Chapter 28. Urinary Elimination

Chapter 28. Urinary Elimination

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

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