Chapter 41 Urinary Elimination

Chapter 41  Urinary Elimination

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse is caring for a patient who is recovering from septic shock. While in the ICU, the patient developed renal failure. Which type of renal failure did the patient most likely develop?
a.
Prerenal
b.
Renal
c.
Post-renal
d.
Mixed

ANS: A
Vascular collapse and lack of blood flow to the kidneys from septic shock led to renal failure. The patient experienced prerenal failure because the cause was prior to the kidneys rather than damage to the kidneys itself or urinary structures.

DIF: Applying REF: p. 1077 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Adaptation: Alterations in Body Systems
NOT: Concepts: Elimination

2. The nurse is caring for a patient with diabetes insipidus. The patient has constant severe thirst, drinks fluids continuously, and voids 3 to 4 L of clear yellow urine daily. Which term will the nurse use in the record to describe this patient’s urinary output?
a.
Anuria
b.
Oliguria
c.
Polyuria
d.
Enuresis

ANS: C
Urinary output greater than 2500 mL/day is polyuria. Insufficient urine output is oliguria, whereas absence of urine is anuria. Enuresis is commonly known as “bedwetting” at night.

DIF: Understanding REF: p. 1078 TOP: Documentation
MSC: NCLEX Client Needs Category: Physiological Adaptation: Alterations in Body Systems
NOT: Concepts: Elimination

3. The nurse is caring for a patient who is experiencing stress incontinence. Which goal is the most important for this patient?
a.
The patient will carefully complete a voiding diary for the duration of 2 weeks.
b.
The patient will not experience involuntary urination during coughing or sneezing.
c.
The patient will be able to recognize and effectively manage perineal dermatitis.
d.
The patient will demonstrate how to appropriately use urinary incontinence products.

ANS: B
The patient with stress incontinence experiences loss of urine when coughing, sneezing, laughing, or exercising. The highest priority goal for this patient is to not experience incontinence at all and remain continent through all daily activities. If the patient remains continent, perineal dermatitis will not be a problem and urinary incontinence products will not be needed.

DIF: Understanding REF: p. 1079 TOP: Planning
MSC: NCLEX Client Needs Category: Basic Care and Comfort: Elimination
NOT: Concepts: Elimination

4. The nurse is caring for a postoperative patient whose urinary catheter was removed 8 hours previously. The patient has not been able to void since the catheter was removed and now reports suprapubic pain. What is the priority action of the nurse?
a.
Encourage oral fluid intake and administer a diuretic.
b.
Obtain a urine sample to test for culture and sensitivity.
c.
Carefully calculate the patient’s daily intake and output.
d.
Obtain an order to straight-catheterize the patient.

ANS: D
The patient who has not voided for 8 hours after urinary catheter removal and is complaining of suprapubic pain has acute urinary retention. The physician should be notified to obtain an order for straight catheterization to drain the bladder. A urine sample for culture and sensitivity is not ordered. Encouraging fluid intake and administering a diuretic will increase the amount of urine in the bladder and make the patient even more uncomfortable.

DIF: Applying REF: p. 1091 TOP: Implementation
MSC: NCLEX Client Needs Category: Reduction of Risk Potential: Potential for Complications from Surgical Procedures NOT: Concepts: Elimination

5. The nurse is caring for a patient who recently underwent ileal conduit surgery. Which nursing diagnosis is the highest priority for this patient?
a.
Ineffective sexuality pattern related to changed body structure
b.
Social isolation related to potential for accidental leakage of urine
c.
Knowledge deficit related to care and maintenance of ostomy appliance
d.
Disturbed body image related to presence of stoma and appliance

ANS: C
The patient with a new ileal conduit needs to learn how to care for the urinary stoma and appliance prior to discharge from the hospital. If the appliance is not used and applied correctly, the patient may experience urinary leakage and significant skin breakdown from exposure to urine. The other diagnoses are less important than the patient’s knowledge deficit about ostomy care.

DIF: Applying REF: p. 1081 | p. 1087 TOP: Diagnosis
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance: Self-Care
NOT: Concepts: Patient Education