Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
Adult Health Exam 4-Renal, Urinary, Gastrointestinal &
Metabolic Diseases, & Central Lines for 2026 exam
questions and answers
Urinary Diseases
1. A female patient has been experiencing recurrent urinary tract infections. What
health education should the nurse provide to this patient?
A. Bathe daily and keep the perineal region clean.
B. Avoid voiding immediately after sexual intercourse.
C. Drink liberal amounts of fluids.
D. Void at least every 6 to 8 hours.
Ans: C. The patient is encouraged to drink liberal amounts of fluids (water is the
best choice) to increase urine production and flow, which flushes the bacteria from
the urinary tract. Frequent voiding (every 2 to 3 hours) is encouraged to empty the
bladder completely because this can significantly lower urine bacterial counts,
reduce urinary stasis, and prevent reinfection. The patient should be encouraged
to shower rather than bathe.
2. A 42-year-old woman comes to the clinic complaining of occasional urinary
incontinence when she sneezes. The clinic nurse should recognize what type of
incontinence?
A. Stress incontinence
B. Reflex incontinence
pg. 1
,Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
C. Overflow incontinence
D. Functional incontinence
Ans: A. Stress incontinence is the involuntary loss of urine through an intact
urethra as a result of sudden increase in intra-abdominal pressure. Reflex
incontinence is loss of urine due to hyperreflexia or involuntary urethral relaxation
in the absence of normal sensations usually associated with voiding.
Overflow incontinence is an involuntary urine loss associated with overdistension
of the bladder. Functional incontinence refers to those instances in which the
function of the lower urinary tract is intact, but other factors (outside the urinary
system) make it difficult or impossible for the patient to reach the toilet in time for
voiding.
3. A nurse is caring for a female patient whose urinary retention has not
responded to conservative treatment. When educating this patient about
self-catheterization, the nurse should encourage what practice?
A. Assuming a supine position for self-
catheterization B. Using clean technique at
home to catheterize
C. Inserting the catheter 1 to 2 inches into the urethra
D. Self-catheterizing every 2 hours at home
Ans: B. The patient may use a clean (nonsterile) technique at home, where
the risk of cross- contamination is reduced. The average daytime clean
intermittent catheterization schedule is every 4 to 6 hours and just before
bedtime. The female patient assumes a Fowlers position and uses a mirror to
help locate the urinary meatus. The nurse teaches her to catheterize herself
by inserting a catheter 7.5 cm (3 inches) into the urethra, in a downward and
pg. 2 backward direction.
,Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
4. A 52-year-old patient is scheduled to undergo ileal conduit surgery. When
planning this patients discharge education, what is the most plausible nursing
diagnosis that the nurse should address?
A. Impaired mobility related to limitations posed by
the ileal conduit B. Deficient knowledge related to care
of the ileal conduit
C. Risk for deficient fluid volume related to urinary diversion
D. Risk for autonomic dysreflexia related to disruption of the sacral plexus
Ans: B. The patient will most likely require extensive teaching about the care and
maintenance of a new urinary diversion. A diversion does not create a serious risk
of fluid volume deficit. Mobility is unlikely to be impaired after the immediate
postsurgical recovery. The sacral plexus I not threatened by the creation of a
urinary diversion.
5. The nurse on a urology unit is working with a patient who has been diagnosed
with oxalate renal calculi. When planning this patients health education, what
nutritional guidelines should the nurse provide?
A. Restrict protein intake as ordered.
B. Increase intake of potassium-rich foods.
C. Follow a low-calcium diet.
D. Encourage intake of food containing oxalates.
pg. 3
, Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
Ans: A. Protein is restricted to 60 g/d, while sodium is restricted to 3 to 4 g/d.
Low-calcium diets are generally not recommended except for true absorptive
hypercalciuria. The patient should avoid intake of oxalate- containing foods and
there is no need to increase potassium intake.
6. The nurse is caring for a patient who underwent percutaneous lithotripsy
earlier in the day. What instruction should the nurse give the patient?
A. Limit oral fluid intake for 1 to 2 days.
B. Report the presence of fine, sand like particles through the
nephrostomy tube. C. Notify the physician about cloudy or foul-
smelling urine.
D. Report any pink-tinged urine within 24 hours after the procedure.
Ans: C. The patient should report the presence of foul-smelling or cloudy urine
since this is suggestive of a UTI. Unless contraindicated, the patient should be
instructed to drink large quantities of fluid each day to flush the kidneys. Sand like
debris is normal due to residual stone products. Hematuria is common after
lithotripsy.
7. A female patients most recent urinalysis results are suggestive of bacteriuria.
When assessing this patient, the nurses data analysis should be informed by
what principle?
A. Most UTIs in female patients are caused by viruses and do not cause obvious
symptoms.
B. A diagnosis of bacteriuria requires three consecutive positive results.
C. Urine contains varying levels of healthy bacterial flora.
pg. 4
Adult Health Exam 4-Renal, Urinary, Gastrointestinal &
Metabolic Diseases, & Central Lines for 2026 exam
questions and answers
Urinary Diseases
1. A female patient has been experiencing recurrent urinary tract infections. What
health education should the nurse provide to this patient?
A. Bathe daily and keep the perineal region clean.
B. Avoid voiding immediately after sexual intercourse.
C. Drink liberal amounts of fluids.
D. Void at least every 6 to 8 hours.
Ans: C. The patient is encouraged to drink liberal amounts of fluids (water is the
best choice) to increase urine production and flow, which flushes the bacteria from
the urinary tract. Frequent voiding (every 2 to 3 hours) is encouraged to empty the
bladder completely because this can significantly lower urine bacterial counts,
reduce urinary stasis, and prevent reinfection. The patient should be encouraged
to shower rather than bathe.
2. A 42-year-old woman comes to the clinic complaining of occasional urinary
incontinence when she sneezes. The clinic nurse should recognize what type of
incontinence?
A. Stress incontinence
B. Reflex incontinence
pg. 1
,Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
C. Overflow incontinence
D. Functional incontinence
Ans: A. Stress incontinence is the involuntary loss of urine through an intact
urethra as a result of sudden increase in intra-abdominal pressure. Reflex
incontinence is loss of urine due to hyperreflexia or involuntary urethral relaxation
in the absence of normal sensations usually associated with voiding.
Overflow incontinence is an involuntary urine loss associated with overdistension
of the bladder. Functional incontinence refers to those instances in which the
function of the lower urinary tract is intact, but other factors (outside the urinary
system) make it difficult or impossible for the patient to reach the toilet in time for
voiding.
3. A nurse is caring for a female patient whose urinary retention has not
responded to conservative treatment. When educating this patient about
self-catheterization, the nurse should encourage what practice?
A. Assuming a supine position for self-
catheterization B. Using clean technique at
home to catheterize
C. Inserting the catheter 1 to 2 inches into the urethra
D. Self-catheterizing every 2 hours at home
Ans: B. The patient may use a clean (nonsterile) technique at home, where
the risk of cross- contamination is reduced. The average daytime clean
intermittent catheterization schedule is every 4 to 6 hours and just before
bedtime. The female patient assumes a Fowlers position and uses a mirror to
help locate the urinary meatus. The nurse teaches her to catheterize herself
by inserting a catheter 7.5 cm (3 inches) into the urethra, in a downward and
pg. 2 backward direction.
,Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
4. A 52-year-old patient is scheduled to undergo ileal conduit surgery. When
planning this patients discharge education, what is the most plausible nursing
diagnosis that the nurse should address?
A. Impaired mobility related to limitations posed by
the ileal conduit B. Deficient knowledge related to care
of the ileal conduit
C. Risk for deficient fluid volume related to urinary diversion
D. Risk for autonomic dysreflexia related to disruption of the sacral plexus
Ans: B. The patient will most likely require extensive teaching about the care and
maintenance of a new urinary diversion. A diversion does not create a serious risk
of fluid volume deficit. Mobility is unlikely to be impaired after the immediate
postsurgical recovery. The sacral plexus I not threatened by the creation of a
urinary diversion.
5. The nurse on a urology unit is working with a patient who has been diagnosed
with oxalate renal calculi. When planning this patients health education, what
nutritional guidelines should the nurse provide?
A. Restrict protein intake as ordered.
B. Increase intake of potassium-rich foods.
C. Follow a low-calcium diet.
D. Encourage intake of food containing oxalates.
pg. 3
, Adult Health Exam 4- Renal, Urinary, Gastrointestinal & Metabolic Diseases, & Central Lines
Ans: A. Protein is restricted to 60 g/d, while sodium is restricted to 3 to 4 g/d.
Low-calcium diets are generally not recommended except for true absorptive
hypercalciuria. The patient should avoid intake of oxalate- containing foods and
there is no need to increase potassium intake.
6. The nurse is caring for a patient who underwent percutaneous lithotripsy
earlier in the day. What instruction should the nurse give the patient?
A. Limit oral fluid intake for 1 to 2 days.
B. Report the presence of fine, sand like particles through the
nephrostomy tube. C. Notify the physician about cloudy or foul-
smelling urine.
D. Report any pink-tinged urine within 24 hours after the procedure.
Ans: C. The patient should report the presence of foul-smelling or cloudy urine
since this is suggestive of a UTI. Unless contraindicated, the patient should be
instructed to drink large quantities of fluid each day to flush the kidneys. Sand like
debris is normal due to residual stone products. Hematuria is common after
lithotripsy.
7. A female patients most recent urinalysis results are suggestive of bacteriuria.
When assessing this patient, the nurses data analysis should be informed by
what principle?
A. Most UTIs in female patients are caused by viruses and do not cause obvious
symptoms.
B. A diagnosis of bacteriuria requires three consecutive positive results.
C. Urine contains varying levels of healthy bacterial flora.
pg. 4
