Deck 29: Promoting Urinary Elimination

Question 1

The nurse is aware that in the elderly, a urinary infection may cause the patient to:

A) run an exceptionally high temperature.
B) have foul urine and diarrhea.
C) become disoriented and confused.
D) become irritable.

Answer 1

become disoriented and confused.

Question 2

The nurse can assist a patient who needs to void but cannot begin the urinary stream by:

A) running water in a nearby sink.
B) pouring cool water over the perineum.
C) inserting an indwelling catheter.
D) distracting the patient with conversation.

Answer 2

running water in a nearby sink.

Question 3

A male patient who suffered a spinal cord injury is learning to perform self-urinary catheterization before being discharged to home. The statement made by the patient that indicates more instruction is needed is:

A) "It is a sterile procedure."
B) "The catheter should be pinched before it is withdrawn."
C) "The penis is lifted to a 60- to 90- degree angle for catheter insertion."
D) "The procedure is done sitting on the toilet."

Answer 3

"It is a sterile procedure."

Question 4

To prevent changes in the chemical characteristics of urine, a nurse sends a sample of fresh urine to the laboratory for urinalysis within at least _____ minutes.

A) 1 to 2
B) 3 to 5
C) 5 to 10
D) 20 to 30

Question 5

An adult male patient who cannot void has an order to have a urinary catheter inserted. Which size catheter would be most appropriate to use?

A) 12 French
B) 16 French
C) 18 French
D) 22 French

Question 6

When the patient who has an order to be out of bed complains of feeling too weak to walk to the bathroom, the nurse assists the patient with urination elimination by:

A) acquiring a walker so that the patient can go to the bathroom.
B) using a fracture bedpan and keep the patient flat.
C) obtaining a raised toilet seat.
D) placing a commode at the bedside.

Question 7

A patient has been ordered to have a 24-hour urine collection as part of a diagnostic workup. The action taken to perform this procedure correctly is to:

A) continue the collection if the patient accidentally voids directly into the toilet.
B) obtain a container and put it in a warm water bath in the bathroom.
C) have the patient void at the beginning of the collection and throw it away.
D) have the patient void for the last time a few hours before the collection ends.

Question 8

The nurse is admitting a patient with suspected urolithiasis. An appropriate nursing intervention in the care of such a patient would be to:

A) place a sieve over the commode.
B) obtain an order for indwelling urinary catheter.
C) place a graduated cylinder near the commode.
D) attach a urinary leg bag.

Question 9

The nurse caring for a severely dehydrated patient who has a Foley catheter in place assesses the patient to confirm adequate urine perfusion by the urine output of _____ mL.

A) 15
B) 30
C) 45
D) 60

Question 10

A nurse is observing a nursing assistant offering a bedpan to a patient. The nurse will intervene if the nursing assistant:

A) closes the bedside curtain.
B) dons clean gloves.
C) keeps the head of the bed flat after placing the bedpan.
D) asks the patient to bend his knees and press down with his feet.

Question 11

An elderly male patient needs to have a condom catheter applied. An appropriate technique is to:

A) shave the perineal area before beginning.
B) apply povidone-iodine to the penis before catheter application.
C) apply an adhesive strip in a circle around the base of the penis.
D) leave 1 to 2 inches between the tip of the penis and the drainage part of the catheter.

Question 12

A nurse is reinforcing instructions about Kegel exercises with a female patient. An appropriate instruction is to:

A) do the exercises 12 times each day.
B) hold each muscle contraction for a count of 3 seconds.
C) tighten the abdominal muscles.
D) tighten the pelvic muscles.

Question 13

To help reduce a patient's risk of recurrent cystitis, the nurse teaches the patient to:

A) eat citrus fruits to alkalinize the urine.
B) always wipe the perineal area from back to front.
C) take long, warm bubble baths.
D) wear cotton underwear and avoid nylon or constrictive clothing.

Question 14

A patient has just had a urinary drainage catheter removed. The nurse plans to measure intake and output for this patient for another _____ hours.

A) 1 to 2
B) 4 to 6
C) 6 to 8
D) 12 to 24

Question 15

A nurse irrigating a patient's indwelling urinary catheter should instill normal saline as ordered, and then:

A) unclamp the tubing and lower the collection bag.
B) massage the patient's bladder.
C) ask the patient to take a deep breath and hold it.
D) keep the tubing clamped for 30 to 45 minutes.

Question 16

A nurse is cleansing the perineal area of a female patient who is having a urinary catheter inserted. The nurse should use the last povidone-iodine-soaked cotton ball to cleanse downward over the:

A) urinary meatus.
B) left labia.
C) right labia.
D) perirectal area.

Question 17

When attempting to catheterize a male patient, there is resistance to catheter insertion. The nurse's initial intervention should be to:

A) withdraw the catheter and start over.
B) ask the patient to take a deep breath.
C) ask the patient to bear down and hold his breath.
D) ask that the patient lie on the right side.

Question 18

An adult patient has an order to have his urinary catheter irrigated with normal saline. The nurse plans to draw up how much solution into the sterile irrigation syringe?

A) 1 to 20 mL
B) 20 to 30 mL
C) 30 to 40 mL
D) 50 to 60 mL

Question 19

A nurse would modify the urine collection technique when a urine sample is needed from an infant by:

A) placing the infant on a bedpan after removing the diaper.
B) removing the diaper after the infant voids and send the diaper to the laboratory.
C) attaching a bag with adhesive backing to the skin surrounding the genitals.
D) applying a very small condom catheter.

Question 20

A patient who underwent prostate surgery is admitted to the surgical unit with a catheter that is used to provide continuous irrigation. The nurse recognizes this catheter is a(n):

A) Alcock.
B) Malecot.
C) Coudé catheter.
D) de Pezzer catheter.

Question 21

A nurse is documenting the removal of a urinary drainage catheter from an assigned patient. If the catheter is removed at 9:00 AM, the nurse recognizes that the patient is due to void by:

A) 11:00 AM.
B) 12 noon.
C) 5:00 PM.
D) 9:00 PM.

Question 22

A nurse instructing a patient about how to prevent recurrent cystitis would include: (Select all that apply.)

A) increase fluid intake to 2500 to 3000 mL/day.
B) consume more citrus fruits and juice.
C) wear cotton underwear.
D) wipe the rectal area from front to back after a bowel movement.
E) avoid sitting in a wet bathing suit for extended periods.
F) empty the bladder every 2 to 3 hours.

Question 23

A patient's urinalysis results are available. Which of the following are considered normal characteristics? (Select all that apply.)

A) Straw-colored
B) Specific gravity (SpG), 1.015
C) pH, 6.0
D) RBCs, more than 1 per high-power field
E) Cloudy appearance

Question 24

A nurse is caring for a patient with prostate enlargement who has an indwelling catheter. As the nurse is attaching a portion of the catheter to the patient's abdomen, the patient asks why this is being done. The correct response is:

A) "Taping the catheter to your abdomen will prevent pulling on the meatus."
B) "The catheter can't be pulled out if it is taped to your abdomen."
C) "Taping it in this way enhances the draining of your bladder."
D) "This will prevent the Foley catheter from kinking."

Question 25

The nurse should provide enough hydration for the patient so that the patient can void at least every _______ hours.

Question 26

A nurse instructing a female patient on obtaining a clean catch urine specimen should stress to:

A) spread the labia apart and clean the center area first.
B) catch the middle portion of urine after voiding a small amount into the toilet.
C) carefully collect the urine in the container as soon as the urine stream starts.
D) fill the urine cup to the brim to ensure an adequate sample.

Question 27

A patient with a history of cystitis had surgery 24 hours ago and is now unable to void. A bladder scan indicates that he has approximately 400 mL of retained urine. The nurse anticipates that the least invasive intervention the physician will order would be:

A) inserting an indwelling Foley catheter.
B) monitoring intake and output.
C) obtaining a midstream specimen.
D) applying Credé's maneuver to the bladder.

Question 28

A patient is being assessed for a possible urinary tract infection in the outpatient clinic. Before sending a urinalysis specimen to the laboratory, the nurse collects a small amount of urine in order to perform a dipstick test in order to detect:

A) protein.
B) glucose.
C) leukocytes.
D) ketones.