Question 1

The nurse is caring for a 23-year-old male client who is in the ICU with second and third degree burns over 40 percent of his body.One of the first symptoms that the client is having organ failure is that the urine output is less than:

Accepted Answer

An output of less than 30 mL/hr indicates possible renal alterations.

Question 2

The nurse is discussing signs and symptoms of both upper and lower urinary tract infections with a client who has a history of both.Which of the following statements by the client reflects the best understanding of the differing symptomatology?

Accepted Answer

Clients with lower UTIs have pain or burning during urination (dysuria)as urine flows over inflamed tissues.Fever,chills,nausea,vomiting,and malaise develop as the infection worsens.An irritated bladder (cystitis)causes a frequent and urgent sensation of the need to void.Irritation to bladder and urethral mucosa results in blood-tinged urine (hematuria).The urine appears concentrated and cloudy because of the presence of WBCs or bacteria.If infection spreads to the upper urinary tract (kidneys-pyelonephritis,a serious renal condition),flank pain,tenderness,fever,and chills are common.The remaining options identify general symptoms that are not condition specific.

Question 3

The nurse is interviewing a client with a history of benign prostatic hypertrophy (BPH).In light of this diagnosis,the nurse should include information regarding which of the following in order to assess the chronic effects of this renal disorder?

Accepted Answer

If a chronic obstruction such as prostate enlargement hinders bladder emptying,over time the micturition reflex changes,causing bladder overactivity,and can cause the bladder to not completely empty.The remaining options focus on the impact the condition has on daily living and the monitoring necessary to determine the presence of prostate cancer.

Question 4

The nurse is assessing a client admitted with complaints related to chronic kidney dysfunction.The nurse recognizes that this client is most likely to present with which of the resulting symptoms?

Accepted Answer

Clients with chronic alterations in kidney function cannot produce sufficient quantities of the hormone erythropoietin;therefore they are prone to anemia.Diabetes mellitus may be a cause of the renal dysfunction,and the client may or may not be depressed.Hypertension,not hypotension,is a typical outcome of kidney dysfunction.

Question 5

The nurse is caring for a 19-year-old male client with a fractured left femur whose leg was pinned 36 hours ago and is now in traction.Which of the following stressors is mostly likely the cause of this client's difficulty related to starting urine flow?

Accepted Answer

Some men who cannot stand to urinate become overly distressed.Although the other options may have some effect,the primary cause is most likely the emotional stress of not being able to assume the usual position for male urination.

Question 6

Urinary elimination may be altered with different pathophysiological conditions.For the client with diabetes mellitus,the nurse anticipates that an initial urinary sign or symptom will be:

Accepted Answer

An initial urinary symptom of diabetes mellitus is polyuria.Urgency is not a symptom of diabetes mellitus.Urgency may be caused by a full bladder,bladder irritation from infection,incompetent urethral sphincter,or psychological stress.Dysuria is not a symptom of diabetes mellitus.Dysuria may be caused by bladder inflammation,trauma,or inflammation of the urethral sphincter.Hematuria is not a symptom of diabetes mellitus.Hematuria may be a symptom of neoplasms of the bladder or kidney,glomerular disease,infection of the kidney or bladder,trauma to urinary structures,calculi,or bleeding disorders.

Question 7

Which of the following statements made by a client experiencing chronic kidney dysfunction reflects the best understanding of the most common physiological effect this disorder can have on the body?

Accepted Answer

Clients with chronic alterations in kidney function cannot produce sufficient quantities of the hormone erythropoietin;therefore they are prone to anemia.The remaining options deal with nonphysiological events or conditions that are more causes of the dysfunction,not effects.

Question 8

Which of the following clients will most benefit from client/parent education regarding the prevention of renal infections via proper hygiene habits?

Accepted Answer

The 3- to 12-year-old female has the shortest urethra and so has the greatest need.The short length of the urethra predisposes women and girls to infection.It is easy for bacteria to enter the urethra from the perineal area.

Question 9

The nurse is discussing urinary elimination alterations with a group of middle-age adults.The nurse appropriately shares with the group that whereas men experience urinary frequency as a result of prostate enlargement,the female:

Accepted Answer

Aging often impairs micturition.In the male,prostate enlargement usually begins during the 40s and continues throughout life,resulting in urinary frequency and possible urinary retention.In women,changes in the urethral mucosa associated with loss of estrogen during and after menopause contribute to increased susceptibility to UTIs.Although pregnancies may affect urinary continence,decreased estrogen levels do not protect against kidney infections.

Question 10

Which of the following statements made by an older adult with a history of urinary tract infections shows the best understanding of interventions that minimize the risk for developing such infections?

Accepted Answer

Make fluids such as cranberry juice available as part of the client's fluid intake.Cranberry juice discourages bacterial adherence to the bladder wall.The remaining options either have less impact on a daily basis or are more related to early detection rather than prevention.

Question 11

The nurse recognizes that a client recovering from anesthesia required for surgical repair of a fractured ulna is likely to experience difficulty urinating primarily because of:

Accepted Answer

Medications,including anesthesia,interfere with both the production and the characteristics of urine and affect the act of urination.The remaining options may affect urination but not to the extent of the anesthetic effects.

Question 12

The nurse realizes that a postsurgical client who underwent a left knee replacement is most likely to experience which of the following urinary complications?

Accepted Answer

Medications including anesthesia interfere with both the production and the characteristics of urine and affect the act of urination.Difficulty with urination is a common complication of general anesthesia.The remaining options are not directly connected to postsurgical complications.

Question 13

A 33-year-old female client in her first trimester of pregnancy complains to the nurse on her prenatal visit that she is needs to urinate more frequently and is concerned about having a urinary tract infection.Which of the following statements would be most appropriate for the nurse to make?

Accepted Answer

In a pregnant woman the developing fetus pushes against the bladder,reducing the bladder's capacity and causing a feeling of fullness.This effect is more likely to occur in the first and third trimesters.Since the client expressed concern regarding a UTI,the nurse should make further assessments to explore that possibility.

Question 14

Which of the following nursing interventions is most specific for a client being monitored for possible urinary retention?

Accepted Answer

With retention the client may void small amounts of urine 2 or 3 times an hour with no real relief of discomfort or may continually dribble urine.Be aware of the volume and frequency of voiding to assess this condition in the client.The alert,oriented client can be asked to notify the nurse each time micturition occurs.The remaining options are more generalized or specific for a urinary tract infection.

Question 15

The nurse knows that which of the following clients is most at risk for a bone fracture:

Accepted Answer

The kidneys affect calcium and phosphate regulation by producing a substance that converts vitamin D into its active form.Clients with chronic alterations in kidney function do not make sufficient amounts of the active vitamin D.They are prone to develop renal bone disease resulting from the demineralization of bone caused by impaired calcium absorption.

Question 16

The nurse is caring for an older adult who is recovering from hip replacement surgery.The client shares with the nurse that he has been using the urinal "a lot but I feel like my bladder isn't empty." Which of the following statements by the nurse shows the best understanding of the appropriate initial intervention for this particular client?

Accepted Answer

With retention the client may void small amounts of urine 2 or 3 times an hour with no real relief of discomfort or may continually dribble urine.Be aware of the volume and frequency of voiding to assess this condition in the client.The alert,oriented client can be asked to notify the nurse each time micturition occurs.The notification of the primary care provider is not the initial intervention.Although measuring the urine output is not inappropriate,it is not specific to this client's complaint.Restricting fluids is neither appropriate nor likely to affect the problem.

Question 17

Which of the following clients is at greatest risk for developing a renal infection?

Accepted Answer

The short length of the urethra predisposes women and girls to infection.It is easy for bacteria to enter the urethra from the perineal area.The 9-year-old female has the shortest urethra and so has the greatest risk.

Question 18

A 70-year-old client is discussing his recent difficulty in initiating his flow of urine while on a cross-country bus tour with a senior citizens' group.Which of the following assessment questions is directed toward the most likely cause of the problem?

Accepted Answer

Attempting to void in a public restroom sometimes results in a temporary inability to void.Although the remaining options may affect urination,this situation strongly suggests an emotional cause.

Question 19

Which of the following statements made by a client with benign prostatic hypertrophy (BPH)during an admissions interview reflects the best understanding of the long-term effects of this condition?

Accepted Answer

If a chronic obstruction such as prostate enlargement hinders bladder emptying,over time the micturition reflex changes,causing bladder overactivity,and can cause the bladder to not completely empty.The remaining options focus on the impact the condition has on daily living and the monitoring of the client for prostate cancer.

Question 20

A condom catheter is to be used for an adult male client in the extended care facility.In the application of the condom catheter,the nurse employs appropriate technique when:

Accepted Answer

A 1- to 2-inch space should be left between the tip of the penis and the end of the catheter.Nonsterile gloves are worn to apply a condom catheter.Standard adhesive tape should never be used to secure a condom catheter because it does not expand with change in penis size and is painful to remove.The tubing of a condom catheter is not taped tightly to the thigh.The drainage bag is attached to the lower bed frame.

Quiz 45: Urinary Elimination