NSG 4067: URINARY FUNCTION
1. A nurse develops a plan of care for a family with nursing diagnosis of Caregiver Role Strain
related to urinary incontinence. Which of the following interventions is the highest priority?
A) Administer diphenhydramine at bedtime.
B) Assist the client to the bathroom prior to bedtime.
C) Limit the fluid intake of the client to 1000 mL each day.
D) Monitor bowels for diarrhea and constipation.
Ans: B
Feedback:
Walking the client to the bathroom encourages voiding prior to bedtime. Urinary incontinence is
a major factor that impacts placement in an institution. Fluid intake should be carefully timed
and should be about 2,000 mL per day. Diphenhydramine relaxes bladder muscles, which can
lead to urinary retention and incontinence.
2. A nurse presents at a conference regarding functional consequences related to urinary
elimination. Which of the following statements should the nurse include?
A) "Most older women will develop urinary incontinence by the age of 85."
B) "Most older adults will experience hypertrophy and relaxation of muscles in the urinary
tract and pelvic floor."
C) "Excretion of penicillin and cimetidine are decreased in older adults."
D) "Healthy older adults experience an increase in glomerular filtration rate."
Ans: C
Feedback:
Age-related changes in kidney function can impact water-soluble medications that are highly
dependent on the glomerular filtration rate. This would include digoxin, penicillin,
aminoglycosides, and cimetidine.
3. A nurse assesses the urinary elimination of older adults. Which of the following actions by the
nurse is most appropriate?
A) Work to identify terms that the older adult comprehends.
B) Wait until the person initiates a discussion of this embarrassing topic.
C) Give the interview questions to the client in writing.
D) Ask the older adult to keep a urination diary.
Ans: A
, Feedback:
Although nurses usually learn to discuss urinary elimination with relative ease, older adults may
feel uncomfortable with the topic, especially if there are gender or age differences between the
older person and the nurse. In addition, older adults may be reluctant to discuss urinary problems
because they tend to accept urinary leakage as an inevitable consequence of aging and gradually
increase their tolerance threshold. Because of varying social contexts, successful interviewing
about urinary elimination and incontinence depends on identifying the terms that are least
embarrassing and most understandable to the older adult.
4. A nurse teaches an older adult man to perform pelvic floor muscle exercises (PFME)? Which
of the following should be included in a nurse's instructions?
A) Interrupt the flow of urine several times each time you urinate.
B) Identify the correct muscle by making the base of your penis move up and down.
C) Contract your legs and buttocks while contracting the pubococcygeal muscle.
D) Perform the exercise while standing over the toilet.
Ans: B
Feedback:
An important element of teaching about pelvic floor exercises is to identify the pubococcygeal
muscle and practice contracting and relaxing this muscle. For men, this can be done by raising
the base of the penis. Once the muscles have been identified, do not continue to stop urinary
flow. These exercises can be performed sitting, standing, or lying down. Keep legs, buttocks, and
abdomen relaxed.
5. A nurse administers medications to an older man. Which of the following statements if made
by the client indicates understanding of the use of tamsulosin?
A) "I am so happy that this medication is working to decrease my urinary incontinence."
B) "I now have had much less bladder pain and cramping."
C) "My blood pressure has been higher since taking this medication."
D) "My urine flow starts much faster now."
Ans: D
Feedback:
Alpha-blockers or 5-alpha reductase inhibitors are used for prostate enlargement and bladder
outlet obstruction: alfuzosin, doxazosin, dutasteride, finasteride, tamsulosin, and terazosin.
Alpha-blockers decrease blood pressure, do not impact bladder pain, and are not generally used
to treat urinary incontinence.
1. A nurse develops a plan of care for a family with nursing diagnosis of Caregiver Role Strain
related to urinary incontinence. Which of the following interventions is the highest priority?
A) Administer diphenhydramine at bedtime.
B) Assist the client to the bathroom prior to bedtime.
C) Limit the fluid intake of the client to 1000 mL each day.
D) Monitor bowels for diarrhea and constipation.
Ans: B
Feedback:
Walking the client to the bathroom encourages voiding prior to bedtime. Urinary incontinence is
a major factor that impacts placement in an institution. Fluid intake should be carefully timed
and should be about 2,000 mL per day. Diphenhydramine relaxes bladder muscles, which can
lead to urinary retention and incontinence.
2. A nurse presents at a conference regarding functional consequences related to urinary
elimination. Which of the following statements should the nurse include?
A) "Most older women will develop urinary incontinence by the age of 85."
B) "Most older adults will experience hypertrophy and relaxation of muscles in the urinary
tract and pelvic floor."
C) "Excretion of penicillin and cimetidine are decreased in older adults."
D) "Healthy older adults experience an increase in glomerular filtration rate."
Ans: C
Feedback:
Age-related changes in kidney function can impact water-soluble medications that are highly
dependent on the glomerular filtration rate. This would include digoxin, penicillin,
aminoglycosides, and cimetidine.
3. A nurse assesses the urinary elimination of older adults. Which of the following actions by the
nurse is most appropriate?
A) Work to identify terms that the older adult comprehends.
B) Wait until the person initiates a discussion of this embarrassing topic.
C) Give the interview questions to the client in writing.
D) Ask the older adult to keep a urination diary.
Ans: A
, Feedback:
Although nurses usually learn to discuss urinary elimination with relative ease, older adults may
feel uncomfortable with the topic, especially if there are gender or age differences between the
older person and the nurse. In addition, older adults may be reluctant to discuss urinary problems
because they tend to accept urinary leakage as an inevitable consequence of aging and gradually
increase their tolerance threshold. Because of varying social contexts, successful interviewing
about urinary elimination and incontinence depends on identifying the terms that are least
embarrassing and most understandable to the older adult.
4. A nurse teaches an older adult man to perform pelvic floor muscle exercises (PFME)? Which
of the following should be included in a nurse's instructions?
A) Interrupt the flow of urine several times each time you urinate.
B) Identify the correct muscle by making the base of your penis move up and down.
C) Contract your legs and buttocks while contracting the pubococcygeal muscle.
D) Perform the exercise while standing over the toilet.
Ans: B
Feedback:
An important element of teaching about pelvic floor exercises is to identify the pubococcygeal
muscle and practice contracting and relaxing this muscle. For men, this can be done by raising
the base of the penis. Once the muscles have been identified, do not continue to stop urinary
flow. These exercises can be performed sitting, standing, or lying down. Keep legs, buttocks, and
abdomen relaxed.
5. A nurse administers medications to an older man. Which of the following statements if made
by the client indicates understanding of the use of tamsulosin?
A) "I am so happy that this medication is working to decrease my urinary incontinence."
B) "I now have had much less bladder pain and cramping."
C) "My blood pressure has been higher since taking this medication."
D) "My urine flow starts much faster now."
Ans: D
Feedback:
Alpha-blockers or 5-alpha reductase inhibitors are used for prostate enlargement and bladder
outlet obstruction: alfuzosin, doxazosin, dutasteride, finasteride, tamsulosin, and terazosin.
Alpha-blockers decrease blood pressure, do not impact bladder pain, and are not generally used
to treat urinary incontinence.
