Prep U Practice Questions (Elimination)
After teaching a patient who is receiving ferrous sulfate about the drug therapy regimen, which patient statement indicates that the teaching was successful? "My stools might turn dark or green." "I need to eat three large meals every day." "I must take the drug on an empty stomach." "I need to watch the amount of fiber I eat."
"My stools might turn dark or green." Explanation: The patient needs to know that his stools may become dark or green. Small frequent meals with snacks can help minimize nausea and GI upset associated with this drug. The patient may take the drug with meals as long as those meals do not include eggs, milk, coffee, and tea. Constipation is possible, so the patient needs to increase the fiber in his diet.
A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response? "People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital." "People in hospitals sometimes exhibit signs of infections they had before being admitted." "Sometimes people in hospitals get exposed to microorganisms that their visitors bring in." "People in hospitals are surrounded by infectious agents, so they can get infections they didn't have before being admitted."
"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital." Explanation: Hospitalized clients are more susceptible to infections than well people because they are exposed to pathogens in the health care environment, may have incisions or invasive equipment (e.g., intravenous lines) that compromise skin integrity, or may be immunosuppressed from poor nutrition, their disease process, or its treatment. Although all answers are correct, the most complete answer is A.
The nurse has an order to obtain a urine specimen from a client with an indwelling Foley catheter. Which supplies would the nurse need to gather? Select all that apply. 10-mL (milliliter) syringe Sterile gloves Sterile specimen container Antiseptic swab Consent form
10-mL (milliliter) syringe Sterile specimen container Antiseptic swab Explanation: The nurse would need to gather a syringe, antiseptic swab, and sterile specimen container. The nurse would need clean, not sterile gloves, to perform the collection. The part of the tubing that connects to the catheter is where the specimen is collected from, and the nurse may need a clamp to allow a collection of urine within the tubing in case urine output is decreased.
The nurse is planning the care of a patient with a major thermal burn. What outcome will the nurse understand will be optimal during fluid replacement? A urinary output of 10 mL/hr A urinary output of 30 mL/hr A urinary output of 80 mL/hr A urinary output of 100 mL/hr
A urinary output of 30 mL/hr Explanation: For adults, a urine output of 30 to 50 mL per hour is used as an indication of appropriate resuscitation in thermal and chemical injuries, whereas in electrical injuries a urine output of 75 to 100 mL per hour is the goal (ABA, 2011a).
In addition to teaching a client with constipation to increase dietary fiber intake to 25 g/day, which of the following would the nurse include as important? Avoiding bran cereals and beans in the diet. Adding fiber-rich foods to the diet gradually. Limiting fluid intake to 5 to 6 glasses per day. Minimizing activity levels for at least 2 months.
Adding fiber-rich foods to the diet gradually. Explanation: The nurse instructs the client to add fiber-rich foods to the diet gradually to avoid bloating, gas, and diarrhea. It is essential for a client to include bran cereals and beans in the diet because they ease defecation. The nurse also instructs the client to increase fluids to 6 to 8 glasses per day to prevent hard, dry stools. The client should also develop a regular exercise program to increase peristalsis and promote bowel elimination.
The patient has called the office to see if using bismuth subsalicylate will work to treat simple diarrhea. The nurse knows this will be a safe and effective treatment for diarrhea unless the patient has: Allergy to aspirin Hypertension Hypothyroidism Urinary retention
Allergy to aspirin Explanation: People with an allergy to aspirin or aspirin products should not take bismuth subsalicylate.
In which phase of Freud's developmental stage does toilet training occur? Anal Oral Latency Genital
Anal Explanation: Toilet training occurs in the anal stage, which occurs between 18 and 36 months of age.
The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure? Client with prostatic hyperplasia Client with intratubular obstruction Client with severe hypovolemia Client with acute pyelonephritis
Client with prostatic hyperplasia Explanation: The most common cause of postrenal kidney failure is prostatic hyperplasia. Postrenal failure results from conditions that obstruct urine outflow. The obstruction can occur in the ureter, bladder, or urethra. Intratubular obstruction and acute pyelonephritis are intrarenal causes of kidney failure, and severe hypovolemia is a prerenal cause.
While reading a client's history, the nurse notes that a client has a colostomy. When assessing the client, the nurse notes that the output is formed stool. What should the nurse do? Document the output; this is normal. Contact the physician immediately. Give the client the ordered laxative. Assess for obstruction.
Document the output; this is normal. Explanation: Output from a colostomy is normally formed stool. Therefore the nurse should document the output as normal. There is no need to contact the physician at this time, assess for an obstruction, or give a laxative since the formed stool is normal.
The nurse has completed instilling fluid with a bladder irrigation and does not have a return of the fluid into the catheter bag. What is the next action the nurse should do? Notify the healthcare provider about the lack of drainage. Change the urinary catheter. Palpate the client's bladder for distention. Ensure there are no kinks in the catheter tubing.
Ensure there are no kinks in the catheter tubing. Explanation: The simplest method to ensure drainage of the catheter is to check the tubing for kinks in the tubing that would affect drainage. After this, palpating the bladder for distention, notifying the healthcare provider, and changing the urinary catheter would be the next steps in troubleshooting this situation.
The nurse is instructing a 3-year-old's mother regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group? Dysuria Enuresis Hematuria Anuria
Enuresis Explanation: The nurse would be most correct to document that enuresis, the involuntary voiding during sleep or commonly called "wetting the bed," is a normal finding in a pediatric client younger than 5 years old. Dysuria (pain on urination), hematuria (red blood cells in urine), and anuria (urine output less than 50 mL/day) are all abnormal findings needing further investigation.
Good hand-washing techniques are important in health care. The nurse knows that bacterial infections can be prevented by good hand washing techniques. Which route of transmission is most common for Clostridium difficile? Fecal-oral transmission Sexual transmission Vertical transmission Iatrogenic transmission
Fecal-oral transmission Explanation: After antibiotic therapy has made the bowel susceptible to infection, colonization by C. difficile occurs by the oral-fecal route. C. difficile infection usually is acquired in the hospital, where the organism is most commonly encountered.
A 65-year-old man complains to his health care provider that, when he urinates, he has to start and stop several times over a period of minutes in order to fully empty his bladder. The nurse is aware that this is not uncommon in men over the age of 60. This "double voiding" is directly related to which of the following? Hyperplasia of the prostate gland Thickening of the seminiferous tubules Fibrotic changes of the corpora cavernosa Hypogonadism
Hyperplasia of the prostate gland Explanation: Urination, without bladder emptying, is an indication that the prostate gland is enlarged. It causes an increased sense of urgency to void, as well as a decreased force of the urine stream. Enlargement of the prostate gland is associated with weakening of prostatic contractions and lower urinary tract obstruction.
A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site? Kidney Ureter Bladder Urethra
Kidney Explanation: The most common site of renal calculi formation is the kidney. Calculi may travel down the urinary tract with or without causing damage and lodge anywhere along the tract or may stay within the kidney. The ureter, bladder, and urethra are less common sites of renal calculi formation.
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? Observe the color of stool. Monitor bowel patterns. Monitor vital signs every 4 hours. Observe urine output.
Observe the color of stool. Explanation: The nurse should observe the color of each stool and test the stool for occult blood. Bowel patterns, vital signs, and urine output do not help in determining the development of peptic ulcers.
A nurse is instructing the client to do Kegel exercises. What should the nurse tell the client to do to perform these pelvic floor exercises? Tighten her stomach muscles. Lift both legs while lying down. Do pelvic squats. Stop the flow of urine while urinating.
Stop the flow of urine while urinating. Explanation: By stopping urine flow during urination, the pelvic floor muscles are contracted. Tightening the leg or stomach muscles doesn't contract the pubococcygeus muscle. Pelvic squats don't tighten the pelvic floor muscles.
A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important? The consistency of stool and comfort when passing stool That the client has a bowel movement daily That the stool is formed and soft The client is able to fully evacuate with each bowel movement
The consistency of stool and comfort when passing stool Explanation: In differentiating normal from abnormal, the consistency of stools and the comfort with which a person passes them are more reliable indicators than is the frequency of bowel elimination. People differ greatly in their bowel habits and normal bowel patterns range from three bowel movements per day to three bowel movements per week. It is important for the stool to be soft to pass without pain. The client may not be able to fully evacuate with a bowel movement; it may take time.
A nurse is caring for an older adult client at his home. The client has had a condom catheter applied. Which describes a condom catheter? a flexible sheath that is rolled around the penis a bag attached by adhesive backing to the skin around the genitals a urine drainage tube inserted but not left in place a urine drainage tube that is left in place over a period of time
a flexible sheath that is rolled around the penis Explanation: A condom catheter is a flexible sheath that is rolled around the penis. A urinary bag (U-bag) is a bag attached by adhesive backing to the skin surrounding the genitals. A straight catheter is a urine drainage tube inserted but not left in place. A retention (or indwelling) catheter is a urine drainage tube that is left in place over a period of time.
In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find: excess output of blood-tinged urine. complaints of flank pain rotating around the abdominal muscles. significant decrease in urine output due to decrease in renal blood flow. an increase in GFR due to relaxation of the afferent arterioles.
significant decrease in urine output due to decrease in renal blood flow. Explanation: During periods of strong sympathetic stimulation, such as shock, constriction of the afferent arteriole causes a marked decrease in renal blood flow and thus glomerular filtration pressure. Consequently, urine output can fall almost to 0. Unless the injury is specific to the kidney, the client will not have blood in urine and urine production will not be excessive. Flank pain is associated with obstruction due to stone formation. The GFR will decrease rather than increase.
