Chapter 33: Urinary Elimination

Chapter 33: Urinary Elimination

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

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

 

 

ANS:  C

Know the average output range for a patient. Adult urinary output averages 2200 to 2700 mL in 24 hours.

 

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 811

OBJ:   Identify factors that alter normal voiding.                          TOP:   Normal Urinary Output

KEY:  Nursing Process Step: Evaluation     MSC:  NCLEX: Physiological Integrity

 

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

 

 

ANS:  C

Minimum average hourly output is 30 mL.

 

DIF:    Cognitive Level: Knowledge            REF:   Text reference: p. 811| Text reference: p. 815

OBJ:   Identify factors that alter normal voiding.                          TOP:   Normal Urinary Output

KEY:  Nursing Process Step: Evaluation     MSC:  NCLEX: Physiological Integrity

 

3. Which activities related to urinary elimination may be delegated to a nursing assistant?

a.	Catheterization
b.	Positioning the patient
c.	Evaluating alternatives to catheter use
d.	Assessing urinary drainage

 

 

ANS:  B

NAP may assist with positioning the patient, focusing lighting for the procedure, and enhancing the patient’s comfort during the procedure through measures such as holding the patient’s hand or keeping the patient warm. The nurse uses sterile asepsis when inserting an indwelling or straight catheter to reduce the risk for bladder infection. The nurse evaluates possible alternatives to catheter use, and assessment is the responsibility of the nurse.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 813

OBJ:   Describe devices used to promote urinary elimination.

TOP:   Delegation Considerations for Inserting a Urinary Catheter

KEY:  Nursing Process Step: Intervention   MSC:  NCLEX: Physiological Integrity

 

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?

a.	5 to 6 French (Fr)
b.	8 to 10 Fr
c.	12 Fr
d.	14 to 16 Fr

 

 

ANS:  C

Gender and age determine catheter size. A 12 Fr catheter may be considered for use in young girls. The prescriber may order a larger size. For infants, 5 to 6 Fr is generally used; for children, 8 to 10 Fr with a 3-mL balloon is used; and 14 to 16 Fr is indicated for adult women.

 

DIF:    Cognitive Level: Analysis                REF:   Text reference: p. 812

OBJ:   Perform the following skills: insert a urinary catheter, and provide care for an indwelling urinary catheter.  TOP:           Size of Urinary Catheter

KEY:  Nursing Process Step: Intervention   MSC:  NCLEX: Physiological Integrity

 

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.

 

 

ANS:  C

If no urine appears, check whether the catheter is in the vagina. If misplaced, leave the catheter in the vagina as a landmark indicating where not to insert it, and insert another catheter into the meatus. Reinserting a catheter that has already been contaminated by vaginal exposure could lead to urinary tract infection.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 819 |Text reference: p. 822

OBJ:   Perform the following skills: place and remove a urinal, insert a urinary catheter, and provide care for an indwelling urinary catheter.  TOP:              Inserting Catheter Into a Female Patient

KEY:  Nursing Process Step: Intervention   MSC:  NCLEX: Physiological Integrity