Fundamentals Test 2 Prep U Urinary Elimination

A client who had transurethral resection of the prostate has dribbling urine after his Foley catheter is removed on the second postoperative day. The nurse notes that the client had 200 mL of urine output in the last 8 hours with a 1,000 mL intake. The nurse should first: A. apply a condom catheter. B. assess for bladder distention. C. obtain a urine specimen for culture. D. teach the client Kegel exercises.

B.

A client with fever and urinary urgency must provide a urine specimen for culture and sensitivity. The nurse should instruct the client to collect the specimen from the: A. first stream of urine from the bladder. B. middle stream of urine from the bladder. C. final stream of urine from the bladder. D. full volume of urine from the bladder.

B.

A nurse is caring for a client who also works in the hospital. The client has recently received a diagnosis of genital herpes and is being treated for a urinary tract infection (UTI). While on lunch break in the cafeteria, the nurse sees the client's coworkers, who voice concern over his condition. The nurse's best response would be: A. "He must be upset that everyone knows he has herpes." B. "I'll be sure to tell him you're thinking of him." C. "He's really upset about his medical condition. I'll get you the chart so you can review his laboratory values." D. "The antibiotics are really helping with his UTI. He should be back to work in no time."

B.

A nurse is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to: A. initiate a stream of urine. B. breathe deeply. C. turn to the side. D. hold the labia or shaft of the penis.

B.

After teaching the mother of a young girl about measures to help prevent urinary tract infections, which of the following statements by the mother indicates successful teaching? A. "She will love the idea of taking more bubble baths." B. "We will make sure she takes a water bottle with her to afterschool events." C. "We will try to get her not to go to the bathroom too frequently." D. "We will let her soak in the bathtub for 30 minutes every day."

B.

After teaching the parents about the urethral catheter placed after surgical repair of their son's hypospadias, the nurse determines that the teaching was successful when the mother states that the catheter in her child's penis accomplishes which goal? A. decreases pain at the surgical site B. keeps the new urethra from closing C. measures his urine correctly D. prevents bladder spasms

B.

The primary reason for lubricating the urinary catheter generously before inserting it into a male client is that this technique helps reduce: A. apasms at the orifice of the bladder. B. friction along the urethra when the catheter is being inserted. C. the number of organisms gaining entrance to the bladder. D. the formation of encrustations that may occur at the end of the catheter.

B.

Using Abraham Maslow's hierarchy of human needs, the nurse assigns highest priority to which client need? A. Arranging a visit from a support group member B. Inserting a Foley catheter C. Raising the side rails on the client's bed D. Placing the client in a double room with another client the same age

B.

When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? A. The client sets the drainage bag on the floor while sitting down. B. The client keeps the drainage bag below the bladder at all times. C. The client clamps the catheter drainage tubing while visiting with the family. D. The client loops the drainage tubing below its point of entry into the drainage bag.

B.

Which client is at highest risk for developing a urinary tract infection? A. a woman who has given vaginal birth to two children B. a man with an indwelling urinary catheter C. a man with a past medical history of renal calculi D. a woman with well-controlled diabetes mellitus

B.

A pregnant client in her third trimester asks why she needs to urinate frequently again, as she did during the first trimester. What should the nurse tell her? A. This symptom is abnormal during the third trimester and may indicate a urinary tract infection. B. This symptom is a normal variation and is easily managed by limiting fluid intake. C. This symptom is normal and results from the fetus exerting pressure on the bladder. D. This symptom is abnormal and should subside after the presenting part of the fetus is engaged.

C.

The nurse is instructing an unlicensed assistive personnel (UAP) to collect a urine specimen from an indwelling catheter. Which statement indicates that the UAP understands the instructions? A. "I should collect urine from the catheter drainage bag at the end of the shift and place it in the specimen container." B. "I will disconnect the drainage tube from the catheter and let urine run from the catheter into the specimen container." C. "I will empty the catheter drainage bag, have the client drink some water, and an hour later collect the urine that drains into the bag." D. "I will get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container."

D.

A confused client with carbon monoxide poisoning experiences dizziness when ambulating to the bathroom. The nurse should: A. put all four side rails up on the bed. B. ask the unlicensed assistive personnel (UAP) to place restraints on the client's upper extremities. C. request that the client's roommate put the call light on when the client is attempting to get out of bed. D. check on the client at regular intervals to ascertain the need to use the bathroom.

D.

A client developed cardiogenic shock after a severe myocardial infarction and has now developed acute renal failure. The client's family asks the nurse why the client has developed acute renal failure. The nurse should base the response on the knowledge that there was: A. a decrease in the blood flow through the kidneys. B. an obstruction of urine flow from the kidneys. C. a blood clot formed in the kidneys. D. structural damage to the kidney resulting in acute tubular necrosis.

A.

A client is diagnosed with acute pyelonephritis. What should the nurse instruct the client to do? A. Urinate frequently. B. Take bubble baths instead of showers. C. Take antibiotics for the rest of the client's life. D. Decrease fluid intake.

A.

A client is to be discharged from same-day surgery 7 hours after his inguinal hernia repair. Which nursing observation indicates this client is ready to be discharged? A. The client voids 500 mL of urine. B. The client tolerates eating a hamburger. C. The client is pain free. D. The client walks in the hallway unassisted.

A.

A nurse is caring for an 8-year-old girl with multiple chronic urinary tract infections. The child's parents appear protective, never leaving their daughter's side. While the nurse helps the child's mother provide morning care, the child states, "My uncle doesn't clean me that way." Her mother becomes visibly upset and gives the girl a stern warning not to discuss the matter. She states, "Don't tell anyone about that again." The nurse has a legal responsibility to: A. notify the nursing supervisor and the authorities of the possibility of abuse. B. offer to clean the child the way her uncle does. C. leave the room so the mother and daughter can have privacy. D. note on the child's chart that the mother is overprotective.

A.

A nurse is caring for an elderly adult client admitted to the hospital from a nursing home because of a change in behavior. The client has a diagnosis of Alzheimer's disease and has started to experience episodes of incontinence. The hospital staff is having difficulty with toileting because the client wanders around the unit all day. To assist with elimination, a nurse should: A. incorporate the client's toileting schedule into the pattern of his wandering. B. ask the physician to order sedation to allow the client to rest. C. ask the physician to order restraints to prevent wandering. D. have the client wear two briefs at a time to ensure absorption of incontinent urine.

A.

A physician orders hourly urine output measurement for a postoperative client with an indwelling catheter. The nurse records the following amounts of output for 2 consecutive hours: 8 a.m. (0800): 50 ml; 9 a.m. (0900): 60 ml. Based on these amounts, which action should the nurse take? A. Continue to monitor and record hourly urine output. B. Notify the physician. C. Irrigate the indwelling urinary catheter. D. Increase the I.V. fluid infusion rate.

A.

A registered nurse and a nursing assistant are caring for a group of clients. Which client's care may safely be delegated to the nursing assistant? A. A client who underwent surgery 12 hours ago whose suprapubic catheter is draining burgundy-colored urine B. A client with uncontrolled diabetes mellitus who underwent radical suprapubic prostatectomy 1 day ago and has an indwelling urinary catheter draining yellow urine with clots C. A client diagnosed with renal calculi who must ambulate four times daily and drink plenty of fluids. D. A client who requires neurological assessment every 4 hours after sustaining a spinal cord injury in a motor vehicle accident that left him with paraplegia

C.

The nurse is assessing a client who has benign prostatic hypertrophy (BPH). The nurse should ask the client if he has: A. impotence. B. flank pain. C. difficulty starting the urinary stream. D. hematuria.

C.

When assessing an 18-year-old primipara who gave birth to a viable neonate under epidural anesthesia 24 hours ago, the nurse determines that the fundus is firm but to the right of midline. Based on this finding, the nurse should further assesses for: A. uterine inversion. B. paralytic ileus. C. urinary retention. D. perineal hematoma.

C.

When teaching a primigravid client how to do Kegel exercises, the nurse explains that the expected outcome of these exercises is to: A. reduce risk of hemorrhoids. B. alleviate lower back discomfort. C. strengthen the perineal muscles. D. strengthen the abdominal muscles.

C.

Which aspects of client care would be most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)? A. catheterizing a 75-year-old male client who has an enlarged prostate B. changing the IV fluid bag for a client whose IV fluid level is running low C. obtaining a urine specimen for a culture and sensitivity analysis from a client who has an indwelling urinary catheter inserted D. administering an antacid to a client with heartburn after verifying the client's report of pain

C.

Which intervention should the nurse suggest to help a client with multiple sclerosis avoid episodes of urinary incontinence? A. Limit fluid intake to 1,000 mL/day. B. Insert an indwelling urinary catheter. C. Establish a regular voiding schedule. D. Administer prophylactic antibiotics, as prescribed.

C.

Which question should the nurse ask first when obtaining a history from the mother of a 10-year-old child with a fever, reports of not feeling well, and swelling around the eyes? A. "Has the child had a sore throat recently?" B. "Is the child playing with friends as usual?" C. "Does the child urinate as much as usual?" D. "Is the urine pale in color?"

C.