PSU
Penn State University
152 • 2 MAXE
NURS College of Nursing — NURS 251 Exam 2 (Part 2)
W E A R E · P E N N S TAT E
251
NURS 251 — Exam 2 (Part 2)
U R I N A R Y, B O W E L , M E D I C AT I O N S , I V T H E R A P Y, R E S P I R ATO R Y & N U R S I N G P R O C E SS
INSTITUTION Penn State University EXAM CODE PSU-NURS251-EX2B-2026
PROGRAM NURS 251 — Health Assessment ACADEMIC YEAR
EXAM TITLE Exam 2 — Urinary, Bowel, Medications, IV, TOTAL QUESTIONS 25 Questions — Comprehensive Review
Respiratory
COURSE TITLE Health Assessment FORMAT Multiple Choice / True-False
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover urinary elimination (anatomy, incontinence types, catheterization), bowel elimination (assessment, alterations,
ostomy care), medication administration (rights, routes, pharmacokinetics), IV therapy (solutions, complications, sites),
respiratory assessment (lung sounds, oxygen therapy), and the nursing process.
▸ Distinguish carefully between stress/urge/reflex/functional/total incontinence, isotonic/hypotonic/hypertonic IV solutions, and
discontinuous vs. continuous lung sounds.
▸ Correct answers and detailed rationales appear below each question.
SECTION I — URINARY, BOWEL, MEDICATIONS, IV, RESPIRATORY & Questions 1 –
NURSING PROCESS 25
1. The urinary system is comprised of which structures?
A. Liver, gallbladder, pancreas, and spleen
B. Kidneys, ureters, bladder, urethra, and urinary meatus
C. Stomach, small intestine, large intestine, and rectum
D. Heart, arteries, veins, and capillaries
CORRECT ANSWER B — The urinary system consists of the kidneys, ureters, bladder, urethra, and urinary meatus. The
kidneys perform glomerular filtration (producing ~1% as urine), reabsorption (water, amino acids,
glucose, electrolytes), and secretion (ammonia, creatinine, uric acid).
RATIONALE The kidneys filter approximately 180 L of blood daily, producing 1–1.5 L of urine. Functions: (1) Glomerular
filtration — filters blood; (2) Reabsorption — returns water, glucose, amino acids, and electrolytes to
bloodstream; (3) Secretion — removes waste products (creatinine, uric acid, ammonia, drug metabolites). The
bladder stores urine and signals the need to void. Normal adult voiding: 6–8 times/day, typically upon
waking, within an hour after meals, and before bedtime.
, 2. Stress incontinence is best defined as:
A. Sudden, involuntary loss of small amounts of urine (<50 mL) due to increased abdominal pressure — occurs with
coughing, sneezing, laughing, or lifting
B. Involuntary loss of urine after a strong urge to void
C. Continuous, unpredictable loss of urine
D. Inability to reach the bathroom in time due to physical barriers
CORRECT ANSWER A — Stress incontinence: small-volume urine loss with activities that increase intra-abdominal
pressure (coughing, sneezing, laughing, lifting, exercising). Caused by weakened pelvic floor muscles
and urethral sphincter.
RATIONALE Urinary incontinence types: Stress — small volume loss with increased abdominal pressure (pelvic floor
weakness, post-childbirth, post-prostate surgery); Urge — involuntary loss after strong urge to void
(overactive bladder, diuretics, caffeine, UTI); Reflex — predictable intervals when specific bladder volume
reached, no sensation (spinal cord/brain injury); Functional — inability to reach bathroom in time
(environmental barriers, physical limitations, cognitive impairment); Total — continuous, unpredictable loss
(neurologic lesion, congenital malformation, surgical injury).
3. True or False: Urinary incontinence is a normal part of aging.
A. True
B. False — incontinence is NOT a normal part of aging and should always be investigated
CORRECT ANSWER FALSE — Urinary incontinence is NOT a normal consequence of aging. It is a symptom that requires
evaluation and treatment.
RATIONALE Age-related changes that affect urinary elimination but are NOT incontinence: decreased bladder capacity,
decreased bladder muscle tone, decreased renal blood flow, prostate enlargement in men, weakened pelvic
muscles in women. True incontinence is always pathological — causes include UTI, medications, pelvic floor
dysfunction, neurological disorders, obstruction, and functional barriers. All types of incontinence are
treatable.
4. Indications for indwelling (Foley) catheterization include all of the following EXCEPT:
A. Monitoring critically ill patients when accurate urinary output assessment is necessary
B. Urinary retention not manageable by intermittent catheterization
C. Convenience for the nursing staff to avoid toileting assistance
D. Management of urinary incontinence in patients with Stage III or IV pressure ulcers on the trunk
CORRECT ANSWER C — Convenience for staff is NEVER an indication for catheterization. Catheters should only be used
when medically necessary due to the significant infection risk.
RATIONALE Legitimate indications: (1) Accurate output monitoring in critically ill patients; (2) Management of
terminally/severely ill patients; (3) Urinary retention not manageable by intermittent catheterization; (4)
Stage III/IV pressure ulcers on the trunk contaminated by urine. Risks of catheterization: CAUTI (catheter-
associated UTI — most common HAI), trauma, loss of bladder tone, urethral strictures. Catheters should be
removed as soon as clinically appropriate. Daily assessment of continued need is required.
Penn State University
152 • 2 MAXE
NURS College of Nursing — NURS 251 Exam 2 (Part 2)
W E A R E · P E N N S TAT E
251
NURS 251 — Exam 2 (Part 2)
U R I N A R Y, B O W E L , M E D I C AT I O N S , I V T H E R A P Y, R E S P I R ATO R Y & N U R S I N G P R O C E SS
INSTITUTION Penn State University EXAM CODE PSU-NURS251-EX2B-2026
PROGRAM NURS 251 — Health Assessment ACADEMIC YEAR
EXAM TITLE Exam 2 — Urinary, Bowel, Medications, IV, TOTAL QUESTIONS 25 Questions — Comprehensive Review
Respiratory
COURSE TITLE Health Assessment FORMAT Multiple Choice / True-False
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover urinary elimination (anatomy, incontinence types, catheterization), bowel elimination (assessment, alterations,
ostomy care), medication administration (rights, routes, pharmacokinetics), IV therapy (solutions, complications, sites),
respiratory assessment (lung sounds, oxygen therapy), and the nursing process.
▸ Distinguish carefully between stress/urge/reflex/functional/total incontinence, isotonic/hypotonic/hypertonic IV solutions, and
discontinuous vs. continuous lung sounds.
▸ Correct answers and detailed rationales appear below each question.
SECTION I — URINARY, BOWEL, MEDICATIONS, IV, RESPIRATORY & Questions 1 –
NURSING PROCESS 25
1. The urinary system is comprised of which structures?
A. Liver, gallbladder, pancreas, and spleen
B. Kidneys, ureters, bladder, urethra, and urinary meatus
C. Stomach, small intestine, large intestine, and rectum
D. Heart, arteries, veins, and capillaries
CORRECT ANSWER B — The urinary system consists of the kidneys, ureters, bladder, urethra, and urinary meatus. The
kidneys perform glomerular filtration (producing ~1% as urine), reabsorption (water, amino acids,
glucose, electrolytes), and secretion (ammonia, creatinine, uric acid).
RATIONALE The kidneys filter approximately 180 L of blood daily, producing 1–1.5 L of urine. Functions: (1) Glomerular
filtration — filters blood; (2) Reabsorption — returns water, glucose, amino acids, and electrolytes to
bloodstream; (3) Secretion — removes waste products (creatinine, uric acid, ammonia, drug metabolites). The
bladder stores urine and signals the need to void. Normal adult voiding: 6–8 times/day, typically upon
waking, within an hour after meals, and before bedtime.
, 2. Stress incontinence is best defined as:
A. Sudden, involuntary loss of small amounts of urine (<50 mL) due to increased abdominal pressure — occurs with
coughing, sneezing, laughing, or lifting
B. Involuntary loss of urine after a strong urge to void
C. Continuous, unpredictable loss of urine
D. Inability to reach the bathroom in time due to physical barriers
CORRECT ANSWER A — Stress incontinence: small-volume urine loss with activities that increase intra-abdominal
pressure (coughing, sneezing, laughing, lifting, exercising). Caused by weakened pelvic floor muscles
and urethral sphincter.
RATIONALE Urinary incontinence types: Stress — small volume loss with increased abdominal pressure (pelvic floor
weakness, post-childbirth, post-prostate surgery); Urge — involuntary loss after strong urge to void
(overactive bladder, diuretics, caffeine, UTI); Reflex — predictable intervals when specific bladder volume
reached, no sensation (spinal cord/brain injury); Functional — inability to reach bathroom in time
(environmental barriers, physical limitations, cognitive impairment); Total — continuous, unpredictable loss
(neurologic lesion, congenital malformation, surgical injury).
3. True or False: Urinary incontinence is a normal part of aging.
A. True
B. False — incontinence is NOT a normal part of aging and should always be investigated
CORRECT ANSWER FALSE — Urinary incontinence is NOT a normal consequence of aging. It is a symptom that requires
evaluation and treatment.
RATIONALE Age-related changes that affect urinary elimination but are NOT incontinence: decreased bladder capacity,
decreased bladder muscle tone, decreased renal blood flow, prostate enlargement in men, weakened pelvic
muscles in women. True incontinence is always pathological — causes include UTI, medications, pelvic floor
dysfunction, neurological disorders, obstruction, and functional barriers. All types of incontinence are
treatable.
4. Indications for indwelling (Foley) catheterization include all of the following EXCEPT:
A. Monitoring critically ill patients when accurate urinary output assessment is necessary
B. Urinary retention not manageable by intermittent catheterization
C. Convenience for the nursing staff to avoid toileting assistance
D. Management of urinary incontinence in patients with Stage III or IV pressure ulcers on the trunk
CORRECT ANSWER C — Convenience for staff is NEVER an indication for catheterization. Catheters should only be used
when medically necessary due to the significant infection risk.
RATIONALE Legitimate indications: (1) Accurate output monitoring in critically ill patients; (2) Management of
terminally/severely ill patients; (3) Urinary retention not manageable by intermittent catheterization; (4)
Stage III/IV pressure ulcers on the trunk contaminated by urine. Risks of catheterization: CAUTI (catheter-
associated UTI — most common HAI), trauma, loss of bladder tone, urethral strictures. Catheters should be
removed as soon as clinically appropriate. Daily assessment of continued need is required.
