Deck 34: Urinary Elimination

Question 1

A patient is scheduled for an intravenous pyelogram (IVP).What should the nurse do for this diagnostic examination?

A) Make no special preparations before the examination.
B) Push oral fluids before the examination.
C) Have the patient fast after the procedure.
D) Assess the patient for an allergy to iodine before the examination.

Answer 1

Assess the patient for an allergy to iodine before the examination.

Question 2

The nurse is caring for a 45-year-old patient with a suspicious tumor in the bladder.The health care provider has ordered a procedure to identify the tumor tissue.Which test is done to collect tissue specimens?

A) Abdominal radiograph
B) Intravenous pyelogram
C) Endoscopy/cystoscopy
D) Ultrasound renal bladder

Answer 2

Endoscopy/cystoscopy

Question 3

A male patient has been admitted with a fever and malaise.The health care provider has ordered a clean catch midstream specimen for urinalysis on this patient.To collect the urine specimen,the nurse should instruct the patient to do which of the following?

A) Return to bed to obtain the specimen using a straight catheter insertion.
B) Use sterile gloves to cleanse his penis and collect the specimen in a sterile cup.
C) Ask the patient to void into a cup or urine collection container.
D) Cleanse his penis, begin his stream, and then void into a sterile cup.

Answer 3

Cleanse his penis, begin his stream, and then void into a sterile cup.

Question 4

A 56-year-old patient,who has recently become postmenopausal,made an appointment with her health care provider for symptoms of an UTI.The patient has had three previously diagnosed UTIs in the past 4 months.She asks the nurse if this is a normal occurrence with postmenopausal women.What is the best response from the nurse?

A) "Yes, because as women go through menopause, the lining of the urethra becomes more susceptible to infections."
B) "No, but why don't you ask your health care provider for some antibiotics to keep on hand?"
C) "Yes, and this must be frustrating because as we become older our body starts to cause us more problems."
D) "Yes, and this is why I'm not looking forward to going through menopause."

Question 5

A 34-year-old patient is being seen in the ED for complaints of severe flank pain lasting for 2 days.The ED physician suspects that the patient has hydroureter.Which of the following tests would the nurse expect the health care provider to order?

A) KUB (kidney, ureter, bladder) radiography
B) IVP (intravenous pyelogram)
C) Endoscopy
D) Ultrasound renal bladder

Question 6

Patients with urinary incontinence are unable to completely empty their bladder.The nurse can assist a patient to void by using which of the following methods? (Select all that apply.)

A) Completing manual bladder compression
B) Having the patient assume the normal position for voiding
C) Telling the patient to void only when he or she has the urge
D) Pressing down on the right and left flanks of the patient
E) Running water in the sink

Question 7

The nurse is assessing a 76-year-old man in a nursing home with a diagnosis of UTI.The nurse notes that the patient is complaining of right flank pain.To assess for tenderness,the nurse should gently do which of the following?

A) Auscultate the costovertebral angle.
B) Palpate the tenth intercostal space.
C) Percuss the costovertebral angle.
D) Palpate the area above the ischial spine.

Question 8

A patient calls the office to tell you that his or her urine has changed to an orange color.The best response of the nurse is which of the following?

A) "Did you recently start a new prescription for Pyridium?"
B) "Did you recently drink a lot of cranberry juice?"
C) "Have you noticed any blood on the tissue when you wipe yourself?"
D) "Please make an appointment with the office right away."

Question 9

An 80-year-old woman with a history of diabetes and arthritis has made an appointment with her health care provider for complaints of urinary incontinence (UI).The patient states that she has recently become incontinent of urine and thinks it is because of her age.What is the best response from the nurse?

A) "That is not normal. You must have a UTI."
B) "You need to decrease your fluid intake so you don't have to go to the bathroom as often."
C) "Are you having issues with walking to the bathroom or toileting?"
D) "As you get older the sensations that your bladder is full become hypersensitive and cause a person to go to the bathroom more frequently."

Question 10

A patient with congestive heart failure reports experiencing increased urination when taking the prescribed medication.The nurse explains that which of the following is true?

A) The patient is probably taking a diuretic.
B) The patient is probably taking an anticholinergic.
C) The patient is probably taking an antispasmodic.
D) The patient probably has a UTI.

Question 11

A 57-year-old woman has been incontinent of urine for the past 2 months.Her health care provider has scheduled her to have a test to check for stress urinary incontinence.For which of the following tests should the nurse prepare the patient?

A) Abdominal radiograph
B) Intravenous pyelogram
C) Endoscopy
D) Ultrasound renal bladder

Question 12

A 20-year-old female college student who suffers from frequent UTIs visits the student health clinic.The student asks how to decrease the frequency of UTIs.What is the nurse's most appropriate response?

A) "Drink at least 6 to 8 glasses of water daily."
B) "Increase your fluid intake by drinking caffeinated beverages."
C) "Cleanse the perineal area from anus to urethral meatus."
D) "Take an over-the-counter urinary tract cleanser."

Question 13

The nurse on a rehabilitation unit is caring for a 77-year-old patient who had undergone total knee replacement surgery.Since surgery,the patient has had several instances of urinary incontinence.The health care provider is contemplating the order of a Foley catheter.What is the nurse's best response to this suggestion?

A) "Perhaps you could order intermittent straight catheter insertions instead?"
B) "I think it would be better to put a disposable undergarment on her."
C) "Could we try a toileting schedule before you order the Foley?"
D) "I think that is a good idea; it will prevent skin breakdown."

Question 14

A nurse suspects that a patient may be experiencing urinary retention.What should the nurse expect to find on assessment of this patient?

A) Spasms and difficulty urinating
B) Pain in the umbilical region
C) Large amounts of voided cloudy urine
D) Small amounts of urine voided 2 to 3 times per hour

Question 15

The health care provider ordered a 24-hour urine specimen to test the renal function of a patient admitted with acute renal failure.The nurse has prepared all the necessary equipment and has asked the patient if he or she needs to void.The nurse knows that the 24-hour collection period will begin:

A) after the first voided specimen is discarded.
B) with the first morning voided specimen.
C) after the second voided specimen is collected.
D) as soon as the necessary equipment arrives.

Question 16

At a recent staff meeting the staff educator discussed the importance of catheter care for the prevention of urinary tract infections (UTI).What percentage of health care-associated infections result from indwelling catheter use?

A) 10%
B) 60%
C) 70%
D) 80%

Question 17

A mother has brought her 3-year-old child to the clinic for an annual well-child checkup.The mother tells the nurse that the child is in the process of being potty trained.The child will state that the need to go to the bathroom,but refuses to go on the toilet.What is the nurse's best response?

A) "This occurs because the child might be frightened of falling in the toilet."
B) "It is recommended that you try putting her in 'time-out' if she continues to refuse to sit on the toilet."
C) "Sometimes children at that age see urine and feces as part of themselves."
D) "Stop, your child is too young to worry about potty-training."

Question 18

A patient has just been diagnosed with diabetes mellitus.The patient voices concerns about possible kidney disease in the future.The patient asks,"In which part of the kidney is urine produced?" The nurse's response is that urine is formed in the:

A) ureter.
B) bladder
C) nephron.
D) glomerulus.

Question 19

A patient with a Foley catheter needs a urine sample for culture and sensitivity.What is the most appropriate action for the nurse to take?

A) Disconnect the drainage tube from the catheter.
B) Open the drainage bag and withdraw urine.
C) Withdraw urine from the closed system drainage bag.
D) Insert a sterile blunt cannula in the catheter port to withdraw urine.

Question 20

The nurse is caring for a patient from a long-term care facility who has a Foley catheter.The urine in the bag is dark yellow and has a cloudy appearance and a strong odor.According to the transfer sheet,the Foley was placed 5 weeks before the hospital admission.What should the nurse do?

A) Contact the health care provider for an order to change the catheter and provide an update on the appearance of the urine.
B) Request an order for a urine for culture and sensitivity but do not change the catheter; the catheter can remain in place for another week per protocol.
C) Contact the health care provider for an order to remove the catheter.
D) Do nothing; the catheter can remain in place for another week per protocol.

Question 21

A patient needs to have a Foley catheter inserted.Place the following steps into the correct order for this procedure.(Separate letters by a comma and space as follows: A,B,C,D.)

A) Apply sterile gloves.
B) Open the catheterization kit.
C) Wash the perineal area with soap and water.
D) Position the patient.
E) Drape the perineum. f. Clean the urethra.