Prep-U Questions Chapter 38: Urinary Elimination
Use of an indwelling urinary catheter leads to the loss of bladder tone. True or False
True People with indwelling urinary catheters lose bladder tone because the bladder muscle is not being stretched by the bladder filling with urine. During prolonged periods of immobility, decreased bladder and sphincter tone can result in poor urinary control and urinary stasis. Other causes of decreased muscle tone include childbearing, muscle atrophy due to decreased estrogen levels as seen with menopause, and damage to muscles from trauma.
What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence? A.) It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. B.) The client can apply it himself with minimal supervision. C.) It can be left in place for a long period of time. D.) A sterile urine specimen can be obtained from the drainage bag tubing.
A.) It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. The external condom catheter is not in the bladder. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters which are placed in the bladder. Because it is not sterile, a sterile urine specimen cannot be obtained. Often, the client does not place the external condom catheter by himself. The catheter is changed every day and inspection of the skin of the penis assessed.
Several of the clients on a geriatric subacute medicine unit are experiencing urinary incontinence from differing causes. Which statement suggests that the client requires further education? A.) "I make sure to limit how much I drink so that I don't have accidents." B.) "I've made a point of scheduling when I drink water instead of waiting until I'm thirsty." C.) "At home, I take my water pill in the morning so that I don't have to use the bathroom as much during the night." D.) "I know it's hard to get there, but I want to try to use the commode instead of wearing an adult diaper."
A.) "I make sure to limit how much I drink so that I don't have accidents." Limiting fluid intake is not a healthy practice, and clients should be encouraged not to use fluid restriction as an incontinence management strategy. Promoting fluid intake is beneficial for most clients who do not possess a contraindication, and it is appropriate and useful to take diuretics in the morning to avoid nocturia. Even though it may involve work for both the client and the nurse, clients who want to use a bathroom or commode rather than an adult absorbent brief should be encouraged to do so.
A client with chronic kidney disease reports not being able to urinate for the past 24 hours. A bladder scan shows no urine in the bladder. How does the nurse document this data? A.) Anuria B.) Oliguria C.) Nocturia D.) Urinary Retention
A.) Anuria Absence of urine for a 24-hour period reflects anuria.
Three days post-surgery for breast reconstruction, the nurse assesses that the client is ambulating several times daily. The health care provider has not yet written an order to discontinue the client's urinary catheter. What is the appropriate nursing action? Select all that apply. A.) Contact the health care provider to ask for an order for catheter discontinuation. B.) Delegate catheter discontinuation to the Unlicensed Assistive Personnel (UAP). C.) Perform, or allow client to perform, perineal hygiene at least once daily. D.) Ensure that the drainage bag is above the level of the bladder at all times. E.) Discontinue to catheter and report this to the healthcare provider.
A.) Contact the health care provider to ask for an order for catheter discontinuation. C.) Perform, or allow client to perform, perineal hygiene at least once daily. The nurse should advocate for catheter discontinuation to prevent catheter-associated urinary tract infections (CAUTI), and still perform or encourage the client to perform daily perineal care. Discontinuation of the catheter should not take place until the nurse has received and order, and delegation should take place only if appropriate based on the UAP's qualification and the nurse's ongoing appropriate supervision. The drainage bag should never remain above the level of the bladder.
What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence? A.) It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. B.) The client can apply it himself with minimal supervision. C.) It can be left in place for a long period of time. D.) A sterile urine specimen can be obtained from the drainage bag tubing.
A.) It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. The external condom catheter is not in the bladder. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters which are placed in the bladder. Because it is not sterile, a sterile urine specimen cannot be obtained. Often, the client does not place the external condom catheter by himself. The catheter is changed every day and inspection of the skin of the penis assessed.
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? A.) Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. B.) Immediately remove the catheter from the vagina, contact the health care provider, and anticipate a prescription for prophylactic antibiotics. C.) Ask the client to bear down until the catheter is expelled. D.) Remove the catheter from the vagina and attempt to insert it into the bladder.
A.) Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. Leaving the catheter in place as a marker assists in the correct placement of the second catheter into the bladder. It is not necessary to contact the health care provider. The vagina is not sterile, so insertion of a sterile catheter poses little risk for infection. Asking the client to bear down is not necessary because the catheter is not typically completely inserted. Removing the catheter from the vagina and attempting to insert it into the bladder will cause cross-contamination.
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.) The birth can cause perineal swelling. B.) A neurogenic bladder results from local anesthesia. C.) A urinary tract infection results from the birth process. D.) Catheterization is necessary for 1 week.
A.) The birth can cause perineal swelling. Trauma from vaginal birth causes swelling in the perineal area, which can obstruct the flow of urine and cause urinary retention during the early postpartum period.
A sterile urine specimen for culture and sensitivity has been ordered for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? A.) Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle. B.) Empty the collection bag, wait 30 minutes, and then collect the contents of the collection bag. C.) Discontinue the indwelling catheter and insert an intermittent catheter to obtain the sterile specimen. D.) Collect a urine specimen from the collection bag first thing in the morning, or a few hours after the client receives a diuretic.
A.) Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle. When it is necessary to collect a urine specimen from a client with an indwelling catheter, it should be obtained from the catheter itself using the special port for specimens. A specimen from the collecting receptacle (drainage bag) may not be fresh urine and could result in an inaccurate analysis. A client's catheter would not be removed for the sole purpose of obtaining a urine specimen. Collection of a specimen does not need to collected in the morning or after a diuretic.
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.) a flexible sheath that is rolled around the penis B.) a bag attached by adhesive backing to the skin around the genitals C.) a urine drainage tube inserted but not left in place D.) a urine drainage tube that is left in place over a period of time
A.) a flexible sheath that is rolled around the penis 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.
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? A.) cloudy, foul odor B.) light yellow, clear C.) clear, dark amber D.) strongly aromatic, amber
A.) cloudy, foul odor The nurse anticipates that the client has an infection, which is characterized by cloudy, foul-smelling urine. Urine is normally light yellow and clear. Dark amber urine that is strongly aromatic could indicate dehydration, but would not create the symptoms noted.
The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate? A.) dehydration B.) hypovolemia C.) balanced fluids D.) renal failure
A.) dehydration The nurse anticipates that the client may be dehydrated, which is characterized by strongly aromatic, dark amber urine. The symptoms are not associated with hypervolemia, balanced fluids, nor renal failure.
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? A.) Dorsal recumbent B.) Sims C.) Supine D.) Semi-Fowler
B.) Sims The Sims, or side-lying, position is especially used for clients who have limited hip mobility because it permits excellent visualization of the urinary meatus. Usually, female clients are placed in a dorsal recumbent position for catheterization, and male clients are put in a supine or semi-Fowler position.
The nurse has an order to obtain a 24-hour urine specimen from a client. Which instruction would be accurate for collection of the specimen? A.) "Begin the collection when you first urinate in the morning." B.) "Discard your first urine and begin the collection after that." C.) "Start collecting the urine with the next time you urinate." D.) "You will need to have a catheter inserted for this collection."
B.) "Discard your first urine and begin the collection after that." The nurse would give the instructions to the client that the first urine would be discarded and collections of urine begin after that point. The urine is then collected for 24 hours and may need to be placed on ice or refrigerated. When the 24 hours is completed, the client would need to be asked to void, and the specimen collection is completed.
A client is preparing to give a clean-catch specimen. Which instruction will the nurse provide? A.) Collect the first urine expelled. B.) After the initial stream is initiated, collect the sample. C.) Wait until the void is almost over to collect a specimen. D.) Collect the entire urinary output.
B.) After the initial stream is initiated, collect the sample. A clean-catch specimen is collected in mid-stream. It is not reasonable, nor necessary, to collect the entire urinary output. It is not correct to collect the first urine expelled or to wait until the void is almost over.
Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence? A.) Incontinence after the age of 3 years is not normal. B.) Boys may take longer for daytime continence than girls. C.) Boys may walk by 1 year and should be continent by 3 years. D.) Daytime continence is usually not achieved by boys until age 5.
B.) Boys may take longer for daytime continence than girls. Children in North American cultures usually achieve daytime urinary continence by 3 years of age; boys may take longer than girls. Nighttime continence may not occur until 4 or 5 years of age.
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? A.) Loosen the internal muscles used to prevent or interrupt urination. B.) Keep muscles contracted for at least 10 seconds. C.) Relax muscles for at least 5 minutes between Kegels. D.) Perform these exercises two times daily for a week.
B.) Keep muscles contracted for at least 10 seconds. Kegel exercises should be performed by tightening the internal muscles used to prevent or interrupt urination for 10 seconds, followed by a period of 10 seconds of relaxation. The client should be instructed to perform this regimen 3-4 times daily for 2 weeks to 1 month.
A nurse is caring for a client who is catheterized following surgery of the prostate. When caring for the client, the nurse performs a continuous irrigation of the catheter. Which intervention should the nurse perform when providing continuous irrigation? A.) Place the sterile solution on the bed. B.) Prime the tubing with the solution. C.) Empty the balloon with a syringe. D.) Clean around the urinary meatus.
B.) Prime the tubing with the solution. When providing continuous irrigation, the nurse must prime the tubing with the irrigation solution to ensure that no air enters the system. The nurse should hang the sterile irrigating solution from an IV pole, rather than place it on the bed, to allow it to flow freely. The nurse empties the balloon with a syringe and also cleans the urinary meatus when removing the catheter—not when irrigating the catheter.
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? A.) Moist perineal skin B.) Reddened perineal skin C.) Presence of smegma D.) Absence of discharge
B.) Reddened perineal skin The presence of reddened perineal skin is an abnormal finding. The healthy skin should be moist and noninflamed with no discharge present. Smegma (an accumulation of white, odorous secretions from sebaceous glands found under the labia minora in women and under the foreskin in men) is considered a normal finding.
A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing? A.) Reflex incontinence B.) Stress incontinence C.) Urge incontinence D.) Functional incontinence
B.) Stress incontinence The nurse should document the client's condition as stress incontinence following weakening of perineal and sphincter muscle tone secondary to giving birth. Reflex incontinence is caused by damage to motor and sensory tracts in the lower spinal cord secondary to trauma. Urge incontinence is caused by bladder irritation secondary to infection. Functional incontinence is caused by impaired mobility, impaired cognition, or an inability to communicate.
What is the micturition reflex? A.) The process of filtration beginning with the glomerulus. B.) The act of bladder contraction and perceived need to void. C.) The reabsorption of the substances the body wants to retain. D.) The secretion of electrolytes that are harmful to the body.
B.) The act of bladder contraction and perceived need to void. Several words are used to describe the process of excreting urine from the body, including urination, voiding, and micturition.
A nurse is preparing to measure a client's urine output. Which interventions would be of highest priority? A.) Using an appropriate measuring container B.) Wearing gloves when handling the urine C.) Measuring the urine container at eye level D.) Noting the color and clarity of the urine
B.) Wearing gloves when handling the urine All of these interventions would be important to ensure safety in handling the client's urine and obtaining an accurate output. However, safety with handling body fluids would be a priority for the nurse to decrease risk of exposure to pathogens or blood that may be in the client's urine.
The nurse is caring for a client with weakness who is ambulatory but tires easily. Which method for urinary elimination does the nurse recommend? A.) fracture pan B.) bedside commode C.) bedpan D.) regular bathroom
B.) bedside commode The client with weakness who tires easily may benefit from a bedside commode. Because the client is ambulatory, a bedpan or fracture pan is not needed. Ambulating to the regular bathroom may increase the risk for falls.
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? A.) indwelling urethral catheter B.) intermittent urethral catheter C.) Foley catheter D.) retention catheter
B.) intermittent urethral catheter An intermittent urethral catheter (straight catheter) is a catheter inserted through the urethra into the bladder to drain urine for a short period of time (5 to 10 minutes). With an indwelling urethral catheter (retention or Foley catheters), a catheter (tube) is inserted through the urethra into the bladder for continuous drainage of urine; a balloon is then inflated to ensure that the catheter remains in the bladder once it is inserted.
A client reports an episode of losing control of urination when a bathroom wasn't close by. The client states, "I'm worried this means that I'm starting to lose control of my bladder." What is the appropriate nursing response? A.) "I agree; please make an appointment with your healthcare provider." B.) "This only happened one time, so it is nothing to worry about." C.) "Let's review your medication history and whether you consume bladder irritants." D.) "I suggest that you invest in incontinence undergarments."
C.) "Let's review your medication history and whether you consume bladder irritants." Urge incontinence can be aggravated by bladder irritants such as caffeine or alcohol, and can take place if diuretics are taking in the morning. The nurse will start by reviewing these factors. The nurse should not discount this as an isolated event without further assessment. It is too soon to refer the client to the healthcare provider, or to recommend incontinence undergarments.
The UAP reports that a client on furosemide has voided 4000 mL in a 24-hour period. What is the appropriate nursing action? A.) Document the finding as normal. B.) Increase IV fluids. C.) Contact the health care provider to decrease furosemide. D.) Administer an additional dose of furosemide.
C.) Contact the health care provider to decrease furosemide. Voiding over 3000 mL/day is considered abnormal. The client may benefit from a reduction in the amount of furosemide that is prescribed. Therefore, it is appropriate to contact the healthcare provider to decrease furosemide. Documenting the finding as normal, increasing IV fluids, and administering an additional dose of furosemide are not appropriate nursing actions.
The health care provider has ordered a 24-hour urine specimen collection for a client. Which nursing action is appropriate? Select all that apply. A.) Have client label own urine collection. B.) Teach client to void only one time per hour. C.) Discard first urine just before starting the test, then collect urine thereafter. D.) Place urine in staff refrigerator. E.) Ask client to void for the last time at exactly the 24-hour mark.
C.) Discard first urine just before starting the test, then collect urine thereafter. E.) Ask client to void for the last time at exactly the 24-hour mark. The client will be instructed to void a first urine to be discarded, then all subsequent urination will be collected until the 24-hour mark when the client will be asked to urinate one last time. The nurse will label the container. Urine collected should be stored in a specimen-dedicated refrigerator; not a staff refrigerator.
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? A.) Remove the catheter every 8 hours, or more often in humid weather. B.) Wipe the penis thoroughly with an alcohol swab and dry thoroughly before application. C.) Fasten the condom securely enough to prevent leakage without constricting blood flow. D.) Ensure the tip of the tubing is touching the tip of the client's penis.
C.) Fasten the condom securely enough to prevent leakage without constricting blood flow. Nursing care of a client with a condom catheter includes vigilant skin care to prevent excoriation. This includes removing the condom catheter daily, washing the penis with soap and water and drying carefully, and inspecting the skin for irritation. In hot and humid weather, more frequent changing may be required. In all cases, care must be taken to fasten the condom securely enough to prevent leakage, yet not so tightly as to constrict the blood vessels in the area. In addition, the tip of the tubing should be kept 1 to 2 in (2.5 to 5 cm) beyond the tip of the penis to prevent irritation to the sensitive glans area.
A nurse notes that the volume of the client's urinary elimination is less than 50 mL/day. What could be the possible cause for the low volume of urination by the client? A.) Diuretic medication B.) Endocrine disease C.) Kidney dysfunction D.) Liver disease
C.) Kidney dysfunction Kidney dysfunction could be a possible cause for the client's low volume of urination. Diuretic medication and endocrine disease would increase the volume of urination. Liver disease would cause the urine to appear brown in color.
A nurse is performing a client's intermittent closed catheter irrigation and realizes that the tubing was not clamped before introducing the irrigation solution. What would be the nurse's best response to this situation? A.) Wait 1 hour and repeat the irrigation. B.) Notify the primary care provider promptly. C.) Repeat the irrigation. D.) Prepare to change the catheter.
C.) Repeat the irrigation. If the tubing was not clamped before introducing the irrigation solution, the nurse should repeat the irrigation. If the tubing is not clamped, the irrigation solution will drain into the urinary drainage bag and not enter the catheter. There is no immediate need to contact the primary care provider or to change the catheter.
A woman is reporting bladder urgency. It is most important to assess: A.) exercise. B.) weight. C.) caffeine intake. D.) vitamin supplements.
C.) caffeine intake. Fluids or food containing alcohol or caffeine, such as coffee, tea, cola, or chocolate, irritate the bladder and contain a diuretic that can increase urine output when ingested in large amounts.
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? A.) reddish-brown, clear B.) clear, light yellow C.) dark brown, cloudy D.) aromatic, green
C.) dark brown, cloudy The client with advanced liver disease is expected to have dark brown or dark amber urine; infection may be represented by cloudy urine. Other answers are incorrect.
A 70-year-old client who has four children and six grandchildren states that she "wets" herself when she sneezes or laughs. She reports that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate? A.) urge B.) reflect C.) stress D.) total
C.) stress Stress incontinence is associated with a raise in intra-abdominal pressure related to activities such as sneezing, coughing, or laughing. Other types of incontinence have different causative factors.
The nurse is caring for a male client with weakness who has been ordered to stay on bed rest for several days. Which method for urinary elimination does the nurse provide? A.) fracture pan B.) bedside commode C.) urinal D.) regular bathroom
C.) urinal The client with weakness who has been ordered to stay on bed rest will benefit from use of a urinal. The client should not be moved to the bedside commode or regular bathroom. A fracture pan may be useful for bowel movements.
The health care provider notifies a client of a diagnosis of glycosuria. When the provider leaves the room, the client states to the nurse, "I don't know what glycosuria means." What is the appropriate nursing response? A.) "This means your urine has blood in it." B.) "The laboratory report shows ketones in your urine." C.) "Your urine has plasma proteins in it." D.) "Laboratory findings indicate there is glucose in your urine."
D.) "Laboratory findings indicate there is glucose in your urine." Glycosuria is a condition that describes the finding of glucose in the urine. Hematuria describes blood in urine; ketonuria describes urine containing ketones; and proteinuria is the term that describes plasma proteins found in urine.
The health care provider has ordered a Foley catheter for a 48-year-old male client who is in traction with leg fractures. The client refuses, stating "I don't want something placed internally into me." What is the appropriate nursing response? A.) "This is the only option for catheterization." B.) "You will have to ambulate to the bathroom to urinate." C.) "Foley catheters do not hurt, and I will be careful placing it." D.) "Let me talk to your health care provider about a condom catheter."
D.) "Let me talk to your health care provider about a condom catheter." The nurse will support the client's autonomy by investigating other options like a condom catheter. It is nontherapeutic to discount the client's concern, or to tell the client that this is the only catheterization option. The client clearly cannot ambulate with leg fractures.
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? A.) "It would be best just to get some adult diapers." B.) "Let me refer you to a urologist who can help you." C.) "Don't worry, this is a normal condition for older adults." D.) "Let's explore structuring activities and toileting breaks."
D.) "Let's explore structuring activities and toileting breaks." The nurse will promote the client's self-esteem by exploring ways in which the client can verbalize feelings, maintain dignity, and become empowered to participate in self-care. Telling the client to get adult undergarments (referring to these as "diapers" is not therapeutic), sending her to a urologist, and telling her not to worry discounts the client's concern.
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? A.) "This is extremely abnormal. You will need to see your son's pediatrician." B.) "I would only worry about this if you were raising a daughter." C.) "It would be appropriate to place your son in incontinence undergarments." D.) "Let's review the types of fluids that your child drinks in the morning."
D.) "Let's review the types of fluids that your child drinks in the morning." Bladder irritants such as caffeine can cause urge incontinence; it is appropriate to determine whether the child is consuming fluids that contain caffeine. The child's urge incontinence is not extremely abnormal, and this physiological response is not related to gender. It is too soon to refer the client to the healthcare provider without taking a history, and it is impractical to simply recommend incontinence undergarments.
What accurately describes a practice guideline that the nurse should follow when inserting an indwelling catheter? A.) Use clean technique when inserting a catheter. B.) Maintain an open system whenever possible. C.) Use the largest appropriate-sized catheter in order to prevent leakage. D.) Avoid irrigation unless needed to relieve an obstruction.
D.) Avoid irrigation unless needed to relieve an obstruction. Irrigation should be avoided to prevent infection unless there is an obstruction. A closed system should be maintained using sterile technique. The smallest appropriate-sized catheter should be used.
A client who visits a health care facility for a routine assessment reports to the nurse that he is unable to control his urinary elimination. This has resulted in him soiling his clothes and has led to a lot of embarrassment. How should the nurse document the client's condition? A.) Albuminuria B.) Nocturia C.) Dysuria D.) Incontinence
D.) Incontinence The nurse should document the client's condition as urinary incontinence. Incontinence is the inability to control either urinary or bowel elimination and is abnormal after a person is toilet-trained. Albuminuria is urine containing excessive protein. Dysuria is difficult or uncomfortable voiding.
A client is suspected of having a disease process affecting the functional unit of the kidney. Which stucture is most likely involved? A.) Glomerulus B.) Bowman's capsule C.) Loop of Henle D.) Nephron
D.) Nephron The functional unit of the kidney is called the nephron. Each kidney has more than 1 million nephrons, and each nephron is capable of forming urine. The nephron consists of the glomerulus, Bowman's capsule, proximal convoluted tubules, loop of Henle, distal tubule, and collecting duct. The glomerulus is a network of blood vessels, surrounded by Bowman's capsule, where urine formation begins. The tubules, loop of Henle, and collecting ducts are passageways that permit urine to flow to the renal pelvis and then to the ureters.
The nurse is choosing a collection device to collect urine from a nonambulatory male client? What would be the nurse's best choice? A.) Specimen hat B.) Large urine collection bag C.) Bedpan D.) Urinal
D.) Urinal A urinal is the best choice to collect urine from a nonambulatory male client. A specimen hat is for a commode. A bedpan is not the best choice for a male client. A large urine collection bag would be used with an indwelling 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? A.) loss of small amount of urine when intra-abdominal pressure rises B.) need to void is perceived frequently, with short-lived ability to sustain control of flow C.) loss of urine control because a toilet is not accessible D.) loss of urine without any identifiable pattern or warning
D.) loss of urine without any identifiable pattern or warning The nurse could describe the client's condition as the loss of urine without any identifiable pattern or warning. Stress incontinence can be described as loss of a small amount of urine when intra-abdominal pressure rises. Urge incontinence can be described as the need to void being perceived frequently with a short-lived ability to sustain control of flow. Functional urinary incontinence can be described as the loss of control over urination because a toilet is not accessible.
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? A.) inability to control either urinary or bowel elimination B.) hygiene measures used to keep meatus and adjacent area of the catheter clean. C.) use of a catheter to collect urine in a sterile environment D.) one or both of the ureters are surgically implanted elsewhere
D.) one or both of the ureters are surgically implanted elsewhere The nurse should understand that in a urinary diversion, one or both of the ureters are surgically implanted elsewhere. This procedure is done for various life-threatening conditions. Incontinence is the inability to control either urinary or bowel elimination. Catheter care means the hygiene measures used to keep meatus and adjacent area of the catheter clean. In order to collect a catheter specimen, the nurse uses a catheter to collect a sample of urine in a sterile environment.
A nurse is the guest speaker at a women's club. Most of the women are over the age of 40 years. The women have asked the nurse to speak on health promotion topics. In the area of urinary urgency, the nurse will instruct the women to: A.) limit fluid intake. B.) increase caffeine daily. C.) take an antispasmodic. D.) perform Kegel exercises.
D.) perform Kegel exercises. Pelvic floor exercises or Kegel exercises strengthen the pubococcygeal muscles and effectively promote urinary control.
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? A.) urge B.) total C.) reflex D.) stress
D.) stress Stress incontinence is associated with a raise in intra-abdominal pressure related to activities such as sneezing, coughing, or laughing. Urge incontinence takes place when there is a delay in accessing a toilet. Reflex incontinence takes place when a client automatically releases urine and cannot control it. Total incontinence takes place without a pattern or warning, and without client control.
The nurse is caring for a client who has been experiencing nausea, vomiting, and diarrhea for 3 days. Which urine characteristics does the nurse anticipate? A.) cloudy, foul odor B.) light yellow, clear C.) clear, colorless D.) strongly aromatic, dark amber
D.) strongly aromatic, dark amber The nurse anticipates that the client may be dehydrated, which is characterized by strongly aromatic, dark amber urine. The other characteristics are not associated with dehydration.
The doctor has ordered the collection of a fresh urine sample for a particular examination. Which urine sample would the nurse discard? A.) the sample collected immediately after lunch B.) the bedtime voiding C.) the voiding collected at 4 p.m. D.) the first voiding of the day
D.) the first voiding of the day The nurse would discard the first void of the day. The bladder has collected urine that has been produced by the kidneys overnight. The first voided urine of the day is usually more concentrated than other urine excreted during the day. Because the first urine of the day is not fresh, but rather an accumulation of a number of hours of kidney output, this urine may or may not be used as a specimen for certain tests. The other options would be appropriate to use for urine tests.
