NSG 4100 EXAM 3 - COMPREHENSIVE URINARY
SYSTEM ASSESSMENT AND CARE 2026
SECTION 1: URINARY INCONTINENCE (Questions 1-25)
Question 1
A nurse is teaching a patient about interventions for stress incontinence. Which instruction should the
nurse include in the teaching plan?
A. Perform Kegel exercises 2-3 times daily in various positions
B. Limit fluid intake to less than 1000 mL per day
C. Avoid all physical activity to prevent leakage
D. Use tight-fitting clothing for better support
ANSWER: A
Rationale:
A (Correct): Kegel exercises should be performed 2-3 times daily with 15 repetitions in standing, sitting,
and lying positions to strengthen pelvic floor muscles and reduce stress incontinence episodes.
B (Incorrect): Limiting fluids excessively can lead to dehydration and concentrated urine, which may
irritate the bladder. Patients should maintain adequate hydration of 6-8 glasses per day.
C (Incorrect): Physical activity should not be avoided; instead, patients should be taught proper
techniques and pelvic floor strengthening to manage incontinence during activity.
D (Incorrect): Tight clothing should be avoided as it can increase abdominal pressure and worsen
incontinence. Cotton underwear is recommended for breathability.
Question 2
The nurse is providing discharge teaching to a patient with stress incontinence. Which patient statement
indicates understanding of the teaching?
A. "I should drink plenty of water and avoid caffeine."
B. "I will stop drinking fluids after 6 PM to prevent accidents."
C. "I should wear tight underwear for better support."
D. "I will avoid doing Kegel exercises when I'm standing."
ANSWER: A
Rationale:
,A (Correct): Patients with stress incontinence should maintain adequate fluid intake (6-8 glasses daily)
while avoiding bladder irritants like caffeine, which can worsen symptoms.
B (Incorrect): While limiting evening fluids may help with nocturia, complete cessation after 6 PM is not
necessary and may lead to dehydration.
C (Incorrect): Tight clothing should be avoided as it increases abdominal pressure. Cotton underwear is
recommended.
D (Incorrect): Kegel exercises should be performed in various positions including standing, sitting, and
lying to strengthen muscles in different positions.
Question 3
A patient with stress incontinence asks the nurse about lifestyle modifications. Which recommendation
is most appropriate?
A. Quit smoking and avoid straining during bowel movements
B. Increase caffeine intake to strengthen bladder muscles
C. Limit all physical activity to prevent leakage
D. Wear synthetic underwear for moisture control
ANSWER: A
Rationale:
A (Correct): Smoking cessation is important because chronic coughing increases intra-abdominal
pressure and worsens incontinence. Avoiding straining and using stool softeners prevents increased
abdominal pressure.
B (Incorrect): Caffeine is a bladder irritant and diuretic that can worsen incontinence symptoms and
should be avoided or limited.
C (Incorrect): Physical activity should be maintained with proper pelvic floor support. Complete
avoidance is not necessary and may lead to other health problems.
D (Incorrect): Cotton underwear is recommended over synthetic materials because it allows better air
circulation and reduces skin irritation.
Question 4
The nurse is developing a care plan for a patient with functional incontinence. Which intervention
should be included?
A. Schedule voiding assistance and ensure easy access to toileting facilities
B. Teach Kegel exercises as the primary intervention
C. Restrict fluids to reduce incontinence episodes
D. Apply an indwelling catheter for continuous drainage
,ANSWER: A
Rationale:
A (Correct): Functional incontinence occurs when patients cannot reach the toilet in time due to physical
or cognitive limitations. Scheduled toileting assistance and environmental modifications are key
interventions.
B (Incorrect): Kegel exercises are primarily effective for stress and urge incontinence, not functional
incontinence which is related to mobility or cognitive issues.
C (Incorrect): Fluid restriction can lead to dehydration and concentrated urine, which may cause bladder
irritation and UTIs.
D (Incorrect): Indwelling catheters increase infection risk and should be avoided unless absolutely
necessary. They are not a first-line intervention for functional incontinence.
Question 5
Which type of incontinence is characterized by urine leakage that occurs with coughing, sneezing, or
physical exertion?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
ANSWER: A
Rationale:
A (Correct): Stress incontinence is characterized by involuntary urine leakage during activities that
increase intra-abdominal pressure such as coughing, sneezing, laughing, or physical exertion.
B (Incorrect): Urge incontinence involves a sudden, intense urge to urinate followed by involuntary loss
of urine, not related to physical activities.
C (Incorrect): Overflow incontinence occurs when the bladder doesn't empty completely, leading to
frequent or constant dribbling of urine.
D (Incorrect): Functional incontinence occurs when physical or mental impairment prevents the patient
from reaching the toilet in time.
Question 6
A nurse is teaching a patient about proper technique for Kegel exercises. Which instruction is correct?
A. "Tighten your pelvic floor muscles as if trying to stop urine flow"
B. "Hold your breath while performing the exercises"
, C. "Tighten your abdominal and buttock muscles during exercises"
D. "Perform exercises only while lying down"
ANSWER: A
Rationale:
A (Correct): The correct technique involves tightening pelvic floor muscles as if trying to stop the flow of
urine or prevent passing gas. This isolates the correct muscle group.
B (Incorrect): Patients should breathe normally during Kegel exercises. Holding breath increases intra-
abdominal pressure and reduces effectiveness.
C (Incorrect): Abdominal and buttock muscles should remain relaxed during Kegels. Only pelvic floor
muscles should be contracted.
D (Incorrect): Kegel exercises should be performed in various positions (standing, sitting, lying) to
strengthen muscles in different positions and ensure functional strength.
Question 7
The nurse is caring for a patient with urge incontinence. Which intervention is most appropriate?
A. Bladder training with scheduled voiding
B. Immediate catheterization
C. Fluid restriction to 500 mL per day
D. Avoidance of all physical activity
ANSWER: A
Rationale:
A (Correct): Bladder training with scheduled voiding helps retrain the bladder and increase the time
between voiding episodes, which is effective for urge incontinence.
B (Incorrect): Catheterization is invasive and increases infection risk. It is not indicated for urge
incontinence management.
C (Incorrect): Severe fluid restriction can lead to dehydration and concentrated urine, which may irritate
the bladder and worsen symptoms.
D (Incorrect): Physical activity should be maintained. Activity restriction is not necessary for urge
incontinence management.
Question 8
Which patient is at highest risk for developing stress incontinence?
A. A 55-year-old woman who has had multiple vaginal deliveries
B. A 25-year-old man with a urinary tract infection
SYSTEM ASSESSMENT AND CARE 2026
SECTION 1: URINARY INCONTINENCE (Questions 1-25)
Question 1
A nurse is teaching a patient about interventions for stress incontinence. Which instruction should the
nurse include in the teaching plan?
A. Perform Kegel exercises 2-3 times daily in various positions
B. Limit fluid intake to less than 1000 mL per day
C. Avoid all physical activity to prevent leakage
D. Use tight-fitting clothing for better support
ANSWER: A
Rationale:
A (Correct): Kegel exercises should be performed 2-3 times daily with 15 repetitions in standing, sitting,
and lying positions to strengthen pelvic floor muscles and reduce stress incontinence episodes.
B (Incorrect): Limiting fluids excessively can lead to dehydration and concentrated urine, which may
irritate the bladder. Patients should maintain adequate hydration of 6-8 glasses per day.
C (Incorrect): Physical activity should not be avoided; instead, patients should be taught proper
techniques and pelvic floor strengthening to manage incontinence during activity.
D (Incorrect): Tight clothing should be avoided as it can increase abdominal pressure and worsen
incontinence. Cotton underwear is recommended for breathability.
Question 2
The nurse is providing discharge teaching to a patient with stress incontinence. Which patient statement
indicates understanding of the teaching?
A. "I should drink plenty of water and avoid caffeine."
B. "I will stop drinking fluids after 6 PM to prevent accidents."
C. "I should wear tight underwear for better support."
D. "I will avoid doing Kegel exercises when I'm standing."
ANSWER: A
Rationale:
,A (Correct): Patients with stress incontinence should maintain adequate fluid intake (6-8 glasses daily)
while avoiding bladder irritants like caffeine, which can worsen symptoms.
B (Incorrect): While limiting evening fluids may help with nocturia, complete cessation after 6 PM is not
necessary and may lead to dehydration.
C (Incorrect): Tight clothing should be avoided as it increases abdominal pressure. Cotton underwear is
recommended.
D (Incorrect): Kegel exercises should be performed in various positions including standing, sitting, and
lying to strengthen muscles in different positions.
Question 3
A patient with stress incontinence asks the nurse about lifestyle modifications. Which recommendation
is most appropriate?
A. Quit smoking and avoid straining during bowel movements
B. Increase caffeine intake to strengthen bladder muscles
C. Limit all physical activity to prevent leakage
D. Wear synthetic underwear for moisture control
ANSWER: A
Rationale:
A (Correct): Smoking cessation is important because chronic coughing increases intra-abdominal
pressure and worsens incontinence. Avoiding straining and using stool softeners prevents increased
abdominal pressure.
B (Incorrect): Caffeine is a bladder irritant and diuretic that can worsen incontinence symptoms and
should be avoided or limited.
C (Incorrect): Physical activity should be maintained with proper pelvic floor support. Complete
avoidance is not necessary and may lead to other health problems.
D (Incorrect): Cotton underwear is recommended over synthetic materials because it allows better air
circulation and reduces skin irritation.
Question 4
The nurse is developing a care plan for a patient with functional incontinence. Which intervention
should be included?
A. Schedule voiding assistance and ensure easy access to toileting facilities
B. Teach Kegel exercises as the primary intervention
C. Restrict fluids to reduce incontinence episodes
D. Apply an indwelling catheter for continuous drainage
,ANSWER: A
Rationale:
A (Correct): Functional incontinence occurs when patients cannot reach the toilet in time due to physical
or cognitive limitations. Scheduled toileting assistance and environmental modifications are key
interventions.
B (Incorrect): Kegel exercises are primarily effective for stress and urge incontinence, not functional
incontinence which is related to mobility or cognitive issues.
C (Incorrect): Fluid restriction can lead to dehydration and concentrated urine, which may cause bladder
irritation and UTIs.
D (Incorrect): Indwelling catheters increase infection risk and should be avoided unless absolutely
necessary. They are not a first-line intervention for functional incontinence.
Question 5
Which type of incontinence is characterized by urine leakage that occurs with coughing, sneezing, or
physical exertion?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
ANSWER: A
Rationale:
A (Correct): Stress incontinence is characterized by involuntary urine leakage during activities that
increase intra-abdominal pressure such as coughing, sneezing, laughing, or physical exertion.
B (Incorrect): Urge incontinence involves a sudden, intense urge to urinate followed by involuntary loss
of urine, not related to physical activities.
C (Incorrect): Overflow incontinence occurs when the bladder doesn't empty completely, leading to
frequent or constant dribbling of urine.
D (Incorrect): Functional incontinence occurs when physical or mental impairment prevents the patient
from reaching the toilet in time.
Question 6
A nurse is teaching a patient about proper technique for Kegel exercises. Which instruction is correct?
A. "Tighten your pelvic floor muscles as if trying to stop urine flow"
B. "Hold your breath while performing the exercises"
, C. "Tighten your abdominal and buttock muscles during exercises"
D. "Perform exercises only while lying down"
ANSWER: A
Rationale:
A (Correct): The correct technique involves tightening pelvic floor muscles as if trying to stop the flow of
urine or prevent passing gas. This isolates the correct muscle group.
B (Incorrect): Patients should breathe normally during Kegel exercises. Holding breath increases intra-
abdominal pressure and reduces effectiveness.
C (Incorrect): Abdominal and buttock muscles should remain relaxed during Kegels. Only pelvic floor
muscles should be contracted.
D (Incorrect): Kegel exercises should be performed in various positions (standing, sitting, lying) to
strengthen muscles in different positions and ensure functional strength.
Question 7
The nurse is caring for a patient with urge incontinence. Which intervention is most appropriate?
A. Bladder training with scheduled voiding
B. Immediate catheterization
C. Fluid restriction to 500 mL per day
D. Avoidance of all physical activity
ANSWER: A
Rationale:
A (Correct): Bladder training with scheduled voiding helps retrain the bladder and increase the time
between voiding episodes, which is effective for urge incontinence.
B (Incorrect): Catheterization is invasive and increases infection risk. It is not indicated for urge
incontinence management.
C (Incorrect): Severe fluid restriction can lead to dehydration and concentrated urine, which may irritate
the bladder and worsen symptoms.
D (Incorrect): Physical activity should be maintained. Activity restriction is not necessary for urge
incontinence management.
Question 8
Which patient is at highest risk for developing stress incontinence?
A. A 55-year-old woman who has had multiple vaginal deliveries
B. A 25-year-old man with a urinary tract infection
