Deck 31: Urinary Elimination and Care

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?

A)The client puts on clean gloves without washing the hands.
B)The client reuses a cleaned catheter for each catheterization.
C)The client wears clean gloves when inserting the catheter.
D)The client denies sensation of bladder fullness prior to the process.

Answer 1

The client puts on clean gloves without washing the hands.

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?

A)Get another nurse to help separate the client's legs.
B)Have the client stand on the floor with her legs apart.
C)Try to insert the catheter with the client lying on her side.
D)Notify the physician for an alternate order.

Answer 2

Try to insert the catheter with the client lying on her side.

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?

A)Allows for direct installation of an anti-infective to the surgery site.
B)Provides continuous bladder irrigation to control clot formation.
C)Separates the irrigation drainage from the client's urinary output.
D)Controls surgery site bleeding better than a two-way catheter.

Answer 3

Provides continuous bladder irrigation to control clot formation.

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?

A)Notify the physician that the catheter cannot be placed.
B)Obtain a silicone catheter for the client.
C)Inform the client that a catheter cannot be used because of her allergies.
D)Switch the indwelling urinary catheter for a three-way catheter.

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?

A)Explain the purpose and length of the test to the client.
B)Get a bedside commode to assist the client in urine collection.
C)Tell the client to notify the nurse when a specimen is ready.
D)Instruct the client to void and dispose of the voided urine now.

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?

A)An indwelling catheter
B)A three-way catheter
C)A straight catheter
D)A coudé catheter

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?

A)Urine specific gravity
B)Urine pH
C)Blood urea nitrogen
D)Creatinine

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?

A)Ask the client every 2 hours about needing help to the bathroom.
B)Assist the client to stand at the bedside and void into the urinal.
C)Inquire if the client is experiencing fear or anxiety about falling.
D)Consider that the client may need an indwelling urinary catheter.

Question 9

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

A)"I need to do Kegel exercises to help strengthen the muscles that control the urine."
B)"I need to drink fluids with my meals but not in between meals."
C)"I should not do sit-ups because that will increase my abdominal pressure."
D)"I should avoid things and activities that make me sneeze or cough."

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?

A)"Your bladder is still pretty full.Do you think you can void again?"
B)"You have a large amount of leftover urine in your bladder, so I will notify the doctor."
C)"You must have really great kidneys to make so much urine so quickly."
D)"There is still some urine in your bladder, but it is an amount considered normal."

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?

A)Anuria
B)Polyuria
C)Oliguria
D)Hematuria

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?

A)The urine is golden yellow in color.
B)The UAP notices a distinctly sweet odor.
C)The collected urine is clear in appearance.
D)The measurement container has a clean bottom.

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?

A)Notify the physician.
B)Document the output amount.
C)Take the client's temperature.
D)Evaluate the client's blood pressure.

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?

A)"This test is done to evaluate how your kidneys function."
B)"Is there something specific about the test I can explain to help you understand?"
C)"The test will determine if you have a urinary tract infection."
D)"I can call your doctor for a complete explanation if you like."

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?

A)A possible rupture of the bladder
B)The development of hydronephrosis
C)Shock related to a fluid deficit
D)Delay in treatment of intense pain

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?

A)To verify that the stone has definitely been passed
B)In order to determine if the client can be released
C)So that pain medication can be adjusted accordingly
D)For analysis to help identify 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?

A)Have the client void every 2 hours during the day, even without an urge.
B)Incorporate the routine of voiding in the morning, after meals, and at bedtime.
C)Provide the client's favorite beverages, which are coffee and iced tea.
D)Shorten time between voiding if the client is incontinent before 2 hours.

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)?

A)Apple juice
B)Cranberry juice
C)Tea
D)Coffee

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?

A)The client with an indwelling urinary catheter who is bedridden
B)The client who is NPO for surgery with a preoperative IV
C)The client who is vomiting with an intake only of ice chips
D)The adult client who is ambulatory but mildly confused

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?

A)Orthotopic bladder substitution
B)Ileal conduit
C)Continent urostomy
D)Suprapubic catheter

Question 21

The nurse needs to acquire a clean-catch midstream urine specimen from a female client.The client is capable of getting the specimen without assistance after the nurse provides instructions.Which instructions will the nurse provide? Select all that apply.

A)Place the open specimen container upright on a flat surface.
B)Hold labia open during cleaning and until the specimen is acquired.
C)Clean the midline from front to back using three wipes, one time each.
D)Begin voiding in the toilet until the bladder feels nearly empty.
E)Collect a specimen of urine by placing the cup in the urinary stream.

Question 22

The nurse is reinforcing teaching for a female client with a history of recurrent urinary tract infections (UTIs).Which behavior, if shared by the client, indicates the client understands the necessary behaviors to avoid another UTI? Select all that apply.

A)Acknowledging that a UTI can travel from the bladder to the kidneys
B)Using a method of birth control other than a diaphragm or spermicides
C)Drinking cranberry juice or take cranberry extract tablets
D)Limiting caffeine intake to just 32 ounces a day
E)Being sure to void after having sexual intercourse

Question 23

The nurse, working in a pediatric clinic, is caring for a preschool client.The client presents with vomiting and diarrhea.The client's parent reports poor appetite and sleeplessness.The nurse suspects a urinary tract infection (UTI).Which additional assessment will help confirm the nurse's suspicion? Select all that apply.

A)Ask which direction the client wipes after using the toilet.
B)Ascertain the method by which the client bathes.
C)Inquire if the client has fallen or injured the perineal area.
D)Determine if the client has recently been incontinent.
E)Evaluate the client's usual daily nutritional intake.