Deck 31: Urinary Elimination and Care

Question 1

A nurse is caring for a patient who has an order for a 24-hour urine specimen collection. The patient asks, "Why do I have to collect my urine for 24 hours?" The nurse's best response would be:

A) "A 24-hour urine test is often done to evaluate how your kidneys function."
B) "Is there some reason that you don't want this test?"
C) "This test is done to determine whether you have a urinary tract infection."
D) "I can call your doctor if you'd like to speak with her."

Answer 1

"A 24-hour urine test is often done to evaluate how your kidneys function."

Question 2

A nurse is caring for a patient who has a three-way catheter with continuous bladder irrigation after a transurethral prostatectomy. The nurse notices a decrease in output in the urinary drainage bag. The nurse should first

A) Increase the flow rate to flush out clots that may be blocking the catheter.
B) Identify when the patient last had his or her pain medication.
C) Instruct the patient to bear down to make sure that the bladder is empty.
D) Palpate the patient's abdomen.

Answer 2

Increase the flow rate to flush out clots that may be blocking the catheter.

Question 3

A nurse receives a new order for a 24-hour urine collection. The best action by the nurse is to

A) Instruct the patient to collect all urine starting at the next even hour.
B) Obtain a bedside commode to collect the urine.
C) Obtain supplies to insert an indwelling catheter.
D) Instruct the patient to void.

Answer 3

Instruct the patient to void.

Question 4

A nurse is caring for a patient with a kidney infection. Output is tallied at the end of the shift, and the nurse notes that the patient has voided 240 mL in the past 8 hours. Next, the nurse should

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

Question 5

A nurse is providing care for a patient who recently had bladder surgery. The patient is being discharged and will need to perform self-catheterization every 4 hours at home. Which of the following statements will the nurse include in the discharge teaching?

A) "You will need to have someone who can do this for you throughout the day."
B) "You will need to use a new suprapubic catheter each time you catheterize yourself."
C) "The straight catheter will be inserted through the urethra and into the bladder to allow urine to be emptied."
D) "This is somewhat difficult. Maybe the doctor will order an indwelling catheter for you instead."

Question 6

A nurse is monitoring the intake and output of a patient who is unable to ambulate to the bathroom. After the patient uses the bedside commode, the nurse should

A) Estimate the amount of urine in the bedside commode.
B) Pour the urine into a graduated container to obtain a measurement.
C) Document that the patient has voided but not try to determine a specific amount.
D) Provide a marked specimen pan to be used the next time the patient uses the bedside commode.

Question 7

A nurse recognizes that teaching has been effective if a patient selects which of the following beverages while undergoing treatment for a urinary tract infection (UTI)?

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

Question 8

A nurse is providing teaching for a woman who is being treated for a urinary tract infection (UTI). The nurse would instruct the patient to contact the physician with which of the following symptoms?

A) Nocturia
B) A feeling of urgency
C) Incontinence
D) Flank pain

Question 9

A nurse is caring for a patient with incontinence who has an order for a catheterized urine specimen to evaluate the presence of a urinary tract infection. It would be appropriate for the nurse to use

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

Question 10

A nurse is caring for a female patient who has a new order for the insertion of a Foley catheter. The nurse prepares a standard catheter kit and then notes that the patient has a latex allergy. The nurse should

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

Question 11

While evaluating the potential presence of a urinary tract infection (UTI), the nurse would be most interested in which of the following laboratory values?

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

Question 12

A nurse is caring for a patient with a suspected kidney stone. The patient's plan of care will most likely include

A) Obtaining a 24-hour urine collection.
B) Providing oral antibiotics.
C) Instructing the patient to avoid tub baths.
D) Straining all urine.

Question 13

A nurse is caring for a patient who is being evaluated for urinary retention. Approximately 10 minutes after the patient voids, the nurse uses the bladder scan and determines that the patient has 80 mL urine remaining in the bladder. The best statement by the nurse is:

A) "Your bladder is still pretty full. Do you think you can void again?"
B) "You have a large amount of residual or leftover urine in your bladder, so I will need to 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 within the limit of what is considered normal."

Question 14

A nurse is caring for a patient with stress incontinence. Teaching has been effective if the patient states:

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 that make me sneeze or cough."

Question 15

While working a night shift and caring for a patient with a 24-hour urine collection that was started at 3:00 p.m., a nursing assistant spills the container. The nurse should

A) Cancel the test and reschedule it for 3:00 p.m. the next day.
B) Document the amount of urine that was spilled.
C) Restart the test the next time the patient voids.
D) Notify the physician.

Question 16

A patient has sustained burns through all skin layers and currently has a urinary output of less than 30 mL/hr. A nurse identifies this output condition as

A) Turbidity.
B) Anuria.
C) Oliguria.
D) Polyuria.

Question 17

A nurse receives a report on a patient who just returned from surgery following a transurethral prostatectomy. The nurse is told that the patient has a urinary catheter. The nurse will most likely find

A) A suprapubic catheter.
B) A three-way catheter.
C) A condom catheter.
D) A coudé catheter.

Question 18

A patient with a urinary tract obstruction is experiencing minimal urine production. A nurse identifies this temporary output condition as

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

Question 19

A nurse is providing home care for a patient who performs self-catheterization. The nurse would be most concerned if

A) The patient puts on gloves without washing his or her hands.
B) The patient reuses a cleaned catheter each time.
C) The patient uses clean gloves to insert the catheter.
D) The patient denies any sensation of bladder fullness before catheterization.

Question 20

A nurse is preparing to place a Foley catheter. First, the nurse should

A) Apply sterile gloves.
B) Clean the urinary meatus with soap and water.
C) Prepare a sterile field with the needed supplies.
D) Fill the balloon with 5 mL sterile normal saline.

Question 21

While obtaining a clean-catch midstream urine specimen, a nurse makes a mistake by

A) Cleaning the meatus with a single antiseptic wipe.
B) Holding the specimen cup in the urine stream to collect the specimen a couple of seconds after the urine stream has begun.
C) Filling the cup to only one-quarter full.
D) Applying a completed label directly to the specimen cup.

Question 22

If a patient has not voided in the 8 hours following the removal of an indwelling catheter or has voided less than 240 mL, a nurse should

A) Notify the health-care provider.
B) Insert a new catheter and obtain a urine specimen.
C) Perform a bladder scan.
D) Irrigate the urethra.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 23

A patient who recently gave vaginal birth to her first child is complaining of issues with incontinence. The nurse identifies that this is most likely due to

A) Urge incontinence.
B) Stress incontinence.
C) Overflow incontinence.
D) Functional incontinence.

Question 24

A patient with congestive heart failure complains of waking up often during the night to urinate. A nurse identifies this condition as ____________________.

Question 25

A patient with kidney failure requires long-term mechanical treatment to filter waste products and salts and to remove excess fluid from her blood. A nurse explains to the patient that this process is called ____________________.

Question 26

A patient is complaining of an inability to keep urine in the bladder long enough to get to the restroom. A nurse identifies that this is most likely due to an overactive bladder, or

A) Neuropathic incontinence.
B) Stress incontinence.
C) Urge incontinence.
D) Overflow incontinence.

Question 27

In providing bladder training for a patient with incontinence, a nurse would include instructions to do which of the following?

A) Drink a maximum of four glasses of water each day.
B) Drink most of the fluids for the day with breakfast.
C) Avoid coffee, tea, or colas with caffeine.
D) Go to the bathroom at least every 2 hours.
E) Drink less in the evening to avoid nighttime difficulties.

Question 28

The characteristics of urine that cannot be determined without the use of supplies and equipment include which of the following?

A) Color
B) pH
C) Clarity
D) Odor
E) Specific gravity

Question 29

While a student nurse is draining urine from a patient's bladder, the patient begins to experience bladder spasms. A nurse explains to the student that he or she should

A) Allow the bladder to drain freely into the drainage bag.
B) Try again with a properly inserted catheter.
C) Twist the catheter slowly to improve urine flow.
D) Always empty the bladder slowly, draining no more than 1000 mL at one time.

Question 30

A nurse is providing care for a female patient with recurrent urinary tract infections (UTIs). Which of the following would be included in the patient's discharge teaching?

A) Avoid consuming caffeine.
B) Avoid baths with bath salts and bubble bath.
C) Increase oral fluid intake.
D) Wipe back to front after toileting.
E) Avoid drinking alcohol.

Question 31

While caring for a patient with a urinary tract infection, a nurse recognizes that teaching has been effective if the patient chooses to drink which of the following beverages?

A) Milk
B) Coffee
C) Cranberry juice
D) Apple juice
E) Lemon-lime soda

Question 32

A patient complains of feeling like he is unable to empty his bladder. A nurse performs a bladder scan to

A) Determine bladder capacity.
B) Look for blockages.
C) Measure residual urine.
D) Check for blockage by the prostate or paraurethral gland.

Question 33

A patient 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. A nurse identifies this type of urinary diversion as a(n)

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

Question 34

A male patient with a recent total hip replacement who cannot ambulate to the bathroom needs assistance with toileting. A nurse should

A) Assist the patient to the bathroom.
B) Have the patient stand at the bedside and void into a urinal.
C) Have the patient use a fracture pan.
D) Roll the patient onto his side and have him void into a bedpan.

Question 35

A patient provides a urine sample with increased turbidity because of the presence of white blood cells. A nurse identifies that when blood is present in the urine-either visible or microscopic blood-it is referred to as ____________________.

Question 36

A nurse recognizes that which of the following symptoms may be indicative of a urinary tract infection (UTI) in a young child?

A) Excessive thirst
B) Poor feeding
C) Sleeplessness
D) Vomiting
E) Diarrhea

Question 37

An instructor is teaching students how to increase the effectiveness of bladder training. A student shows the need for additional instruction when saying:

A) "I should ensure that the patient is drinking at least 64 ounces of fluid per day."
B) "I should change the patient's incontinence briefs and perform perineal care twice a day."
C) "I should teach patients to avoid drinking caffeinated beverages."
D) "I should assist the patient to the bathroom or offer a bedpan every 2 hours."

Question 38

When attempting to insert a standard catheter, a nurse is unable to separate a female patient's legs because of severe contractures. The nurse should

A) Get another nurse to help spread the patient's legs.
B) Have the patient stand on the floor with her legs spread.
C) Try to insert the catheter while the patient is lying on her side.
D) Notify the doctor immediately.

Question 39

A nurse is caring for a patient who is being monitored for kidney function. Which of the following laboratory tests does the nurse expect to be ordered?

A) Hemoglobin
B) Blood urea nitrogen (BUN)
C) Urinalysis
D) Arterial blood gases
E) Creatinine