Question 1

A patient complains that she passes urine whenever she sneezes or coughs.How should the nurse document this complaint in the patient's healthcare record?

Accepted Answer

A)   Transient incontinence
B)   Overflow incontinence
C)   Urge incontinence
D)   Stress incontinence D

Question 2

A patient is admitted with high BUN and creatinine levels,low blood pH,and elevated serum potassium level.Based on these laboratory findings the nurse suspects which diagnosis?

Accepted Answer

A)   Cystitis
B)   Renal Calculi
C)   Enuresis
D)   Renal Failure D

Question 3

Which daily urine output is within normal limits for a newborn weighing 8 pounds?

Accepted Answer

A)   288 mL
B)   180 mL
C)   36 mL
D)   18 mL B

Question 4

Which outcome is appropriate for the patient who underwent urinary diversion surgery and creation of an ileal conduit for invasive bladder cancer?

Accepted Answer

A)   Patient will resume his normal urination pattern by (target date) .
B)   Patient will perform urostomy self-care by (target date) .
C)   Patient will perform self-catheterization by (target date) .
D)   Patient's urine will remain clear with sufficient volume.

Question 5

A patient who sustained a spinal cord injury will perform intermittent self-catheterization after discharge.After discharge teaching,which statement by the patient would indicate correct understanding of the procedure?

Accepted Answer

A)   "I will need to replace the catheter weekly."
B)   "I can use clean, rather than sterile, technique at home."
C)   "I will remember to inflate the catheter balloon after insertion."
D)   "I will dispose of the catheter after use and get a new one each time."

Question 6

What position should the patient assume before the nurse inserts an indwelling urinary catheter?

Accepted Answer

A)   Modified Trendelenburg
B)   Prone
C)   Dorsal recumbent
D)   Semi-Fowler's

Question 7

While performing a physical assessment,the student nurse tells her instructor that she cannot palpate her patient's bladder.Which statement by the instructor is best?

Accepted Answer

A)   "Try to palpate it again; it takes practice but you will locate it."
B)   "Palpate the patient's bladder only when it is distended by urine."
C)   "Document this abnormal finding on the patient's chart."
D)   "Immediately notify the nurse assigned to the care of your patient."

Question 8

Which of the following are considered normal processes and changes in the urinary system that occur with aging in older adults? Select all that apply.

Accepted Answer

A)   The number of functional nephrons decreases with age.
B)   The volume of urine that the bladder can hold lessens with age.
C)   Increased pelvic floor muscle tone contributes to incontinence.
D)   Loss of bladder elasticity leads to urinary retention.
E)   Prostate enlargement causes urinary incontinence.

Question 9

The nurse is caring for a patient with suspected kidney dysfunction.In reviewing the patient's home medication list,the nurse is most alerted to which medications? Select all that apply.

Accepted Answer

A)   Aspirin
B)   Gentamicin
C)   Estrogen
D)   Ibuprofen
E)   Insulin

Question 10

The nurse measures the urine output of a patient who requires a bedpan to void.Which action should the nurse take first? Put on gloves and:

Accepted Answer

A)   Have the patient void directly into the bedpan
B)   Pour the urine into a graduated container
C)   Read the volume with the container on a flat surface at eye level
D)   Observe the color and clarity of the urine in the bedpan

Question 11

What is the best technique for obtaining a sterile urine specimen from an indwelling urinary catheter?

Accepted Answer

A)   Use antiseptic wipes to cleanse the meatus prior to obtaining the sample.
B)   Briefly disconnect the catheter from the drainage tube to obtain sample.
C)   Withdraw urine through the port using a needleless access device.
D)   Obtain the urine specimen directly from the collection bag.

Question 12

The nurse is caring for a patient who underwent a bowel resection 2 hours ago.His urine output for the past 2 hours totals 50 mL.Which action should the nurse take?

Accepted Answer

A)   Do nothing; this is normal postoperative urine output.
B)   Increase the infusion rate of the patient's IV fluids.
C)   Notify the provider about the patient's oliguria.
D)   Administer the patient's routine diuretic dose early.

Question 13

The nurse has received a prescription to obtain a urinalysis and microscopic analysis.When is the ideal time of the day for the nurse to collect this specimen?

Accepted Answer

A)   In the morning
B)   In the evening before bedtime
C)   Before a meal
D)   After the patient drinks 1 liter of water

Question 14

What type of indwelling catheter is most suitable for long-term use?

Accepted Answer

A)   Silver-alloy catheter
B)   Polyvinyl chloride (PV
C)   catheter
C)   Silicone catheter
D)   Triple-lumen catheter

Question 15

The student nurse asks the provider if she will prescribe an indwelling urinary catheter for a hospitalized patient who is incontinent.The provider explains that catheters should be utilized only when absolutely necessary because:

Accepted Answer

A)   They are the leading cause of nosocomial infection
B)   They are too expensive for routine use
C)   They contain latex, increasing the risk for allergies
D)   Insertion is painful for most patients

Question 16

The nurse is inserting an indwelling urinary catheter for a female patient.Upon insertion of the catheter the nurse accidently touches the patient's leg and bed sheet with the tip of the catheter.What is the most appropriate action by the nurse?

Accepted Answer

A)   Cleanse the tip of the catheter with povidone iodine before proceeding with the insertion.
B)   Cleanse the tip of the catheter with alcohol before proceeding with the insertion.
C)   Obtain a new catheter and reinsert it using sterile technique.
D)   Continue with the procedure as the nurse only lightly touched the surfaces.

Question 17

The nurse is seeing a 20-year-old client with a urinary tract infection (UTI)at the women's health clinic.The client says to the nurse,"It seems to me more women get urinary infections than men.Why is this?" What is the best response by the nurse?

Accepted Answer

A)   "Because women are usually more sexually active than men, they are at higher risk for infections."
B)   "Men have a prostate gland that protects them against urinary tract infections."
C)   "The female urethra is longer than a male making women more prone to infections."
D)   "Hormone changes during pregnancy and pressure of the uterus on the bladder can make women more prone to UTIs."

Question 18

The surgeon orders hourly urine output measurement for a patient after abdominal surgery.The patient's urine output has been greater than 60 mL/hour for the past 2 hours.Suddenly,the patient's urine output drops to almost nothing.What should the nurse do first?

Accepted Answer

A)   Irrigate the catheter with 30 mL of sterile solution.
B)   Replace the patient's indwelling urinary catheter.
C)   Infuse 500 mL of normal saline solution IV over 1 hour.
D)   Notify the surgeon immediately.

Question 19

A patient's catheter bag is empty 2 hours after it was last drained.The nurse's first action is to:

Accepted Answer

A)   Irrigate the catheter
B)   Perform a bladder scan
C)   Replace the catheter
D)   Check for kinks or compression

Question 20

The nurse is teaching an older female patient how to manage urge incontinence at home.What is the first-line approach to reducing involuntary leakage of urine?

Accepted Answer

A)   Insertion of a pessary
B)   Intermittent self-catheterization
C)   Bladder training
D)   Anticholinergic medication

Exam 28: Urinary Elimination