Prep U Questions and Answers Chapter 37

PrepU Questions and Answers Chapter 37: 1. Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence? a. Boys may take longer for daytime continence than girls. 2. When collecting a urine sample from a client for examination, the nurse notes that the sample appears reddish-brown in color. What could cause this variation in color of the urine? a. blood 3. A client with chronic kidney disease reports not being able to urinate for the past 24 hours. A bladder scan shows no urine in the bladder. How does the nurse document this data? a. Anuria 4. A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain? a. dark brown, cloudy 5. The nurse is providing care for an older adult admitted to the hospital with urinary retention. The client asks the nurse, “What is wrong with me?” Which is the best response by the nurse? a. “As men age, the prostate enlarges over time.” 6. The nurse is caring for a client with an indwelling urinary catheter secondary to neurogenic bladder. The nurse completes a prescription to obtain a urine specimen from the catheter. After reviewing the image, what is the most accurate narrative note the nurse would document to demonstrate the steps to obtain the urine specimen were performed appropriately? a. Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well. 7. A client reports an episode of losing control of urination when a bathroom was not close by. The client states, “I am worried this means that I am starting to lose control of my bladder.” What is the appropriate nursing response? a. “Let’s review your medication history and whether you consume bladder irritants.” 8. A nurse is caring for a client with a hemodialysis access site. Which action should the nurse take? a. Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration. 9. The nurse is reviewing the urinalysis of a client suspected of having a urinary tract infection. The potential diagnosis will be supported by the presence of: a. pus 10. The nurse is preparing to insert an indwelling urinary catheter into a female client's bladder. The nurse has opened the sterile catheterization tray using sterile technique, donned sterile gloves and has opened all sterile supplies. Arrange the following steps in the correct order. a. Clean each labial fold, then the area directly over the meatus b. Insert the lubricated catheter into the urethra c. Advance the catheter until there is a return of urine d. Inflate the balloon with the correct amount of sterile saline e. Discard used supplies 11. The parent of a 5-year-old child tells the nurse that on two occasions her son has lost control of urination when he had to wait to go to the bathroom at school. What is the appropriate nursing response? a. “Let’s review the types of fluids that your child drinks in the morning.” 12. The nurse is caring for a client who informs the nurse that it is difficult to void when experiencing stress, and asks why this happens. Which response by the nurse is appropriate? a. “Stress causes the muscles to become tense.” 13. A 70-year-old client who has four children and six grandchildren states that she “wets” herself when she sneezes or laughs. She reports that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate? a. Stress 14. The client is a new client in the outpatient wellness clinic. The client reports frequent urinary incontinence of recent onset. The nurse reviews the client's list of medications. Which medication classification will the nurse review with the client to determine when the prescription was started? a. Antihypertensive 15. Which catheter would the nurse use to drain a client’s bladder for short periods (5 to 10 minutes)? a. Straight catheter 16. The nurse is caring for a client who reports burning upon urination, and an ongoing sense of needing to urinate. Which urine characteristics does the nurse anticipate? a. Cloudy, foul odor 17. Use of an indwelling urinary catheter leads to the loss of bladder tone. a. True 18. The nurse is caring for a client with weakness who is ambulatory but tires easily. Which method for urinary elimination does the nurse recommend? a. Bedside commode 19. The nurse is educating a client with an ileal conduit about the effects of food and fluid intake on the amount and quality of urine produced by the body. Which teaching points should the nurse include? Select all that apply. a. Dehydration leads to increased fluid reabsorption by the kidneys, leading to decreased and concentrated urine production b. Fluid overload leads to excretion of a large quantity of dilute urine 20. The nurse is inserting a urinary catheter into a 63-year-old male client and encounters resistance. What is the most likely cause of the resistance? a. The client has an enlarged prostate 21. The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client? a. The birth can cause perineal swelling 22. What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence? a. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters 23. An older adult client informs the nurse that they are experiencing urinary incontinence. The client has no other health problems, and states, “I don’t want anybody to know about this problem.” How will the nurse promote the client’s self-esteem? a. Discuss the use of protective undergarments to avoid embarrassment from incontinence 24. The nurse caring for an older adult male client is determining whether the client can use a urinal to void. Which aspects of the client's medical history may contraindicate the use of a urinal? a. The client is acutely confused and has been diagnosed with delirium 25. A sterile urine specimen for culture and sensitivity has been prescribed for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? a. Withdraw several milliliters of urine from the port on the collection tubing, using aseptic technique 26. The nurse is preparing to place a Foley catheter for a female client who will soon have surgery. Into what position will the nurse place the client? a. Dorsal recumbent 27. A woman is reporting bladder urgency. It is most important to assess: a. Caffeine intake 28. The nurse is caring for a client who has been experiencing nausea, vomiting, and diarrhea for 3 days. Which urine characteristics does the nurse anticipate? a. Strongly aromatic, dark amber 29. Which urinary care teaching will the nurse provide to a young adult female client? a. Refrain from douching unless ordered by a health care provider 30. The nurse is teaching an older adult female client who must provide a urine specimen. Which is the proper method to instruct the client to use to obtain a clean-catch urine specimen? a. Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet. 31. A client at a health care facility is being treated for cancer of the bladder. The physician uses a urinary diversion to help the client with urinary elimination. What describes a urinary diversion? a. One or both of the ureters are surgically implanted elsewhere 32. A nurse is preparing a discharge teaching plan for a client being sent home with a peritoneal dialysis catheter in place. Which guideline should be included in the instructions? a. The client should avoid wearing tight clothes or belts near the site 33. A 70-year-old client confides to the nurse that she is “terribly embarrassed” that she has developed urinary incontinence over the past year. Which nursing response supports the client’s self-esteem? a. “Let’s explore structuring activities and toileting breaks.” 34. The nurse is preparing a client for a cystoscopy procedure. Which intervention would be part of the preparation for this? a. Having the client sign a consent form for the procedure 35. The nurse is performing a portable bladder ultrasound on a client who has palpable bladder distention. The scanner reveals little urine in the bladder. What should the nurse do next? a. Ensure proper positioning of the scanner head and rescan 36. The nurse has an order to obtain a 24-hour urine specimen from a client. Which instruction would be accurate for collection of the specimen? a. “Discard your first urine and begin the collection after that.” 37. The client is preparing to obtain a clean-catch midstream urine specimen. Place in order the steps needed to complete the diagnostic test. Use all options. a. Provide instruction to the client b. Clean the area surrounding the urinary meatus with the provided cloth c. d. e. f. Void a small amount into toilet or bedpan Void into the provided collection device Secure the lid on the specimen container Submit collected specimen to the health care professional 38. The nurse is choosing a collection device to collect urine from a nonambulatory male client. What would be the nurse’s best choice? a. Urinal 39. While providing care to a client admitted to the health care facility, the client states that she has "a burning sensation when urinating." After further questioning, the nurse inspects the client's perineal area. Which sign/symptom would the nurse document as an abnormal finding? a. Reddened perineal skin 40. The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate? a. Dehydration 41. A client who visits a health care facility for a routine assessment reports to the nurse being unable to control urinary elimination. This has resulted in the client soiling clothes and has led to a lot of embarrassment. Which nursing intervention will be appropriate to use with this client? a. Regular toileting routine