WorksheetsChapter 41 Urinary Elimination: Review Questions 1-4
Total questions: 23
Worksheet time: 12mins
A patient with an indwelling urinary catheter reports an urgent need to void. What is the priority nursing action?
Check whether the catheter is patent.
Reassure the patient that voiding is impossible with a catheter in place.
Replace the catheter with a larger-gauge catheter.
Notify the primary care provider immediately.
Rationale application: Why is checking catheter position and patency the first step when a catheterized patient reports the urge to void?
It rules out a mechanical obstruction such as the catheter tip resting against the bladder wall.
It confirms that the patient’s sensation is psychological rather than physiologic.
It ensures the balloon is fully inflated to prevent leakage.
It verifies that the patient needs a larger-gauge catheter.
Which instruction is correct when collecting a urine specimen for culture and sensitivity from a patient without a catheter?
Have the patient void and pour urine into a labeled container.
Ask the patient to void into the toilet, stop midstream, then finish into the sterile container.
Discard the first void and collect the next void for the specimen.
Collect all urine for 24 hours in a chilled, opaque container.
For culture and sensitivity testing, which statement best explains why urine should be collected by the clean-catch, midstream method into a sterile container?
It concentrates bacteria for easier testing.
It minimizes contamination from external genital flora.
It allows transfer from any container to the lab cup.
It is only required when a catheter is present.
Which patient statement best demonstrates effective education on preventing recurrent urinary tract infections (UTIs) in a female patient?
I will limit my fluid intake to 40 ounces per day.
I will use only organic bath bombs when bathing.
I will wait to wear tight jeans until my urine is clear.
I will wipe from the front to back after voiding.
Reasoning about UTI prevention: Why is front-to-back perineal wiping recommended after voiding?
It decreases urine pH to deter bacterial growth.
It prevents transfer of microorganisms from the rectum or vagina to the urethral meatus.
It increases dehydration to reduce bacterial colonization.
It removes residual antiseptic that could irritate the urethra.
A patient is scheduled for an intravenous pyelogram (IVP). Which preprocedure assessment finding is most critical to identify?
A urinalysis negative for sugar and acetone
A history of allergies
A history of a recent thyroid scan
The frequency of urination
Priority setting scenario: A catheterized patient reports bladder fullness and discomfort. The drainage bag has minimal output in the past hour. What should the nurse do first?
Irrigate the catheter with sterile saline.
Check for kinks and assess catheter patency and positioning.
Administer prescribed analgesics.
Notify the provider to replace the catheter.
Specimen handling judgment: When obtaining a urine culture from a noncatheterized patient, which action would compromise the specimen’s integrity?
Collecting midstream directly into a sterile container
Transferring urine from a bedpan into the specimen container
Teaching perineal cleansing before collection
Labeling the specimen at the bedside
The presence of blood in urine that may result from obstruction related to an enlarged prostate or kidney stones most directly changes urine color to which appearance?
Brownish
Orange
Red or pink
Cloudy white
A patient with a new urostomy is being discharged. Which self-care instruction is most important to include for daily routine peristomal care?
Change the appliance before going to bed each night
Cut the wafer 1 inch larger than the stoma
Cleanse the peristomal skin with warm water and mild soap
Use firm pressure to attach the wafer to the skin every application
What is the primary nursing priority when inserting an indwelling urinary catheter for a postoperative patient unable to void?
Teach deep-breathing techniques
Maintain strict aseptic technique
Medicate the patient for pain prior to the procedure
Position the patient for comfort only
During assessment, a nurse finds an indwelling catheter is not draining and the patient’s bladder is distended. What should the nurse do next?
Notify the primary care provider immediately
Assess the tubing for kinks and ensure downward flow
Change the catheter as soon as possible
Aspirate urine from the catheter for culture
Which rationale best supports cleansing the peristomal skin with warm water and mild soap for patients with a urostomy?
It ensures a face plate is not required
It promotes a good fit and helps prevent urine leakage and skin breakdown
It allows the appliance to be changed nightly
It eliminates the need to size the wafer
A nurse is inserting an indwelling catheter in a female patient and accidentally places the catheter into the vagina. What is the next action the nurse should implement?
Collect a urine specimen and notify the primary care provider.
Leave the catheter in place and insert a new catheter into the urethra.
Remove the catheter from the vagina and place it into the urethra.
Ask another nurse to attempt the catheterization of the patient.
Rationale application: Why is the initially misplaced catheter left in the vagina during a second catheterization attempt?
It allows urine sampling to confirm placement.
It helps accurately identify the urethra to prevent misplacement again.
It keeps the catheter sterile for reuse after correct placement.
It reduces the risk of bladder infection by sealing the vagina.
What should be done with the catheter that was inadvertently placed in the vagina after correct catheterization is achieved?
Clean it and reuse it for the patient.
Leave it in place to drain residual vaginal fluid.
Discard it because it is no longer sterile.
Sterilize it at the bedside with antiseptic wipes and reuse.
Which action is NOT appropriate immediately after misplacing a catheter into the vagina during insertion?
Leaving the misplaced catheter in the vagina and attempting insertion with a new sterile catheter.
Aspirating urine to confirm placement from the catheter in the vagina.
Requesting assistance only if difficulty persists with proper placement.
Inserting the new catheter into the urethra using the first as a landmark.
Why is documenting anuria inappropriate when a patient complains of repeatedly passing small amounts of urine?
Anuria refers to excessive urination at night.
Anuria refers to a complete absence of urine output.
Anuria refers to excretion of 50 to 100 mL or less of urine each day, which does not match the complaint.
Anuria refers to urinary retention due to outlet obstruction.
In a patient with suspected urinary retention and oliguria, when should the nurse consider notifying the primary care provider about the need for catheterization?
Immediately upon hearing the complaint of small urine volumes.
After assessing for bladder distention and retention not relieved by less invasive methods.
Only if the patient is incontinent at night.
Only after obtaining a urine specimen.
Which situation would make placing a waterproof pad on the patient’s bed most appropriate, according to the rationale provided?
Patient with oliguria and suspected retention.
Patient with incontinence or experiencing nocturia.
Patient with anuria confirmed by bladder scan.
Patient with urinary tract infection and dysuria.
Concept connection: Oliguria is best described in this context as which of the following?
Reduced urine volume that prompts assessment for bladder distention and retention.
Absence of urine output requiring immediate catheterization.
Nighttime urination exceeding usual frequency.
Painful urination associated with infection.
Clinical reasoning: After palpating the bladder for distention in a patient with oliguria, what is the next noninvasive assessment mentioned before considering catheterization?
Measure intake and output over 24 hours.
Obtain a urine culture.
Perform a bladder scan for possible retention.
Start intravenous fluids and reassess.
