Exam (elaborations)
Chapter 41 Urinary Elimination
- Course
- Fundamentals of Nursing
- Institution
- Oxford College Of Emory University
Chapter 41 Urinary Elimination
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DAWITChapter 41: Urinary Elimination
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3RD Edition
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. The nurse recognizes which type of renal failure the patient
most likely developed?
a. Prerenal
b. Renal
c. Postrenal
d. Mixed
ANS: A
Prerenal failure occurs as a result of reduction in blood flow to the kidneys, which would
occur with septic shock. Causes of prerenal failure include dehydration, vascular collapse, and
low cardiac output. Structural issues with the kidneys, from primary glomerular diseases or
vascular lesions, result in renal failure. Postrenal failure is related to a mechanical or
functional obstruction of the flow of urine.
DIF: Applying OBJ: 41.2 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation
NOT: Concepts: Elimination
2. The nurse is caring for a patient with a neurological condition that causes constant severe
thirst, drinking fluids continuNusR
oU , aI
lyS dG
nN voTidBin.gC
3OtoM4 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 OBJ: 41.2 TOP: Documentation
MSC: NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation
NOT: Concepts: Elimination
3. The nurse is caring for a patient who is experiencing stress incontinence. The nurse identifies
which goal to be 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
, DAWIT
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 OBJ: 41.5 TOP: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity: Basic Care and Comfort
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. 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 6 to 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 OBJ: 41.6 TOP: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential
NOT: Concepts: Elimination NURSINGTB.COM
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. Impaired sexual function related to changed body structure
b. Social isolation related to potential for accidental leakage of urine
c. Lack of knowledge 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 lack of knowledge
about ostomy care.
DIF: Understanding OBJ: 41.4 TOP: Diagnosis
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: Concepts: Patient Education
6. The nurse is caring for a patient who reports an urgent need to urinate but is unable to pass
more than a few drops of urine in the toilet. Which is the priority assessment to be performed
by the nurse?
a. Bladder scan to determine the amount of urine in the bladder
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