Quiz 84: Urinary Elimination Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition

Questions 27
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Quiz 84: Urinary Elimination
Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition

Questions 27
Instructor Verified Answers Included
WarofGrades Guaranteed A+ Graded Tutorial

MULTIPLE CHOICE

1. The nurse is assessing a patient whose 24-hour output is 2400 mL. Which finding reflects the nurse’s understanding of urine output?
a. Increased output
b. Decreased output
c. Normal output
d. Balanced output

2. On the basis of the nurse’s assessment of kidney function for an adult patient, which finding is normal?
a. 10 mL/hr
b. 20 mL/hr
c. 30 mL/hr
d. 100 mL/hr

3. Which activities related to urinary elimination may be delegated to a nursing assistive personnel (NAP)?
a. Catheterization
b. Positioning the patient
c. Evaluating alternatives to catheter use
d. Assessing urinary drainage

4. The nurse is planning care for a 12-year-old female patient who needs a Foley catheter inserted. It is most important for the nurse to use a catheter of which size French (Fr)?
a. 5 to 6 Fr
b. 8 to 10 Fr
c. 12 Fr
d. 14 to 16 Fr

5. The nurse notes that urine does not flow after a female patient is catheterized. The nurse believes that the catheter has been placed into the vagina. Which action should the nurse take?
a. Remove the catheter and reinsert it.
b. Irrigate the catheter with saline.
c. Leave the catheter in place and insert another one.
d. Insert the catheter 9 to 10 inches farther into the patient to verify that it is in the vagina.

6. When the balloon on an indwelling urinary catheter is inflated and the patient expresses discomfort, it is essential for the nurse to take which action?
a. Remove the catheter.
b. Continue to blow up the balloon because discomfort is expected.
c. Aspirate the fluid from the balloon and advance the catheter.
d. Pull back on the catheter slightly to determine tension.

7. The nurse is caring for a patient who has an indwelling urinary catheter. Which intervention is most important to include in this patient’s plan of care?
a. Maintaining tension on the tubing
b. Emptying the urinary collection bag every 24 hours
c. Cleaning in a circular motion from the meatus down the catheter
d. Keeping the drainage bag on the bed or attached to the side rails

8. The nurse has been ordered to perform closed intermittent irrigation of a patient’s indwelling urinary catheter. Which intervention is indicative of safe practice?
a. Applies sterile gloves.
b. Instills 100 mL of irrigant.
c. Leaves the drainage tubing unclamped irrigation.
d. Determines the amount of urinary drainage by subtracting the amount of irrigant from the total output.

9. When evaluating the health care team member’s ability to apply a condom catheter, it is most important for the nurse to provide further instruction for which intervention?
a. Clipping of hair at the base of the penis
b. Applying skin preparation to the penis before catheter placement
c. Using regular adhesive tape to hold the catheter in place
d. Leaving 1 to 2 inches of space between the tip of the penis and the end of the catheter

10. When providing care for a patient with a suprapubic catheter who has acquired a urinary tract infection (UTI), which intervention is most important for the nurse to implement?
a. Using clean technique
b. Securing the tube to the inner thigh
c. Cleansing the insertion site in a direction toward the drain
d. Promoting intake of 2200 mL of fluid per day

11. Which symptom is the patient with fluid overload likely to exhibit?
a. Oliguria
b. Distended neck veins
c. Increased skin temperature
d. Increased urine specific gravity

12. When observing a patient for symptoms of dehydration, the nurse should observe which assessment?
a. Increased salivation
b. Diuresis
c. Periorbital edema
d. Decreased capillary filling

13. When providing care for a patient in need of an indwelling catheter, the nurse understands that which of the following is an indication for this need?
a. Presence of stage III and IV pressure ulcers
b. Presence of a yeast infection
c. Need for inaccurate measurement of urinary output
d. Need to manage urinary elimination

14. The nurse receives an order to insert a Foley catheter. In obtaining a catheter of the right size, the nurse is aware that large catheters can lead to which complication?
a. Urethral damage
b. Bladder relaxation
c. Obstruction of urinary flow
d. Decreased risk for infection

15. The nurse is caring for a patient who has an indwelling catheter attached to a drainage bag. To achieve the desired outcome of this procedure, which nursing action should be taken?
a. Make sure the tubing has dependent loops to gather urine.
b. Make sure the tubing is coiled and secured to the bed.
c. Make sure the tubing is kinked.
d. Make sure the collection bag is higher than the bladder.

16. The nurse is caring for a patient who is experiencing inadequate bladder emptying. To determine postvoid residual, which technique is most important for the nurse to implement?
a. Bladder scanner
b. Indwelling catheterization
c. Straight/intermittent catheterization
d. Foley catheterization

17. The nurse is preparing the patient for a bladder scan to determine postvoid residual (PVR). Which of the following is part of the preparation?
a. Limit food intake for 2 hours before the scan.
b. Begin scan 10 minutes after the patient has voided.
c. Limit liquid intake for 30 minutes before the scan.
d. Administer an analgesic 30 minutes before the scan.

MULTIPLE RESPONSE

1. In assisting a male patient in using a urinal, which of the following actions should the nurse take? (Select all that apply.)
a. Assess for orthostatic hypotension.
b. Assess the patient’s normal elimination habits.
c. Assess for periods of incontinence.
d. Prop the urinal in place if the patient is unable to hold it.
e. Always stay with the patient during urinal use.

2. The nurse has inserted an indwelling catheter and secured the catheter to the patient’s thigh, making sure that there is enough slack that movement will not create tension on the catheter. The nurse understands that the chief purpose of properly securing Foley catheters is to obtain which outcome? (Select all that apply.)
a. Minimized risk for bleeding
b. Reduced risk for bladder spasm
c. Reduced risk for meatal necrosis
d. Reduced risk for trauma
e. Increased bladder relaxation

COMPLETION

1. Antimicrobial catheters coated with silver or antibiotics have been shown to reduce the incidence of ________________.

2. The risk for catheter-associated urinary tract infection can be reduced by using ___________ when inserting the catheter.

3. A single-lumen catheter that is inserted into the bladder through the urethra only to empty the bladder and then is removed is known as a _______________ catheter.

4. An ______________ has a separate lumen that is used to inflate a balloon so the catheter remains in the bladder for short- or long-term use.

5. _________________ is the volume of urine in the bladder after a normal voiding.

6. A noninvasive device that is used to provide accurate determination of a patient’s bladder volume by first creating an ultrasound image of the patient’s bladder and then calculating the urine volume in the bladder is known as a ______________.

7. A ___________________ is a noninvasive alternative for management of male urinary incontinence. Because it is noninvasive, the risk for urinary tract infection (UTI) is decreased. The device fits over the penis and connects to a small collection bag that attaches to the leg with a strap, or to a standard urinary collection bag that hangs on the bedframe below the level of the bladder.

8. __________________ involves the insertion of a urinary catheter directly into the bladder through the lower abdominal wall. Urine drains from the catheter into a urinary drainage bag.

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