Deck 43: Urinary Elimination

Question 1

In determining the patient's urinary status,which of the following daily urinary outputs does the nurse anticipate for an average healthy adult?

A) 800 to 1000 mL per day
B) 1000 to 1200 mL per day
C) 1500 to 1600 mL per day
D) 2000 to 2300 mL per day

Answer 1

C

Question 2

The nurse is aware that patients with chronic alterations in kidney function have insufficient amounts of which of the following vitamins?

A) Vitamin A
B) Vitamin D
C) Vitamin E
D) Vitamin K

Answer 2

B

Question 3

Which of the following methods is most appropriate to assist a cognitively impaired older adult with bladder training?

A) Self-catheterization
B) Prompted voiding
C) Urinary diary
D) Adult diapers

Answer 3

B

Question 4

On reviewing the results of a routine urinalysis test,the nurse notes that which of the following findings is normal?

A) pH 2.54
B) Specific gravity 1.020
C) Protein amounts to 10 mg per 100 mL
D) White blood cell count of 5 to 8 per low-power field

Question 5

Which of the following processes are used in hemodialysis to help cleanse a patient's blood?

A) Osmosis
B) Pinocytosis
C) Active transport
D) Passive transport

Question 6

In the assessment of a patient with reflex incontinence,which of the following does the nurse expect to find?

A) The patient has a constant dribbling of urine.
B) The patient has an uncontrollable loss of urine when coughing or sneezing.
C) The patient has no urge to void and an unawareness of bladder filling.
D) The patient has an immediate urge to void but not enough time to reach the bathroom.

Question 7

A 3-year-old child is visiting the pediatric clinic.The nurse suspects that the child has a UTI.Which of the following methods is appropriate for the nurse to implement to obtain a urine specimen from the child?

A) Use an in-dwelling catheter.
B) Offer fluids 30 minutes in advance.
C) Apply pressure over the urinary bladder.
D) Place a diaper on the child, and squeeze out the specimen.

Question 8

Which one of the following measures should be included in a bladder habit retraining program for a patient in an extended care facility?

A) Providing negative reinforcement when the patient is incontinent
B) Having the patient wear adult diapers as a preventive measure
C) Initiating a voiding schedule
D) Promoting the intake of caffeine to stimulate voiding

Question 9

Which of the following inhibits the release of antidiuretic hormone (ADH)?

A) Tea
B) Cola
C) Coffee
D) Alcohol

Question 10

A patient in the hospital has an in-dwelling urinary catheter,and the nurse is instructing the nursing student in the appropriate care to provide.Which one of the following does the nurse teach the student to do?

A) Empty the drainage bag at least every eight hours.
B) Cleanse up the length of the catheter to the perineum.
C) Use sterile technique to obtain a specimen for culture and sensitivity.
D) Place the drainage bag on the patient's lap while transporting the patient to testing.

Question 11

The nurse is working with a patient who has a urinary diversion.Included in the plan of care for this patient is which of the following instructions?

A) Special clothing will need to be ordered to fit around the diversion.
B) A stomal bag will need to be worn only at night.
C) A reduction in physical activity will be planned.
D) Special skin care is a priority.

Question 12

A postpartum patient has been unable to void since her delivery of a baby this morning.Which of the following nursing measures would be beneficial for the patient initially?

A) Increase the patient's fluid intake to 3500 mL.
B) Insert in-dwelling Foley catheter.
C) Pour warm water over the patient's perineum.
D) Apply firm pressure over the patient's bladder.

Question 13

The nurse suspects that the patient has a urinary tract infection (UTI)based on the patient exhibiting which of the following early signs or symptoms?

A) Chills
B) Dysuria
C) Flank pain
D) Lower back pain

Question 14

What is the average normal capacity of an adult bladder?

A) 250 mL
B) 500 mL
C) 750 mL
D) 1000 mL

Question 15

Immediately after an intravenous pyelogram (IVP),the nurse should observe the patient for which of the following symptoms?

A) Infection in the urinary bladder
B) An allergic reaction to the contrast material
C) Urinary suppression caused by injury to kidney tissues
D) Incontinence as a result of paralysis of the urinary sphincter

Question 16

The nurse is visiting the patient who has a nursing diagnosis of "Alteration in urinary elimination,retention." On assessment,the nurse anticipates that this patient will exhibit which of the following symptoms?

A) Severe flank pain and hematuria
B) Pain and burning on urination
C) A loss of the urge to void
D) A feeling of pressure and voiding of small amounts

Question 17

Which of the following techniques is appropriate for the nurse to implement to obtain a clean-voided urine specimen?

A) Apply sterile gloves for the procedure.
B) Restrict fluids before the specimen collection.
C) Place the specimen in a clean urinalysis container.
D) Collect the specimen after the initial stream of urine has passed.

Question 18

A timed urine specimen collection is ordered.The test will need to be restarted if which one of the following occurs?

A) The patient voids in the toilet.
B) The urine specimen is kept cold.
C) The first voided urine is discarded.
D) The preservative is placed in the collection container.

Question 19

The patient has an in-dwelling catheter.How should the nurse obtain a sterile urine specimen?

A) Disconnect the catheter from the drainage tubing.
B) Withdraw urine from a urinometer.
C) Open the drainage bag and remove urine.
D) Use a needle to withdraw urine from the catheter port.

Question 20

The patient is going to have a cystoscopy.Which of the following statements or questions reflects the correct information that should be taught or obtained before the procedure?

A) "Are you allergic to iodine?"
B) "There will be no need to have a special consent form."
C) "You will need to have fluids restricted the evening before the cystoscopy."
D) "You will probably be given sedatives before the procedure."

Question 21

In general,when energy requirements are completely met by kilocalorie (kcal)intake in food

A) Weight increases.
B) Weight decreases.
C) Weight does not change.
D) Kilocalories are not a factor.

Question 22

In teaching mothers-to-be about infant nutrition,the nurse instructs patients to

A) Give cow's milk during the first year of life.
B) Supplement breast milk with corn syrup.
C) Add honey to infant formulas for increased energy.
D) Remember that breast milk or formula is sufficient for the first 4 to 6 months.

Question 23

The energy needed to maintain life-sustaining activities for a specific period of time at rest is known as

A) BMR.
B) REE.
C) Nutrients.
D) Nutrient density.

Question 24

Some proteins are manufactured in the body,but others are not.Those that must be obtained through diet are known as

A) Amino acids.
B) Dispensable amino acids.
C) Triglycerides.
D) Indispensable amino acids.

Question 25

In providing diet education for a patient on a low-fat diet,it is important for the nurse to understand that with few exceptions

A) Saturated fats are found mostly in vegetable sources.
B) Saturated fats are found mostly in animal sources.
C) Unsaturated fats are found mostly in animal sources.
D) Linoleic acid is a saturated fatty acid.

Question 26

The patient has been diagnosed with cardiovascular disease and placed on a low-fat diet.The patient asks the nurse,"How much fat should I have? I guess the less fat,the better." The nurse needs to explain that

A) Fats have no significance in health and the incidence of disease.
B) All fats come from external sources so can be easily controlled.
C) Deficiencies occur when fat intake falls below 10% of daily nutrition.
D) Vegetable fats are the major source of saturated fats and should be avoided.

Question 27

Knowing that protein is required for tissue growth,maintenance,and repair,the nurse must understand that for optimal tissue healing to occur,the patient must be in

A) Negative nitrogen balance.
B) Positive nitrogen balance.
C) Total dependence on protein for kcal production.
D) Neutral nitrogen balance.

Question 28

When teaching a patient about current dietary guidelines for the general population,the nurse explains referenced daily intakes (RDIs)and daily reference values (DRVs),otherwise known as daily values.In providing this information,the nurse understands that daily values

A) Have replaced recommended daily allowances (RDAs).
B) Have provided a more understandable format of RDAs for the public.
C) Are based on percentages of a diet consisting of 1200 kcal/day.
D) Are not usually easy to find computer experience is required.

Question 29

The patient is an 80-year-old male who is visiting the clinic today for his routine physical examination.The patient's skin turgor is fair,but he has been complaining of fatigue and weakness.The skin is warm and dry,pulse rate is 126 beats per minute,and urinary sodium level is slightly elevated.After assessment,the nurse should recommend that the patient

A) Decrease his intake of milk and dairy products to decrease the risk of osteoporosis.
B) Drink more grapefruit juice to enhance vitamin C intake and medication absorption.
C) Drink more water to prevent further dehydration.
D) Eat more meat because meat is the only source of usable protein.

Question 30

In providing prenatal care to a patient,the nurse teaches the expectant mother that

A) Protein intake needs to decrease to preserve kidney function.
B) Calcium intake is especially important in the first trimester.
C) Folic acid is needed to help prevent birth defects and anemia.
D) The mother should take in as many extra vitamins and minerals as possible.

Question 31

The nurse is assessing a patient for nutritional status.In doing so,the nurse must

A) Choose a single objective tool that fits the patient's condition.
B) Combine multiple objective measures with subjective measures.
C) Forego the assessment in the presence of chronic disease.
D) Use the Mini Nutritional Assessment for pediatric patients.

Question 32

The ChooseMyPlate program was developed to replace MyFoodPyramid as a basic guide for buying food and meal preparations.This system was developed by the

A) Food and Drug Administration.
B) 1990 Nutrition Labeling and Education Act.
C) Referenced daily intakes (RDIs).
D) U.S. Department of Agriculture.

Question 33

The ChooseMyPlate program includes guidelines for

A) Children younger than 2 years.
B) Balancing calories.
C) Increasing portion size.
D) Decreasing water consumption.

Question 34

Fats are composed of triglycerides and fatty acids.Triglycerides

A) Are made up of three fatty acids.
B) Can be saturated.
C) Can be monounsaturated.
D) Can be polyunsaturated.

Question 35

The patient has a calculated body mass index (BMI)of 34.This would classify the patient as

A) Unclassifiable.
B) Normal weight.
C) Overweight.
D) Obese.

Question 36

The nurse is providing nutrition teaching to a Korean patient.In doing so,the nurse must understand that the focus of the teaching should be on

A) Changing the patient's diet to a more conventional American diet.
B) Discouraging the patient's ethnic food choices.
C) Food preferences of the patient, including racial and ethnic choices.
D) Comparing the patient's ethnic preferences with American dietary choices.

Question 37

In determining kcal expenditure,the nurse knows that carbohydrates and proteins provide 4 kcal of energy per gram ingested.The nurse also knows that fats provide _____ kcal per gram.

A) 3
B) 4
C) 6
D) 9

Question 38

The nurse is teaching the patient about dietary guidelines.In discussing the four components of dietary reference intakes (DRIs),it is important to understand that

A) The estimated average requirement (EAR) is appropriate for 100% of the population.
B) The recommended dietary allowance (RDA) meets the needs of the individual.
C) Adequate intake (AI) determines the nutrient requirements of the RDA.
D) The tolerable upper intake level (UL) is not a recommended level of intake.

Question 39

To counter obesity in adolescents,increasing physical activity is often more important than curbing intake.Sports and regular,moderate to intense exercise necessitate dietary modifications to meet increased energy needs for adolescents.The nurse understands that these modifications include

A) Decreasing carbohydrates to 25% to 30% of total intake.
B) Decreasing protein intake to .75 g/kg/day.
C) Ingesting water before and after exercise.
D) Providing vitamin and mineral supplements.

Question 40

In creating a plan of care to meet the nutritional needs of the patient,the nurse needs to explore the patient's feelings about weight and food.The nurse must do this to

A) Determine which category of plan to use.
B) Set realistic goals for the patient.
C) Mutually plan goals with patient and team.
D) Prevent the need for a dietitian consult.

Question 41

The patient is on PN and is lethargic.He has been complaining of thirst and headache and has had increased urination.Which of the following problems would cause these symptoms?

A) Electrolyte imbalance
B) Hypoglycemia
C) Hyperglycemia
D) Hypercapnia

Question 42

At present,the most reliable method for verification of placement of small-bore feeding tubes is

A) Auscultation.
B) Aspiration of contents.
C) X-ray.
D) pH testing.

Question 43

The patient is admitted with facial trauma,including a broken nose,and has a history of esophageal reflux and of aspiration pneumonia.Given this information,which of the following tubes is appropriate for this patient?

A) Nasogastric tube
B) Percutaneous endoscopic gastrostomy (PEG) tube
C) Nasointestinal tube
D) Jejunostomy tube

Question 44

The nurse is preparing to insert a nasogastric tube in a patient who is semiconscious.To determine the length of the tube needed to be inserted,the nurse measures from the

A) Tip of the nose to the xiphoid process of the sternum.
B) Earlobe to the xiphoid process of the sternum.
C) Tip of the nose to the earlobe.
D) Tip of the nose to the earlobe to the xiphoid process.

Question 45

In determining the nutritional status of a patient and developing a plan of care,it is important to evaluate the patient according to

A) Published standards.
B) Nursing professional standards.
C) Absence of family input.
D) Patient input only.

Question 46

The patient with cardiovascular disease must be taught how to reduce the risk of cardiovascular disease by balancing calorie intake with exercise to maintain a healthy body weight.In addition to this,the nurse instructs the patient to

A) Eat fish at least 5 times per week.
B) Limit saturated fat to less than 7%.
C) Limit cholesterol to less than 200 mg/day.
D) Avoid high-fiber foods.

Question 47

Dysphagia refers to difficulty when swallowing.Of the following causes of dysphagia,which is considered neurogenic?

A) Myasthenia gravis
B) Stroke
C) Candidiasis
D) Muscular dystrophy

Question 48

The nurse is concerned about pulmonary aspiration when providing her patient with tube feedings.The nurse should

A) Verify tube placement before feeding.
B) Lower the head of the bed to a supine position.
C) Add blue food coloring to the enteral formula.
D) Run the formula over 12 hours to decrease volume.

Question 49

The patient is elderly and has been diagnosed with Imbalanced nutrition: less than body requirements.Her treatment regimen should include having the nurse

A) Encourage weight gain as rapidly as possible.
B) Encourage large meals three times a day.
C) Decrease fluid intake to prevent feeling full.
D) Encourage fiber intake.

Question 50

To provide successful nutritional therapies to patients,the nurse must understand that

A) Patients will have to change diet preferences drastically to be successful.
B) The patient will tell the nurse when to change the plan of care.
C) Expectations of nurses frequently differ from those of the patient.
D) Nurses should never alter the plan of care regardless of outcome.

Question 51

The patient has just started on enteral feedings but is complaining of abdominal cramping.The nurse should

A) Slow the rate of tube feeding.
B) Instill cold formula to "numb" the stomach.
C) Place the patient in a supine position.
D) Change the tube feeding to a high-fat formula.

Question 52

The nurse is caring for a patient who will be receiving PN.To reduce the risk of developing sepsis,the nurse

A) Takes down a running bag of TPN after 36 hours.
B) Runs lipids for no longer than 24 hours.
C) Wears a sterile mask when changing the CVC dressing.
D) Wears clean gloves when changing the CVC dressing.

Question 53

Before giving the patient an intermittent tube feeding,the nurse should

A) Make sure that the tube is secured to the gown with a safety pin.
B) Have the tube feeding at room temperature.
C) Inject air into the stomach via the tube and auscultate.
D) Place the patient in a supine position.

Question 54

The nurse is providing home care for a patient diagnosed with AIDS.In preparing meals for this patient,the nurse should

A) Provide small, frequent nutrient-dense meals.
B) Encourage intake of fatty foods to increase caloric intake.
C) Prepare hot meals because they are more easily tolerated.
D) Avoid salty foods and limit liquids to preserve electrolytes.

Question 55

The patient has just been started on an enteral feeding and has developed diarrhea after being on the feeding for 2 hours.The most likely cause of the diarrhea would be

A) Clostridium difficile.
B) Antibiotic therapy.
C) Formula intolerance.
D) Bacterial contamination.

Question 56

Patients who are unable to digest or absorb enteral nutrition benefit from parenteral nutrition (PN).However,the goal to move toward use of the GI tract is constant because PN

A) Can be given only in the hospital setting.
B) Cannot be used in patients in highly stressed situations.
C) Can be given only by way of a peripheral IV line.
D) Can lead to villous atrophy and cell shrinkage.

Question 57

The patient is to receive multiple medications via the nasogastric tube.The nurse is concerned that the tube may become clogged.To prevent this,the nurse

A) Irrigates the tube with 60 mL of water after all medications are given.
B) Checks with the pharmacy to find out if liquid forms of the medications are available.
C) Instills nonliquid medications without diluting.
D) Mixes all medications together to decrease the number of administrations.

Question 58

The patient is having at least 75% of his nutritional needs met by enteral feeding,so the physician has ordered the PN to be discontinued.However,the nurse notices that the PN infusion has fallen behind.The nurse should

A) Increase the rate to get the volume caught up before discontinuing.
B) Stop the infusion and hang a normal saline drip in place.
C) Taper the PN infusion gradually.
D) Hang 5% dextrose if the PN runs out.

Question 59

In providing diabetic teaching for a patient with type 1 diabetes mellitus,the nurse instructs the patient that

A) Insulin is the only consideration that must be taken into account.
B) Saturated fat should be limited to less than 7% of total calories.
C) Cholesterol intake should be greater than 200 mg/day.
D) Nonnutritive sweeteners can be used without restriction.

Question 60

In measuring the effectiveness of nutritional interventions,the nurse should

A) Expect results to occur rapidly.
B) Not be concerned with physical measures such as weight.
C) Expect to maintain a course of action regardless of changes in condition.
D) Evaluate outcomes according to the patient's expectations and goals.

Question 61

Dietary reference intakes (DRIs)present evidence-based criteria for an acceptable range of amounts of vitamins and nutrients for each gender and age group.Components of DRIs include which of the following?

A) Estimated average requirement (EAR)
B) Recommended dietary allowance (RDA)
C) The Food Guide Pyramid
D) Adequate intake (AI)
E) The tolerable upper intake level (UL)

Question 62

To create a new nutritional plan of care for a patient,the nurse needs to do which of the following?

A) Utilize the characteristics of a normal nutritional status.
B) Evaluate previous patient responses to nursing interventions.
C) Exclude established expected outcomes to evaluate patient responses.
D) Design innovative interventions to meet the patient's needs.
E) Follow through with evaluation and counseling.

Question 63

The patient is asking the nurse about the best way to stay healthy.The nurse explains to the patient that from a nutritional point of view,the patient should

A) Maintain body weight in a healthy range.
B) Increase physical activity.
C) Increase intake of meat and other high-protein foods.
D) Keep total fat intake to 10% or less.
E) Choose and prepare foods with little salt.

Question 64

When developing a plan of care for a patient with altered nutritional needs,the nurse must assess the patient for which of the following?

A) What is the condition now?
B) Is the condition stable?
C) Will the condition get worse?
D) Will the disease process accelerate deterioration?
E) Which single objective measure will predict the course of action?

Question 65

When expected nutritional outcomes are not being met,the nurse should

A) Revise the nurse measures or expected outcomes.
B) Alter the outcomes based on nursing standards.
C) Ensure that patient expectations are congruent with the nurse's expectations.
D) Readjust the plan to exclude cultural beliefs.