CHAPTER 47 NURSING ASSESSMENT: URINARY SYSTEM
ACTUAL COMPLETE EXAM|WITH ACCURATE QUESTIONS
AND VERIFIED ANSWERS|GRADED A
1. When reading a patient's chart, the nurse notes that the patient has had
dysuria. To assess whether there is any improvement, which question
will the nurse ask?
a. "Do you have any blood in your urine?"
b. "Do you have to get up at night to urinate?"
c. "Do you have any pain when you urinate?"
d. "Do you have to urinate very frequently?" Ans✓✓✓ C
Rationale: Dysuria is painful urination. The alternate responses are used
to assess other urinary tract symptoms: hematuria, nocturia, and
frequency.
Cognitive Level: Application Text Reference: pp. 1143, 1145
Nursing Process: Assessment
Physiological Integrity
2. When admitting a patient who has a history of paraplegia as a result
of a spinal cord injury, the nurse will plan to
a. check the patient for urinary incontinence every 2 hours to maintain
skin integrity.
b. assist the patient to the toilet on a scheduled basis to help ensure
bladder emptying.
,c. use intermittent catheterization on a regular schedule to avoid the risk
of infection.
d. ask the patient about the usual urinary pattern and measures used for
bladder control. Ans✓✓✓ D
Rationale: Before planning any interventions, the nurse should complete
the assessment and determine the patient's normal bladder pattern and
the usual measures used by the patient at home. All the other responses
may be appropriate, but until the assessment is complete, an
individualized plan for the patient cannot be developed.
Cognitive Level: Application Text Reference: pp. 1143-1144
Nursing Process: Planning
Physiological Integrity
3. A patient's urine dipstick indicates a large amount of protein in the
urine. The next action by the nurse should be to
a. check which medications the patient is currently taking.
b. ask the patient about any family history of chronic renal failure.
c. send a urine specimen to the laboratory to test for ketones and
glucose.
d. obtain a clean-catch urine for culture and sensitivity testing.
Ans✓✓✓ A
, Rationale: 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.
Cognitive Level: Application Text Reference: p. 1146
Nursing Process: Assessment
Physiological Integrity
4. A creatinine clearance test is ordered for a hospitalized patient with
possible renal insufficiency. Which equipment will the nurse need to
obtain?
a. Foley catheter and drainage bag
b. Towelettes for perineal cleaning
c. Basin of ice
d. Sterile specimen cup Ans✓✓✓ C
Rationale: Creatinine clearance testing involves a 24-hour urine
specimen collection. The urine should be refrigerated or cooled, or a
preservative should be used. Catheterization, cleaning of the perineum
with antiseptic towelettes, and a sterile specimen cup are not needed for
this test.
Cognitive Level: Application Text Reference: p. 1146
Nursing Process: Implementation
ACTUAL COMPLETE EXAM|WITH ACCURATE QUESTIONS
AND VERIFIED ANSWERS|GRADED A
1. When reading a patient's chart, the nurse notes that the patient has had
dysuria. To assess whether there is any improvement, which question
will the nurse ask?
a. "Do you have any blood in your urine?"
b. "Do you have to get up at night to urinate?"
c. "Do you have any pain when you urinate?"
d. "Do you have to urinate very frequently?" Ans✓✓✓ C
Rationale: Dysuria is painful urination. The alternate responses are used
to assess other urinary tract symptoms: hematuria, nocturia, and
frequency.
Cognitive Level: Application Text Reference: pp. 1143, 1145
Nursing Process: Assessment
Physiological Integrity
2. When admitting a patient who has a history of paraplegia as a result
of a spinal cord injury, the nurse will plan to
a. check the patient for urinary incontinence every 2 hours to maintain
skin integrity.
b. assist the patient to the toilet on a scheduled basis to help ensure
bladder emptying.
,c. use intermittent catheterization on a regular schedule to avoid the risk
of infection.
d. ask the patient about the usual urinary pattern and measures used for
bladder control. Ans✓✓✓ D
Rationale: Before planning any interventions, the nurse should complete
the assessment and determine the patient's normal bladder pattern and
the usual measures used by the patient at home. All the other responses
may be appropriate, but until the assessment is complete, an
individualized plan for the patient cannot be developed.
Cognitive Level: Application Text Reference: pp. 1143-1144
Nursing Process: Planning
Physiological Integrity
3. A patient's urine dipstick indicates a large amount of protein in the
urine. The next action by the nurse should be to
a. check which medications the patient is currently taking.
b. ask the patient about any family history of chronic renal failure.
c. send a urine specimen to the laboratory to test for ketones and
glucose.
d. obtain a clean-catch urine for culture and sensitivity testing.
Ans✓✓✓ A
, Rationale: 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.
Cognitive Level: Application Text Reference: p. 1146
Nursing Process: Assessment
Physiological Integrity
4. A creatinine clearance test is ordered for a hospitalized patient with
possible renal insufficiency. Which equipment will the nurse need to
obtain?
a. Foley catheter and drainage bag
b. Towelettes for perineal cleaning
c. Basin of ice
d. Sterile specimen cup Ans✓✓✓ C
Rationale: Creatinine clearance testing involves a 24-hour urine
specimen collection. The urine should be refrigerated or cooled, or a
preservative should be used. Catheterization, cleaning of the perineum
with antiseptic towelettes, and a sterile specimen cup are not needed for
this test.
Cognitive Level: Application Text Reference: p. 1146
Nursing Process: Implementation
