Deck 42: Urinary Elimination

Question 1

Mr.Ravinder is rushed to the emergency department with what his health care provider suspects to be necrosis of the ileal conduit stoma.What evidence supports this diagnosis?

A)Stoma is black in colour.
B)Stoma is moist.
C)Stoma is pink and shiny.
D)There is slight bleeding from stoma.

Answer 1

Stoma is black in colour.

Question 2

Mr.Allenby,77 years old,experiences frequent urination at night.Except for a diuretic he takes once per day for hypertension,he is otherwise healthy.How would the nurse explain the reason for his nocturia to Mr.Allenby?

A)Decrease in bladder capacity increases frequency of urination
B)Expected effect of the diuretic
C)Decrease in the number of nephrons
D)Increase in cardiac output

Answer 2

Decrease in bladder capacity increases frequency of urination

Question 3

Which two hormones are responsible for the regulation of sodium and water in the proximal convoluted tubule?

A)Cortisol and adrenocorticotropic
B)Atrial natriuretic peptide and brain natriuretic peptide
C)Secretin and cholecystokinin
D)Aldolsterone and antidiuretic hormone

Answer 3

Atrial natriuretic peptide and brain natriuretic peptide

Question 4

A client brings in a specimen for a routine urinalysis.Which of the following findings are considered normal?

A)pH 6 and no glucose present
B)Blood present and no ketones
C)Specific gravity 1.035
D)Dark amber colour

Question 5

Mrs.Archer is a nurse on a busy surgical floor.She states that on some days she has gone 8 hours without emptying her bladder.What is Mrs.Archer at greater risk for?

A)Urinary tract infection (UTI)
B)Formation of renal calculi
C)Relaxation of urethral sphincter
D)Chronic urinary retention

Question 6

Impaired blood flow to the kidneys or impending renal failure result in an output of less than 500 mL daily.What is the term used to describe a urinary output of less than 500 mL per day?

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

Question 7

Effective management of secondary enuresis may include instigated waking and reward systems.

Question 8

The nurse is to collect a urine specimen from an indwelling catheter without a needleless port.There is no urine in the tubing.After collecting all required equipment,and preparing the client,what would the nurse do first?

A)Open the sterile container
B)Insert a needle into the tubing
C)Clamp the catheter tubing
D)Clean the tubing with disinfectant swab

Question 9

Mrs.Armstrong has a chronic neurogenic bladder disorder.She is being taught how to complete a self-catheterization.Which of the following are important considerations?

A)Catheterization should be done when the bladder is full
B)Wash the red rubber catheter between uses with soap and water
C)Use a catheter with a 5-10 mL balloon
D)Leave catheter in place for 15-20 minutes

Question 10

Lisa,18,is being seen at the walk-in clinic about dysuria,urgency,and frequency.Which of the following conditions is a primary cause of these urinary alterations?

A)Stress
B)Pregnancy
C)Diabetes mellitus
D)Urinary tract infection

Question 11

What is the basic functioning unit of the renal system?

A)Bladder
B)Glomerulus
C)Nephron
D)Loop of Henle

Question 12

Mrs.Cabrera comes into the clinic with complaints of not being able to empty her bladder completely.Which of the following medications Mrs.Cabrera is taking may be contributing to her condition?

A)Glucosamine
B)Levothyroxin
C)Lasix
D)Hydralazine

Question 13

Lisa,18,is being seen at the walk-in clinic about dysuria and frequency.What kind of urine specimen will the nurse expect the health care provider to order?

A)Routine voided urine specimen
B)Clean catch or midstream urine specimen
C)Residual urine specimen
D)24-hour urine specimen

Question 14

Mrs.Lacroix was seen in the clinic 1 month ago with complaints of frequent urinary tract infections.After her last infection was treated,she was provided with information on how she could prevent further infections.Which of the following statements indicates to the nurse that further teaching is required?

A)She is wearing cotton undergarments instead of nylon.
B)Mrs.Lacroix has increased her coffee consumption.
C)She is drinking 6-8 glasses of water or cranberry juice per day.
D)She is taking showers instead of baths.

Question 15

Mrs.Rourke has returned from the operating room following surgery.She has a retention catheter in place.Which of the following nursing interventions is appropriate when providing perineal and catheter care for her?

A)Wear sterile gloves
B)Retape the catheter to the thigh
C)Deflate and inflate the balloon at least once a day
D)Retract the labia majora away from the urinary meatus

Question 16

Mrs.Gill has a 2 1/2-year-old son who she is attempting to toilet train.She asks the nurse at what age should she expect her son to gain daytime bladder control.How will the nurse respond?

A)2 years old
B)3 years old
C)4 years old
D)5 years old

Question 17

Mr.Elliott has a three-way indwelling catheter after having a transurethral resection of the prostate (TURP).He tells the nurse he needs to void.What action should the nurse take?

A)Irrigate the catheter
B)Reposition the catheter
C)Retape the catheter to the abdomen
D)Deflate and then re-inflate the balloon

Question 18

Which of the following clients is at risk for difficulty in urinary elimination?

A)Mr.Lincoln,who had bladder cancer and now has a newly created ileal conduit
B)Ms.Joyce,a 25-year-old female client with low self-esteem
C)Mr.Allen,an 80-year-old male reporting frequent urination at night
D)Mrs.Ethier,who takes a diuretic every day for her blood pressure

Question 19

Blood pressure within the renal capillaries is maintained at a slightly lower pressure than generally found in capillary structures in the body.

Question 20

Mrs.Carson,30 years old,has had several bladder infections in the past year.Which of the following nursing interventions would help prevent future urinary tract infections?

A)After urinating,wipe the perineum from back to front
B)Encourage the use of bubble baths
C)Have the client increase sugar in the diet
D)Instruct the client to empty the bladder completely

Question 21

Mr.Hornby is a 24-year-old quadriplegic with a urinary retention catheter.He has recently experienced frequent urinary tract infections (UTIs).What information can the home care nurse provide him about foods that may decrease his risk of UTI?

A)Milk and milk products
B)Whole grains and eggs
C)Green,leafy vegetables and corn
D)Legumes,rice

Question 22

Mrs.Eglington,a 54-year-old woman,is to have an indwelling urinary catheter inserted.What is the correct technique for cleansing the female genitalia immediately prior to catheterization?

A)Separating the labia and cleansing from back to front
B)Separating the labia and cleansing from front to back
C)Cleanse around the urinary meatus in a circular motion
D)Cleansing the labia from back to front using alcohol

Question 23

Mr.Wilson is 1 day post-operative from a mitral valve replacement.Which of the following would be reported to the physician as a significant finding?

A)Urine output in the past 8 hours is 150 mL.
B)Urine is very pale yellow.
C)Urine output over the past 2 hours is 70 mL.
D)Urine is dark amber in colour.

Question 24

Mr.Wilson is having a heart valve replacement today.He is in preoperative hold being prepped for surgery.He has benign prostatic hypertrophy (BPH).Which of the following is an appropriate choice of urinary catheters for Mr.Wilson?

A)Indwelling coude
B)Straight
C)Indwelling retention
D)Three-way foley

Question 25

Mr.Singh has a three-way foley catheter in place.He has been receiving intermittent bladder irrigations.When assessing Mr.Singh,the nurse notes that he has no urine output in his catheter bag.What should her first action be?

A)Call the physician
B)Check the tubing for kinks
C)Run irrigating fluid into the bladder
D)Remove catheter and reinsert

Question 26

The nurse is planning to teach Mr.Ravinder about his ileal conduit.Which of the following should be incorporated into the teaching plan for him?

A)Change the appliance every day
B)Increase fluid intake
C)Notify the physician if the stoma is deep pink and shiny
D)Notify physician if strands of mucus appear in the urine

Question 27

Mrs.Stuart is a 54-year-old client with an indwelling catheter.What instructions should the nurse give to the X-ray technician who is accompanying Mrs.Stuart to the radiology department for an X-ray?

A)The drainage bag should be kept below bladder level at all times.
B)Mrs.Stuart may feel some abdominal pressure while she is walking about.
C)The drainage bag should be disconnected before leaving Mrs.Stuart's bedside.
D)The drainage bag should be placed on the X-ray table beside Mrs.Stuart.

Question 28

Mrs.Eglington has just had her catheter removed.What teaching would the nurse provide her that may help prevent a UTI?

A)Practice frequent voiding (every 2 to 4 hours)
B)Drink four 250 mL glasses of water each day
C)Take daily bubble baths
D)Caffeinated beverages are recommended