Deck 41: Urinary Elimination

Question 1

The nurse is caring for a patient who has urinary frequency. Which nursing diagnosis is the highest priority for this patient?

A) Risk for compromised human dignity r/t occasional incontinence
B) Risk-prone health behavior r/t living alone at home with nocturia
C) Risk for contamination r/t urine contact with perineal area skin
D) Risk for falls r/t hurried trips to the bathroom during the day and night

Answer 1

Risk for falls r/t hurried trips to the bathroom during the day and night

Question 2

The nurse is caring for a patient with diabetes insipidus. The patient has constant severe thirst, drinks fluids continuously, and voids 3 to 4 L of clear yellow urine daily. Which term will the nurse use in the record to describe this patient's urinary output?

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

Answer 2

Polyuria

Question 3

The nurse is caring for a patient who is experiencing stress incontinence. Which goal is the most important for this patient?

A) The patient will carefully complete a voiding diary for the duration of 2 weeks.
B) The patient will not experience involuntary urination during coughing or sneezing.
C) The patient will be able to recognize and effectively manage perineal dermatitis.
D) The patient will demonstrate how to appropriately use urinary incontinence products.

Answer 3

The patient will not experience involuntary urination during coughing or sneezing.

Question 4

The nurse is caring for a patient who has urinary retention resulting from benign prostatic hyperplasia (BPH). The patient requires catheterization in order to drain the urine from his bladder. Which action will the nurse take to facilitate this procedure?

A) Use a double-lumen Coudé catheter.
B) Attach a leg bag to the catheter prior to insertion.
C) Trim the pubic hair before cleaning the perineal area.
D) Wait until the bladder is full to perform catheterization.

Question 5

The nurse is caring for a patient who had prostate surgery the previous day. The patient has had significantly decreased urine output over the last shift despite ample oral and IV fluid intake. The patient's urine from the indwelling catheter is cherry red with occasional small clots. What is the appropriate action of the nurse?

A) Remove the urinary catheter and replace it with a new one
B) Gently irrigate the catheter using warmed sterile normal saline
C) Send a sample of the patient's urine to the laboratory for analysis
D) Call the physician and obtain an order for kidney and bladder ultrasound

Question 6

The nurse is caring for a postoperative patient whose urinary catheter was removed 8 hours previously. The patient has not been able to void since the catheter was removed and now reports suprapubic pain. What is the priority action of the nurse?

A) Encourage oral fluid intake and administer a diuretic.
B) Obtain a urine sample to test for culture and sensitivity.
C) Carefully calculate the patient's daily intake and output.
D) Obtain an order to straight-catheterize the patient.

Question 7

The nurse is caring for a patient with the nursing diagnosis of Urge urinary incontinence related to urinary tract infection. Which statement is appropriate for the "as evidenced by" portion of the patient's diagnosis?

A) Sudden leakage of urine when patient is unable to get to the toilet in time.
B) Continuous urine flow from the bladder regardless of attempts to use the toilet
C) Leakage of urine from the bladder when the patient coughs, sneezes, or laughs
D) Leakage of urine because the patient is unable to indicate need to use the toilet

Question 8

The nurse is caring for a patient who reports an urgent need to urinate but is unable to pass more than a few drops of urine on the toilet. Which is the priority assessment to be performed by the nurse?

A) Bladder scan to determine the amount of urine in the bladder
B) Auscultation to assess circulation through the right and left renal arteries
C) Bimanual palpation to assess for possible enlargement of the kidneys
D) Calculate the patient's intake and output to check for fluid volume deficit

Question 9

The nurse is caring for a patient who has developed kidney failure. Which test finding leads the nurse to contact the nephrologist and arrange for emergency hemodialysis?

A) Serum potassium level 7.4 mEq/L
B) Serum creatinine level of 2.8 mg/dL
C) Large amounts of protein in the urine
D) 1500 mL of retained urine in the bladder

Question 10

The nurse is caring for a patient with an indwelling urinary catheter caused by severe prostate enlargement. Which is the priority nursing diagnosis for this patient?

A) Risk for infection r/t indwelling urinary catheter
B) Disturbed body image r/t presence of catheter
C) Risk for contamination r/t potential leakage of urine on clothing
D) Urinary retention r/t blockage of bladder outlet

Question 11

The nurse is caring for a patient who recently underwent ileal conduit surgery. Which nursing diagnosis is the highest priority for this patient?

A) Ineffective sexuality pattern related to changed body structure
B) Social isolation related to potential for accidental leakage of urine
C) Knowledge deficit related to care and maintenance of ostomy appliance
D) Disturbed body image related to presence of stoma and appliance

Question 12

The nurse is caring for a seriously ill patient whose laboratory results show a serum creatinine level of 3.5 mg/dL and a serum BUN of 35 mg/dL. Which conclusion can the nurse draw from these test results?

A) The patient is severely dehydrated.
B) The patient's kidneys have been damaged.
C) The patient has a urinary tract infection.
D) The patient has developed a renal calculus.

Question 13

The nurse is caring for a patient who is to undergo computed tomography (CT) of the kidneys and ureters. Which assessment finding by the nurse must be reported to the physician and radiologist before the patient has the procedure?

A) The patient is allergic to bananas and latex.
B) The patient thinks that she might be pregnant.
C) The patient has a family history of bladder cancer.
D) The patient currently has a urinary tract infection.

Question 14

The preceptor is watching a nursing student care for a male patient who requires a condom catheter. Which action by the nursing student indicates that the procedure is performed correctly?

A) Sterile gloves are donned before touching the catheter.
B) Adhesive tape is applied securely around the base of the penis.
C) Water-soluble lubricant is applied to the end of the catheter.
D) The foreskin is returned to its natural position before the catheter is applied.

Question 15

The nurse is caring for a patient who will undergo ultrasound testing of the bladder and kidneys the next morning. Which instruction will the nurse provide to the patient about the test?

A) "A small IV will be inserted into your arm to inject the contrast dye."
B) "You will need to drink lots of water but not use the toilet."
C) "You should not have anything to eat or drink after midnight."
D) "You will receive a cleansing enema before you have the test."

Question 16

The nurse is caring for a patient who is recovering from septic shock. While in the ICU, the patient developed renal failure. Which type of renal failure did the patient most likely develop?

A) Prerenal
B) Renal
C) Post-renal
D) Mixed

Question 17

The nurse is caring for a patient who has just had an intravenous pyelography (IVP) completed. Which assessment is the nurse's highest priority after the patient returns from the test?

A) Carefully calculate of the patient's intake and output.
B) Monitor for discoloration of the patient's urine.
C) Assess for possible iodine or shellfish allergies.
D) Inquire if the patient has burning or pain with urination.

Question 18

The nurse is caring for a patient with benign prostatic hypertrophy who states that he feels a constant urge to urinate but cannot pass more than 30 to 60 mL of urine into the toilet at a time. The nurse performs a bladder scan and finds that there are 1100 mL of urine in the patient's bladder. What is the priority nursing diagnosis for this patient?

A) Alteration in comfort r/t continual urge to urinate
B) Overflow urinary incontinence r/t over-distention of the bladder
C) Urinary retention r/t obstruction of urinary bladder outlet
D) Toileting self-care deficit r/t inability to pass urine into the toilet

Question 19

The nurse is caring for an incontinent male patient who has a deep decubitus ulcer on his sacrum. Which intervention will best manage the patient's urinary incontinence and facilitate healing of the ulcer?

A) Use of disposable absorbable incontinence briefs
B) Daily application of perineal barrier cream containing zinc oxide
C) Careful perineal care and application of a condom catheter
D) Insertion of a single-lumen straight urinary catheter

Question 20

The nurse is caring for a patient with a history of type I diabetes. Which assessment finding indicates to the nurse that the patient may not be compliant with his diabetic treatment regimen?

A) The patient is always thirsty and frequently voids very large amounts of urine.
B) The patient's urine is very concentrated with a dark amber color.
C) The patient complains of throbbing flank pain and burning with urination.
D) The patient has urinary hesitancy and difficulty initiating a stream of urine.

Question 21

The nurse is caring for a patient who is to complete a 24-hour urine collection to measure creatinine clearance. Which tasks related to this test may be delegated to the nursing assistant? (Select all that apply.)

A) Teaching the patient about sterile specimen collection
B) Keeping the urine collection container cool on ice
C) Dumping the urine from the patient's first void
D) Restricting the patient's oral fluid intake during the test
E) Transporting the specimen to the laboratory for testing
F) Reminding the patient not to put toilet paper in the urine

Question 22

The nurse is caring for a patient with a history of incontinence and poor perineal hygiene practices. The patient has had four urinary tract infections in the past year. Which is the priority goal for the nursing diagnosis of Ineffective therapeutic regimen management?

A) The patient will be provided with educational materials about risks of urosepsis.
B) The patient will allow family members to assist with daily bathing and perineal care.
C) The patient will clearly state why she refuses to provide adequate care for herself.
D) Regular home care nursing visits and follow-up telephone contact will be arranged.

Question 23

The nurse is caring for a male patient who will be performing intermittent self-catheterization at home. Which actions by the patient indicate the need for additional teaching about this procedure? (Select all that apply.)

A) Patency of the balloon is tested prior to insertion of the catheter.
B) The catheter is inserted another 2 inches after urine is seen in the tubing.
C) The catheter is carefully secured to the leg to prevent accidental removal.
D) The foreskin is returned to its natural position after the catheter is removed.
E) Catheterization is performed regularly before the bladder becomes distended.
F) Water-soluble lubricant is generously applied along the length of the catheter.

Question 24

The nurse is caring for an elderly patient whose dementia has become worse over the last 24 hours. The nurse suspects that the patient may have developed a urinary tract infection and obtains a urine sample. Which assessment findings prompt the nurse to contact the physician to obtain an order for urine culture and sensitivity testing? (Select all that apply.)

A) Urinary dipstick testing is positive for nitrates.
B) The urine appears cloudy with a foul odor.
C) The urine is concentrated and dark amber in color.
D) The urine smells faintly like nail polish remover.
E) The patient is urinating more frequently than usual.
F) The patient is normally continent but wet herself twice.

Question 25

The nurse is working with a new nursing assistant who is providing care to patients with urinary difficulties. Which action by the nursing assistant indicates that additional teaching is required so that the assistant will learn to care for patients correctly? (Select all that apply.)

A) The length of the urinary catheter is cleaned up to the patient's perineum.
B) A urine sample is obtained from the drainage bag immediately after catheter insertion.
C) A fresh condom catheter is applied every other day following careful perineal care.
D) Zinc oxide barrier cream is applied liberally to the perineal area for incontinent patients.
E) The catheter drainage bag is disconnected in order to put pants on the patient.
F) Clean technique is used to obtain a urine specimen for culture and sensitivity from the catheter.