Med Surg 2 NSG
233 Exam 4 540 Question And Answers 2025
A GRADE.
An older male patient states that he is having problems starting and stopping his stream
of urine and he feels the urgency to void. The best way to assist this patient is to:
A) Help him stand to void.
B) Place a condom catheter.
C) Have him practice Credé's method.
D) Initiate Kegel exercises. - ANSWER-Initiate Kegel exercises.
Since removal of the patient's Foley catheter, the patient has voided 50 to 100 mL every
2 to 3 hours. Which action should the nurse take first?
A) Check for bladder distention
B) Encourage fluid intake
C) Obtain an order to recatheterize the patient
D) Document the amount of each voiding for 24 hours - ANSWER-Check for bladder
distention
To minimize the patient experiencing nocturia, the nurse would teach him or her to:
A) Perform perineal hygiene after urinating.
B) Set up a toileting schedule.
C) Double void.
D) Limit fluids before bedtime. - ANSWER-Limit fluids before bedtime
A patient with a Foley catheter carries the collection bag at waist level when ambulating.
The nurse tells the patient that he or she is at risk for: (Select all that apply.)
A) Infection.
B) Retention.
C) Stagnant urine.
D) Reflux of urine. - ANSWER-Infection.
Reflux of urine.
The patient is incontinent, and a condom catheter is placed. The nurse should take
which action?
A) Secure the condom with adhesive tape
B) Change the condom every 48 hours
C) Assess the patient for skin irritation
D) Use sterile technique for placement - ANSWER-Assess the patient for skin irritation
After a transurethral prostatectomy a patient returns to his room with a triple-lumen
indwelling catheter and continuous bladder irrigation. The irrigation is normal saline at
,150 mL/hr. The nurse empties the drainage bag for a total of 2520 mL after an 8-hour
period. How much of the total is urine output? - ANSWER-1320
The RN directs the LPN/LVN to remove a Foley catheter at 1300. The nurse would
check if the patient has voided by:
A) 1400.
B) 1600
C) 1700.
D) 2300. - ANSWER-1700.
The postoperative patient has difficulty voiding after surgery and is feeling
"uncomfortable" in the lower abdomen. Which action should the nurse implement first?
A) Encourage fluid intake
B) Administer pain medication
C) Catheterize the patient
D) Turn on the bathroom faucet as he tries to void - ANSWER-Turn on the bathroom
faucet as he tries to void
The patient is to have an intravenous pyelogram (IVP). Which of the following apply to
this procedure? (Select all that apply.)
A) Note any allergies.
B) Monitor intake and output.
C) Provide for perineal hygiene.
D) Assess vital signs.
E) Encourage fluids after the procedure. - ANSWER-Note any allergies.
Encourage fluids after the procedure.
The nurse assesses that the patient has a full bladder, and the patient states that he or
she is having difficulty voiding. The nurse would teach the patient to:
A) Use the double-voiding technique.
B) Perform Kegel exercises.
C) Use Credé's method.
D) Keep a voiding diary. - ANSWER-Use Credé's method.
The patient states that she "loses urine" every time she laughs or coughs. The nurse
teaches the patient measures to regain urinary control. The nurse recognizes the need
for further teaching when the patient states:
A) "I will perform my Kegel exercises every day."
B) "I joined weight watchers."
C) "I drink two glasses of wine with dinner."
D) "I have tried urinating every 3 hours." - ANSWER-"I drink two glasses of wine with
dinner."
The nurse notes that the patient's Foley catheter bag has been empty for 4 hours. The
priority action would be to:
A) Irrigate the Foley.
,B) Check for kinks in the tubing.
C) Notify the health care provider.
D) Assess the patient's intake. - ANSWER-Check for kinks in the tubing.
A female patient reports that she is experiencing burning on urination, frequency, and
urgency. The nurse notes that a clean-voided urine specimen is markedly cloudy. The
probable cause of these symptoms and findings is:
A) Cystitis.
B) Hematuria.
C) Pyelonephritis.
D) Dysuria. - ANSWER-A) Cystitis.
A male patient returned from the operating room 6 hours ago with a cast on his right
arm. He has not yet voided. Which action would be the most beneficial in assisting the
patient to void?
A) Suggest he stand at the bedside
B) Stay with the patient
C) Give him the urinal to use in bed
D) Tell him that, if he doesn't urinate, he will be catheterized - ANSWER-A) Suggest he
stand at the bedside
Elimination changes that result from inability of the bladder to empty properly may
cause which of the following? (Select all that apply.)
A) Incontinence
B) Frequency
C) Urgency
D) Urinary retention
E) Urinary tract infection - ANSWER-A) Incontinence
B) Frequency
C) Urgency
D) Urinary retention
E) Urinary tract infection
Confirmed by palpation and x-ray study, the client's right kidney is lower than the left
kidney. What is the nurse's interpretation of this finding?
A. The client has a problem involving the right kidney.
B. The client has a problem involving the left kidney.
C. The client has both kidneys in the normal position.
D. The client is at increased risk for kidney impairment. - ANSWER-ANS: C
Normally, the right kidney is positioned somewhat lower than the left kidney. This
anatomic difference in otherwise symmetric organs is caused by liver displacement. The
significance of this difference is that the right kidney is easier to palpate in an adult than
is the left kidney.
What would be the response if a person's nephrons were not able to filter normally due
to scarring of the proximal convoluted tubule leading to inhibition of reabsorption?
, A. Increased urine output, fluid volume deficit
B. Decreased urine output, fluid volume deficit
C. Increased urine output, fluid volume overload
D. Decreased urine output, fluid volume overload - ANSWER-ANS: A
The nephrons filter about 120 mL/min. Most of this filtrate is reabsorbed in the proximal
convoluted tubule. If the tubule were not able to reabsorb the fluid that has been filtered,
urine output would greatly increase, leading to rapid and severe dehydration.
With a renal threshold for glucose of 220 mg/dL, what is the expected response when a
client has a blood glucose level of 400 mg/dL?
A. 400 mg/dL of excreted glucose in the urine
B. 220 mg/dL of excreted glucose in the urine
C. 180 mg/dL of glucose is excreted in the urine
D. No excreted glucose in the urine - ANSWER-ANS: C
Blood glucose is freely filtered at the glomerulus. Therefore, if a client has a blood sugar
level of 400 mg/dl, the filtrate in the proximal convoluted tubule will have a glucose
concentration of 400 mg/dL. With a renal threshold of 220 mg/dl, a total of 220 mg/dL of
the 400 mg/dL will be reabsorbed back into the systemic circulation, and the final urine
will have a glucose concentration of 180 mg/dL.
Which of the following conditions are associated with oversecretion of rennin?
A. Alzheimer's disease
B. Hypertension
C. Diabetes mellitus
D. Diabetes insipidus - ANSWER-ANS: B
Renin is secreted when special cells in the DCT, called the macula densa, sense
changes
in blood volume and pressure. When the macula densa cells sense that blood volume is
low, blood pressure is low, or blood sodium levels are low, renin is secreted. Renin then
converts angiotensinogen into angiotensin I. This leads to a series of reactions that
cause
the secretion of the hormone aldosterone. This hormone increases kidney reabsorption
of
sodium and water, increasing blood pressure, blood volume, and blood sodium levels.
Inappropriate or excessive renin secretion is a major cause of persistent hypertension.
The client is taking a medication for an endocrine problem that inhibits aldosterone
secretion and release. To what complications of this therapy should the nurse be alert?
A. Dehydration, hypokalemia
B. Dehydration, hyperkalemia
C. Overhydration, hyponatremia
D. Overhydration, hypernatremia - ANSWER-ANS: B
Aldosterone is a mineralocorticoid that increases the reabsorption of water and sodium
in
the kidney at the same time that it promotes excretion of potassium. Any drug or
233 Exam 4 540 Question And Answers 2025
A GRADE.
An older male patient states that he is having problems starting and stopping his stream
of urine and he feels the urgency to void. The best way to assist this patient is to:
A) Help him stand to void.
B) Place a condom catheter.
C) Have him practice Credé's method.
D) Initiate Kegel exercises. - ANSWER-Initiate Kegel exercises.
Since removal of the patient's Foley catheter, the patient has voided 50 to 100 mL every
2 to 3 hours. Which action should the nurse take first?
A) Check for bladder distention
B) Encourage fluid intake
C) Obtain an order to recatheterize the patient
D) Document the amount of each voiding for 24 hours - ANSWER-Check for bladder
distention
To minimize the patient experiencing nocturia, the nurse would teach him or her to:
A) Perform perineal hygiene after urinating.
B) Set up a toileting schedule.
C) Double void.
D) Limit fluids before bedtime. - ANSWER-Limit fluids before bedtime
A patient with a Foley catheter carries the collection bag at waist level when ambulating.
The nurse tells the patient that he or she is at risk for: (Select all that apply.)
A) Infection.
B) Retention.
C) Stagnant urine.
D) Reflux of urine. - ANSWER-Infection.
Reflux of urine.
The patient is incontinent, and a condom catheter is placed. The nurse should take
which action?
A) Secure the condom with adhesive tape
B) Change the condom every 48 hours
C) Assess the patient for skin irritation
D) Use sterile technique for placement - ANSWER-Assess the patient for skin irritation
After a transurethral prostatectomy a patient returns to his room with a triple-lumen
indwelling catheter and continuous bladder irrigation. The irrigation is normal saline at
,150 mL/hr. The nurse empties the drainage bag for a total of 2520 mL after an 8-hour
period. How much of the total is urine output? - ANSWER-1320
The RN directs the LPN/LVN to remove a Foley catheter at 1300. The nurse would
check if the patient has voided by:
A) 1400.
B) 1600
C) 1700.
D) 2300. - ANSWER-1700.
The postoperative patient has difficulty voiding after surgery and is feeling
"uncomfortable" in the lower abdomen. Which action should the nurse implement first?
A) Encourage fluid intake
B) Administer pain medication
C) Catheterize the patient
D) Turn on the bathroom faucet as he tries to void - ANSWER-Turn on the bathroom
faucet as he tries to void
The patient is to have an intravenous pyelogram (IVP). Which of the following apply to
this procedure? (Select all that apply.)
A) Note any allergies.
B) Monitor intake and output.
C) Provide for perineal hygiene.
D) Assess vital signs.
E) Encourage fluids after the procedure. - ANSWER-Note any allergies.
Encourage fluids after the procedure.
The nurse assesses that the patient has a full bladder, and the patient states that he or
she is having difficulty voiding. The nurse would teach the patient to:
A) Use the double-voiding technique.
B) Perform Kegel exercises.
C) Use Credé's method.
D) Keep a voiding diary. - ANSWER-Use Credé's method.
The patient states that she "loses urine" every time she laughs or coughs. The nurse
teaches the patient measures to regain urinary control. The nurse recognizes the need
for further teaching when the patient states:
A) "I will perform my Kegel exercises every day."
B) "I joined weight watchers."
C) "I drink two glasses of wine with dinner."
D) "I have tried urinating every 3 hours." - ANSWER-"I drink two glasses of wine with
dinner."
The nurse notes that the patient's Foley catheter bag has been empty for 4 hours. The
priority action would be to:
A) Irrigate the Foley.
,B) Check for kinks in the tubing.
C) Notify the health care provider.
D) Assess the patient's intake. - ANSWER-Check for kinks in the tubing.
A female patient reports that she is experiencing burning on urination, frequency, and
urgency. The nurse notes that a clean-voided urine specimen is markedly cloudy. The
probable cause of these symptoms and findings is:
A) Cystitis.
B) Hematuria.
C) Pyelonephritis.
D) Dysuria. - ANSWER-A) Cystitis.
A male patient returned from the operating room 6 hours ago with a cast on his right
arm. He has not yet voided. Which action would be the most beneficial in assisting the
patient to void?
A) Suggest he stand at the bedside
B) Stay with the patient
C) Give him the urinal to use in bed
D) Tell him that, if he doesn't urinate, he will be catheterized - ANSWER-A) Suggest he
stand at the bedside
Elimination changes that result from inability of the bladder to empty properly may
cause which of the following? (Select all that apply.)
A) Incontinence
B) Frequency
C) Urgency
D) Urinary retention
E) Urinary tract infection - ANSWER-A) Incontinence
B) Frequency
C) Urgency
D) Urinary retention
E) Urinary tract infection
Confirmed by palpation and x-ray study, the client's right kidney is lower than the left
kidney. What is the nurse's interpretation of this finding?
A. The client has a problem involving the right kidney.
B. The client has a problem involving the left kidney.
C. The client has both kidneys in the normal position.
D. The client is at increased risk for kidney impairment. - ANSWER-ANS: C
Normally, the right kidney is positioned somewhat lower than the left kidney. This
anatomic difference in otherwise symmetric organs is caused by liver displacement. The
significance of this difference is that the right kidney is easier to palpate in an adult than
is the left kidney.
What would be the response if a person's nephrons were not able to filter normally due
to scarring of the proximal convoluted tubule leading to inhibition of reabsorption?
, A. Increased urine output, fluid volume deficit
B. Decreased urine output, fluid volume deficit
C. Increased urine output, fluid volume overload
D. Decreased urine output, fluid volume overload - ANSWER-ANS: A
The nephrons filter about 120 mL/min. Most of this filtrate is reabsorbed in the proximal
convoluted tubule. If the tubule were not able to reabsorb the fluid that has been filtered,
urine output would greatly increase, leading to rapid and severe dehydration.
With a renal threshold for glucose of 220 mg/dL, what is the expected response when a
client has a blood glucose level of 400 mg/dL?
A. 400 mg/dL of excreted glucose in the urine
B. 220 mg/dL of excreted glucose in the urine
C. 180 mg/dL of glucose is excreted in the urine
D. No excreted glucose in the urine - ANSWER-ANS: C
Blood glucose is freely filtered at the glomerulus. Therefore, if a client has a blood sugar
level of 400 mg/dl, the filtrate in the proximal convoluted tubule will have a glucose
concentration of 400 mg/dL. With a renal threshold of 220 mg/dl, a total of 220 mg/dL of
the 400 mg/dL will be reabsorbed back into the systemic circulation, and the final urine
will have a glucose concentration of 180 mg/dL.
Which of the following conditions are associated with oversecretion of rennin?
A. Alzheimer's disease
B. Hypertension
C. Diabetes mellitus
D. Diabetes insipidus - ANSWER-ANS: B
Renin is secreted when special cells in the DCT, called the macula densa, sense
changes
in blood volume and pressure. When the macula densa cells sense that blood volume is
low, blood pressure is low, or blood sodium levels are low, renin is secreted. Renin then
converts angiotensinogen into angiotensin I. This leads to a series of reactions that
cause
the secretion of the hormone aldosterone. This hormone increases kidney reabsorption
of
sodium and water, increasing blood pressure, blood volume, and blood sodium levels.
Inappropriate or excessive renin secretion is a major cause of persistent hypertension.
The client is taking a medication for an endocrine problem that inhibits aldosterone
secretion and release. To what complications of this therapy should the nurse be alert?
A. Dehydration, hypokalemia
B. Dehydration, hyperkalemia
C. Overhydration, hyponatremia
D. Overhydration, hypernatremia - ANSWER-ANS: B
Aldosterone is a mineralocorticoid that increases the reabsorption of water and sodium
in
the kidney at the same time that it promotes excretion of potassium. Any drug or
