Chapter 28 Urinary Elimination

Chapter 28  Urinary Elimination

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. While performing a physical assessment, the student nurse tells her instructor that she cannot palpate her patient’s bladder. Which statement by the instructor is best?
a)
“Try to palpate it again; it takes practice but you will locate it.”
b)
“Palpate the patient’s bladder only when it is distended by urine.”
c)
“Document this abnormal finding on the patient’s chart.”
d)
“Immediately notify the nurse assigned to the care of your patient.”

ANS: B
The bladder is not palpable unless it is distended by urine. It is not difficult to palpate the bladder when distended. The nurse should document her finding, but it is not an abnormal finding. It is not necessary to notify the nurse assigned to the patient.

Difficulty: Easy
Nursing Process: Assessment
Client Need: PSI
Cognitive Level: Application

PTS: 1

2. Which urine specific gravity would be expected in a patient admitted with dehydration?
a)
1.002
b)
1.010
c)
1.021
d)
1.030

ANS: D
Normal urine specific gravity ranges from 1.010 to 1.025. Specific gravity less than 1.010 indicates fluid volume excess, such as when the patient has fluid overload (too much IV fluid) or when the kidneys fail to concentrate urine. Specific gravity greater than 1.025 is a sign of deficient fluid volume that occurs, for example, as a result of blood loss or dehydration.

Difficulty: Moderate
Nursing Process: Assessment
Client Need: PSI
Cognitive Level: Application

PTS: 1

3. The nurse identifies the nursing diagnosis Urinary Incontinence (Total) in an older adult patient admitted after a stroke. Urinary Incontinence places the patient at risk for which complication?
a)
Skin breakdown
b)
Urinary tract infection
c)
Bowel incontinence
d)
Renal calculi

ANS: A
Urine contains ammonia, which may cause excoriation with prolonged contact with the skin. Bowel incontinence, not urinary incontinence, increases the patient’s risk for urinary tract infection. Immobility and high consumption of calcium-containing foods increase the risk for renal calculi.

Difficulty: Moderate
Nursing Process: Assessment
Client Need: PSI
Cognitive Level: Application

PTS: 1

4. The nurse is caring for a patient who underwent a bowel resection 2 hours ago. His urine output for the past 2 hours totals 50 mL. Which action should the nurse take?
a)
Do nothing; this is normal postoperative urine output.
b)
Increase the infusion rate of the patient’s IV fluids.
c)
Notify the provider about the patient’s oliguria.
d)
Administer the patient’s routine diuretic dose early.

ANS: C
The amount of 50 mL in 2 hours is not normal output. The kidneys typically produce 60 mL of urine per hour. Therefore, the nurse should notify the provider when the patient shows diminished urine output (oliguria). Patients who undergo abdominal surgery commonly require increased infusions of IV fluid during the immediate postoperative period. The nurse cannot provide increased IV fluids without a provider’s order. The nurse should not administer any medications before the scheduled time without a prescription. The provider may hold the patient’s scheduled dose of diuretic if he determines that the patient is experiencing deficient fluid volume.

Difficulty: Difficult
Nursing Process: Interventions
Client Need: PSI
Cognitive Level: Application

PTS: 1

5. The nurse measures the urine output of a patient who requires a bedpan to void. Which action should the nurse take first? Put on gloves and:
a)
Have the patient void directly into the bedpan
b)
Pour the urine into a graduated container
c)
Read the volume with the container on a flat surface at eye level
d)
Observe the color and clarity of the urine in the bedpan

ANS: A
First, the nurse should put on gloves and have the patient void directly into the bedpan. Next, she should pour the urine into a graduated container, place the measuring device on a flat surface, and read the amount at eye level. She should observe the urine for color, clarity, and odor. Then, if no specimen is required, she should discard the urine in the toilet and clean the container and bedpan. Finally, she should record the amount of urine voided on the patient’s intake and output record.

Difficulty: Easy
Nursing Process: Interventions
Client Need: Safe and Effective Care
Cognitive Level: Analysis

PTS: 1