NUR224 EXAM-URINARY ELIMINATION TEST BANK
QUESTIONS WITH ANSWERS 2022/2023
MULTIPLE CHOICE
If obstructed, which component of the urination system would cause peristaltic waves?
a.
Kidney
b.
Ureters
c.
Bladder
d.
Urethra
ANS: B
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 and urethra typically does not occur.
DIF: Remember REF: 1044 OBJ: Describe the process of urination.
TOP: Evaluation of Urinary Complications MSC: Urinary
When reviewing laboratory results, the nurse should immediately notify the health
care provider about which finding?
a.
Glomerular filtration rate of 20 mL/min
b.
Urine output of 80 mL/hr
c.
pH of 6.4
d.
Protein level of 2 mg/100 mL
ANS: A
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/hr or less for 2 or more hours would
be cause for concern. The normal pH of urine is between 4.6 and 8.0. Protein up to 8 mg/100
mL is acceptable; however, values in excess of this could indicate renal disease.
DIF: Apply REF: 1043| 1052
OBJ: Describe the nursing implications of common diagnostic tests of the urinary system.
TOP: Implementation MSC: Urinary Elimination
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.
ANS: C
,NUR224 EXAM-URINARY ELIMINATION TEST BANK
QUESTIONS WITH ANSWERS 2022/2023
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 the patient is retaining water. Increasing fluids is effective if
the patient does not have adequate intake, or if dehydration occurs. Caffeine can work as a
diuretic but is not helpful if an underlying pathology is present. An order for diuretics can be
obtained if the patient was retaining water, but this should not be the first action.
DIF: Analyze REF: 1045
OBJ: Describe characteristics of normal and abnormal urine. TOP: Assessment
MSC: Urinary Elimination
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 muscles to relax
enough to void.
b.
The patient does not recognize the physiological signals that indicate a need to
void.
c.
The patient is lonely, and calling the nurse in under false pretenses is a way to
get attention.
d.
The patient is not drinking enough fluids to produce adequate urine output.
ANS: A
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 and adequate time if
appropriate. No evidence suggests that an underlying physiological or psychological
condition exists.
DIF: Understand REF: 1045
OBJ: Identify factors that commonly influence urinary elimination.
TOP: Implementation MSC: Urinary Elimination
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 sphincters.
d.
The patient will not interrupt the procedure by asking to go to the bathroom.
ANS: C
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
voiding. With spinal anesthesia, the patient will not be able to ambulate during the procedure.
A full bladder has no impact on the pulse rate of the mother.
DIF: Understand REF: 1045
OBJ: Identify factors that commonly influence urinary elimination.
, NUR224 EXAM-URINARY ELIMINATION TEST BANK
QUESTIONS WITH ANSWERS 2022/2023
TOP: Implementation MSC: Urinary Elimination
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.
Escherichia coli pathogens are transmitted during surgical or
catheterization procedures.
c.
Perineal care is often neglected by nursing staff.
d.
Bedpans and urinals are not stored properly and transmit infection.
ANS: B
E. coli is the leading pathogen causing UTIs; this pathogen enters during procedures. Sterile
technique is imperative to prevent the spread of infection. Frequent catheterizations can place
a patient at high risk for UTI; however, infection is caused by bacteria, not by the procedure
itself. Perineal care is important, and buildup of bacteria can lead to infection, but this is not
the greatest cause. Bedpans and urinals may become bacteria ridden and should be cleaned
frequently. Bedpans and urinals are not inserted into the urinary tract, so they are unlikely to
be the primary cause of UTI.
DIF: Understand REF: 1046-1047
OBJ: Compare and contrast common alterations in urinary elimination.
TOP: Implementation MSC: Urinary Elimination
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
ANS: D
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. Urgency is the feeling of the need to void
immediately.
DIF: Apply REF: 1047
OBJ: Identify nursing diagnoses appropriate for patients with alterations in urinary elimination.
TOP: Nursing Diagnosis MSC: Urinary Elimination
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 problem?
a.
Clear the path to the bathroom of all obstacles before bed.
b.
Leave the bathroom light on to illuminate a pathway.
c.
Limit fluid and caffeine intake before bed.
QUESTIONS WITH ANSWERS 2022/2023
MULTIPLE CHOICE
If obstructed, which component of the urination system would cause peristaltic waves?
a.
Kidney
b.
Ureters
c.
Bladder
d.
Urethra
ANS: B
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 and urethra typically does not occur.
DIF: Remember REF: 1044 OBJ: Describe the process of urination.
TOP: Evaluation of Urinary Complications MSC: Urinary
When reviewing laboratory results, the nurse should immediately notify the health
care provider about which finding?
a.
Glomerular filtration rate of 20 mL/min
b.
Urine output of 80 mL/hr
c.
pH of 6.4
d.
Protein level of 2 mg/100 mL
ANS: A
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/hr or less for 2 or more hours would
be cause for concern. The normal pH of urine is between 4.6 and 8.0. Protein up to 8 mg/100
mL is acceptable; however, values in excess of this could indicate renal disease.
DIF: Apply REF: 1043| 1052
OBJ: Describe the nursing implications of common diagnostic tests of the urinary system.
TOP: Implementation MSC: Urinary Elimination
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.
ANS: C
,NUR224 EXAM-URINARY ELIMINATION TEST BANK
QUESTIONS WITH ANSWERS 2022/2023
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 the patient is retaining water. Increasing fluids is effective if
the patient does not have adequate intake, or if dehydration occurs. Caffeine can work as a
diuretic but is not helpful if an underlying pathology is present. An order for diuretics can be
obtained if the patient was retaining water, but this should not be the first action.
DIF: Analyze REF: 1045
OBJ: Describe characteristics of normal and abnormal urine. TOP: Assessment
MSC: Urinary Elimination
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 muscles to relax
enough to void.
b.
The patient does not recognize the physiological signals that indicate a need to
void.
c.
The patient is lonely, and calling the nurse in under false pretenses is a way to
get attention.
d.
The patient is not drinking enough fluids to produce adequate urine output.
ANS: A
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 and adequate time if
appropriate. No evidence suggests that an underlying physiological or psychological
condition exists.
DIF: Understand REF: 1045
OBJ: Identify factors that commonly influence urinary elimination.
TOP: Implementation MSC: Urinary Elimination
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 sphincters.
d.
The patient will not interrupt the procedure by asking to go to the bathroom.
ANS: C
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
voiding. With spinal anesthesia, the patient will not be able to ambulate during the procedure.
A full bladder has no impact on the pulse rate of the mother.
DIF: Understand REF: 1045
OBJ: Identify factors that commonly influence urinary elimination.
, NUR224 EXAM-URINARY ELIMINATION TEST BANK
QUESTIONS WITH ANSWERS 2022/2023
TOP: Implementation MSC: Urinary Elimination
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.
Escherichia coli pathogens are transmitted during surgical or
catheterization procedures.
c.
Perineal care is often neglected by nursing staff.
d.
Bedpans and urinals are not stored properly and transmit infection.
ANS: B
E. coli is the leading pathogen causing UTIs; this pathogen enters during procedures. Sterile
technique is imperative to prevent the spread of infection. Frequent catheterizations can place
a patient at high risk for UTI; however, infection is caused by bacteria, not by the procedure
itself. Perineal care is important, and buildup of bacteria can lead to infection, but this is not
the greatest cause. Bedpans and urinals may become bacteria ridden and should be cleaned
frequently. Bedpans and urinals are not inserted into the urinary tract, so they are unlikely to
be the primary cause of UTI.
DIF: Understand REF: 1046-1047
OBJ: Compare and contrast common alterations in urinary elimination.
TOP: Implementation MSC: Urinary Elimination
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
ANS: D
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. Urgency is the feeling of the need to void
immediately.
DIF: Apply REF: 1047
OBJ: Identify nursing diagnoses appropriate for patients with alterations in urinary elimination.
TOP: Nursing Diagnosis MSC: Urinary Elimination
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 problem?
a.
Clear the path to the bathroom of all obstacles before bed.
b.
Leave the bathroom light on to illuminate a pathway.
c.
Limit fluid and caffeine intake before bed.
