Deck 36: Urinary Elimination

Question 1

An older adult woman has constant dribbling of urine. The associated discomfort, odor, and embarrassment may support which of the following nursing diagnoses?

A) Social Isolation
B) Impaired Adjustment
C) Defensive Coping
D) Impaired Memory

Answer 1

Social Isolation

Question 2

A nurse working in a community pediatric clinic explains the process of toilet training to mothers of toddlers. Which is a recommended guideline for initiating this training?

A) The child should be able to hold urine for four hours.
B) The child should be between 18 and 24 months old.
C) The child should be able to communicate the need to void.
D) The child does not need the desire to gain control of voiding.

Answer 2

The child should be able to communicate the need to void.

Question 3

Which of the following describes the term micturition?

A) Emptying the bladder
B) Catheterizing the bladder
C) Collecting a urine specimen
D) Experiencing total incontinence

Answer 3

Emptying the bladder

Question 4

After surgery, a postoperative client has not voided for eight hours. Where would the nurse assess the bladder for distention?

A) Between the symphysis pubis and the umbilicus
B) Over the costovertebral region of the flank
C) In the left lower quadrant of the abdomen
D) Between ribs 11 and 12 and the umbilicus

Question 5

During a visit to the pediatrician's office, a parent inquires about toilet training her daughter age 2 years. The nurse informs the mother that one factor in determining toilet-training readiness is when ...

A) the child can recognize bladder fullness.
B) the child can hold the urine for four to five hours.
C) The child cannot control urination until seated on the toilet.
D) The child ignores the desire to void.

Question 6

A patient has developed edema in her lower legs and feet, prompting her physician to prescribe furosemide (Lasix), a diuretic medication. After the client has begun this new medication, what should the nurse anticipate?

A) Increased output of dilute urine
B) Increased urine concentration
C) A risk of urinary tract infections
D) Transient incontinence and increased urine production

Question 7

A male client who has had outpatient surgery is unable to void while lying supine. What can the nurse do to facilitate his voiding?

A) Assist him to a standing position.
B) Tell him he has to void to be discharged.
C) Pour cold water over his genitalia.
D) Ask his wife to assist with the urinal.

Question 8

A client with urine retention related to a complete prostatic obstruction requires a urinary catheter to drain the bladder. Which type of catheter is most appropriate for a client that has an obstructed urethra?

A) Suprapubic catheter
B) Indwelling urethral catheter
C) Intermittent urethral catheter
D) Straight catheter

Question 9

An older woman who is a resident of a long-term care facility has to get up and void several times during the night. This can be the result of what physiologic change with normal aging?

A) Diminished kidney ability to concentrate urine
B) Increased bladder muscle tone causing urinary frequency
C) Increased bladder contractility causing urinary stasis
D) Decreased intake of fluids during daytime hours

Question 10

A nurse is assessing the urine output of a client with Parkinson's disease who is on levodopa. Which of the following is a common finding for a client on this medication?

A) The urine may be brown or black.
B) The urine may be blood-tinged.
C) The urine may be green or blue-green.
D) The urine may be orange or orange-red.

Question 11

A nurse is delegating the collection of urinary output to an assistant. What should the nurse tell the assistant to do while measuring the urine?

A) Compare the amount of output with intake.
B) Use a clean measuring cup for each voiding.
C) Tell the client to wash the urethra before voiding.
D) Wear gloves when handling a client's urine.

Question 12

During a health history interview, a male client tells the nurse that he does not feel that he completely empties his bladder when he voids. He has been diagnosed with an enlarged prostate. What is the name of this symptom?

A) Urinary incontinence
B) Urinary retention
C) Involuntary voiding
D) Urinary frequency

Question 13

A nurse has instructed a client at the clinic about collecting a specimen for a routine urinalysis. The client makes the following statements. Which one indicates a need for more teaching?

A) "I need to tell you that I am having my menstrual period."
B) "I will void into the specimen bottle you gave me."
C) "I will keep the toilet paper in the specimen."
D) "I will be sure that no stool is included in my urine."

Question 14

A nurse is assessing the urine on a newborn's diaper. What would be a normal assessment finding?

A) Scanty to no urine
B) Highly concentrated urine
C) Light in color and odorless
D) Dark in color and odorous

Question 15

A nurse is caring for older adult clients in an assisted-living facility. Which effect of aging should the nurse consider when performing a urinary assessment?

A) The diminished ability of the kidneys to concentrate urine may result in urinary tract infection.
B) Increased bladder muscle tone may reduce the capacity of the bladder to hold urine, resulting in frequency.
C) Decreased bladder contractility may lead to urine retention and stasis, which increase the likelihood of urinary tract infection.
D) Neuromuscular problems may result in the client finding urinary control too much trouble, resulting in incontinence.

Question 16

A client tells the nurse, "Every time I sneeze, I wet my pants." What is this type of involuntary escape of urine called?

A) Urinary incontinence
B) Urinary incompetence
C) Normal micturition
D) Uncontrolled voiding

Question 17

A nurse is educating a client on the amount of water to drink each day. What is the recommended daily fluid intake for adults?

A) 1 to 2 (4-oz) glasses per day
B) 5 to 6 (6-oz) glasses per day
C) 8 to 10 (8-oz) glasses per day
D) 16 to 20 (12-oz) glasses per day

Question 18

A student is collecting a sterile urine specimen from an indwelling catheter. How will the student correctly obtain the specimen?

A) Pour urine from the collecting bag.
B) Remove the catheter and ask the client to void.
C) Aspirate urine from the collecting bag.
D) Aspirate urine from the collection port.

Question 19

A nurse is preparing to catheterize a female client. What will the nurse consider when comparing the anatomy of the female urethra with that of the male urethra?

A) Has different innervation
B) No connection with bladder
C) Shorter in length
D) Longer in length

Question 20

A nurse is initiating a 24-hour urine collection for a client at home. What will be the first thing the nurse will ask the client to do at the beginning of the specimen collection?

A) Void and discard the urine.
B) Begin the collection at a specific time.
C) Add the first voiding to the specimen.
D) Keep the urine warm during collection.

Question 21

A client has been taught how to do Kegel exercises. What statement by the client indicates a need for further information?

A) "I understand these will help me control stress incontinence."
B) "I know this is also called pelvic floor muscle training."
C) "I will do these 30 to 80 times a day for two months."
D) "I will contract the muscles in my abdomen and thighs."

Question 22

A nurse is caring for a client who is being treated for bladder infection. The client complains to the nurse that he has been having difficulty voiding and feels uncomfortable. How should the nurse document the client's condition?

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

Question 23

A nurse uses a catheter to collect a sterile urine specimen from a client at a health care facility. If a catheter is required temporarily, which type of catheter should the nurse use?

A) Condom catheter
B) Urinary bag
C) Straight catheter
D) Retention catheter

Question 24

A nurse is preparing a client for an invasive diagnostic procedure of the urinary system. What statement by the nurse would help reduce the client's anxiety?

A) "We do these procedures every day, so you don't need to worry."
B) "I have had this done to me, and it only hurt for a little while."
C) "Why are you so worried? Do you think you have a tumor?"
D) "Let me explain to you what they do during this procedure."

Question 25

A client with a urinary tract infection is to be discharged from the health care facility. After teaching the client about measures to prevent urinary tract infections, the nurse determines that the education was successful when the client states which of the following?

A) "I should take frequent bubble baths."
B) "I need to void after sexual intercourse."
C) "I should wipe from back to front after going to the bathroom."
D) "I need to wear pants that are snug fitting."

Question 26

A man with urinary incontinence tells the nurse he wears adult diapers for protection. What risks should the nurse discuss with this client?

A) Public embarrassment
B) Skin breakdown and UTI
C) Inability to control urine
D) Odor and leakage

Question 27

A client is admitted to the health care facility with complaints of pain on urination that is secondary to a urinary tract infection (UTI). The nurse documents this finding as which of the following?

A) Polyuria
B) Dysuria
C) Nocturia
D) Hematuria

Question 28

A client is taking diuretics. What should the nurse teach the client about his urine?

A) Urinary output will be decreased.
B) Urinary output will be increased.
C) Urine will be a pale yellow color.
D) Urine may be brown or black.

Question 29

A nurse is inserting an indwelling urethral catheter. What type of supplies will the nurse need for this procedure?

A) A clean catheter and rubber gloves
B) A sterile catheterization kit or tray
C) Solutions to sterilize the urethra
D) Solutions to sterilize the vagina

Question 30

A nurse is carrying out an order to remove an indwelling catheter. What is the first step of this skill?

A) Deflate the balloon by aspirating the fluid.
B) Ask the client to take several deep breaths.
C) Tell the client burning may initially occur.
D) Wash hands and put on gloves.

Question 31

A nurse has catheterized a client to obtain urine for measuring postvoid residual (PVR) amount. The nurse obtains 40 mL of urine. What should the nurse do next?

A) Report this abnormal finding to the physician.
B) Perform another catheterization to verify the amount.
C) Document this normal finding for postvoid residual.
D) Palpate the abdomen for a distended bladder.

Question 32

The home health nurse is caring for an older adult woman living alone at home who is incontinent of urine and changes her adult diaper daily. Which of the following nursing diagnoses is the most appropriate for this client?

A) Risk for activity intolerance
B) Risk for impaired skin integrity
C) Risk for infection
D) Risk for falls

Question 33

A school nurse is educating a class of middle-school girls on how to promote urinary system health. Which of the following statements by one of the girls indicates a need for more information?

A) "I will take showers rather than baths."
B) "I will wear underpants with cotton crotches."
C) "I will tell my parents if I have burning or pain."
D) "I will wipe back to front after going to the toilet."

Question 34

A nurse is using a bladder scanner to assess the bladder volume of a client with urinary frequency. In which of the following positions would the nurse place the client?

A) Supine
B) Sims'
C) High Fowler's
D) Dorsal recumbent

Question 35

What is the micturition reflex?

A) The process of filtration beginning with the glomerulus
B) The act of bladder contraction and perceived need to void
C) The reabsorption of the substances the body wants to retain
D) The secretion of electrolytes that are harmful to the body