PrepU

During data collection, the client expresses concern over a change in the color of the urine from tea-colored to green since beginning a new medication. Which appropriate question would the nurse ask this client? -"Are you taking any B-complex vitamins?" -"Are you taking levodopa?" -"Are you taking phenazopyridine?" -"Are you taking a diuretic?"

"Are you taking any B-complex vitamins?"

The nurse educator is presenting a lecture on clients at risk for developing urinary tract infections (UTIs). Which response made by the staff nurse would indicate to the educator a need for further teaching? -"A woman using an intrauterine device for contraceptive reason is at risk for developing a UTI." -"I will make sure to teach my clients with diabetes mellitus to control their glucose level to help prevent a UTI." -"Having sexual relationships does not put a woman at risk for developing a UTI." -"Due to the physiologic changes with aging, the elderly are at risk for developing a UTI."

"Having sexual relationships does not put a woman at risk for developing a UTI."

A client is diagnosed with frequent urinary tract infections. What would be an appropriate question for the nurse to ask the client? -"How often do you have a bowel movement?" -"Are you on any type of special diet at home?" -"Are you on any blood pressure medications?" -"How frequently do you urinate each day?"

"How frequently do you urinate each day?"

The experienced nurse is observing a new nurse who is preparing to catheterize a female client. Which statement by the new nurse requires immediate intervention by the experienced nurse? -"I will use clean gloves to handle the catheter and other equipment." -"The client will be placed in a reclining position with knees bent." -"Washing hands before and after the procedure is important." -"I will place a bath blanket over the client to provide privacy."

"I will use clean gloves to handle the catheter and other equipment."

The health care provider has prescribed an indwelling catheter for a 48-year-old male client who is in traction with leg fractures. Which information will the nurse give the client when he states not wanting the indwelling catheter? -"Indwelling catheters do not hurt, and I will be careful placing it." -"This is the only option for catheterization." -"Let me talk to your health care provider about a condom catheter." -"This is what your health care provider has prescribed."

"Let me talk to your health care provider about a condom catheter."

A 70-year-old client confides to the nurse that she is "terribly embarrassed" that she has developed urinary incontinence over the past year. Which nursing response supports the client's self-esteem? -"Don't worry, this is a normal condition for older adults." -"Let me refer you to a urologist who can help you." -"It would be best just to get some adult diapers." -"Let's explore structuring activities and toileting breaks."

"Let's explore structuring activities and toileting breaks."

The parent of a 5-year-old child tells the nurse that on two occasions her son has lost control of urination when he had to wait to go to the bathroom at school. What is the appropriate nursing response? -"This is extremely abnormal. You will need to see your son's pediatrician." -"Let's review the types of fluids that your child drinks in the morning." -"I would only worry about this if you were raising a daughter." -"It would be appropriate to place your son in incontinence undergarments."

"Let's review the types of fluids that your child drinks in the morning."

The nurse is preparing to insert an indwelling urinary catheter into a female client's bladder. The nurse has opened the sterile catheterization tray using sterile technique, donned sterile gloves and has opened all sterile supplies. Arrange the following steps in the correct order. -1 Clean each labial fold, then the area directly over the meatus. -2 Inflate the balloon with the correct amount of sterile saline. -3 Advance the catheter until there is a return of urine. -4 Discard used supplies. -5 Insert the lubricated catheter into the urethra.

-1 Clean each labial fold, then the area directly over the meatus. -5 Insert the lubricated catheter into the urethra. -3 Advance the catheter until there is a return of urine. -2 Inflate the balloon with the correct amount of sterile saline. -4 Discard used supplies.

The client is preparing to obtain a clean-catch midstream urine specimen. Place in order the steps needed to complete the diagnostic test. Use all options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. -1 Clean the area surrounding the urinary meatus with the provided cloth. -2 Submit collected specimen to the health care professional. -3 Void a small amount into toilet or bedpan. -4 Provide instruction to the client. -5 Void into the provided collection device. -6 Secure the lid on the specimen container.

-4 Provide instruction to the client. -1 Clean the area surrounding the urinary meatus with the provided cloth. -3 Void a small amount into toilet or bedpan. -5 Void into the provided collection device. -6 Secure the lid on the specimen container. -2 Submit collected specimen to the health care professional.

During the well-child checkup for 2-year-old twins (one boy, one girl), their mother asks the nurse about preparing to toilet train the children. What information can be provided to the parent? Select all that apply. -Daytime incontinence is not a concern while toilet training -Nighttime continence will occur in some children after age 4 or 5 years. -Children who are able to remain dry for a few hours at a time may be signaling readiness for toilet training. -Children old enough to undress themselves will have increased abilities to toilet train. -It is typically more difficult to toilet train a female child.

-Daytime incontinence is not a concern while toilet training -Children who are able to remain dry for a few hours at a time may be signaling readiness for toilet training. -Children old enough to undress themselves will have increased abilities to toilet train.

The nurse is caring for a client diagnosed with a urinary tract infection. The primary care provider orders include an antibiotic, an antipyretic, and a urine culture and sensitivity, and urine specimen for nitrates. Which actions should the nurse take? Select all that apply. -Obtain the urine specimens before beginning the ordered antibiotic. -Place the collected specimen with proper label in a biohazard bag and send it to the lab after collection. -Administer the antipyretic before obtaining the urine culture and sensitivity. -Collect the first void clean urine specimen since the client presented in the emergency department at 0500. -Instruct the client on the midstream urine collection process.

-Obtain the urine specimens before beginning the ordered antibiotic. -Place the collected specimen with proper label in a biohazard bag and send it to the lab after collection. -Collect the first void clean urine specimen since the client presented in the emergency department at 0500. -Instruct the client on the midstream urine collection process.

Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine? -random specimen -intermittent specimen -clean-catch specimen -24-hour specimen

24-hour specimen

The nurse is caring for an older adult client suspected of having a urinary tract infection. The nurse should assess for what finding specifically associated with the development of this condition in the older adult? -High fever -Dysuria -Nausea -Acute confusion

Acute confusion

The health care provider has prescribed an indwelling catheter for a client. When the nurse explains the procedure, the client refuses to allow placement of the catheter. Which action should the nurse take? -Ask the client why he or she does not want a catheter. -Continue to place the indwelling catheter because it has been prescribed. -Gather appropriate supplies to teach the client to perform straight catheterization. -Inform the client that the health care provider will be contacted.

Ask the client why he or she does not want a catheter.

A nurse is caring for a client with a hemodialysis access site. Which action should the nurse take? -Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration. -Administer an IV on the arm high above the access site. -Measure the client's blood pressure on the arm above the access site. -Perform venipuncture below the access site to obtain a blood sample for laboratory testing.

Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration.

The nurse is caring for a client who has a history of renal failure. What is an accurate step when caring for the client's hemodialysis access? -Auscultate over the site with a stethoscope to listen for a bruit. -Use the affected arm if an IV must be started to avoid impairment of both arms. -If a thrill is not palpable and/or a bruit is not detectable, assess for these signs in the other arm. -Percuss the site to feel for a thrill or vibration.

Auscultate over the site with a stethoscope to listen for a bruit.

The health care provider notifies a client of a diagnosis of glycosuria. Which additional assessment information will the nurse obtain from the client next? -Blood pressure -Blood sugar -Intake and output -Frequency of urine

Blood sugar

The nurse is teaching an older adult female client who must provide a urine specimen. Which is the proper method to instruct the client to use to obtain a clean-catch urine specimen? -Catch the urine in the cup after cleansing the perineum. -Catch the urine while holding the labia apart, then cleanse each side of the labia with prepared aseptic swabs. -Catch the urine while holding the labia apart, after cleansing. Fill the specimen cup. -Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet.

Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet.

When preparing to irrigate a Foley catheter, which is the appropriate initial nursing action? -Explain the procedure to the client. -Gather equipment and supplies. -Assess urine characteristics. -Check health record for provider's orde

Check health record for provider's order.

A client could experience increased urination when using which classification of medication? -Analgesic medications -Central nervous system depressants -Cholinergic agents -Stool softeners

Cholinergic agents

A nurse is the guest speaker at a women's club. Most of the women are older than 40 years of age and have asked the nurse to speak about health promotion topics. The nurse states that exercises may help with urinary urgency. Which exercise instruction will the nurse provide to the women? -Contract abdominal muscles 10 times per day. -Squat down and then jump up to a standing position. -Lie on the floor, raise, then lower your legs 20 times per day. -Contract the pubic muscles for 3 seconds, then relax.

Contract the pubic muscles for 3 seconds, then relax.

An older adult client informs the nurse that they are experiencing urinary incontinence. The client has no other health problems, and states, "I don't want anybody to know about this problem." How will the nurse promote the client's self-esteem? -Encourage the client to confide in family members and tell them about the accidents. -Discuss the use of protective undergarments to avoid embarrassment from incontinence. -Tell the client that this happens to all people when they get older. -Inform the client that this is not normal and make a referral to a urologist.

Discuss the use of protective undergarments to avoid embarrassment from incontinence.

The nurse is performing a portable bladder ultrasound on a client who has palpable bladder distention. The scanner reveals little urine in the bladder. What should the nurse do next? -Have the client drink 8 ounces of water every 15 minutes for 1 hour. -Place the client on either side and rescan. -Ensure proper positioning of the scanner head and rescan. -Wipe off some of the ultrasound gel and rescan.

Ensure proper positioning of the scanner head and rescan.

A nurse is caring for a client with an external condom catheter. Which guideline should be implemented when applying and caring for this type of catheter? -Ensure the tip of the tubing is touching the tip of the client's penis. -Wipe the penis thoroughly with an alcohol swab and dry thoroughly before application. -Fasten the condom securely enough to prevent leakage without constricting blood flow. -Remove the catheter every 8 hours, or more often in humid weather.

Fasten the condom securely enough to prevent leakage without constricting blood flow.

A male client is being transferred to the hospital from a long-term care facility with a diagnosis of dehydration and urinary bladder infection. His skin is also excoriated from urinary incontinence. Which nursing diagnosis is most appropriate for this client? -Urinary Incontinence related to urinary tract infection -Impaired Skin Integrity related to urinary bladder infection and dehydration -Impaired Skin Integrity related to functional incontinence -Risk for Urinary Tract Infection related to dehydration

Impaired Skin Integrity related to urinary bladder infection and dehydration

A home care nurse visits a client diagnosed with depression who informs the nurse that he has been prescribed amitriptyline. What would the nurse include when educating the client about the effects of this medication? -It decreases sensation of bladder fullness. -It causes urinary retention. -It decreases glomerular filtrate rate. -It causes urine to turn blue-green.

It causes urine to turn blue-green.

The nurse is working with a client who requires continence training. Which client teaching about pelvic floor muscle exercises (Kegel exercises) will the nurse include? -Loosen the internal muscles used to prevent or interrupt urination. -Perform these exercises two times daily for a week. -Relax muscles for at least 5 minutes between Kegels. -Keep muscles contracted for at least 10 seconds.

Keep muscles contracted for at least 10 seconds.

The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate? -Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. -Remove the catheter from the vagina and attempt to insert it into the bladder. -Ask the client to bear down until the catheter is expelled. -Immediately remove the catheter from the vagina, contact the health care provider, and anticipate a prescription for prophylactic antibiotics.

Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter.

A nurse is maintaining a client's continuous bladder irrigation. When appraising the effectiveness of this therapy, the nurse should prioritize what assessment? -Assessing PVR using a bladder scanner -Palpating the client's bladder region -Monitoring the characteristics of the urinary output -Calculating the flow rate of urinary output

Monitoring the characteristics of the urinary output

A client is suspected of having a disease process affecting the functional unit of the kidney. Which structure is most likely involved? -Bowman's capsule -Glomerulus -Loop of Henle -Nephron

Nephron

A client with an emergently placed central venous catheter (CVC) is to have emergent hemodialysis. Upon assessment of the CVC the nurse visualizes redness, drainage, and odor to the area around the CVC. Palpation of the surrounding skin causes the client pain. Which intervention is the priority? -Notifying the health care provider of the assessment findings -Checking for blood return in the CVC -Obtaining laboratory studies -Placing the client as N.P.O. status

Notifying the health care provider of the assessment findings

The nurse is collecting a clean-catch specimen from a client. Which nursing action is performed correctly in this procedure? -Position the container near the meatus, and collect at least 10 mL of urine. -Collect the first 10 mL of urine voided in the sterile specimen container. -Continue collecting the urine in the container until the bladder is empty. -Don sterile gloves

Position the container near the meatus, and collect at least 10 mL of urine.

While providing care to a client admitted to the health care facility, the client states that she has "a burning sensation when urinating." After further questioning, the nurse inspects the client's perineal area. Which sign/symptom would the nurse document as an abnormal finding? -Reddened perineal skin -Moist perineal skin -Absence of discharge -Presence of smegma

Reddened perineal skin

A client who visits a health care facility for a routine assessment reports to the nurse being unable to control urinary elimination. This has resulted in the client soiling clothes and has led to a lot of embarrassment. Which nursing intervention will be appropriate to use with this client? -Fluid restriction -Indwelling catheterization -Regular toileting routine -Encouraging the client to stay close to home

Regular toileting routine

The health care provider requests an indwelling urinary catheter to be inserted into a woman who has had a total hip replacement and is on strict bed rest. When inserting the catheter, the nurse would place the client in which position? -Supine -Dorsal recumbent -Semi-Fowler -Sims

Sims

The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client? -A neurogenic bladder results from local anesthesia. -A urinary tract infection results from the birth process. -The birth can cause perineal swelling. -Catheterization is necessary for 1 week.

The birth can cause perineal swelling.

The clinic nurse is collecting data from a female client with frequent, recurrent urinary tract infections who was discharged from the hospital. Which data collection would indicate to the nurse that the client is adhering to discharge instructions? -The client drinks eight 8-oz glasses of cranberry juice daily. -Since the client is symptom-free, she no longer takes the prescribed antibiotics. -The client drinks two glasses of water before and after sexual intercourse. -The client soaks in the bathtub daily for perineal care.

The client drinks two glasses of water before and after sexual intercourse.

The nurse caring for an older adult male client is determining whether the client can use a urinal to void. Which aspects of the client's medical history may contraindicate the use of a urinal? -The client has a history of benign prostatic hyperplasia (BPH; prostate enlargement). -The client was treated for kidney stones a few months earlier. -The client is acutely confused and has been diagnosed with delirium. -The client has had urinary catheters in place repeatedly during previous admissions.

The client is acutely confused and has been diagnosed with delirium.

A nurse is preparing a discharge teaching plan for a client being sent home with a peritoneal dialysis catheter in place. Which guideline should be included in the instructions? -The client should avoid wearing tight clothes or belts near the site. -A dressing should always be worn over the site to avoid leaking. -The client may bathe rather than shower, provided the site is covered with gauze. -Sterile technique must be observed by the client in the home setting.

The client should avoid wearing tight clothes or belts near the site.

A nurse is caring for a client who has just undergone surgery to create an ileal conduit for urinary elimination via a stoma. Which fact about this procedure should the nurse mention to the client? -The client will need to change the urinary pouch every 4 hours. -The client will have to wear an external appliance to collect urine. -This urinary diversion is only temporary. -Urination can be voluntarily controlled after the stoma heals from the initial surgery.

The client will have to wear an external appliance to collect urine.

The nurse mentor is observing a novice nurse preparing to insert an indwelling catheter for a female client with urinary retention. The mentor would intervene if which action by the novice nurse is noted? -The novice nurse selects an 18 French Foley catheter to insert. -The novice nurse asks the client to take a deep breath when resistance was met during insertion of the catheter. -The novice nurse places a trash receptacle within easy reach. -The novice nurse assists the client to a dorsal recumbent position with knees flexed, feet about 2 ft (0.6 m) apart.

The novice nurse selects an 18 French Foley catheter to insert.

The nurse is teaching a client how to perform pelvic floor muscle exercises (Kegel exercises). Which teaching will the nurse include? -Perform these exercises 10 times daily for 1 month. -Relax muscles for at least 1 minute between contractions. -Tighten the internal muscles used to prevent or interrupt urination. -Keep muscles contracted for at least 30 seconds.

Tighten the internal muscles used to prevent or interrupt urination.

Use of an indwelling urinary catheter leads to the loss of bladder tone. -False -True

True

The nurse is choosing a collection device to collect urine from a nonambulatory male client. What would be the nurse's best choice? -Urinal -Specimen hat -Large urine collection bag -Bedpan

Urinal

The nurse is caring for a client with an indwelling urinary catheter secondary to neurogenic bladder. The nurse completes a prescription to obtain a urine specimen from the catheter. After reviewing the image, what is the most accurate narrative note the nurse would document to demonstrate the steps to obtain the urine specimen were performed appropriately? -Cleansed access port with warm soap and water, syringe attached and aspirated 10 mL of urine and placed in specimen container. -Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well. -Obtained urine specimen from urinary drainage bag using a syringe, client expressed no discomfort during or after the procedure, verified prescription and cleansed access port. -Gathered supplies, checked prescription, collected urine from access port and notified health care provider at the completion of the procedure.

Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well.

A nurse is preparing to measure a client's urine output. Which interventions would be of highest priority? -Measuring the urine container at eye level -Wearing gloves when handling the urine -Noting the color and clarity of the urine -Using an appropriate measuring container

Wearing gloves when handling the urine

A sterile urine specimen for culture and sensitivity has been prescribed for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? -Empty the collection bag, wait 30 minutes, and then collect the contents of the collection bag. -Collect a urine specimen from the collection bag first thing in the morning, or a few hours after the client receives a diuretic. -Discontinue the indwelling catheter and insert an intermittent catheter to obtain the sterile specimen. -Withdraw several milliliters of urine from the port on the collection tubing, using aseptic technique.

Withdraw several milliliters of urine from the port on the collection tubing, using aseptic technique.

A woman is reporting bladder urgency. It is most important to assess: -vitamin supplements. -weight. -exercise. -caffeine intake.

caffeine intake.

The nurse is preparing a client for a cystoscopy procedure. Which intervention would be part of the preparation? -maintaining the client without liquids before the procedure -inserting a Foley catheter the morning of the procedure -explaining to the client that the procedure will be painful -checking that the client has signed a consent form for the procedure

checking that the client has signed a consent form for the procedure

The nurse is caring for a client who reports burning upon urination, and an ongoing sense of needing to urinate. Which urine characteristics does the nurse anticipate? -cloudy, foul odor -clear, dark amber -strongly aromatic, amber -light yellow, clear

cloudy, foul odor

During his stay in the hospital, a male client has established a pattern of maintaining urinary continence during the day, but he is experiencing incontinence at night. What intervention should the nurse implement in this client's care? -toileting the client every 2 hours -intermittent catheterization at bedtime -condom catheter -indwelling catheter

condom catheter

A client has been NPO. after midnight for surgery. It is 11 a.m. and the nurse has asked her to void before being transferred to the surgical suite. The nurse should expect her urine to be what color? -tea colored -pale yellow -colorless -dark amber

dark amber

A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain? -clear, light yellow -reddish-brown, clear -dark brown, cloudy -aromatic, green

dark brown, cloudy

The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate? -hypovolemia -renal failure -balanced fluids -dehydration

dehydration

A 57-year-old man is suffering from polyuria. What can cause polyuria? -renal disease -urinary tract infection -diabetes insipidus -renal calculi

diabetes insipidus

A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample? -evening -before bedtime -first thing in the morning -afternoon

first thing in the morning

The nurse observes that a client frequently experiences urine loss when being transferred from a chair to the bed. Which type of incontinence does the nurse identify that the client is experiencing? -total -urge -functional -reflex

functional

A client in a long-term care facility becomes confused and disoriented at night and is incontinent during these periods of confusion due to the inability to find the commode. During the day, the client does not experience confusion and is continent. What type of incontinence is this client experiencing during the nighttime hours? -transient incontinence -stress incontinence -functional incontinence -reflex incontinence

functional incontinence

A client at a health care facility has been diagnosed with polyuria. How would the nurse describe the client's condition in the medical record? -inadequate elimination of urine -absence of urine -greater than normal urinary volume -difficult or uncomfortable voiding

greater than normal urinary volume

A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance? -indwelling urethral catheter -Foley catheter -intermittent urethral catheter -retention catheter

intermittent urethral catheter

A client at the health care facility has been diagnosed with total urinary incontinence. How could the nurse describe the condition of the client? -loss of small amount of urine when intra-abdominal pressure rises -need to void is perceived frequently, with short-lived ability to sustain control of flow -loss of urine without any identifiable pattern or warning -loss of urine control because a toilet is not accessible

loss of urine without any identifiable pattern or warning

A client at a health care facility is being treated for cancer of the bladder. The physician uses a urinary diversion to help the client with urinary elimination. What describes a urinary diversion? -inability to control either urinary or bowel elimination -one or both of the ureters are surgically implanted elsewhere -use of a catheter to collect urine in a sterile environment -hygiene measures used to keep meatus and adjacent area of the catheter clean

one or both of the ureters are surgically implanted elsewhere

A client reports to the nurse that after delivering a baby, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate? -reflex -urge -total -stress

stress