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WorksheetsNormal Structure and Function of the Urinary System
Total questions: 86
Worksheet time: 43mins
Which structure carries urine from the kidneys to the bladder?
Ureters
Bladder
Urethra
Nephrons
What is the primary function of the bladder walls during urine storage?
Contract and flatten
Relax and expand
Secrete hormones
Filter blood
During voiding, what action of the bladder walls facilitates urine elimination?
Relaxation and expansion
Contraction and flattening
Peristalsis of the ureters
Opening of the nephron
Which characteristic describes normal urine?
Contains bacteria and viruses
Sterile and free from fungi
Composed only of water
Contains proteins as a major component
A patient’s urine contains fluids, salts, and waste products but is free from microorganisms. How should this urine be characterized?
Abnormal due to high protein
Normal urine
Indicative of infection
Concentrated due to dehydration
A nurse notes that a patient has reduced urine volume. Which term best fits this finding?
Anuria
Polyuria
Nocturia
Oliguria
Which term refers to an excessive volume of urine produced?
Nocturia
Polyuria
Oliguria
Anuria
Nocturia is best defined as which of the following?
Painful urination
Excessive urination at night
Abnormal presence of red blood cells in urine
Inability of the bladder to empty
A patient reports painful urination. What term should be documented?
Dysuria
Hematuria
Polyuria
Anuria
Which statement about hematuria is accurate?
It means decreased urine output.
It indicates blood cells in urine, and urine color does not reflect degree of blood loss.
It is defined as frequent nighttime voiding due to diabetes insipidus.
It is always visible as bright red urine.
Which urinary incontinence type involves urine loss during physical activity such as coughing or lifting?
Urge incontinence
Stress incontinence
Overflow incontinence
Functional incontinence
A sudden strong urge to void accompanied by rapid bladder contraction characterizes which condition?
Urge incontinence
Mixed incontinence
Temporary incontinence
Stress incontinence
Mixed incontinence is defined as which of the following?
Combination of stress and urge incontinence
Urine leakage due to incomplete bladder emptying
Lack of urine control with no identified abnormalities
Short-term leakage from infection or medication
Which description best matches overflow incontinence?
Loss of urine control in absence of abnormalities
Incomplete bladder emptying with constant dribbling of urine
Excessive nighttime urination
Painful urination
Temporary incontinence may be caused by which factor according to the material?
Severe constipation, infection, or medication
Prostate enlargement only
Normal aging alone
High fluid intake at night
Urinary retention is primarily defined as which of the following?
Inability of the bladder to empty
Presence of RBCs in urine
Rapid bladder contraction with urgency
Excessive volume of urine
Which is a listed cause of urinary retention?
Excess fluid intake
Urinary tract obstruction
Stress incontinence
Diabetes mellitus
Which characteristic is associated with urinary retention?
Polyuria with nocturia
Chronic or acute pain with weak urine flow and difficulty starting a stream
Sudden strong urge to void with leakage
Constant dribbling without urgency
Which item is listed as a factor affecting urinary elimination?
Developmental factors
Respiratory rate
Skin turgor
Visual acuity
A client’s urinary elimination is most directly influenced by which dietary element noted in the material?
Food and fluid intake
Vitamin supplements
Caffeine only
Sodium restriction only
Which clinical situation represents a pathologic condition that can affect urinary elimination as categorized in the material?
Urinary tract infections
Seasonal allergies
Myopia
Eczema
During an initial assessment, which finding may indicate elevated nitrogenous wastes in the blood secondary to kidney dysfunction?
Changes in mental status
Bradycardia
Rash on the forearm
Dilated pupils
Frequent urination with burning during micturition is a classic symptom of which condition?
Urinary tract infection
Kidney stones only
Dehydration
Congestive heart failure
According to the initial assessment notes, which general complaint is common among clients with kidney disorders?
Fatigue
Euphoria
Increased appetite
Photosensitivity
During an abdominal assessment for urinary elimination, which pair of techniques is appropriate to start with before percussion and palpation?
Palpation and percussion
Auscultation and percussion
Inspection and auscultation
Percussion and inspection
Which finding most directly suggests that bacteria or mucus may be affecting urine characteristics?
Change in urine clarity
Increase in urine volume
Fruity urine odor
Dark amber color
Which factor listed is identified as a potential influence on urine odor?
Hematuria only
Dehydration, food, genetics, and diseases
Ambient room temperature
Urine specific gravity
Normal urine output is roughly equal to fluid intake. What hourly urine output is cited as the normal benchmark?
10 mL/hr
20 mL/hr
30 mL/hr
60 mL/hr
Which laboratory test pairing is most specific to evaluating kidney function in the blood?
Urine pH and ketones
Blood urea nitrogen and creatinine
Urine glucose and protein
Microscopic analysis and nitrates
In routine urinalysis, what does specific gravity primarily reflect?
Balance of water and solutes in urine
Presence of blood cells
Degree of proteinuria
Glucose tolerance
Which urinalysis component is used to screen for diabetes and assess glucose tolerance?
Ketones
Glucose
Protein
pH
Which laboratory test is specifically used to diagnose a urinary tract infection (UTI) and may be followed by sensitivity testing if organisms grow?
Urine specific gravity test
Urine culture
24-hour urine protein measurement
Serum creatinine level
What is the primary purpose of performing sensitivity testing after a urine culture grows organisms?
To determine hydration status
To identify the appropriate antimicrobial therapy
To measure kidney size
To calculate glomerular filtration rate
A 24-hour urine collection is most directly used to determine which of the following?
Amount of creatinine cleared through the kidneys
Presence of ketones in a random urine sample
Serum blood urea nitrogen level
Bladder size and shape
Which statement about 24-hour urine collection is accurate regarding client preparation?
Clients must be NPO after midnight
Client preparation is not required
Clients must avoid all fluids for 8 hours
Clients must take a diuretic before starting
Beyond creatinine clearance, a 24-hour urine collection measures levels of which of the following?
Only bacteria
Protein, hormones, minerals, and other chemical compounds
Blood glucose only
Red blood cells only
Which diagnostic examination assesses the size, shape, and location of the kidneys without radiation exposure?
Intravenous pyelography
Kidney, ureter, and bladder (KUB) x-ray
Ultrasound of the bladder or kidneys
CT scan with contrast
A KUB x-ray study is used primarily to investigate which conditions according to the instructional material?
Hydronephrosis only
Gastrointestinal conditions such as bowel obstruction or gallstones, and kidney stones
UTI sensitivity patterns
Renal blood flow
During intravenous pyelography (IVP), what sequence best describes the process?
Contrast is injected and a single immediate image is taken
X-ray study of the kidneys, bladder, ureters, and urethra with images taken at timed intervals
Ultrasound is performed after oral contrast
MRI followed by urine culture
Which finding is IVP specifically used to identify or evaluate, based on the content?
Electrolyte imbalances
Kidney stones, tumors, or infection; urinary tract tumors; or damage after injury
Serum creatinine trends
Bladder capacity during urodynamics
Which diagnostic imaging modality is commonly used to diagnose kidney stones, bladder stones, or blockage of the urinary tract?
Ultrasound
Computed tomography
Cystoscopy
Kidney/ureter/bladder x-ray
During cystoscopy, what structures are directly examined using a cystoscope?
Kidneys and ureters
Bladder and urethra
Prostate and urethral glands
Renal pelvis only
What is the purpose of using contrast media in computed tomography of the urinary system?
To increase urine output during the scan
To identify blockages, growths, infections, or other diseases
To anesthetize the urethra for insertion
To measure residual urine volume
Which finding would most appropriately prompt a cystoscopy rather than relying solely on x-ray images?
Suspected femur fracture
Areas that do not show up well on x-ray images
Evaluation of blood glucose control
Assessment of lung capacity
A patient presents with hematuria, dysuria, incontinence, frequency, urgency, and possible urinary retention. Which diagnostic examination is specifically noted as useful to determine the cause of these symptoms?
Cystoscopy
Computed tomography
Kidney/ureter/bladder x-ray
Renal biopsy
Which statement best distinguishes cystoscopy from computed tomography in evaluating urinary conditions?
Cystoscopy is noninvasive and CT is invasive
Cystoscopy allows direct visualization of the bladder and urethra, whereas CT produces cross-sectional images often with contrast media
CT can identify urethral mucosal lesions better than cystoscopy
Both procedures require contrast media to be diagnostic
In planning diagnostic testing for suspected urinary tract obstruction, which sequencing reflects strategic use of tests based on their described strengths?
Begin with cystoscopy to visualize kidneys, then CT to view urethra
Begin with CT to detect stones or blockage; follow with cystoscopy if direct bladder/urethral visualization is needed
Begin with renal biopsy; confirm with CT
Skip imaging and rely on urinalysis alone
Which nursing problem listed is most directly supported by findings of absent urinary output, lower abdominal distention, and residual urine on bladder scan?
Impaired Urination
Urinary Retention
Impaired Self-Toileting
Risk for Infection
Which short-term goal aligns with managing a urinary tract infection (UTI)?
Client will report resolution of UTI symptoms within 5 days of taking prescribed antibiotic treatment.
Client will increase fluid intake to 2 liters daily.
Client will demonstrate clean intermittent catheterization technique.
Client will avoid caffeine for 1 week.
A post-operative client has a nursing diagnosis related to urinary retention. Which goal best reflects expected resolution according to the examples?
Client will void every 2 hours on a schedule.
Client will spontaneously empty bladder completely without assistance within 12 hours after surgery.
Client will perform Crede maneuver with assistance.
Client will maintain urine output of 30 mL/hr.
Which goal is most appropriate for a diagnosis of impaired self-toileting?
Client will identify signs of dehydration.
Client will effectively wipe self with left hand after urination within 5 days.
Client will keep a bladder diary for 3 days.
Client will request assistance before ambulating to the bathroom.
Which statement best describes the time frame associated with UTI symptom resolution in the listed goals?
Within 48 hours of starting antibiotics
Within 5 days of taking prescribed antibiotic treatment
Within 12 hours after surgery
Within 7 days of discharge
Which statement best represents a long-term goal for a client with urinary elimination concerns?
Client will void within 6 hours after catheter removal.
Client will report no UTIs since the last outpatient visit 12 months ago.
Client will have a post-void residual less than 100 mL today.
Client will demonstrate proper perineal care before discharge.
A client had bladder surgery and is scheduled for a 6‑month follow‑up. Which outcome aligns with a long-term goal related to urinary retention?
No urinary retention noted on bladder scan at the 6‑month visit.
Urine output exceeds 30 mL/hr during the first postoperative shift.
Client reports dysuria during the first week after surgery.
Client increases oral fluid intake to 2 liters today.
Which goal focuses on promoting toileting independence after a severe cerebrovascular accident with right‑sided paralysis?
Client will call for help before ambulating to the bathroom today.
Client will demonstrate ability to safely perform toileting tasks without assistance within 9 months.
Client will accept assistance with toileting as needed during hospitalization.
Client will wear incontinence briefs to prevent falls at night.
Which outcome best aligns with UTI prevention as part of long-term planning?
Client will complete a urine culture today.
Client will report no UTIs having occurred over the past 12 months.
Client will take antibiotics for 3 days after discharge.
Client will void every 2 hours while awake for the next shift.
During implementation and evaluation of urinary elimination care, what is the primary purpose of ongoing assessment and follow‑up?
Document intake and output only.
Ensure quality of care provided and determine need for further nursing interventions.
Discontinue goals once initial improvement is seen.
Delegate all toileting tasks to unlicensed personnel.
Client education during implementation primarily helps with which aspect of urinary elimination care?
Reducing the need for follow‑up appointments
Aiding in maintaining urinary tract health
Eliminating the risk of urinary retention
Replacing nursing interventions
Which nursing action best promotes normal urinary patterns in a health care facility?
Integrate client voiding habits into daily care
Restrict fluids after 5 p.m. for all clients
Delay toileting to strengthen bladder
Use restraints to prevent unscheduled bathroom trips
Which intervention helps maintain dignity and supports normal elimination during hospitalization?
Turn on bright lights and keep door open
Provide privacy when using a bedpan, urinal, or commode
Encourage clients to hold urine until rounds
Limit toileting to once per shift
A client is on a toileting schedule to reduce incontinence episodes. Which approach aligns with this intervention?
Offer assistance at regular intervals based on the client’s usual pattern
Wait for the call light before offering help
Provide fluids only at mealtimes
Discourage use of a bedside commode
When monitoring intake and output, which items are counted as intake?
Oral fluids, tube feedings, and intravenous fluids
Urine and wound drainage
Perspiration only
Stool output and emesis only
Which statement correctly defines output in intake and output monitoring?
All fluids consumed, including IV medications
Only urine volume voided
Fluid and drainage removed from the body
Total solid food consumed
A client with stress urinary incontinence is beginning Kegel exercises. Which instruction demonstrates correct technique?
Contract and relax pelvic floor muscles regularly; biofeedback can assist training
Perform rapid abdominal crunches to strengthen the bladder
Restrict fluids to reduce urine volume
Hold the breath while tightening gluteal muscles only
Which teaching point helps prevent urinary tract infections?
Wear tight clothing to reduce movement
Limit water intake to avoid frequent urination
Urinate when the urge is felt and practice good perineal hygiene
Take frequent bubble baths
Which catheter type is a single-use device inserted to drain the bladder and then immediately removed?
Foley catheter
Straight catheter
Coudé catheter
Triple lumen catheter
Which catheter has a curved, stiff tip designed to navigate around an enlarged prostate?
Foley catheter
Straight catheter
Coudé catheter
Triple lumen catheter
A catheter with three ports that allows for continuous bladder irrigation in addition to drainage is best described as which type?
Straight catheter
Foley catheter
Coudé catheter
Triple lumen catheter
Which of the following is an appropriate indication for urinary catheterization?
Routine convenience for staff
Accurate measurement of urine in critically ill clients
To prevent UTIs in healthy clients
To treat mild dehydration
A client with sacral pressure injuries and incontinence needs to keep tissue dry to promote healing. Which action aligns with indications for catheterization?
Insert an indwelling catheter to maintain dry tissue
Restrict fluids to reduce urine output
Administer diuretics
Encourage frequent toileting without devices
Which scenario best matches the indication 'support of client comfort at the end of life' for catheter use?
Ambulatory client with adequate voiding
Client immobilized for an extended period near end of life requiring reduced repositioning for toileting
Client needing a routine urine specimen
Client admitted for short outpatient procedure
For external female urinary catheter systems, which component is commonly paired to move urine from the collection device?
Gravity drain only
Wall suction
Manual syringe aspiration
Intermittent catheter balloon inflation
What is the recommended routine for condom catheter management?
Replace every 72 hours and avoid hygiene between uses
Replace daily, assess for complications, and provide hygiene between applications
Replace weekly and avoid manipulation
Replace only if leakage occurs
A postoperative client needs continuous bladder irrigation due to hematuria. Which catheter should the nurse prepare?
Straight catheter
Foley catheter
Triple lumen catheter
Coudé catheter
Which method is recommended for culture and sensitivity urine testing to minimize contamination?
Routine void into any clean container
Clean-catch (midstream) into a sterile specimen cup
Collect from the drainage bag of an indwelling catheter
24-hour urine collection in a nonsterile jug
For a routine urinalysis on an ambulatory client, which action is appropriate?
Obtain urine via straight catheter using sterile technique
Have the client void into a specimen cup or clean urinal/bedpan
Clamp the indwelling catheter and aspirate from the tubing
Collect the first urine voided in the morning only
When obtaining a urine specimen from a client with an indwelling catheter, the nurse should:
Remove urine directly from the collection bag
Detach the catheter from the client and collect midstream
Remove a specimen from the catheter tubing using sterile technique
Ask the client to void around the catheter into a cup
Which statement best describes straight catheterization for urine specimen collection?
It is a nonsterile procedure for routine testing
It requires sterile technique and the catheter is removed after collection
The catheter remains indwelling to monitor output
It is only used for 24-hour urine tests
During evaluation, which primary purpose guides the decision to continue, modify, or discontinue care plans?
To ensure all interventions are documented
To return clients to their previous state of health or help them adapt to functional changes
To reduce staffing workload
To standardize care across all units
Which step is part of evaluating urinary elimination interventions?
Initiating a new diagnosis
Determining the effectiveness of interventions
Teaching clean-catch technique
Inserting an indwelling catheter
Which collection method is most appropriate when a sterile urine specimen is required but the client has no catheter and cannot provide a clean-catch sample?
Collect urine from a bedpan and refrigerate
Perform straight catheterization using sterile technique
Use the first voided urine of the day
Collect urine from incontinence brief
Which action is correct when preparing a client for clean-catch urine culture and sensitivity testing?
Instruct the client to begin voiding and then collect the midstream urine into a sterile cup
Collect urine directly from a bedpan into any clean container
Clamp the catheter and obtain from the drainage bag
Ask the client to avoid washing the perineum before voiding
During evaluation of a urinary elimination care plan, what should the nurse do first?
Discontinue all interventions
Determine achievement of goals and outcomes
Schedule a follow-up culture
Educate the client on indwelling catheter care
A client is experiencing a failure to produce or excrete urine. Which term should the nurse document?
Anuria
Polyuria
Dysuria
Oliguria
Which abnormal urination pattern is characterized by painful or difficult urination?
Anuria
Polyuria
Dysuria
Nocturia
A postoperative client voids 250 mL in 12 hours. Which term best describes this pattern?
Anuria
Oliguria
Polyuria
Hematuria
