the client's techniques will the nurse correct?

Accepted Answer

Washing hands before putting on gloves is a crucial step in preventing the introduction of bacteria into the urinary system, which can lead to a urinary tract infection (UTI).

Question 2

The nurse is attempting to insert a standard urinary catheter in a female client who is unable to separate her legs because of severe contractures.Which adjustment will the nurse make?

Accepted Answer

Inserting the catheter with the client lying on her side is a practical adjustment for a patient who cannot separate her legs due to severe contractures. This position can provide adequate access for catheterization while accommodating the patient's physical limitations.

Question 3

The nurse receives a report on a client who just returned from surgery following a transurethral prostatectomy (TURP).The nurse is told that the client has a three-way urinary catheter.The nurse associates the catheter selection based on which client need?

Accepted Answer

The three-way urinary catheter is primarily used for continuous bladder irrigation to prevent clot formation following procedures like a transurethral prostatectomy (TURP). This helps in ensuring the bladder remains clear and reduces the risk of blockage and infection.

Question 4

The nurse is caring for a female client who has a new order for the insertion of an indwelling urinary catheter.The nurse notes that the client has a latex allergy.Which action will the nurse perform?

Accepted Answer

For a client with a latex allergy, it is important to avoid using any latex products to prevent an allergic reaction. Silicone catheters are a safe alternative for clients with latex allergies, as they do not contain latex and thus minimize the risk of an allergic reaction.

Question 5

The nurse receives a new order to start a 24-hour urine collection for a hospitalized client.Which is the most important intervention for the nurse to implement first?

Accepted Answer

The most important first step in starting a 24-hour urine collection is to have the client void and dispose of this initial urine. This establishes the starting point for the 24-hour period.

Question 6

The nurse is caring for a client with incontinence who has an order for a catheterized urine specimen to evaluate the presence of a urinary tract infection.Which catheter will the nurse select to obtain the specimen?

Accepted Answer

A straight catheter is the best choice for obtaining a urine specimen for evaluation of a urinary tract infection (UTI) because it minimizes the risk of introducing bacteria into the urinary tract, which can occur with indwelling catheters. It is used for a single, quick drainage of the bladder or for obtaining a sterile urine sample.

Question 7

The nurse is evaluating the potential presence of a urinary tract infection (UTI).In which laboratory value will the nurse be most interested?

Accepted Answer

The answer of The nurse is evaluating the potential presence...

Question 8

The nurse is caring for a male client with a recent total hip replacement who cannot ambulate to the bathroom without difficulty.The client has a urinal but reports a continued inability to void.Which intervention by the nurse will assist the client with toileting?

Accepted Answer

Standing can help facilitate urination in male clients, as it is a more natural position for voiding compared to lying down.

Question 9

The nurse is caring for a client with urinary stress incontinence.Which statement by the client indicates that teaching has been effective?

Accepted Answer

Kegel exercises are recommended for strengthening the pelvic floor muscles, which can help control urinary stress incontinence. This indicates the client understands an effective management strategy.

Question 10

A nurse is caring for a client who is being evaluated for urinary retention.Approximately 10 minutes after the client voids, the nurse uses the bladder scan and determines that the client has 80 mL urine remaining in the bladder.Which is the best statement for the nurse to make?

Accepted Answer

Post-void residual (PVR) urine volume of less than 100 mL is generally considered within normal limits. Therefore, 80 mL of urine remaining in the bladder after voiding is considered a normal amount, indicating effective bladder emptying.

Question 11

A client with severe dehydration is experiencing minimal urine production.Which terminology does the nurse use to document the client's urinary output?

Accepted Answer

Oliguria refers to significantly reduced urine output, which is common in conditions like severe dehydration. It typically means urine output is less than 400 mL per 24 hours in adults.

Question 12

The LPN/LVN understands that alterations in the characteristics of urine can be an important indication of a client's condition.Which urine characteristic does the LPN/LVN expect an unlicensed assistive personnel (UAP)to report?

Accepted Answer

A distinctly sweet odor in urine can indicate diabetes mellitus, where excess glucose is excreted in the urine, giving it a sweet smell. This is an important change that needs to be reported and further assessed by a healthcare professional.

Question 13

A nurse is caring for a client with a kidney infection.Output is tallied at the end of the shift, and the nurse notes that the client has voided 240 mL in the past 8 hours.Which action should the nurse take next?

Accepted Answer

Documenting the output amount is the appropriate next action because it provides a record of the client's urinary output, which is important for monitoring the client's fluid status and kidney function.

Question 14

The nurse is caring for a client who has an order for a 24-hour urine specimen collection.The client asks, "Why do I have to collect my urine for 24 hours?" Which answer by the nurse is best?

Accepted Answer

A 24-hour urine collection is primarily used to assess kidney function by measuring various components in the urine over a full day. This helps in evaluating the kidneys' ability to filter and reabsorb substances.

Question 15

The nurse is working in the emergency department (ED).A client arrives stating the inability to empty the bladder for the past three days.An ultrasound reveals an extremely distended bladder, and the physician orders immediate placement of an indwelling urinary catheter.Which possible complication does the nurse associate with the urgency of the order?

Accepted Answer

The answer of The nurse is working in the emergency...

Question 16

The nurse is providing care for a client admitted to the hospital due to a renal stone.The physician orders that all urine be strained.Which reason does the nurse recognize as the primary purpose of straining the client's urine?

Accepted Answer

Straining the client's urine is primarily done to analyze the stone to help identify the cause and treatment.

Question 17

The LPN/LVN is working in a long-term care facility.A client is having difficulty managing urinary continence, and the LPN/LVN begins a program of bladder training with the client.Which part of the bladder training program should the LPN/LVN reconsider?

Accepted Answer

Caffeinated beverages like coffee and iced tea can irritate the bladder and potentially worsen urinary incontinence, making them unsuitable for a bladder training program.

Question 18

The nurse recognizes that teaching has been effective if a client selects which beverage while undergoing treatment for a urinary tract infection (UTI)?

Accepted Answer

Cranberry juice is recommended for clients with UTIs because it contains compounds that can prevent bacteria from adhering to the walls of the urinary tract, potentially reducing the risk of infections or aiding in recovery.

Question 19

The nurse is providing care for multiple clients in the hospital who are ordered on intake and output (I&O)measurement.Which client does the nurse anticipate will need extra assistance in obtaining accurate data?

Accepted Answer

The client who is vomiting with an intake only of ice chips will need extra assistance in obtaining accurate data because the ice chips will not be accurately measured.

Question 20

A client has surgery that creates a pouch from his intestine.His ureters empty into the pouch, while a nipple valve allows him to perform self-catheterization to intermittently empty the pouch.Which type of urinary diversion does the nurse identify?

Accepted Answer

The described surgical procedure is a continent urostomy, which involves creating a pouch from the intestine that collects urine. The ureters are rerouted to this pouch, and a nipple valve mechanism allows for self-catheterization to empty the pouch, differentiating it from other types of urinary diversions that either do not involve self-catheterization (ileal conduit) or involve different mechanisms for urine storage and elimination (orthotopic bladder substitution, suprapubic catheter).

Quiz 31: Urinary Elimination and Care

The home-care nurse is visiting a client who performs self-catheterization.The nurse observes the client's technique as a plan to decrease the possibility of urinary tract infection (UTI) .Which observation of the client's techniques will the nurse correct?