Test Bank Lewis’s Medical-Surgical
Nursing in Canada, 5th Edition Chapter
47&49 Questions and Correct Answers
Latest Update, Download to Get a
Perfect Score Key!!
Chapter 47: Urinary System Tyerman- Nursing Assessment (Lewis’s Medical-Surgical Nursing in
Canada, 5th Edition)
A creatinine clearance test is ordered for a hospitalized patient with possible renal
insufficiency. Which of the following equipment will the nurse need to obtain?
a. Sterile specimen cup
b. Large container for urine
c. Foley catheter and drainage bag
d. Towelettes for perineal cleaning - Correct Answers-ANS: B
Since creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large
container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes,
and a sterile specimen cup are not needed for this test.
A patient who had a cystoscopy the previous day calls the urology clinic and gives the nurse all the
following information. Which of the following patient statements should be reported immediately to the
health care provider?
a. "My urine still looks pink."
b. "My IV site is still bruised."
c."I have a temperature of 38.3°C (100.9°F)."
d. "I did not sleep well last night." - Correct Answers-ANS: C
The patient's elevated temperature may indicate a bladder infection, a possible complication of
cystoscopy. The health care provider should be notified so that antibiotic therapy can be started. Pink-
tinged urine is expected after a cystoscopy. The insomnia and bruising should be discussed further with
the patient but do not indicate a need to notify the health care provider.
,A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine
specimen that is an orange colour. Which of the following actions should the nurse take first?
a. Notify the patient's health care provider.
b. Ask the patient about use of any medications.
c. Question the patient about any UTI risk factors.
d. Teach about the correct procedure for midstream urine collection. - Correct Answers-ANS: B
An orange colour in the urine is normal with some medications such as sulfasalazine. The colour would
not be expected with urinary tract infection, is not a sign that poor technique was used in obtaining the
specimen and does not need to be communicated to the health care provider until further assessment is
done.
A patient's urine dipstick indicates a small amount of protein in the urine. Which of the
following actions should the nurse take next?
a. Check which medications the patient is currently taking.
b. Obtain a clean-catch urine specimen for culture and sensitivity testing.
c. Ask the patient about any family history of persistent renal failure.
d. Send a urine specimen to the laboratory to test for ketones and glucose. - Correct Answers-ANS: A
Normally the urinalysis will show zero to trace amounts of protein, but some medications may give
false-positive readings. The other actions by the nurse may be appropriate, but checking for medications
that may affect the dipstick accuracy should be done first.
During assessment of a patient with decreased renal function, which of the following medications taken
by the patient at home is of most concern to the nurse?
a. Ibuprofen
b. Warfarin
c. Folic acid
d. Penicillin - Correct Answers-ANS: A
The nonsteroidal anti-inflammatory drugs (NSAIDs) are nephrotoxic and should be avoided in patients
with impaired renal function. The nurse also should ask about reasons the patient is taking the other
medications, but the medication of most concern is the ibuprofen.
For which of the following purposes does the nurse use auscultation during assessment of the urinary
system?
a. Check for ureteral peristalsis.
b. Assess for bladder distension.
, c. Identify renal artery or aortic bruits.
d. Determine the position of the kidneys. - Correct Answers-ANS: C
The presence of a bruit may indicate problems such as renal artery tortuosity or abdominal aortic
aneurysm. Auscultation would not be helpful in assessing for the other listed urinary tract information.
The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a
patient with a suspected urinary tract infection (UTI). Which of the following actions should the nurse
implement to obtain the specimen?
a. Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a
sterile specimen cup.
b. Have the patient empty the bladder completely, and then obtain the next urine specimen that the
patient is able to void.
c. Insert a short, small "mini" catheter attached to a collecting container into the urethra and bladder to
obtain the specimen.
d. Clean the area around the meatus with a povidone-iodine swab, and then have the patient void into a
sterile container. - Correct Answers-ANS: A
Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a
sterile specimen cup best describes the technique for obtaining a clean-catch specimen. The answer
beginning, "insert a short, small, 'mini' catheter attached to a collecting container" describes a
technique that would result in a sterile specimen, but a health care provider's order for a catheterized
specimen would be required. Using povidone-iodine before obtaining the specimen is not necessary and
might result in suppressing the growth of some bacteria. And the technique described in the answer
beginning "have the patient empty the bladder completely" would not result in a sterile specimen.
The nurse is admitting an older-adult patient with benign prostatic hyperplasia. Which of the following
actions should be included in the nursing plan of care?
a. Limit fluid intake to no more than 1500 mL/day.
b. Leave a light on in the bathroom during the night.
c. Pad the patient's bed to accommodate overflow incontinence.
d. Ask the patient to use a urinal so that all urine can be measured. - Correct Answers-ANS: B
The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom
is appropriate. Fluids should be encouraged because dehydration is more common in older patients. The
information in the question does not indicate that measurement of the patient's output is necessary or
that the patient has overflow incontinence.
The nurse is assessing a patient's urinary system and is unable to palpate either kidney. Which of the
following actions should the nurse take next?
a. Obtain a urine specimen to check for hematuria.
Nursing in Canada, 5th Edition Chapter
47&49 Questions and Correct Answers
Latest Update, Download to Get a
Perfect Score Key!!
Chapter 47: Urinary System Tyerman- Nursing Assessment (Lewis’s Medical-Surgical Nursing in
Canada, 5th Edition)
A creatinine clearance test is ordered for a hospitalized patient with possible renal
insufficiency. Which of the following equipment will the nurse need to obtain?
a. Sterile specimen cup
b. Large container for urine
c. Foley catheter and drainage bag
d. Towelettes for perineal cleaning - Correct Answers-ANS: B
Since creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large
container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes,
and a sterile specimen cup are not needed for this test.
A patient who had a cystoscopy the previous day calls the urology clinic and gives the nurse all the
following information. Which of the following patient statements should be reported immediately to the
health care provider?
a. "My urine still looks pink."
b. "My IV site is still bruised."
c."I have a temperature of 38.3°C (100.9°F)."
d. "I did not sleep well last night." - Correct Answers-ANS: C
The patient's elevated temperature may indicate a bladder infection, a possible complication of
cystoscopy. The health care provider should be notified so that antibiotic therapy can be started. Pink-
tinged urine is expected after a cystoscopy. The insomnia and bruising should be discussed further with
the patient but do not indicate a need to notify the health care provider.
,A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine
specimen that is an orange colour. Which of the following actions should the nurse take first?
a. Notify the patient's health care provider.
b. Ask the patient about use of any medications.
c. Question the patient about any UTI risk factors.
d. Teach about the correct procedure for midstream urine collection. - Correct Answers-ANS: B
An orange colour in the urine is normal with some medications such as sulfasalazine. The colour would
not be expected with urinary tract infection, is not a sign that poor technique was used in obtaining the
specimen and does not need to be communicated to the health care provider until further assessment is
done.
A patient's urine dipstick indicates a small amount of protein in the urine. Which of the
following actions should the nurse take next?
a. Check which medications the patient is currently taking.
b. Obtain a clean-catch urine specimen for culture and sensitivity testing.
c. Ask the patient about any family history of persistent renal failure.
d. Send a urine specimen to the laboratory to test for ketones and glucose. - Correct Answers-ANS: A
Normally the urinalysis will show zero to trace amounts of protein, but some medications may give
false-positive readings. The other actions by the nurse may be appropriate, but checking for medications
that may affect the dipstick accuracy should be done first.
During assessment of a patient with decreased renal function, which of the following medications taken
by the patient at home is of most concern to the nurse?
a. Ibuprofen
b. Warfarin
c. Folic acid
d. Penicillin - Correct Answers-ANS: A
The nonsteroidal anti-inflammatory drugs (NSAIDs) are nephrotoxic and should be avoided in patients
with impaired renal function. The nurse also should ask about reasons the patient is taking the other
medications, but the medication of most concern is the ibuprofen.
For which of the following purposes does the nurse use auscultation during assessment of the urinary
system?
a. Check for ureteral peristalsis.
b. Assess for bladder distension.
, c. Identify renal artery or aortic bruits.
d. Determine the position of the kidneys. - Correct Answers-ANS: C
The presence of a bruit may indicate problems such as renal artery tortuosity or abdominal aortic
aneurysm. Auscultation would not be helpful in assessing for the other listed urinary tract information.
The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a
patient with a suspected urinary tract infection (UTI). Which of the following actions should the nurse
implement to obtain the specimen?
a. Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a
sterile specimen cup.
b. Have the patient empty the bladder completely, and then obtain the next urine specimen that the
patient is able to void.
c. Insert a short, small "mini" catheter attached to a collecting container into the urethra and bladder to
obtain the specimen.
d. Clean the area around the meatus with a povidone-iodine swab, and then have the patient void into a
sterile container. - Correct Answers-ANS: A
Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a
sterile specimen cup best describes the technique for obtaining a clean-catch specimen. The answer
beginning, "insert a short, small, 'mini' catheter attached to a collecting container" describes a
technique that would result in a sterile specimen, but a health care provider's order for a catheterized
specimen would be required. Using povidone-iodine before obtaining the specimen is not necessary and
might result in suppressing the growth of some bacteria. And the technique described in the answer
beginning "have the patient empty the bladder completely" would not result in a sterile specimen.
The nurse is admitting an older-adult patient with benign prostatic hyperplasia. Which of the following
actions should be included in the nursing plan of care?
a. Limit fluid intake to no more than 1500 mL/day.
b. Leave a light on in the bathroom during the night.
c. Pad the patient's bed to accommodate overflow incontinence.
d. Ask the patient to use a urinal so that all urine can be measured. - Correct Answers-ANS: B
The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom
is appropriate. Fluids should be encouraged because dehydration is more common in older patients. The
information in the question does not indicate that measurement of the patient's output is necessary or
that the patient has overflow incontinence.
The nurse is assessing a patient's urinary system and is unable to palpate either kidney. Which of the
following actions should the nurse take next?
a. Obtain a urine specimen to check for hematuria.
