Nur 203 GU Exam With Complete Solution
The student nurse is performing an abdominal assessment on her patient and tells her
instructor that she cannot palpate the patient's bladder. Which of the following
instructor statements is most appropriate? a) "Try to palpate again; it takes practice but
you will find it." b) The patient's bladder should be palpated only when it is distended
with urine. c) "This is an abnormal finding and should be documented on the patient's
chart."
d) "Immediately notify the nurse assigned to the care of your patient." - Answer Answer:
B
The bladder is not palpable unless it is distended by urine. It is not difficult to palpate the
bladder when distended. The nurse should document her finding, but it is not an
abnormal finding. It is not necessary to notify the nurse assigned to the patient.
Which of the following urine specific gravities would you expect for a client who was
admitted for dehydration?
a) 1.002
b) 1.010
c) 1.021
d) 1.030 - Answer Answer: D
Normal ranges for urine specific gravity are from 1.010 to 1.025. Specific gravity less
than 1.010 indicates fluid volume excess, for example when the patient has fluid
overload or when the kidneys fail to concentrate urine. Specific gravity greater than
1.025 indicates deficient fluid volume, occurring, for example, as a result of blood loss
or dehydraation.
The nurse identifies the nursing diagnosis Urinary Incontinence (Total) for a older adult
client who was admitted after experiencing a stroke. Urinary Incontinence puts this
client at risk for which complication?
a) Skin Breakdown
b) Urinary Tract Infection
,c) Bowel Incontinence
d) Renal Calculi - Answer Answer: A
Urine contains ammonia. which can cause excoriation if there is prolonged contact with
the skin. Bowel Incontinence, not urinary, increases the patient's risk for UTI. Immobility
and high consumption of calcium-containing foods increase teh risk for renal calculi.
The nurse is caring for a PT who underwent a bowel resection 2 hours ago. His urine
output for the past 2 hours totals 50 mL. Which action should the nurse take?
a) Do nothing; this is normal postoperative urine output.
b) Increase the infusion rate of the PT's IV fluids.
c) Notify the provider about the PT's oliguria.
d) Administer the PT's routine diuretic dose early. - Answer Answer: C
The amount of 50 mL in 2 hours is not a normal output. The renal system should produce
60 mL an hour. Therefore, the nurse should notify the provider in cases where the
patient develops oliguria. During the immediate postoperative period, patients who have
undergone abdominal surgery may require increased infusions of IV fluid. The nurse is
not authorized to administer increased IV fluids without an order from a provider.
Without a prescription, no medication can be administered by the nurse before the
scheduled time. It is upon this the provider may hold the patient's scheduled dose of
diuretic if he deems that the patient is in a state of deficient fluid volume.
The nurse measures the urine output of a PT who requires bedpan to void. Which of
these nursing action should be done first. Put gloves on and:
a) Have the PT void directly onto the bedpan
b) Pour the urine into a graduated container
c) Read the volume with the container on a flat surface at eye level
d) Observe the color and clarity of the urine in the bedpan - Answer Answer: A
First, the nurse should put on gloves and have the patient void directly into the bedpan.
Next, she should pour the urine into a graduated container. The patient then places the
measuring device on a flat surface, reads the amount at eye level, and records the
color, clarity, and odor of the urine. Finally, if a specimen is not needed, she is supposed
to eliminate the urine into the toilet and clean the container and bedpan. Finally, she
should record the amount of urine eliminated on the patient's intake and output record.
, The nurse instructs a female client on how to obtain a clean-catch urine specimen. The
following statement by the patient demonstrates that she understands the procedure
correctly?
a) I will be certain to urinate into the 'hat' that you place in the toilet
b) I will wipe my genital area from front to back before I collect the specimen midstream
c) I will have to lie still while you insert a urinary catheter to obtain the specimen.
d) I will collect my urine each time I void for the next 24 hours. - Answer Answer: B
To obtain a clean-catch urine specimen, the nurse should instruct the patient to perform
genital cleaning from front to back and then obtain the specimen in midstream. This is
an example of the principle of working from "clean" to "dirty." While observing the
patient's urinary output, the ambulatory patient is to be encouraged to void into a "hat"
but not when a clean-catch urine specimen is to be obtained. A sterile urine specimen
requires a urinary catheter, not a clean-catch specimen. Some disorders may require a
24-hour urine collection to be evaluated but a clean-catch specimen is a one-time
collection.
What position should the patient assume before the nurse inserts an indwelling urinary
catheter?
a) Modified Trendelenburg
b) Prone
c) Dorsal Recumbent
d) Semi-Fowler's - Answer Answer: C
The patient should be placed supine with knees flexed, feet flat on the bed in a dorsal
recumbent position. If the patient is unable to assume this position, then the nurse
should assist the patient to a side-lying position. Modified Trendelenburg position is
used for the purpose of central venous catheter placement. Prone position is
occasionally used to facilitate oxygenation in patients with adult respiratory distress
syndrome. Semi-Fowler's position is utilized to prevent aspiration in those receiving
enteral feedings.
A patient reports that she leaks urine whenever she sneezes or coughs. What does the
nurse record in the patient's health record to document this complaint?
a) Transient Incontinence
The student nurse is performing an abdominal assessment on her patient and tells her
instructor that she cannot palpate the patient's bladder. Which of the following
instructor statements is most appropriate? a) "Try to palpate again; it takes practice but
you will find it." b) The patient's bladder should be palpated only when it is distended
with urine. c) "This is an abnormal finding and should be documented on the patient's
chart."
d) "Immediately notify the nurse assigned to the care of your patient." - Answer Answer:
B
The bladder is not palpable unless it is distended by urine. It is not difficult to palpate the
bladder when distended. The nurse should document her finding, but it is not an
abnormal finding. It is not necessary to notify the nurse assigned to the patient.
Which of the following urine specific gravities would you expect for a client who was
admitted for dehydration?
a) 1.002
b) 1.010
c) 1.021
d) 1.030 - Answer Answer: D
Normal ranges for urine specific gravity are from 1.010 to 1.025. Specific gravity less
than 1.010 indicates fluid volume excess, for example when the patient has fluid
overload or when the kidneys fail to concentrate urine. Specific gravity greater than
1.025 indicates deficient fluid volume, occurring, for example, as a result of blood loss
or dehydraation.
The nurse identifies the nursing diagnosis Urinary Incontinence (Total) for a older adult
client who was admitted after experiencing a stroke. Urinary Incontinence puts this
client at risk for which complication?
a) Skin Breakdown
b) Urinary Tract Infection
,c) Bowel Incontinence
d) Renal Calculi - Answer Answer: A
Urine contains ammonia. which can cause excoriation if there is prolonged contact with
the skin. Bowel Incontinence, not urinary, increases the patient's risk for UTI. Immobility
and high consumption of calcium-containing foods increase teh risk for renal calculi.
The nurse is caring for a PT who underwent a bowel resection 2 hours ago. His urine
output for the past 2 hours totals 50 mL. Which action should the nurse take?
a) Do nothing; this is normal postoperative urine output.
b) Increase the infusion rate of the PT's IV fluids.
c) Notify the provider about the PT's oliguria.
d) Administer the PT's routine diuretic dose early. - Answer Answer: C
The amount of 50 mL in 2 hours is not a normal output. The renal system should produce
60 mL an hour. Therefore, the nurse should notify the provider in cases where the
patient develops oliguria. During the immediate postoperative period, patients who have
undergone abdominal surgery may require increased infusions of IV fluid. The nurse is
not authorized to administer increased IV fluids without an order from a provider.
Without a prescription, no medication can be administered by the nurse before the
scheduled time. It is upon this the provider may hold the patient's scheduled dose of
diuretic if he deems that the patient is in a state of deficient fluid volume.
The nurse measures the urine output of a PT who requires bedpan to void. Which of
these nursing action should be done first. Put gloves on and:
a) Have the PT void directly onto the bedpan
b) Pour the urine into a graduated container
c) Read the volume with the container on a flat surface at eye level
d) Observe the color and clarity of the urine in the bedpan - Answer Answer: A
First, the nurse should put on gloves and have the patient void directly into the bedpan.
Next, she should pour the urine into a graduated container. The patient then places the
measuring device on a flat surface, reads the amount at eye level, and records the
color, clarity, and odor of the urine. Finally, if a specimen is not needed, she is supposed
to eliminate the urine into the toilet and clean the container and bedpan. Finally, she
should record the amount of urine eliminated on the patient's intake and output record.
, The nurse instructs a female client on how to obtain a clean-catch urine specimen. The
following statement by the patient demonstrates that she understands the procedure
correctly?
a) I will be certain to urinate into the 'hat' that you place in the toilet
b) I will wipe my genital area from front to back before I collect the specimen midstream
c) I will have to lie still while you insert a urinary catheter to obtain the specimen.
d) I will collect my urine each time I void for the next 24 hours. - Answer Answer: B
To obtain a clean-catch urine specimen, the nurse should instruct the patient to perform
genital cleaning from front to back and then obtain the specimen in midstream. This is
an example of the principle of working from "clean" to "dirty." While observing the
patient's urinary output, the ambulatory patient is to be encouraged to void into a "hat"
but not when a clean-catch urine specimen is to be obtained. A sterile urine specimen
requires a urinary catheter, not a clean-catch specimen. Some disorders may require a
24-hour urine collection to be evaluated but a clean-catch specimen is a one-time
collection.
What position should the patient assume before the nurse inserts an indwelling urinary
catheter?
a) Modified Trendelenburg
b) Prone
c) Dorsal Recumbent
d) Semi-Fowler's - Answer Answer: C
The patient should be placed supine with knees flexed, feet flat on the bed in a dorsal
recumbent position. If the patient is unable to assume this position, then the nurse
should assist the patient to a side-lying position. Modified Trendelenburg position is
used for the purpose of central venous catheter placement. Prone position is
occasionally used to facilitate oxygenation in patients with adult respiratory distress
syndrome. Semi-Fowler's position is utilized to prevent aspiration in those receiving
enteral feedings.
A patient reports that she leaks urine whenever she sneezes or coughs. What does the
nurse record in the patient's health record to document this complaint?
a) Transient Incontinence
