Chapter 34: Urinary Elimination

Chapter 34: Urinary Elimination

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. An 80-year-old woman with a history of diabetes and arthritis has made an appointment with her health care provider for complaints of urinary incontinence (UI). The patient states that she has recently become incontinent of urine and thinks it is because of her age. What is the best response from the nurse?

ANS:   C

Functional UI is caused by factors that prohibit or interfere with a patient’s access to the toilet or other acceptable receptacle for urine. It is a significant problem for older adults who experience problems with mobility or the dexterity to manage their clothing and toileting behaviors. Functional UI may also be caused by poor motivation for continence, as seen in severe depression or by cognitive decline that has impaired the ability to sense and act upon the urge to void in an appropriate manner. Functional UI can be associated with underlying stress, urge, or mixed UI. In many cases functional incontinence is the direct result of caregivers not responding in a timely manner to requests for help with toileting.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    953-954           OBJ:    Identify factors that commonly influence urinary elimination.

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

2. At a recent staff meeting the staff educator discussed the importance of catheter care for the prevention of urinary tract infections (UTI). What percentage of health care–associated infections result from indwelling catheter use?

ANS:   D

Eighty percent of health care–associated infections are associated with indwelling catheter use.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    953                  OBJ:    Discuss nursing measures to reduce urinary tract infections.

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

3. A 56-year-old patient, who has recently become postmenopausal, made an appointment with her health care provider for symptoms of an UTI. The patient has had three previously diagnosed UTIs in the past 4 months. She asks the nurse if this is a normal occurrence with postmenopausal women. What is the best response from the nurse?

ANS:   A

There is a decrease in estrogenization of perineal tissue in women that increases the risk of urinary tract infection. The vaginal tissue of postmenopausal women may be dryer and less pink than in younger women. Health care providers would not give antibiotics to keep on hand. Nurses should not imply that a UTI is an expected problem of aging. Relaying what the nurse thinks about aging is not appropriate to voice to the patient.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    953 | 962         OBJ:    Discuss nursing measures to reduce urinary tract infections.

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Physiological Integrity

4. A mother has brought her 3-year-old child to the clinic for an annual well-child checkup. The mother tells the nurse that the child is in the process of being potty trained. The child will state that the need to go to the bathroom, but refuses to go on the toilet. What is the nurse’s best response?

ANS:   C

When children begin to achieve bladder control and learn the appropriate skills, they sometimes resist urinating on the toilet. Children often associate their urine and feces as extensions of self, and they do not want to flush part of themselves away. The neurological system is not well developed until 2 to 3 years of age. Up until this time, the small child is not able to associate the sensations of filling and urge with urination. When the child recognizes feelings of urge, he or she can hold urine for 1 to 2 hours, and is able to communicate a need to eliminate, toilet training becomes successful. Fear of falling in the toilet may be a concern, but it is not the most appropriate answer for this question.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    957                  OBJ:    Identify factors that commonly influence urinary elimination.

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity