Chapter 41: Urinary Elimination

Chapter 41: Urinary Elimination

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

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