NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
Urinary Diseases
1. The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal
calculi. When planning this patients health education, what nutritional guidelines should the nurse
provide?
A. Restrict protein intake as ordered.
B. Increase intake of potassium-rich foods.
C. Follow a low-calcium diet.
D. Encourage intake of food containing oxalates.
Ans: A. Protein is restricted to 60 g/d, while sodium is restricted to 3 to 4 g/d. Low-calcium diets are
generally not recommended except for true absorptive hypercalciuria. The patient should avoid
intake of oxalate- containing foods and there is no need to increase potassium intake.
2. The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day.
What instruction should the nurse give the patient?
A. Limit oral fluid intake for 1 to 2 days.
B. Report the presence of fine, sand like particles through the nephrostomy
tube. C. Notify the physician about cloudy or foul-smelling urine.
D. Report any pink-tinged urine within 24 hours after the procedure.
Ans: C. The patient should report the presence of foul-smelling or cloudy urine since this is suggestive
of a UTI. Unless contraindicated, the patient should be instructed to drink large quantities of fluid each
day to flush the kidneys. Sand like debris is normal due to residual stone products. Hematuria is
common after lithotripsy.
3. A female patients most recent urinalysis results are suggestive of bacteriuria. When assessing
this patient, the nurses data analysis should be informed by what principle?
A. Most UTIs in female patients are caused by viruses and do not cause obvious symptoms.
B. A diagnosis of bacteriuria requires three consecutive positive results.
C. Urine contains varying levels of healthy bacterial flora.
D. Urine samples are frequently contaminated by bacteria normally present in the
urethral area.
Ans: D. Because urine samples (especially in women) are commonly contaminated by the
5
bacteria normally present in the urethral area, a bacterial count exceeding01
colonies/mL of clean-
catch, midstream urine is the measure that distinguishes true bacteriuria from
contamination. A diagnosis does not require three consecutive positive results and urine
does not contain a normal flora in the absence of a UTI. Most UTIs have a bacterial etiology.
4. The clinic nurse is preparing a plan of care for a patient with a history of stress incontinence. What
role will the nurse have in implementing a behavioral therapy approach?
A. Provide medication teaching related to pseudoephedrine
sulfate. B. Teach the patient to perform pelvic floor muscle
exercises.
C. Prepare the patient for an anterior vaginal repair procedure.
1
,NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
D. Provide information on periurethral bulking.
Ans: B. Pelvic floor muscle exercises (sometimes called Kegel exercises) represent the cornerstone of
behavioral intervention for addressing symptoms of stress, urge, and mixed incontinence. None of the
other listed interventions has a behavioral approach.
5. The nurse and urologist have both been unsuccessful in catheterizing a patient with a prostatic
obstruction and a full bladder. What approach does the nurse anticipate the physician using to drain
the patients bladder?
A. Insertion of a suprapubic catheter
B. Scheduling the patient immediately for a prostatectomy
C. Application of warm compresses to the perineum to assist with relaxation
D. Medication administration to relax the bladder muscles and reattempting catheterization in 6hrs
Ans: A. When the patient cannot void, catheterization is used to prevent overdistention of the bladder.
In the case of prostatic obstruction, attempts at catheterization by the urologist may not be successful,
requiring insertion of a suprapubic catheter. A prostatectomy may be necessary, but would not be
undertaken for the sole purpose of relieving a urethral obstruction. Delaying by applying compresses
or administering medications could result in harm.
6. The nurse has implemented a bladder retraining program for an older adult patient. The nurse places
the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The
nurse notes that the patient typically has approximately 50 mL of urine remaining in her bladder after
voiding. What would be the nurses best response to this finding?
A. Perform a straight catheterization on this patient.
B. Avoid further interventions at this time, as this is an acceptable finding.
C. Place an indwelling urinary catheter.
D. Press on the patients bladder in an attempt to encourage complete emptying
Ans: B. In adults older than 60 years of age, 50 to 100 mL of residual urine may remain after
each voiding because of the decreased contractility of the detrusor muscle. Consequently,
further interventions are not likely warranted.
7. The nurse is caring for a patient recently diagnosed with renal calculi. The nurse should instruct the
patient to increase fluid intake to a level where the patient produces at least how much urine each
day?
A. 1,250 mL
B. 2,000 mL
C. 2,750 mL
D. 3,500 mL
Ans: B. Unless contraindicated by renal failure or hydronephrosis, patients with renal stones should
drink at least eight 8-ounce glasses of water daily or have IV fluids prescribed to keep the urine dilute.
A urine output exceeding 2 L a day is advisable.
8. A patient with cancer of the bladder has just returned to the unit from the PACU after surgery to create an
ileal conduit. The nurse is monitoring the patients urine output hourly and notifies the physician when
the hourly output is less than what?
A. 30 mL
B. 50 mL
C. 100 mL
2
,NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
D. 125 mL
Ans: A. A urine output below 30 mL/hr may indicate dehydration or an obstruction in the ileal conduit,
with possible backflow or leakage from the ureteroileal anastomosis.
9. The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that
what nursing action helps prevent infection in a patient with an indwelling catheter?
A. Vigorously clean the meatus area daily.
B. Apply powder to the perineal area twice daily.
C. Empty the drainage bag at least every 8 hours.
D. Irrigate the catheter every 8 hours with normal saline.
Ans: C. To reduce the risk of bacterial proliferation, the nurse should empty the collection bag at least
every 8 hours through the drainage spout, and more frequently if there is a large volume of urine.
Vigorous cleaning of the meatus while the catheter is in place is discouraged, because the cleaning
action can move the catheter, increasing the risk of infection. The spout (or drainage port) of any
urinary drainage bag can become contaminated when opened to drain the bag. Irrigation of the
catheter opens the closed system, increasing the likelihood of infection.
10.The nurse is teaching a health class about UTIs to a group of older adults. What characteristic of
UTIs should the nurse cite?
A. Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic.
B. The prevalence of UTIs in men older than 50 years of age approaches that of women in the
same age group.
C. Men of all ages are less prone to UTIs, but typically experience more severe symptoms.
D. The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.
Ans: B. The antibacterial activity of the prostatic secretions that protect men from bacterial
colonization of the urethra and bladder decreases with aging. The prevalence of infection in men older
than 50 years of age approaches that of women in the same age group. Men are not more likely to be
asymptomatic and are not known to be reluctant to report UTIs.
11.A patient has been admitted to the postsurgical unit following the creation of an ileal conduit.
What should the nurse measure to determine the size of the appliance needed?
A. The circumference of the stoma
B. The narrowest part of the
stoma C. The widest part of the
stoma
D. Half the width of the stoma
Ans: C. The correct appliance size is determined by measuring the widest part of the stoma with a
ruler. The permanent appliance should be no more than 1.6 mm (1/8 inch) larger than the diameter of
the stoma and the same shape as the stoma to prevent contact of the skin with drainage.
16.A patient being treated in the hospital has been experiencing occasional urinary retention. What
nursing action should the nurse take to encourage a patient who is having difficulty voiding?
A. Use a slipper bedpan.
B. Apply a cold compress to the perineum.
C. Have the patient lie in a supine
position. D. Provide privacy for the patient.
Ans: D. Nursing measures to encourage normal voiding patterns include providing privacy, ensuring an
3
, NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
environment and body position conducive to voiding, and assisting the patient with the use of the
bathroom or bedside commode, rather than a bedpan, to provide a more natural setting for voiding.
Most people find supine positioning not conducive to voiding.
17.A nurses colleague has applied an incontinence pad to an older adult patient who has experienced
occasional episodes of functional incontinence. What principle should guide the nurses management
of urinary incontinence in older adults?
A. Diuretics should be promptly discontinued when an older adult experiences incontinence.
B. Restricting fluid intake is recommended for older adults experiencing incontinence.
C. Urinary catheterization is a first-line treatment for incontinence in older adults
with incontinence.
D. Urinary incontinence is not considered a normal consequence of aging.
Ans: D. Nursing management is based on the premise that incontinence is not inevitable with illness
or aging and that it is often reversible and treatable. Diuretics cannot always be safely discontinued.
Fluid restriction and catheterization are not considered to be safe, first-line interventions for the
treatment of incontinence.
18. The nurse is working with a patient who has been experiencing episodes of urinary retention.
What assessment finding would suggest that the patient is experiencing retention?
A. The patients suprapubic region is dull on percussion.
B. The patient is uncharacteristically drowsy.
C. The patient claims to void large amounts of urine 2 to 3 times daily.
D. The patient takes a beta adrenergic blocker for the treatment of hypertension.
Ans: A. Dullness on percussion of the suprapubic region is suggestive of urinary retention. Patients
retaining urine are typically restless, not drowsy. A patient experiencing retention usually voids
frequent, small amounts of urine and the use of beta-blockers is unrelated to urinary retention.
19.A patient with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL).
What should the nurse include in the patients post-procedure care?
A. Strain the patients urine following the procedure.
B. Administer a bolus of 500 mL normal saline following the procedure.
C. Monitor the patient for fluid overload following the procedure.
D. Insert a urinary catheter for 24 to 48 hours after the procedure.
Ans: A. Following ESWL, the nurse should strain the patients urine for gravel or sand. There is no need
to administer an IV bolus after the procedure and there is not a heightened risk of fluid overload.
Catheter insertion is not normally indicated following ESWL.
20. The nurse is caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours
postoperatively, the nurses assessment reveals that the stoma is a dark purplish color. What is the
nurses most appropriate response?
A. Document the presence of a healthy stoma.
B. Assess the patient for further signs and symptoms of infection.
C. Inform the primary care provider that the vascular supply may be compromised.
4
2022/2023 UPDATE
Urinary Diseases
1. The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal
calculi. When planning this patients health education, what nutritional guidelines should the nurse
provide?
A. Restrict protein intake as ordered.
B. Increase intake of potassium-rich foods.
C. Follow a low-calcium diet.
D. Encourage intake of food containing oxalates.
Ans: A. Protein is restricted to 60 g/d, while sodium is restricted to 3 to 4 g/d. Low-calcium diets are
generally not recommended except for true absorptive hypercalciuria. The patient should avoid
intake of oxalate- containing foods and there is no need to increase potassium intake.
2. The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day.
What instruction should the nurse give the patient?
A. Limit oral fluid intake for 1 to 2 days.
B. Report the presence of fine, sand like particles through the nephrostomy
tube. C. Notify the physician about cloudy or foul-smelling urine.
D. Report any pink-tinged urine within 24 hours after the procedure.
Ans: C. The patient should report the presence of foul-smelling or cloudy urine since this is suggestive
of a UTI. Unless contraindicated, the patient should be instructed to drink large quantities of fluid each
day to flush the kidneys. Sand like debris is normal due to residual stone products. Hematuria is
common after lithotripsy.
3. A female patients most recent urinalysis results are suggestive of bacteriuria. When assessing
this patient, the nurses data analysis should be informed by what principle?
A. Most UTIs in female patients are caused by viruses and do not cause obvious symptoms.
B. A diagnosis of bacteriuria requires three consecutive positive results.
C. Urine contains varying levels of healthy bacterial flora.
D. Urine samples are frequently contaminated by bacteria normally present in the
urethral area.
Ans: D. Because urine samples (especially in women) are commonly contaminated by the
5
bacteria normally present in the urethral area, a bacterial count exceeding01
colonies/mL of clean-
catch, midstream urine is the measure that distinguishes true bacteriuria from
contamination. A diagnosis does not require three consecutive positive results and urine
does not contain a normal flora in the absence of a UTI. Most UTIs have a bacterial etiology.
4. The clinic nurse is preparing a plan of care for a patient with a history of stress incontinence. What
role will the nurse have in implementing a behavioral therapy approach?
A. Provide medication teaching related to pseudoephedrine
sulfate. B. Teach the patient to perform pelvic floor muscle
exercises.
C. Prepare the patient for an anterior vaginal repair procedure.
1
,NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
D. Provide information on periurethral bulking.
Ans: B. Pelvic floor muscle exercises (sometimes called Kegel exercises) represent the cornerstone of
behavioral intervention for addressing symptoms of stress, urge, and mixed incontinence. None of the
other listed interventions has a behavioral approach.
5. The nurse and urologist have both been unsuccessful in catheterizing a patient with a prostatic
obstruction and a full bladder. What approach does the nurse anticipate the physician using to drain
the patients bladder?
A. Insertion of a suprapubic catheter
B. Scheduling the patient immediately for a prostatectomy
C. Application of warm compresses to the perineum to assist with relaxation
D. Medication administration to relax the bladder muscles and reattempting catheterization in 6hrs
Ans: A. When the patient cannot void, catheterization is used to prevent overdistention of the bladder.
In the case of prostatic obstruction, attempts at catheterization by the urologist may not be successful,
requiring insertion of a suprapubic catheter. A prostatectomy may be necessary, but would not be
undertaken for the sole purpose of relieving a urethral obstruction. Delaying by applying compresses
or administering medications could result in harm.
6. The nurse has implemented a bladder retraining program for an older adult patient. The nurse places
the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The
nurse notes that the patient typically has approximately 50 mL of urine remaining in her bladder after
voiding. What would be the nurses best response to this finding?
A. Perform a straight catheterization on this patient.
B. Avoid further interventions at this time, as this is an acceptable finding.
C. Place an indwelling urinary catheter.
D. Press on the patients bladder in an attempt to encourage complete emptying
Ans: B. In adults older than 60 years of age, 50 to 100 mL of residual urine may remain after
each voiding because of the decreased contractility of the detrusor muscle. Consequently,
further interventions are not likely warranted.
7. The nurse is caring for a patient recently diagnosed with renal calculi. The nurse should instruct the
patient to increase fluid intake to a level where the patient produces at least how much urine each
day?
A. 1,250 mL
B. 2,000 mL
C. 2,750 mL
D. 3,500 mL
Ans: B. Unless contraindicated by renal failure or hydronephrosis, patients with renal stones should
drink at least eight 8-ounce glasses of water daily or have IV fluids prescribed to keep the urine dilute.
A urine output exceeding 2 L a day is advisable.
8. A patient with cancer of the bladder has just returned to the unit from the PACU after surgery to create an
ileal conduit. The nurse is monitoring the patients urine output hourly and notifies the physician when
the hourly output is less than what?
A. 30 mL
B. 50 mL
C. 100 mL
2
,NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
D. 125 mL
Ans: A. A urine output below 30 mL/hr may indicate dehydration or an obstruction in the ileal conduit,
with possible backflow or leakage from the ureteroileal anastomosis.
9. The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that
what nursing action helps prevent infection in a patient with an indwelling catheter?
A. Vigorously clean the meatus area daily.
B. Apply powder to the perineal area twice daily.
C. Empty the drainage bag at least every 8 hours.
D. Irrigate the catheter every 8 hours with normal saline.
Ans: C. To reduce the risk of bacterial proliferation, the nurse should empty the collection bag at least
every 8 hours through the drainage spout, and more frequently if there is a large volume of urine.
Vigorous cleaning of the meatus while the catheter is in place is discouraged, because the cleaning
action can move the catheter, increasing the risk of infection. The spout (or drainage port) of any
urinary drainage bag can become contaminated when opened to drain the bag. Irrigation of the
catheter opens the closed system, increasing the likelihood of infection.
10.The nurse is teaching a health class about UTIs to a group of older adults. What characteristic of
UTIs should the nurse cite?
A. Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic.
B. The prevalence of UTIs in men older than 50 years of age approaches that of women in the
same age group.
C. Men of all ages are less prone to UTIs, but typically experience more severe symptoms.
D. The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.
Ans: B. The antibacterial activity of the prostatic secretions that protect men from bacterial
colonization of the urethra and bladder decreases with aging. The prevalence of infection in men older
than 50 years of age approaches that of women in the same age group. Men are not more likely to be
asymptomatic and are not known to be reluctant to report UTIs.
11.A patient has been admitted to the postsurgical unit following the creation of an ileal conduit.
What should the nurse measure to determine the size of the appliance needed?
A. The circumference of the stoma
B. The narrowest part of the
stoma C. The widest part of the
stoma
D. Half the width of the stoma
Ans: C. The correct appliance size is determined by measuring the widest part of the stoma with a
ruler. The permanent appliance should be no more than 1.6 mm (1/8 inch) larger than the diameter of
the stoma and the same shape as the stoma to prevent contact of the skin with drainage.
16.A patient being treated in the hospital has been experiencing occasional urinary retention. What
nursing action should the nurse take to encourage a patient who is having difficulty voiding?
A. Use a slipper bedpan.
B. Apply a cold compress to the perineum.
C. Have the patient lie in a supine
position. D. Provide privacy for the patient.
Ans: D. Nursing measures to encourage normal voiding patterns include providing privacy, ensuring an
3
, NURS 101 ADULT HEALTH EXAM 4 QUESTIONS WITH ANSWERS
2022/2023 UPDATE
environment and body position conducive to voiding, and assisting the patient with the use of the
bathroom or bedside commode, rather than a bedpan, to provide a more natural setting for voiding.
Most people find supine positioning not conducive to voiding.
17.A nurses colleague has applied an incontinence pad to an older adult patient who has experienced
occasional episodes of functional incontinence. What principle should guide the nurses management
of urinary incontinence in older adults?
A. Diuretics should be promptly discontinued when an older adult experiences incontinence.
B. Restricting fluid intake is recommended for older adults experiencing incontinence.
C. Urinary catheterization is a first-line treatment for incontinence in older adults
with incontinence.
D. Urinary incontinence is not considered a normal consequence of aging.
Ans: D. Nursing management is based on the premise that incontinence is not inevitable with illness
or aging and that it is often reversible and treatable. Diuretics cannot always be safely discontinued.
Fluid restriction and catheterization are not considered to be safe, first-line interventions for the
treatment of incontinence.
18. The nurse is working with a patient who has been experiencing episodes of urinary retention.
What assessment finding would suggest that the patient is experiencing retention?
A. The patients suprapubic region is dull on percussion.
B. The patient is uncharacteristically drowsy.
C. The patient claims to void large amounts of urine 2 to 3 times daily.
D. The patient takes a beta adrenergic blocker for the treatment of hypertension.
Ans: A. Dullness on percussion of the suprapubic region is suggestive of urinary retention. Patients
retaining urine are typically restless, not drowsy. A patient experiencing retention usually voids
frequent, small amounts of urine and the use of beta-blockers is unrelated to urinary retention.
19.A patient with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL).
What should the nurse include in the patients post-procedure care?
A. Strain the patients urine following the procedure.
B. Administer a bolus of 500 mL normal saline following the procedure.
C. Monitor the patient for fluid overload following the procedure.
D. Insert a urinary catheter for 24 to 48 hours after the procedure.
Ans: A. Following ESWL, the nurse should strain the patients urine for gravel or sand. There is no need
to administer an IV bolus after the procedure and there is not a heightened risk of fluid overload.
Catheter insertion is not normally indicated following ESWL.
20. The nurse is caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours
postoperatively, the nurses assessment reveals that the stoma is a dark purplish color. What is the
nurses most appropriate response?
A. Document the presence of a healthy stoma.
B. Assess the patient for further signs and symptoms of infection.
C. Inform the primary care provider that the vascular supply may be compromised.
4
