Chapter 43 Urinary Elimination Potter et al Canadian Fundamentals of Nursing, 6th Edition, Exams of Nursing

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Chapter 43 Urinary Elimination Potter et

al Canadian Fundamentals of Nursing,

6th Edition Test Bank

1. If obstructed, which component of the urination system would cause peristaltic waves? - ANS: Ureters.
2. When reviewing laboratory results, the nurse should immediately notify the health care provider about which finding? - ANS: Glomerular filtration rate of 20 mL/min.
3. A patient is experiencing oliguria. Which action should the nurse perform first? - ANS: Assess for bladder distension.
4. A patient requests the nurse's assistance to the bedside commode and becomes frustrated when unable to void in front of the nurse. The nurse understands that the patient is unable to void for which reason? - ANS: Anxiety can make it difficult for abdominal and perineal muscles to relax enough to void.
5. The nurse knows that urinary tract infection (UTI) is the most common health care-associated infection for which reason? - ANS: Escherichia coli pathogens are transmitted during surgical or catheterization procedures.
6. An 86-year-old patient tells the nurse that she is experiencing uncontrollable leakage of urine. Which nursing diagnosis should the nurse include in the patient's plan of care? - ANS: Urinary incontinence.
7. A patient has fallen several times in the past week when attempting to get to the bathroom. The patient informs the nurse that he gets up three or four times a night to urinate. Which recommendation by the nurse is most appropriate in correcting this urinary problem? - ANS: Limit fluid and caffeine intake before bed.
8. When caring for a patient with urinary retention, the nurse would anticipate an order for which of the following? - ANS: A urinary catheter.

9. Upon palpation, the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate. The nurse should follow up by asking which question? - ANS: "When was the last time you voided?"
10. Which of the following is the primary function of the kidneys? - ANS: Maintaining fluid and electrolyte balance.
11. While receiving a shift report on a patient, the nurse is informed that the patient has urinary incontinence. Upon assessment, what would the nurse expect to find? - ANS: Reddened irritated skin on the buttocks. Which nursing diagnosis related to alterations in urinary function in an older person should be a nurse's first priority for action? - ANS: Risk of infection.
12. A patient asks about treatment for urge urinary incontinence. The nurse's best response is which advice to the patient? - ANS: Perform pelvic floor exercises.
13. The nurse suspects that a urinary tract infection has progressed to cystitis when the patient complains of which symptom? - ANS: Frequency
14. Which assessment question should the nurse ask if stress incontinence is suspected? - ANS: "Do you experience urine leakage when you cough or sneeze?"
15. To obtain a clean-voided urine specimen from a female patient, the nurse should teach the patient to do which of the following? - ANS: Hold the labia apart while voiding into the specimen cup.
16. When viewing a urine specimen under a microscope, what would the nurse expect to see if the specimen is from a patient with a urinary tract infection? - ANS: Bacteria.
17. The nurse would expect the urine of a patient with uncontrolled diabetes mellitus to be which of the following? - ANS: Sweet smelling..

19. What signs and symptoms would the nurse expect to observe in a patient with excessive numbers of white blood cells present in the urine? - ANS: Fever and chills.
20. For a patient who has severe flank pain and calcium phosphate crystals revealed on urinalysis, the nurse would anticipate an order for which diagnostic test? - ANS: Intravenous pyelography.
21. A nurse is caring for a patient who just underwent intravenous pyelography that revealed a renal calculus obstructing the left ureter. What is the nurse's first priority in caring for this patient? - ANS: Monitor the patient for fever, rash, and difficulty breathing.
22. Which statement by the patient about upcoming computed tomography (CT) indicates a need for further teaching? - ANS: "I will be anaesthetized so that I lie perfectly still during the procedure."
23. The nurse is visiting the patient who has a nursing diagnosis of Impaired urinary elimination: retention. On assessment, the nurse anticipates that this patient will exhibit which of the following? - ANS: Sensation of urgency and voiding of small amounts.
24. A nurse anticipates urodynamic testing for a patient with which symptom? - ANS: Involuntary urine leakage.
25. A patient is having difficulty voiding in a bedpan but states that she feels her bladder is full. To stimulation micturition, which nursing intervention should the nurse try first? - ANS: Utilizing the power of suggestion by turning on the faucet and letting the water run.
26. A nurse is caring for an 8-year-old patient who is embarrassed about urinating in his bed at night. Which intervention should the nurse suggest to reduce the frequency of this occurrence? - ANS: "Drink your nightly glass of milk earlier in the evening."
27. Many individuals have difficulty voiding in a bedpan or urinal while lying in bed for which reason? - ANS: They would feel more comfortable assuming a normal voiding position.
28. The nurse would anticipate inserting a coudé catheter for which patient? - ANS: A 56-year-old man admitted for bladder irrigation.

29. The nurse knows that which in-dwelling catheter procedure places the patient at greatest risk for acquiring a urinary tract infection? - ANS: Placing the drainage bag on the side rail of the patient's bed.
30. A nurse notifies the provider immediately if a patient with an in-dwelling catheter does which of the following? - ANS: Has not collected any urine in the drainage bag for 2 hours.
31. The nurse would question an order to insert a urinary catheter in which patient? - ANS: A 30-year- old patient requiring drug screening for employment.
32. When caring for a hospitalized patient with a urinary catheter, which nursing action best prevents the patient from acquiring an infection? - ANS: Performing hand hygiene before and after providing perineal care.
33. An 86-year-old patient asks the nurse what lifestyle changes will reduce the chance of a urinary tract infection. Which response is accurate? - ANS: Increasing consumption of acidic foods such as cranberry juice will reduce the chance of infection.
34. A nurse is providing education to a patient being treated for a urinary tract infection. Which of the following statements by the patient indicates an understanding? - ANS: "My medication may discolour my urine; this should resolve once the medication is stopped."
35. To reduce patient discomfort during closed-catheter irrigation, what should the nurse do? - ANS: Use room temperature irrigation solution.
36. Which observation by the nurse best indicates that bladder irrigation for urinary retention has been effective? - ANS: An output that is larger than the amount instilled.
37. The nurse anticipates urinary diversion from the kidneys to a site other than the bladder for which patient? - ANS: A 12-year-old girl with severe abdominal trauma.
38. Which of the following symptom is most closely associated with uremic syndrome? - ANS: Headache.

39. The nurse understands that peritoneal dialysis and hemodialysis involve which of the following processes to clean the patient's blood? - ANS: Osmosis and diffusion. A female patient reports that she is experiencing burning on urination, frequency, and urgency. The nurse notes that a clean-voided urine specimen is markedly cloudy. Which of the following is the probable cause of these symptoms and findings? - ANS: Cystitis Hospital-acquired urinary tract infections (UTIs) are most often related to poor hand hygiene and which of the following? - ANS: Improper catheter care. To minimize nocturia, when should patients avoid fluids? - ANS: For 2 hours before bedtime. A Foley catheter drainage bag is placed below the bladder to prevent which of the following? - ANS: Urinary reflux. When a condom catheter is applied, the catheter should be secured on the penile shaft in such a manner that the catheter is which of the following? - ANS: Snug and secure but without causing constriction that impedes blood flow. Correct A patient undergoes ultrasonography of a kidney. The nurse providing postprocedure care remembers that which of the following is true regarding precautions that should be taken for this procedure? - ANS: No special precautions must be taken. A patient underwent total knee replacement and was placed on patient-controlled analgesia. The patient has been activating the medication button an average of four times per hour. The nurse has assisted the patient on and off the bedpan two or three times an hour for the past 2 hours. Urine output was about 50 mL with each void. The nurse now begins to suspect which of the following? - ANS: Retention overflow. The nurse recognizes that which organism most frequently causes UTIs in women? - ANS: Escherichia coli A patient is scheduled for intravenous pyelography (IVP). Before the test, the most important assessment the nurse performs is asking about which of the following? - ANS: Allergies to shellfish.

A 34-year-old man is in hospital rehabilitating from a spinal cord injury. He is incontinent of urine at regular intervals. He is unaware when he is incontinent. This describes which of the following types of incontinence? - ANS: Reflex incontinence. Urine may appear concentrated and cloudy because of the presence of white blood cells or which of the following? - ANS: Bacteria After undergoing transurethral prostatectomy, a patient returns to his room with a triple-lumen indwelling catheter for continuous bladder irrigation. The irrigation fluid is normal saline delivered at a rate of 150 mL/hour. After 8 hours, the nurse empties the drainage bag, which contains a total of 2520 mL. Of the total fluid output, how much is urine? - ANS: 1320 mL. An obstruction to the flow of urine in the urinary collecting system may cause which of the following? (Select all that apply.) - ANS: Renal damage. Urinary retention. UTI. A female patient is having difficulty voiding after a vaginal delivery. The nurse implements which of the following interventions to promote voiding? (Select all that apply.) - ANS: Turning the water tap on. Ambulating the patient to the bathroom. Trickling warm water over the mons pubis. A patient reports to the nurse that he wakes up early because of a need to urinate. The nurse recommends that the patient avoid which of the following liquids after 8:00 P.M.? (Select all that apply.)

• ANS: Tea. Cola. Wine. Coffee. A patient with multiple sclerosis is being taught how to perform self-catheterization. As part of this teaching, the nurse instructs the patient to do which of the following? (Select all that apply.) - ANS: Increase intake of fluids.

Always use clean technique.