If obstructed, which component of the urination system would cause peristaltic waves?
A. Kidney
B. Ureters
C. Bladder
D. Urethra
B. Ureters
Ureters drain urine from the kidneys into the bladder; if they become obstructed, peristaltic waves attempt to push the obstruction into the bladder. The kidney, bladder, and urethra do not produce peristaltic waves. Obstruction of both bladder
When reviewing laboratory results, the nurse should immediately notify the health care provider about which finding?
A. GFR of 20 mL/min
B. Urine output of 80 mL/hr
C. pH of 6.4
D. Protein level of 2 mg/100 mL
A. GFR of 20 mL/min
Normal glomerular filtration rate should be around 125 mL/min; a severe decrease in renal perfusion could indicate a life-threatening problem such as shock or dehydration. Normal urine output is 1000 to 2000 mL/day; an output of 30 mL/
A patient is experiencing oliguria. Which action should the nurse perform first?
A. Increase the patient's intravenous fluid rate
B. Encourage the patient to drink caffeinated beverages
C. Assess for bladder distention
D. Request an order for diuretics
C. Assess for bladder distention
The nurse first should gather all assessment data to determine the potential cause of oliguria. It could be that the patient does not have adequate intake, or it could be that the bladder sphincter is not functioning and t
A patient requests the nurse's assistance to the bedside commode and becomes frustrated when unable to void in front of the nurse. The nurse understands the patient's inability to void because
A. Anxiety can make it difficult for abdominal and perineal mu
A. Anxiety can make it difficult for abdominal and perineal muscles to relax enough to void
Attempting to void in the presence of another can cause anxiety and tension in the muscles that make voiding difficult. The nurse should give the patient privacy a
The nurse knows that indwelling catheters are placed before a cesarean because:
A. The patient may void uncontrollably during the procedure
B. A full bladder can cause the mother's heart rate to drop
C. Spinal anesthetics can temporarily disable urethral
C. Spinal anesthetics can temporarily disable urethral sphincters
Spinal anesthetics may cause urinary retention due to the inability to sense or carry out the need to void. The patient is more likely to retain urine, rather than experience uncontrollable
The nurse knows that urinary tract infection (UTI) is the most common health care-associated infection because:
A. Catheterization procedures are performed more frequently than indicated
B. E. coli pathogens are transmitted during surgical or catheterizat
B. E. coli pathogens are transmitted during surgical or catheterization procedures
E. coli is the leading pathogen causing UTIs; this pathogen enters during procedures. Sterile technique is imperative to prevent the spread of infection. Frequent catheteri
An 86-year-old patient tells the nurse that she is experiencing uncontrollable leakage of urine. Which nursing diagnosis should the nurse include in the patient's plan of care?
A. Urinary retention
B. Hesitancy
C. Urgency
D. Urinary incontinence
D. Urinary incontinence
Age-related changes such as loss of pelvic muscle tone can cause involuntary loss of urine known as Urinary incontinence. Urinary retention is the inability to empty the bladder. Hesitancy occurs as difficulty initiating urination.
A patient has fallen several times in the past week when attempting to get to the bathroom. The patient informs the nurse that he gets up 3 or 4 times a night to urinate. Which recommendation by the nurse is most appropriate in correcting this urinary pro
C. Limit fluid and caffeine intake before bed
Reducing fluids, especially caffeine and alcohol, before bedtime can reduce nocturia. Clearing a path to the restroom or illuminating the path, or shortening the distance to the restroom, may reduce falls but
When caring for a patient with urinary retention, the nurse would anticipate an order for:
A. Limited fluid intake
B. A urinary catheter
C. Diuretic medication
D. A renal angiogram
B. A urinary catheter
A urinary catheter would relieve urinary retention. Reducing fluids would reduce the amount of urine produced but would not alleviate the urine retention. Diuretic medication would increase urine production and may worsen the discomf
Upon palpation, the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate. The nurse should follow up by asking:
A. "When was the last time you voided?"
B. "Do you lose urine when you cough or sneeze?"
C. "Have you
A. "When was the last time you voided?"
To obtain an accurate assessment, the nurse should first determine the source of the discomfort. Urinary retention causes the bladder to be firm and distended. Further assessment to determine the pathology of the co
Which of the following is the primary function of the kidney?
A. Metabolizing and excreting medications
B. Maintaining fluid and electrolyte balance
C. Storing and excreting urine
D. Filtering blood cells and proteins
B. Maintaining fluid and electrolyte balance
The main purpose of the kidney is to maintain fluid and electrolyte balance by filtering waste products and regulating pressures. The kidneys filter the byproducts of medication metabolism. The bladder stores a
While receiving a shift report on a patient, the nurse is informed that the patient has urinary incontinence. Upon assessment, the nurse would expect to find:
A. An indwelling Foley catheter
B. Reddened irritated skin on the buttocks
C. Tiny blood clots i
B. Reddened irritated skin on the buttocks
Urinary incontinence is uncontrolled urinary elimination; if the urine has prolonged contact with the skin, skin breakdown can occur. An indwelling Foley catheter is a solution for urine retention. Blood clots an
Which nursing diagnosis related to alternations in urinary function in an older adult should be a nurse's first priority?
A. Self-care deficit related to decreased mobility
B. Risk of infection
C. Anxiety related to urinary frequency
D. Impaired self-este
B. Risk of infection
Older adults often experience poor muscle tone, which leads to an inability of the bladder to fully empty. Residual urine greatly increases the risk of infection. Following Maslow's hierarchy of needs, physical health risks should be
A patient asks about treatment for urge urinary incontinence. The nurse's best response is to advise the patient to:
A. Perform pelvic floor exercises
B. Drink cranberry juice
C. Avoid voiding frequently
D. Wear an adult diaper
A. Perform pelvic floor exercises
Poor muscle tone leads to an inability to control urine flow. The nurse should recommend pelvic muscle strengthening exercises such as Kegel exercises; this solution best addresses the patient's problem. Drinking cranberr
The nurse suspects that a urinary tract infection has progressed to cystitis when the patient complains of which symptom?
A. Dysuria
B. Flank pain
C. Frequency
D. Fever and chills
C. Frequency
Cystitis is inflammation of the bladder; associated symptoms include hematuria and urgency/frequency. Dysuria is a common symptom of a lower urinary tract infection. Flank pain, fever, and chills are all signs of pyelonephritis.
Which assessment question should the nurse ask if stress incontinence is suspected?
A. "Does your bladder feel distended?"
B. "Do you empty your bladder completely when you void?"
C. "Do you experience urine leakage when you cough or sneeze?"
D. "Do your
C. "Do you experience urine leakage when you cough or sneeze?"
Stress incontinence can be related to intra-abdominal pressure causing urine leakage, as would happen during coughing or sneezing. Asking the patient about the fullness of his bladder would ru
When establishing a diagnosis of altered urinary elimination, the nurse should first:
A. Establish normal voiding patterns for the patient
B. Encourage the patient to flush kidneys by drinking excessive fluids
C. Monitor patients' voiding attempts by assi
D. Discuss causes and solutions to problems related to micturition
The nurse should assess first to determine cause, then should discuss and create goals with the patient, so nurse and patient can work in tandem to normalize voiding. The nurse should inco
To obtain a clean-voided urine specimen for a female patient, the nurse should teach the patient to:
A. Cleanse the urethral meatus from the area of most contamination to least
B. Initiate the first part of the urine stream directly into the collection cu
C. Hold the labia apart while voiding into the specimen cup
The patient should hold the labia apart to reduce bacterial levels in the specimen. The urethral meatus should be cleansed from the area of least contamination to greatest contamination (or front
When viewing a urine specimen under a microscope, what would the nurse expect to see in a patient with a urinary tract infection?
A. Bacteria
B. Casts
C. Crystals
D. Protein
A. Bacteria
Bacteria indicate a urinary tract infection. Crystals would be seen with renal stone formation. Casts indicate renal alterations. Protein is not visible under a microscope and indicates renal disease.
The nurse would expect the urine of a patient with uncontrolled diabetes mellitus to be:
A. Cloudy
B. Discolored
C. Sweet smelling
D. Painful
C. Sweet smelling
Incomplete fat metabolism and buildup of ketones give urine a sweet or fruity odor. Cloudy urine may indicate infection or renal failure. Discolored urine may result from various medications. Painful urination indicates an alteration in
What signs and symptoms would the nurse expect to observe in a patient with excessive white blood cells present in the urine?
A. Fever and chills
B. Difficulty holding in urine
C. Increased blood pressure
D. Abnormal blood sugar
A. Fever and chills
The presence of white blood cells in urine indicates a urinary tract infection. Difficulty with urinary elimination indicates blockage or renal damage. Increased blood pressure is associated with renal disease or damage and some medica
The nurse would anticipate an order for which diagnostic test for a patient who has severe flank pain and calcium phosphate crystals revealed on urinalysis?
A. Renal ultrasound
B. Bladder scan
C. KUB x-ray
D. Intravenous pyelogram
D. Intravenous pyelogram
Flank pain and calcium phosphate crystals are associated with renal calculi. An intravenous pyelogram allows the provider to observe pathological problems such as obstruction of the ureter. A renal ultrasound is performed to ident
A nurse is caring for a patient who just underwent intravenous pyelography that revealed a renal calculus obstructing the left ureter. What is the nurse's first priority in caring for this patient?
A. Turn the patient on the right side to alleviate pressu
D. Monitor the patient for fever, rash, and difficulty breathing
Intravenous pyelography is performed by administering iodine-based dye to view functionality of the urinary system. Many individuals are allergic to shellfish; therefore, the first nursing p
Which statement by the patient about an upcoming computed tomography (CT) scan indicates a need for further teaching?
A. "I'm allergic to shrimp, so I should monitor myself for an allergic reaction."
B. "I will complete my bowel prep program the night bef
C. "I will be anesthetized so that I lie perfectly during the procedure."
Patients are not put under anesthesia for a CT scan; instead the nurse should educate patients about the need to lie perfectly still and about possible methods of overcoming feeling
The nurse anticipates preparing a patient who is allergic to shellfish for an arteriogram by:
A. Obtaining baseline vital signs after the start of the procedure
B. Monitoring the extremity for neurocirculatory function
C. Keeping the patient on bed rest f
D. Administering an antihistamine medication to the patient
Before the procedure is begun, the nurse should assess the patient for food and other allergies and should administer an antihistamine, because a contrast iodine-based dye is used for the procedu
A nurse anticipates urodynamic testing for a patient with which symptom?
A. Involuntary urine leakage
B. Severe flank pain
C. Presence of blood in urine
D. Dysuria
A. Involuntary urine leakage
Urodynamic testing evaluates the muscle function of the bladder and is used to look for the cause of urinary incontinence. Severe flank pain indicates renal calculi; CT scan or IVP would be a more efficient diagnostic test. Bl
A patient is having difficulty voiding in a bedpan but states that she feels her bladder is full. To stimulation micturition, which nursing intervention should the nurse try first?
A. Exiting the room and informing the patient that the nurse will return i
B. Utilizing the power of suggestion by turning on the faucet and letting the water run
To stimulate micturition, the nurse should attempt noninvasive procedures first. Running warm water or stroking the inner aspect of the upper thigh promotes sensory pe
A nurse is caring for an 8-year-old patient who is embarrassed about urinating in his bed at night. Which intervention should the nurse suggest to reduce the frequency of this occurrence?
A. "Drink your nightly glass of milk earlier in the evening."
B. "S
A. "Drink your nightly glass of milk earlier in the evening."
Nightly incontinence and nocturia are often resolved by limiting fluid intake 2 hours before bedtime. Setting the alarm clock to wake does not correct the physiological problem, nor does lining
Many individuals have difficulty voiding in a bedpan or urinal while lying in bed because they:
A. Are embarrassed that they will urinate on the bedding
B. Would feel more comfortable assuming a normal voiding position
C. Feel they are losing their indepe
B. Would feel more comfortable assuming a normal voiding position
Assuming a normal voiding position helps patients relax and be able to void; lying in bed is not the typical position in which people void. Men usually are most comfortable when standing; w
The nurse would anticipate inserting a Coud� catheter for which patient?
A. An 8-year-old male undergoing anesthesia for a tonsillectomy
B. A 24-year-old female who is going into labor
C. A 56-year-old male admitted for bladder irrigation
D. An 86-year-ol
C. A 56-year-old male admitted for bladder irrigation
A Coud� catheter has a curved tip that is used for patients with enlarged prostates. This would be indicated for a middle-aged male who needs bladder irrigation. Coud� catheters are not indicated for c
The nurse knows that which indwelling catheter procedure places the patient at greatest risk for acquiring a urinary tract infection?
A. Emptying the drainage bag every 8 hours or when half full
B. Kinking the catheter tubing to obtain a urine specimen
C.
C. Placing the drainage bag on the side rail of the patient's bed
Placing the drainage bag on the side rail of the bed could allow the bag to be raised above the level of the bladder and urine to flow back into the bladder. The urine in the drainage bag i
A nurse notifies the provider immediately if a patient with an indwelling catheter:
A. Complains of discomfort upon insertion of the catheter
B. Places the drainage bag higher than the waist while ambulating
C. Has not collected any urine in the drainage
C. Has not collected any urine in the drainage bag for 2 hours
If the patient has not produced urine in 2 hours, the physician needs to be notified immediately because this could indicate renal failure. Discomfort upon catheter insertion is unpleasant but
The nurse would question an order to insert a urinary catheter on which patient?
A. A 26-year-old patient with a recent spinal cord injury at T2
B. A 30-year-old patient requiring drug screening for employment
C. A 40-year-old patient undergoing bladder r
B. A 30-year-old patient requiring drug screening for employment
Urinary catheterization places the patient at increased risk for infection and should be performed only when necessary. Urine can be obtained via clean-catch technique for a drug screening o
When caring for a hospitalized patient with a urinary catheter, which nursing action best prevents the patient from acquiring an infection?
A. Inserting the catheter using strict clean technique
B. Performing hand hygiene before and after providing perine
B. Performing hand hygiene before and after providing perineal care
Hand hygiene helps prevent infection in patients with a urinary catheter. A catheter should be inserted in the hospital setting using sterile technique. Inflating the balloon fully preven
An 86-year-old patient asks the nurse what lifestyle changes will reduce the chance of a urinary tract infection. Which response is accurate?
A. Urinary tract infections are unavoidable in the elderly because of a weakened immune system
B. Decreasing flui
D. Increasing consumption of acidic foods such as cranberry juice will reduce the chance of infection
Cranberry juice and other acidic foods decrease adherence of bacteria to the bladder wall. Urinary tract infections are avoidable in the elderly populati
A nurse is providing education to a patient being treated for a urinary tract infection. Which of the following statements by the patient indicates an understanding?
A. "Since I'm taking medication, I do not need to worry about proper hygiene."
B. "I shou
C. "My medication may discolor my urine; this should resolve once the medication is stopped."
Some anti-infective medications turn urine colors; this is normal and will dissipate as the medication leaves the system. Even if the patient is on medication, h
To reduce patient discomfort during closed catheter irrigation, the nurse should:
A. Use room temperature irrigation solution
B. Administer the solution as quickly as possible
C. Allow the solution to sit in the bladder for at least 1 hour
D. Raise the ba
A. Use room temperature irrigation solution
Using cold solutions, instilling solutions too quickly, and prolonging filling of the bladder can cause discomfort and cramping. To reduce this, ensure that the solution is at room temperature, lower the solutio
Which observation by the nurse best indicates that bladder irrigation for urinary retention has been effective?
A. Recording an output that is larger than the amount instilled
B. Presence of blood clots or sediment in the drainage bag
C. Reduction in disc
A. Recording an output that is larger than the amount instilled
Recording an output that is greater than what was irrigated into the bladder shows progress that the bladder is draining urine. The other observations do not objectively measure the increase
The nurse anticipates urinary diversion from the kidneys to a site other than the bladder for which patient?
A. A 12 year old female with severe abdominal trauma
B. A 24 year old male with severe genital warts around the urethra
C. A 50 year old male with
A. A 12 year old female with severe abdominal trauma
Urinary diversion would be needed in a patient with abdominal trauma who might have injury to the urinary system. Genital warts are not needed for urinary diversion. Patients with a prostatectomy may re
Which nursing actions are acceptable when collecting a urine specimen? (Select all that apply.)
A. Growing urine cultures for up to 12 hours
B. Labeling all specimens with date, time, and initials
C. Wearing gown, gloves, and mask for all specimen handlin
B. Labeling all specimens with date, time, and initials
D. Allowing the patient adequate time and privacy to void
F. Transporting specimens to the laboratory in a timely fashion
G. Placing a plastic bag over the child's urethra to catch urine
All specimen
The nurse properly obtains a 24-hour urine specimen collection by (Select all that apply.)
A. Asking the patient to void and to discard the first sample
B. Keeping the urine collection container on ice
C. Withholding all patient medications for the day
D.
A. Asking the patient to void and to discard the first sample
B. Keeping the urine collection container on ice
When obtaining a 24-hour urine specimen, it is important to keep the urine in cool condition. The patient should be asked to void and to discard
Which of the following are indications for irrigating a urinary catheter? (Select all that apply.)
A. Sediment occluding within the tubing
B. Blood clots in the bladder following surgery
C. Rupture of the catheter balloon
D. Bladder infection
E. Presence
A. Sediment occluding within the tubing
B. Blood clots in the bladder following surgery
D. Bladder infection
Catheter irrigation is used to flush and remove blockage that may be impeding the catheter from properly draining the bladder. Irrigation is used
Which of the following symptoms are most closely associated with uremic syndrome? (Select all that apply.)
A. Fever
B. Nausea and vomiting
C. Headache
D. Altered mental status
E. Dysuria
B. Nausea and vomiting
C. Headache
D. Altered mental status
Uremic syndrome is associated with end-stage renal disease. Signs and symptoms include headache, altered mental status, coma, seizures, nausea, vomiting, and pericarditis.
The nurse understands that peritoneal dialysis and hemodialysis use which processes to clean the patient's blood? (Select all that apply.)
A. Gravity
B. Osmosis
C. Diffusion
D. Filtration
B. Osmosis
C. Diffusion
Osmosis and diffusion are the two processes used to clean the patient's blood in both types of dialysis. In peritoneal dialysis, osmosis and dialysis occur across the semi-permeable peritoneal membrane. In hemodialysis, osmosis and
When collecting a urine specimen for routine urinalysis from a patient, the nurse must keep in mind which of the following?
A. A sterile specimen is required for collection
B. Results may be altered if a sample is left standing at room temperature for a l
B. Results may be altered if a sample is left standing at room temperature for a long time
Urine chemistry it altered after urine stands at room temperature for a long period of time. For a routine urinalysis, a clean specimen is adequate. The external me
Which of the following would the nurse incorporate into the teaching plan for a patient to promote healthy urinary function?
A. Drinking more then 2,000 mL per day will cause fluid retention
B. The healthy adult should drink four to six 8 oz glasses of wa
D. Caffeine-containing beverages should be monitored to prevent excess intake
Caffeine intake should be limited because it is irritating to the bladder mucosa. It is recommend that the healthy adult drink eight to ten 8 oz glasses of water. Unless a disea
When a person as a fever or diaphoresis, how would the urine output be described?
A. Decreased and highly concentrated
B. Decreased and highly dilute
C. Increased and concentrated
D. Increased and dilute
A. Decreased and highly concentrated
Fever and diaphoresis cause the kidneys to conserve body fluids, Thus, the urine is concentrated and decreased in amount.
The doctor has ordered an indwelling catheter inserted in a hospitalized male patient. The nurse is aware of which of the following considerations?
A. The male urethra is more vulnerable to injury during insertion
B. In the hospital, a clean technique is
A. The male urethra is more vulnerable to injury during insertion
Because of its length the male urethra is more prone to injury and requires that the catheter be inserted 6" to 8". This procedure requires surgical asepsis to prevent introducing bacteria
Nursing care for a patient with an indwelling catheter includes which of the following:
A. Irrigation of the catheter with a 30 mL of normal saline solution every 4 hours
B. Disconnecting and reconnecting the drainage system quickly to obtain a urine samp
C. Encourage a generous fluid intake if not contraindicated by the patient
A generous fluid intake promotes healthy urinary tract function. Irrigation may introduce bacteria into the urinary tract and is not routinely ordered. The drainage system should n
Mr. Chang, a hospitalized patient with diabetes mellitus, has developed a UTI. He is 80 years old and has an indwelling catheter in place. Which factor is most likely the cause of the UTI?
A. The close proximity of the male genitalia to the rectum
B. Decr
D. The indwelling urinary catheter
Most UTI in hospitalized patients are caused by the presence of indwelling catheters. Additionally, although less significant, causes of UTI include a decrease in immunity in elder people with the presence of glucose in
Which of the following terms notes a patient's inability to void even though the kidneys are producing urine that enters the bladder?
A. Urgency
B. Retention
C. Oliguria
D. Dysuria
B. Retention
Urgency is a strong desire to void.
Oliguria is scanty or greatly diminished amount of urine voided in a given time.
Dysuria is difficulty urinating.
Mrs. Jones is an alert, ambulatory, older nursing home resident, who frequently has difficulty making it to the bathroom in time. The nurse planning her care is aware of which of the following?
A. Incontinence is to be expected and a woman of Mrs. Jones a
C. Keagle exercises performed at regular intervals throughout the day mayb e helpful
Keagle exercises may help a patient regain control of the micturition process. Incontinence is not a normal consequence of aging, and at least half of nursing home reside
A patient taking Phenazopyridine (pyridium, a urinary track analgesic) should be cautioned that her urine may change to what color?
A. Pale yellow
B. Green
C. Orange red
D. Brown
C. Orange red
Pyridium is noted for turning the urine orange red, and the patient needs to be aware of this.
Mr. Bales is 60 years old and alert. He is timid and reluctant to talk about his urinary retention problem. Which part of this plan could create stress for Mr. Bales and possibly increase his inability to urinate?
A. Assisting him in assuming his normal v
C. Staying with him while voiding
Mr. Bales will probably be embarrassed if the nurse remains with him as he attempts to void and is more likely to have difficulty voiding.
Which of the following is a nursing priority when caring for a male patient with a condom catheter?
A. Preventing the tubing from kinking to maintain free urinary drainage
B. Not removing the catheter for any reason
C. Fastening the condom tightly to prev
A. Preventing the tubing from kinking to maintain free urinary drainage
The catheter should be allowed to drain freely through toothing that is not kink. It also should be removed daily to prevent skin excoriation and should not be fastened too tightly fo
A patient has a nursing diagnosis of impaired urinary elimination related to maturational enuresis. You recognize that your patient is which of the following?
A. An older adult that is 65 years of age is incontinent
B. A child older than four years of age
B. A child older than four years of age who has an voluntary urination
Maturational enuresis is in voluntary urination after an age when continence should be present. A 12 month old child is not expected to be continent, and incontinence and neurological
Data must be collected to evaluate the effectiveness of a plan to reduce urinary incontinence in an older adult patient. Of the information below, which is the least important for the evaluation process?
A. The incontinence pattern
B. State of physical mo
D. Age of patient
Incontinence is not a natural consequence of the aging process. All the other factors are necessary information for the plan of care.