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WorksheetsFundamentals Final Exam Quiz 2 (Urinary Elimination)
Total questions: 100
Worksheet time: 51mins
Which of the following is NOT a component of voiding?
Bladder contraction
Urethral sphincter relaxation
Pelvic floor muscle relaxation
Bladder relaxation
Fill in the blank: Stretching of the ______ wall signals the micturition center in the sacral spinal cord.
bladder
urethral
rectal
intestinal
SATA: Urinary elimination depends on the function of which organs?
Kidneys
Ureters
Bladder
Urethra
Colon
Which organ serves as a reservoir for urine until the urge to urinate develops?
Bladder
Liver
Fallopian Tubes
Kidney
When BP falls, GFR falls, promoting retention of which substances?
Sodium, chloride, and water
Potassium, calcium, and phosphate
Glucose, amino acids, and urea
Bicarbonate, hydrogen ions, and creatinine
Which hormone is secreted by the kidneys to regulate the production of red blood cells (RBCs)?
Erythropoietin
Insulin
Thyroxine
Cortisol
The kidneys synthesize vitamin D into its active form, which is important for calcium absorption and parathyroid hormone regulation.
True
False
What is the functional unit of the kidney that forms urine?
Nephron
Alveolus
Neuron
Osteon
Which of the following is NOT a step of urine formation?
A) Glomerular Filtration
B) Tubular Reabsorption
C) Tubular Secretion
D) Renal Concentration
List the three steps of urine formation in the correct order.
1. Glomerular Filtration, 2. Tubular Reabsorption, 3. Tubular Secretion
1. Glomerular Filtration, 2. Tubular Absorption, 3. Tubular Excretion
1. Glomerular Reabsorption, 2. Tubular Secretion, 3. Renal Filtration
1. Glomerular Filtration, 2. Tubular Secretion, 3. Tubular Reabsorption
Identify factors that commonly influence urinary elimination.
HR, BP, volume of fluid in circulation, hormones (RAAS, ADH)
HR, Temp, volume of fluid in circulation, hormones (TSH, PP2)
RR, BP, volume of fluid in circulation, hormones (RAAS, ATH)
HR, BP, volume of fluid in circulation, hormones (RASS, ATP)
What is the NORMAL amount of renal filtrate that SHOULD BE formed in 1 minute (GFR)?
125 mL/min
10 mL/min
500 mL/min
1 mL/min
Increased blood flow to the kidneys increases GFR and urine output.
True
False
Approximately what percentage of renal filtrate is reabsorbed into plasma during tubular reabsorption?
99%
50%
80%
10%
Drugs need to be in which form to leave the body through urine?
Lipid soluble
Water soluble
Sodium soluble
Woodford Reserve soluble
What hormone regulates the osmolality of body fluids?
antidiuretic hormone
Insulin
thyroid stimulating hormone
growth hormone
diuretic hormone
Which of the following is an effect of ADH (antidiuretic hormone)?
Causes renal cells to reabsorb water
Increases urine volume
Dilutes urine while concentrating blood
Is secreted from the anterior pituitary gland
ADH is secreted from which gland?
Posterior pituitary gland
Thyroid gland
Adrenal gland
Pancreas
Anterior pituitary gland
SATA: Which of the following CNS structures influence urination?
Cerebral cortex
Sacral spinal cord
Thalamus
Brainstem
Hypothalamus
Which of the following factors can influence urine output?
Medications
Alcohol
Disease processes
All of the above
Which of the following is NOT a psychological factor that can influence urine output?
A) Anxiety
B) Stress
C) Privacy
D) Medications
Define nocturia.
Night increase in urination
Daytime increase in urination
Decrease in urination at night
Complete absence of urination
Define polyuria.
Increase in urination
Decrease in urination
Blood in urine
Painful urination
Define oliguria.
Decrease in urination
Increase in urination
Absence of urination
Painful urination
Define anuria.
No urine output
Excessive urine output
Painful urination
Presence of blood in urine
What is urinary retention?
Urinary retention is the accumulation of urine due to inability to empty bladder.
Urinary retention is the excessive production of urine due to overactive kidneys.
Urinary retention is the involuntary leakage of urine during physical activity.
Urinary retention is the complete absence of urine formation in the kidneys.
Compare & contrast common alterations in urinary elimination. What is urinary incontinence?
Urinary incontinence is involuntary leakage or procedure.
Urinary incontinence is the voluntary retention of urine.
Urinary incontinence is the complete absence of urine production.
Urinary incontinence is a surgical method to control urination.
Compare & contrast common alterations in urinary elimination. What is a urinary tract infection and why are females more susceptible?
Urinary tract infection results from catheterization or procedure. Females are more susceptible due to shorter urethra and proximity to anus.
Urinary tract infection is caused by dehydration. Females are more susceptible due to higher fluid intake.
Urinary tract infection is a genetic disorder. Females are more susceptible due to hormonal changes.
Urinary tract infection is usually caused by kidney stones. Females are more susceptible due to increased physical activity.
Urinary tract infection results from catheterization or procedure. Females are more susceptible due to the patriarchy.
Compare & contrast common alterations in urinary elimination. What is urinary diversion?
Urinary diversion is the diversion of urine to external source.
Urinary diversion is the process of filtering blood in the kidneys.
Urinary diversion is the surgical removal of the bladder.
Urinary diversion is the use of medication to increase urine output.
A history of hypertension and/or diabetes mellitus is a vital piece of information when obtaining a medical history on a patient suffering from urinary dysfunction.
True
False
When obtaining nursing history for a patient with urinary elimination problems, which of the following should be assessed?
Presence of edema, shortness of breath, or weight gain
Presence of fever and cough
History of recent fractures
Presence of skin rashes
What is the normal bladder capacity in adults?
600-1000mL
100-200mL
2000-3000mL
50-100mL
What is the normal urine output for adults over 24 hours?
1500-1600 mL
500-700 mL
2500-3000 mL
300-400 mL
Urine output less than ___ mL per hour is a danger sign.
30
50
10
100
Which of the following is NOT a type of urinary incontinence?
Obstructive
Reflex
Functional
Digestive
Overflow
Which of the following is related to confusion and decreased mobility?
Functional incontinence
Reflex incontinence
Overflow incontinence
Stress incontinence
When obtaining urine samples from patients with Foley catheters, from where should you draw the sample?
From the port near Statlock
From the drainage bag
From the tubing below the bag
From the catheter insertion site
It is acceptable to use old or contaminated urine for specimens.
True
False
What is reflex incontinence caused by?
Damage to the spinal cord above sacral region
Blockage such as prostate enlargement
Overly full bladder
Sudden leakage of urine with activities
Obstructive incontinence is caused by a blockage such as _________.
prostate enlargement
renal bronchioles
overactive bladder muscles
dehydration
Hyperreflexia is life threatening and affects HR and BP. It is usually caused by:
Overly full bladder
Sudden leakage of urine
Menopause
E. coli infection
Overflow incontinence occurs when bladder is overly full and bladder pressure exceeds ______ pressure.
bladder
sphincter
rectal
renal
blood
Stress incontinence is usually triggered by:
A) Activities that increase intra-abdominal pressure
B) Blockage in the urinary tract
C) Overly full bladder
D) Continuous loss of urine
Urge incontinence is defined as involuntary passage of urine occurring soon after a strong sense of ________ to void.
urgency
relief
pain
fullness
Total incontinence is characterized by:
Continuous and unpredictable loss of urine
Occasional leakage of urine with activities that increase intra-abdominal pressure
Overly full bladder
Blockage in the urinary tract
What bacteria is the most common cause of UTIs?
E. coli
Staphylococcus
Indwelling catheter
Menopause
Streptococcus
80% of UTIs are the result of ________ catheter use.
indwelling
external
intermittent
short-term
purewick
Which of the following is NOT a symptom of UTI?
Weight loss
Chills
Pain
Fever
Burning
What does a urine culture determine?
A urine culture determines the NUMBER of bacteria present as well as IDENTIFIES the organism causing infection.
A urine culture determines the SIZE of bacteria present as well as IDENTIFIES the organism causing infection.
A urine culture determines the NUMBER of bacteria present as well as LOCATES the organism causing infection.
A urine culture determines the NUMBER of WBCs present as well as IDENTIFIES the bad boy causing infection.
What does sensitivity testing in urine culture determine?
Sensitivity testing determines which antibiotic will be most effective.
Sensitivity testing determines the number of bacteria and the type of infectious organism present.
Sensitivity testing determines which probiotic will be most effective.
Sensitivity testing determines which bacteria will be most negatively affected when they are told mean things.
Urine C&S should be obtained BEFORE antibiotics are started.
True
False
What is the normal range for specific gravity in urinalysis?
1.0053-1.03
1.000-1.005
1.030-1.050
0.900-1.000
High specific gravity (SG) in urine indicates:
Concentrated urine
Dilute urine
Low specific gravity (SG) in urine indicates:
Concentrated urine
Dilute urine
What is the normal pH range for urine?
4.6-8.0
1.0-3.0
8.5-10.0
10.5-12.0
What is the approximate normal pH of urine?
6
2
8.5
10
What is the normal protein level in urine?
None is normal
10-20 mg/dL
50-100 mg/dL
100-200 mg/dL
What is the normal glucose level in urine?
None
0-2
0-4
Above 5
Glucose spillage in urine is seen with which condition?
Dehydration
Diabetes
Starvation
UTI
What is the normal ketone level in urine?
0-2
0-4
None
Above 5
Ketones in urine are seen with conditions of acute metabolic demand such as dehydration, starvation, and ________.
diabetes mellitus
hypertension
asthma
hypothyroidism
What is the normal range of WBCs/hpf in urine?
0-2
0-4
Above 5
None
A WBCs/hpf level above 5 in urine indicates what condition?
Diabetes
UTI
Starvation
Dehydration
What is the normal range of RBCs/hpf in urine?
0-2
0-4
Above 5
None
Serum creatinine is a waste product from muscle metabolism and is a good indicator of ________ function.
kidney
liver
lung
heart
Which of the following statements is true regarding 24-hour urine collection?
The first urine void is saved
The first urine void is discarded
Only morning urine is collected
Only night urine is collected
Urinalysis and ultrasound are BOTH useful diagnostic tests used to assess the urinary system.
True
False, ultrasound is not useful for assessing the urinary system
False, urinalysis is not useful for assessing the urinary system
False, neither urinalysis or ultrasound are useful for assessing the urinary system
Fill in the blank: A 24hr urine collection is very useful for measuring ______ function.
renal
hepatic
bladder
urethral
The 24-hour time for urine collection begins at which point?
At the time the first urine is discarded
At midnight
After the first urine is collected
At any random time
Which of the following is NOT a nursing priority to consider for patients with urinary incontinence?
Social isolation
Pain, both acute and chronic
Infrequent exercise
Risk for infection
Renal ultrasound is a painless procedure.
True
False
Which of the following lists three nursing priorities to consider for patients with urinary incontinence?
Skin integrity, fluid intake, toileting schedule
Pain management, wound care, infection control
Nutritional assessment, medication reconciliation, mobility exercises
Respiratory assessment, cardiac monitoring, glucose control
An important nursing intervention to promote normal micturition in older adults is:
Encouraging regular toileting schedules
Restricting fluid intake
Limiting physical activity
Delaying toileting until the urge is strong
Older adults have a ______ bladder capacity.
smaller
larger
unchanged
elastic
You should encourage geriatric patients to empty their bladder completely before and after meals, as well as before ______. (Fill in the blank)
bed
meditation
breakfast
medication
How much water should patients be encouraged to drink per day to increase fluid intake?
2-3 glasses
4-5 glasses
8-10 glasses
12-15 glasses
SATA: Discourage drinking of which of the following fluids because they have diuretic effects?
Coffee
Tea
Soda
Alcohol
Restricting fluid intake decreases urinary incontinence severity or frequency.
True
False
List three ways to stimulate the micturition reflex for health promotion in all patients.
Maintaining elimination habits, maintaining adequate fluid intake, promoting complete bladder emptying
Restricting fluid intake, delaying urination, avoiding physical activity
Ignoring the urge to void, reducing fiber intake, limiting mobility
Using high doses of diuretics, skipping scheduled toileting, consuming excessive caffeine
Name some methods to prevent infection in urinary health promotion.
Administer medications as ordered, catheterization only when necessary, strengthen pelvic floor muscles, bladder retraining
Increase sugar intake, avoid hydration, delay urination, ignore hygiene
Use sterile catheters, limit handwashing, avoid prescribed medications, skip bladder retraining
Encourage holding urine for long periods, avoid pelvic exercises, use random medications, ignore symptoms
The correct technique to insert a urinary catheter is:
Maintain aseptic technique, gently insert into the urethra until urine flows, then advance a bit further before inflating the balloon.
Maintain clean technique, lubricate the catheter, gently insert into the urethra, inflate the balloon, and then keep advancing until urine flows.
Maintain sterile technique, lubricate the catheter, gently insert into the urethra until urine flows, then advance a bit further before inflating the balloon.
Inflate the balloon, maintain aseptic technique, lubricate the catheter in barbeque sauce, forcefully insert into the urethra until urine flows.
Nursing measures to reduce urinary tract infection include which of the following?
Encouraging adequate fluid intake
Limiting hand hygiene
Delaying catheter care
Restricting patient mobility
What is the recommended practice regarding the use of indwelling catheters?
Use indwelling catheters routinely
Remove indwelling catheters as soon as possible
Never use indwelling catheters
Only use indwelling catheters for drainage care
Proteinuria is the loss of _______ in the urine, which may reflect renal illness.
proteins
glucose
lipids
vitamins
Oliguria is defined as urinary output less than _______ mL/d. Results in renal failure if unresolved.
400
1000
800
200
Anuria is the complete absence of _______ formation.
urine
blood
saliva
sweat
Diuresis is the secretion and passage of _______ amounts of urine.
large
small
moderate
minimal
Polyuria is urination in excess of _______ mL/kg of body weight per day, indicating excessive urination.
50
10
100
5
Urinary retention is the incomplete _______ of the bladder.
emptying
filling
infection
contraction
Residual urine is urine left in the bladder after _______; this is abnormal.
urination
drinking water
digestion
breathing
Intake and Output refers to the amount of fluid taken in and excreted by the body in a specified _______.
timeframe
location
temperature
method
Cystitis is the inflammation of the _______ wall.
bladder
stomach
lung
kidney
What does KUB stand for in relation to ultrasound imaging of the urinary system?
kidneys, urethra, bladder
kidneys, ureters, bladder
kidneys, urethra, bronchioles
ketchup, umami, burger
A serum blood urea nitrogen test (BUN) is more sensitive than a serum creatinine test.
True
False
Some medications can give false positives for ketone levels.
True
False
Fill in the blanks: Most bacteria favor a _____ environment, so urine is maintained mildly _____.
alkaline, acidic
acidic, alkaline
warm, cool
cool, warm
Hyperreflexia is usually neurogenic in nature, but can sometimes be caused by a physical obstruction.
True
False
SATA: Which factors of a patient's urine should the nurse assess?
amount
color
clarity
odor
taste
How is uremic syndrome, which is caused by end stage renal failure, treated?
dialysis
diuretics
frequent IV potassium pushes
not treatable, these patients are toast
volume expanders
What percentage of renal filtrate is excreted as urine?
1%
99%
90%
50%
