RNRS 117- Urinary Elimination Sherpath (Exam II)
An obese patient reports leaking urine while coughing. Which management strategy should be included in the patient's treatment plan? Select all that apply. Adequate fluid intake Kegel exercises Heavy weight lifting Weight control measures Caffeinated beverages
Kegel exercises Weight control measures
The patient's urine specific gravity is 1.05. The urine tests positive for ketone bodies. Which condition is a possible cause? Select all that apply. Starvation Dilute urine Dehydration Overhydration Diabetes mellitus
Starvation Dehydration Diabetes mellitus
A nurse is assessing the severity of a patient's urinary elimination problem. Which question is most appropriate for the nurse to ask? "Does your urinary problem restrict you from doing your usual activities?" "Do you dribble urine before voiding, after voiding, or at other times?" "Have you been hospitalized or have you received a diagnosis of a new medical problem recently?" "How often are you awakened with the urge to void while you are sleeping?"
"How often are you awakened with the urge to void while you are sleeping?"
The patient states that she "loses urine" every time she laughs or coughs. The nurse teaches the patient measures to regain urinary control. Which statement by the patient indicates the need for further teaching? "I will perform my Kegel exercises every day." "I joined a weight loss program." "I drink two glasses of wine with dinner." "I have tried urinating every 3 hours."
"I drink two glasses of wine with dinner."
A nurse is educating a patient who has altered urinary elimination on how to maintain a healthy bladder. Which statement by a patient indicates a need for further education? Select all that apply. "I'll drink 6-8 glasses of water a day." "I'll avoid drinking beverages that contain caffeine." "I'll avoid drinking fluids 4 hours before bedtime to decrease nocturia." "I'll immediately tell my doctor if I experience pain when voiding." "After each voiding and bowel movement, I'll cleanse my perineum from back to front."
"I'll avoid drinking fluids 4 hours before bedtime to decrease nocturia." "After each voiding and bowel movement, I'll cleanse my perineum from back to front."
A patient tells a nurse "I lose small amounts of urine while coughing, laughing, exercising, and walking but not at night while sleeping." Which response by the nurse is most appropriate? "You may require intermittent catheterization." "You should avoid caffeine, artificial sweeteners, and alcohol." "I'll teach you pelvic muscle exercises that you can perform regularly to address the problem." "You can perform urge-inhibition exercises to obtain relief from symptoms of urinary incontinence."
"I'll teach you pelvic muscle exercises that you can perform regularly to address the problem."
Which statement by a student nurse regarding urinary incontinence requires correction? "Urinary incontinence is common in older adults." "Urge incontinence and stress incontinence are common forms of urinary incontinence." "Urinary incontinence is characterized by an involuntary loss of urine." "Mixed incontinence is a combination of stress and functional incontinence."
"Mixed incontinence is a combination of stress and functional incontinence."
Which instruction regarding bladder training would be included in the teaching plan for the family of a patient who is incontinent because of a stroke? "Use an indwelling catheter at night to prevent accidents." "Offer the patient the commode or urinal every 2 hours." "Decrease the patient's oral fluid intake to 1 L per day." "Instruct the patient to hold the urine as long as possible to restore bladder tone."
"Offer the patient the commode or urinal every 2 hours."
A registered nurse is educating nursing students about the factors that influence urination. Which statement by a student nurse indicates a need for further education? "Patients with anxiety and stress may have increased frequency of voiding." "Patients who take atropine may have an increased risk of urinary retention." "Patients who undergo lower abdominal surgery may require the temporary use of an indwelling urinary catheter." "Patients with pathological conditions such as arthritis and dementia may experience either bladder overactivity or deficient bladder emptying."
"Patients with pathological conditions such as arthritis and dementia may experience either bladder overactivity or deficient bladder emptying."
A 55-year old man is admitted to the hospital with urinary retention. The health care provider prescribes catheterization for the patient. When setting up the supplies for catheterization would the nurse select for this patient? 8 Fr 10 Fr 14 Fr 18 Fr
14 Fr
While performing continuous bladder irrigation, a nurse assesses the patient's urine for color, amount, clarity, and the presence of mucus, blood clots, or sediment. What is the nurse looking for? Bladder spasms A need for further patient instruction Accurate urine output measurements A need for increased irrigation rate to prevent bleeding
A need for increased irrigation rate to prevent bleeding
Which patient would the nurse anticipate to require the use of a short or long-term urinary catheter? Select all that apply. A patient who has chronic urinary retention A patient who has reflex urinary incontinence A patient who has stress urinary incontinence A patient who needs accurate monitoring of urine output after a gynecological procedure A patient who is unable to completely empty the bladder because of a neurological condition
A patient who needs accurate monitoring of urine output after a gynecological procedure A patient who is unable to completely empty the bladder because of a neurological condition
Which patient is most likely to exhibit symptoms such as dysuria, urgency, frequency, and nocturia? A patient with kidney failure A patient receiving diuretic therapy A patient with a urinary tract infection A patient with uncontrolled diabetes mellitus
A patient with a urinary tract infection
The patient is incontinent, and a condom catheter is placed. The nurse should take which action? Secure the condom with adhesive tape Change the condom every 48 hours Assess the patient for skin irritation Use sterile technique for placement
Assess the patient for skin irritation
A nurse is caring for an elderly patient who has recently started taking an antimuscarinic medication to treat urinary incontinence. Which nursing intervention is most important in the situation? Teaching pelvic muscle exercises Assessing the patient for mental status changes Reminding the patient to drink adequate amounts of water Instructing the patient to restrict fluid intake 2 hours before bedtime
Assessing the patient for mental status changes
A nurse is assisting the health care provider assess a patient with altered urinary elimination. After assessing the patient, the health care provider suspects that the patient has an obstruction of the ureters. Which diagnostic test does the nurse expect the patient to undergo? Cystoscopy Abdominal roentgenogram Ultrasound of the urinary bladder Axial computed tomography scan
Axial computed tomography scan
The nurse is caring for a patient with urinary incontinence. Which action would the nurse perform to promote comfort for the patient? Select all that apply. Change dressings & linens when wet. Limit fluid intake. Use absorbent pads. Increase coffee intake. Catheterize the patient.
Change dressings & linens when wet. Use absorbent pads. Catheterize the patient.
The nurse is caring for a patient with urinary incontinence. Which action would the nurse perform to promote comfort for the patient? Select all that apply. Change dressings and linens when wet Limit fluid intake Use absorbent pads Increase coffee intake Catheterize the patient
Change dressings and linens when wet Use absorbent pads Catheterize the patient
The nurse notes that the patient's indwelling catheter bag has been empty for 4 hours. Which action is priority? Irrigate the indwelling catheter. Check for kinks in the tubing. Notify the health care provider. Assess the patient's intake.
Check for kinks in the tubing.
How would the nurse position a female patient for examining the genitalia for inflammation and infection related to urinary elimination problems? Supine Fowler's Squatting Dorsal recumbent
Dorsal recumbent
How would the nurse position a female patient for examining the genitalia for inflammation and infection related to urinary elimination problems? Supine Fowler's Squatting Dorsal recumbent
Dorsal recumbent
A 70-year-old woman complains about involuntary passage of urine. The leakage of urine occurs in small amounts and is more frequent when she coughs. The nursing assessment reveals that the patient is obese, has had 3 pregnancies, and has already gone through menopause. The nurse understands that the patient is at an increased risk of developing a urinary tract infection. Which nursing intervention can help prevent a urinary tract infection in the patient? Select all that apply. Emphasize reduced fluid intake. Emphasize wearing cotton underwear. Emphasize the need for continuous bladder catheterization. Promote complete emptying of bladder by double voiding. Emphasize the importance of perineal hygiene.
Emphasize wearing cotton underwear. Promote complete emptying of bladder by double voiding. Emphasize the importance of perineal hygiene.
A nurse is caring for a patient who is receiving treatment for a urinary elimination problem. After a few days of taking the prescribed medications, the patient reports a dry mouth, constipation, and blurred vision. Which medication is the most likely cause of the patient's symptoms? Atropine Mirabegron Fesoterodine Phenezopyridine
Fesoterodine
The nurse is reviewing the laboratory report of a patient. The presence of which substance in the urine hints at the possibility of an abnormality? Protein, 6 mg/mL Glucose, 2+ Red blood cells, 2 White blood cells, 4
Glucose, 2+
A patient who has undergone urological surgery is prescribed urinary catheterization. Which diameter of catheter does the nurse anticipate will be used for this patient? 5 to 6 Fr 8 to 10 Fr 12 Fr Greater than 16 Fr
Greater than 16 Fr
A patient who presents with dribbling of urine is diagnosed with stress incontinence. Which datum would the nurse include in the assessment of this patient? Select all that apply. Height & weight History of osteoarthritis Menopausal status Number of live births Alcohol use
Height & weight Menopausal status Number of live births
An older male patient states that he is having problems starting and stopping his stream of urine and he feels the urgency to void. The best way to assist this patient is to: Help him stand to void. Place a condom catheter. Have him practice the Credé method. Initiate Kegel exercises.
Help him stand to void.
What should the nurse include in the plan of care for a patient with urge urinary incontinence? Helping the patient learn efficient and safe toilet transfers Helping the patient with leg-strengthening exercises Helping the patient strengthen the pelvic floor muscles and learn fluid and food modifications Helping the patient obtain assistive devices for the home that are covered by insurance
Helping the patient strengthen the pelvic floor muscles and learn fluid and food modifications
The nurse receives a prescription to obtain a postvoid residual for a patient via catheterization. Which method to obtain this measurement is best? Intermittent catheterization Long-term indwelling catheterization Short-term indwelling catheterization Medium-term indwelling catheterization
Intermittent catheterization
A nurse is caring for a patient with an indwelling catheter. Which nursing action may increase the risk of a catheter-associated urinary tract infection? Collecting specimens via a port in the tubing. Keeping the drainage bag above the level of the bladder. Allowing the patient to wear a leg bag while ambulating. Monitoring the drainage system to prevent backflow of urine.
Keeping the drainage bag above the level of the bladder.
Which symptom would the nurse anticipate in a patient with urge urinary incontinence? Select all that apply. Distended bladder on palpation Leaks on the way to the bathroom Leaks without awareness Strong urge or leaks upon hearing water running Loss of a small volume of urine while coughing or laughing
Leaks on the way to the bathroom Strong urge or leaks upon hearing water running
A patient is being assessed for a possible urinary tract infection (UTI). Before sending a urinalysis specimen to the laboratory, the nurse collects a small amount of urine to perform a dipstick test. If the patient has a UTI, which component should be detected in the urine? Protein Glucose Ketones Leukocytes
Leukocytes
A nurse is caring for a patient with a spinal cord injury who reports an absence of awareness of bladder filling and the urge to void. A family member adds that the patient also sometimes has leakage of urine without awareness. Which nursing intervention is most important for the patient? Placing an indwelling catheter. Monitoring for autonomic dysreflexia. Encouraging the patient to perform pelvic muscle exercises. Monitoring the postvoid residual volume according to the health care provider's direction.
Monitoring for autonomic dysreflexia.
A nurse instructs an elderly patient to restrict fluid intake 2 hours before bedtime. Which complication is the nurse trying to reduce? Nocturia Urinary retention Urinary tract infection Stress urinary incontinence
Nocturia
A nurse is caring for an elderly patient who is receiving treatment for urinary incontinence. After reviewing the patient's prescription, the nurse knows to observe the patient for cognitive impairment. Which medication is the patient most likely taking? Atropine Diuretics Oxybutinin Phenazopyridine
Oxybutinin
Which intervention is most appropriate for a patient with a functional urinary incontinence? Insert an indwelling catheter. Increase fluid intake to flush the kidneys. Provide normal fluid intake and establish a toilet schedule. Restrict fluid intake to decrease the episodes of incontinence.
Provide normal fluid intake and establish a toilet schedule.
After assessing a patient with urinary incontinence, the health care provider confirms that the patient is at risk of a life-threatening condition that causes severe elevation of the blood pressure and pulse rate as well as diaphoresis. Which type of of urinary incontinence does this patient have? Transient incontinence Stress urinary incontinence Reflex urinary incontinence Urgency urinary incontinence
Reflex urinary incontinence
The nurse notices pus in the catheter of a patient who had an indwelling catheter inserted 4 days ago. Which nursing measure is appropriate for this patient? Irrigating the catheter with 10 mL of water Replacing the catheter with a new one Irrigating the catheter with antiseptic solution Milking the catheter from proximal end to distal end
Replacing the catheter with a new one
A patient reports having the urge to void, but urine starts leaking before the patient reaches the bathroom. Which treatment strategy would be helpful for this patient? Select all that apply. Scheduled toileting Absorbent products Electrical stimulation Clothing modification Antomuscarinic agents
Scheduled toileting Absorbent products Clothing modification
A patient who is a smoker complains of involuntary passage of urine after a strong sense of urgency to void. Which nursing intervention would be helpful to this patient? Select all that apply. Crede method Smoking cessation Intermittent catheterization Antimuscarinic agents Behavioral interventions
Smoking cessation Antimuscarinic agents Behavioral interventions
The nurse is reviewing laboratory results for patient and notices the urine tested positive for ketones. Which underlying factor may lead to the presence of urinary ketone bodies? Select all that apply. Epilepsy Starvation Dehydration Hyperthyroidism Uncontrolled diabetes mellitus
Starvation Dehydration Uncontrolled diabetes mellitus
A male patient returned from the operating room 6 hours ago with a cast on his right arm. He has not yet voided. Which action would be most beneficial in assisting the patient to void? Suggest that he stand at the bedside. Stay with the patient. Give him the urinal to use in bed. Tell him that if he does not urinate he will be catheterized.
Suggest that he stand at the bedside.
A 70-year-old woman complains about involuntary passage of urine. The leakage of urine occurs in small amounts and is more frequent when she coughs. The nursing assessment reveals that the patient is obese, has had three pregnancies, and has already gone through menopause. Which nursing interventions would help this patient reduce incontinence? Advise the patient to suppress coughs. Teach the patient Kegel exercises. Advise the patient to avoid caffeinated drinks. Stress the importance of losing eight. Encourage lifting heavy weight to increase muscle strength.
Teach the patient Kegel exercises. Advise the patient to avoid caffeinated drinks. Stress the importance of losing weight.
While caring for a female patient with altered urinary elimination, the nurse instructs the patient to assume a squatting position when voiding. Which rationale is the reason behind the recommendation? To prevent infections To promote normal micturition To promote complete bladder emptying To help relieve stress urinary incontinence
To promote complete bladder emptying
A postoperative patient has difficulty voiding after surgery and is feeling "uncomfortable" in the lower abdomen. Which action would the nurse implement first? Encourage fluid intake. Administer pain medication. Catheterize the patient. Turn on the bathroom faucet as the patient tries to void.
Turn on the bathroom faucet as the patient tries to void.
The nurse assesses that the patient has a full bladder, and the patient states that he/she is having difficulty voiding. Which instruction would the nurse provide the patient? Use the double voiding technique. Perform Kegel exercises. Use the Crede method. Keep a voiding diary.
Use the Crede method.
