Chapter 31. Urinary Elimination and Care
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. While evaluating the potential presence of a urinary tract infection (UTI), the nurse would be most interested
in which of the following laboratory values?
1. Urine specific gravity.
2. Urine pH.
3. Blood urea nitrogen.
4. Creatinine.
2. A nurse is caring for a patient with stress incontinence. Teaching has been effective if the patient states:
1. “I need to do Kegel exercises to help strengthen the muscles that control the urine.”
2. “I need to drink fluids with my meals but not in between meals.”
3. “I should not do sit-ups because that will increase my abdominal pressure.”
4. “I should avoid things that make me sneeze or cough.”
3. A nurse is caring for a patient with incontinence who has an order for a catheterized urine specimen to
evaluate the presence of a urinary tract infection. It would be appropriate for the nurse to use
1. An indwelling catheter.
2. A three-way catheter.
3. A straight catheter.
4. A coudé catheter.
4. A nurse receives a report on a patient who just returned from surgery following a transurethral prostatectomy.
The nurse is told that the patient has a urinary catheter. The nurse will most likely find
1. A suprapubic catheter.
2. A three-way catheter.
3. A condom catheter.
4. A coudé catheter.
5. A nurse is caring for a female patient who has a new order for the insertion of a Foley catheter. The
nurse prepares a standard catheter kit and then notes that the patient has a latex allergy. The nurse should
1. Notify the physician that the catheter cannot be placed.
2. Obtain a silicone catheter for the patient.
3. Inform the patient that a catheter cannot be used because of her allergies.
4. Switch the Foley catheter for a three-way catheter.
6. A nurse is preparing to place a Foley catheter. First, the nurse should
1. Apply sterile gloves.
2. Clean the urinary meatus with soap and water.
3. Prepare a sterile field with the needed supplies.
4. Fill the balloon with 5 mL sterile normal saline.
7. A nurse is caring for a patient who has an order for a 24-hour urine specimen collection. The patient asks,
“Why do I have to collect my urine for 24 hours?” The nurse’s best response would be:
1. “A 24-hour urine test is often done to evaluate how your kidneys function.”
2. “Is there some reason that you don’t want this test?”
3. “This test is done to determine whether you have a urinary tract infection.”
4. “I can call your doctor if you’d like to speak with her.”
, 8. A nurse receives a new order for a 24-hour urine collection. The best action by the nurse is to
1. Instruct the patient to collect all urine starting at the next even hour.
2. Obtain a bedside commode to collect the urine.
3. Obtain supplies to insert an indwelling catheter.
4. Instruct the patient to void.
9. While working a night shift and caring for a patient with a 24-hour urine collection that was started at 3:00
p.m., a nursing assistant spills the container. The nurse should
1. Cancel the test and reschedule it for 3:00 p.m. the next day.
2. Document the amount of urine that was spilled.
3. Restart the test the next time the patient voids.
4. Notify the physician.
10. A nurse is caring for a patient with a suspected kidney stone. The patient’s plan of care will most likely
include
1. Obtaining a 24-hour urine collection.
2. Providing oral antibiotics.
3. Instructing the patient to avoid tub baths.
4. Straining all urine.
11. A nurse is caring for a patient with a kidney infection. Output is tallied at the end of the shift, and the nurse
notes that the patient has voided 240 mL in the past 8 hours. Next, the nurse should
1. Notify the physician.
2. Document the amount as normal output.
3. Take the patient’s temperature.
4. Evaluate the patient’s blood pressure.
12. A nurse is monitoring the intake and output of a patient who is unable to ambulate to the bathroom. After the
patient uses the bedside commode, the nurse should
1. Estimate the amount of urine in the bedside commode.
2. Pour the urine into a graduated container to obtain a measurement.
3. Document that the patient has voided but not try to determine a specific amount.
4. Provide a marked specimen pan to be used the next time the patient uses the
bedside commode.
13. A nurse is caring for a patient who is being evaluated for urinary retention. Approximately 10 minutes after
the patient voids, the nurse uses the bladder scan and determines that the patient has 80 mL urine remaining
in the bladder. The best statement by the nurse is:
1. “Your bladder is still pretty full. Do you think you can void again?”
2. “You have a large amount of residual or leftover urine in your bladder, so I will need
to notify the doctor.”
3. “You must have really great kidneys to make so much urine so quickly.”
4. “There is still some urine in your bladder, but it is within the limit of what is
considered normal.”
14. A nurse is providing care for a patient who recently had bladder surgery. The patient is being discharged and
will need to perform self-catheterization every 4 hours at home. Which of the following statements will the
nurse include in the discharge teaching?
1. “You will need to have someone who can do this for you throughout the day.”
2. “You will need to use a new suprapubic catheter each time you catheterize yourself.”
3. “The straight catheter will be inserted through the urethra and into the bladder to
allow urine to be emptied.”
, 4. “This is somewhat difficult. Maybe the doctor will order an indwelling catheter for
you instead.”
15. A nurse is caring for a patient who has a three-way catheter with continuous bladder irrigation after a
transurethral prostatectomy. The nurse notices a decrease in output in the urinary drainage bag. The
nurse should first
1. Increase the flow rate to flush out clots that may be blocking the catheter.
2. Identify when the patient last had his or her pain medication.
3. Instruct the patient to bear down to make sure that the bladder is empty.
4. Palpate the patient’s abdomen.
16. A nurse is providing teaching for a woman who is being treated for a urinary tract infection (UTI). The nurse
would instruct the patient to contact the physician with which of the following symptoms?
1. Nocturia
2. A feeling of urgency
3. Incontinence
4. Flank pain
17. A nurse recognizes that teaching has been effective if a patient selects which of the following beverages while
undergoing treatment for a urinary tract infection (UTI)?
1. Apple juice
2. Cranberry juice
3. Tea
4. Coffee
18. A nurse is providing home care for a patient who performs self-catheterization. The nurse would be most
concerned if
1. The patient puts on gloves without washing his or her hands.
2. The patient reuses a cleaned catheter each time.
3. The patient uses clean gloves to insert the catheter.
4. The patient denies any sensation of bladder fullness before catheterization.
19. A patient has sustained burns through all skin layers and currently has a urinary output of less than 30 mL/hr.
A nurse identifies this output condition as
1. Turbidity.
2. Anuria.
3. Oliguria.
4. Polyuria.
20. A patient with a urinary tract obstruction is experiencing minimal urine production. A nurse identifies this
temporary output condition as
1. Anuria.
2. Polyuria.
3. Oliguria.
4. Hematuria.
21. A male patient with a recent total hip replacement who cannot ambulate to the bathroom needs assistance with
toileting. A nurse should
1. Assist the patient to the bathroom.
2. Have the patient stand at the bedside and void into a urinal.
3. Have the patient use a fracture pan.
4. Roll the patient onto his side and have him void into a bedpan.
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. While evaluating the potential presence of a urinary tract infection (UTI), the nurse would be most interested
in which of the following laboratory values?
1. Urine specific gravity.
2. Urine pH.
3. Blood urea nitrogen.
4. Creatinine.
2. A nurse is caring for a patient with stress incontinence. Teaching has been effective if the patient states:
1. “I need to do Kegel exercises to help strengthen the muscles that control the urine.”
2. “I need to drink fluids with my meals but not in between meals.”
3. “I should not do sit-ups because that will increase my abdominal pressure.”
4. “I should avoid things that make me sneeze or cough.”
3. A nurse is caring for a patient with incontinence who has an order for a catheterized urine specimen to
evaluate the presence of a urinary tract infection. It would be appropriate for the nurse to use
1. An indwelling catheter.
2. A three-way catheter.
3. A straight catheter.
4. A coudé catheter.
4. A nurse receives a report on a patient who just returned from surgery following a transurethral prostatectomy.
The nurse is told that the patient has a urinary catheter. The nurse will most likely find
1. A suprapubic catheter.
2. A three-way catheter.
3. A condom catheter.
4. A coudé catheter.
5. A nurse is caring for a female patient who has a new order for the insertion of a Foley catheter. The
nurse prepares a standard catheter kit and then notes that the patient has a latex allergy. The nurse should
1. Notify the physician that the catheter cannot be placed.
2. Obtain a silicone catheter for the patient.
3. Inform the patient that a catheter cannot be used because of her allergies.
4. Switch the Foley catheter for a three-way catheter.
6. A nurse is preparing to place a Foley catheter. First, the nurse should
1. Apply sterile gloves.
2. Clean the urinary meatus with soap and water.
3. Prepare a sterile field with the needed supplies.
4. Fill the balloon with 5 mL sterile normal saline.
7. A nurse is caring for a patient who has an order for a 24-hour urine specimen collection. The patient asks,
“Why do I have to collect my urine for 24 hours?” The nurse’s best response would be:
1. “A 24-hour urine test is often done to evaluate how your kidneys function.”
2. “Is there some reason that you don’t want this test?”
3. “This test is done to determine whether you have a urinary tract infection.”
4. “I can call your doctor if you’d like to speak with her.”
, 8. A nurse receives a new order for a 24-hour urine collection. The best action by the nurse is to
1. Instruct the patient to collect all urine starting at the next even hour.
2. Obtain a bedside commode to collect the urine.
3. Obtain supplies to insert an indwelling catheter.
4. Instruct the patient to void.
9. While working a night shift and caring for a patient with a 24-hour urine collection that was started at 3:00
p.m., a nursing assistant spills the container. The nurse should
1. Cancel the test and reschedule it for 3:00 p.m. the next day.
2. Document the amount of urine that was spilled.
3. Restart the test the next time the patient voids.
4. Notify the physician.
10. A nurse is caring for a patient with a suspected kidney stone. The patient’s plan of care will most likely
include
1. Obtaining a 24-hour urine collection.
2. Providing oral antibiotics.
3. Instructing the patient to avoid tub baths.
4. Straining all urine.
11. A nurse is caring for a patient with a kidney infection. Output is tallied at the end of the shift, and the nurse
notes that the patient has voided 240 mL in the past 8 hours. Next, the nurse should
1. Notify the physician.
2. Document the amount as normal output.
3. Take the patient’s temperature.
4. Evaluate the patient’s blood pressure.
12. A nurse is monitoring the intake and output of a patient who is unable to ambulate to the bathroom. After the
patient uses the bedside commode, the nurse should
1. Estimate the amount of urine in the bedside commode.
2. Pour the urine into a graduated container to obtain a measurement.
3. Document that the patient has voided but not try to determine a specific amount.
4. Provide a marked specimen pan to be used the next time the patient uses the
bedside commode.
13. A nurse is caring for a patient who is being evaluated for urinary retention. Approximately 10 minutes after
the patient voids, the nurse uses the bladder scan and determines that the patient has 80 mL urine remaining
in the bladder. The best statement by the nurse is:
1. “Your bladder is still pretty full. Do you think you can void again?”
2. “You have a large amount of residual or leftover urine in your bladder, so I will need
to notify the doctor.”
3. “You must have really great kidneys to make so much urine so quickly.”
4. “There is still some urine in your bladder, but it is within the limit of what is
considered normal.”
14. A nurse is providing care for a patient who recently had bladder surgery. The patient is being discharged and
will need to perform self-catheterization every 4 hours at home. Which of the following statements will the
nurse include in the discharge teaching?
1. “You will need to have someone who can do this for you throughout the day.”
2. “You will need to use a new suprapubic catheter each time you catheterize yourself.”
3. “The straight catheter will be inserted through the urethra and into the bladder to
allow urine to be emptied.”
, 4. “This is somewhat difficult. Maybe the doctor will order an indwelling catheter for
you instead.”
15. A nurse is caring for a patient who has a three-way catheter with continuous bladder irrigation after a
transurethral prostatectomy. The nurse notices a decrease in output in the urinary drainage bag. The
nurse should first
1. Increase the flow rate to flush out clots that may be blocking the catheter.
2. Identify when the patient last had his or her pain medication.
3. Instruct the patient to bear down to make sure that the bladder is empty.
4. Palpate the patient’s abdomen.
16. A nurse is providing teaching for a woman who is being treated for a urinary tract infection (UTI). The nurse
would instruct the patient to contact the physician with which of the following symptoms?
1. Nocturia
2. A feeling of urgency
3. Incontinence
4. Flank pain
17. A nurse recognizes that teaching has been effective if a patient selects which of the following beverages while
undergoing treatment for a urinary tract infection (UTI)?
1. Apple juice
2. Cranberry juice
3. Tea
4. Coffee
18. A nurse is providing home care for a patient who performs self-catheterization. The nurse would be most
concerned if
1. The patient puts on gloves without washing his or her hands.
2. The patient reuses a cleaned catheter each time.
3. The patient uses clean gloves to insert the catheter.
4. The patient denies any sensation of bladder fullness before catheterization.
19. A patient has sustained burns through all skin layers and currently has a urinary output of less than 30 mL/hr.
A nurse identifies this output condition as
1. Turbidity.
2. Anuria.
3. Oliguria.
4. Polyuria.
20. A patient with a urinary tract obstruction is experiencing minimal urine production. A nurse identifies this
temporary output condition as
1. Anuria.
2. Polyuria.
3. Oliguria.
4. Hematuria.
21. A male patient with a recent total hip replacement who cannot ambulate to the bathroom needs assistance with
toileting. A nurse should
1. Assist the patient to the bathroom.
2. Have the patient stand at the bedside and void into a urinal.
3. Have the patient use a fracture pan.
4. Roll the patient onto his side and have him void into a bedpan.
