1.

) A client comes to the doctor's office with the complaints of going to the bathroom all the time, pain
on urination, small amounts of urine being passed when voiding, and a foul smell to the urine. A urine
specimen has been sent for analysis. Based on the signs and symptoms expressed by the client, which
of the following health problems would be anticipated?

a.) Acute renal failure

b.) Renal stone
c.) Urinary tract infection
d.) Chronic renal failure

RATIONALE
The noted signs and symptoms help to identify the problem of urinary tract infection. The
signs and symptoms noted are not common with the other diseases listed.

2.) An appropriate health goal for clients with urinary elimination problems would include:

a.) Ignoring normalization of voiding pattern. That the patient has the ability to void is the most
important aspect of care.
b.) Encouraging the client to follow measures to show a larger than normal urine output to flush to
kidneys
c.) Always assisting the client with toileting activities in order to monitor amount
d.) Preventing associated risks, such as infections and fluid and electrolyte imbalances.

RATIONALE
Preventing associated risks related to urinary disease is the only appropriate goal noted.

3.) Which nursing assessment in the home care environment for clients with urinary elimination
problems is inappropriate?

a.) Client self-care abilities

b.) Distance and barriers to accessing the bathroom
c.) Need/use of ambulatory aids as required
d.) No dietary restrictions needed
RATIONALE
Dietary guides related to fiber and fluid balance are given to clients with this problem. The
remaining actions are noted in the assessment guide, and are appropriate measures to use with clients.

4.) You are requested to perform teaching to a client in the Emergency Department related to the
diagnosis of an urinary tract infection. An intervention to be followed by the client includes:

a.) Avoid tight-fitting pants or clothing

b.) Drink six glasses of water per day
c.) Type of soap when bathing has no significance in this area.
d.) Voiding pattern in the course of the day has no significance with this problem.

RATIONALE
Tight-fitting clothing creates irritation to the urethra and prevents ventilation of the perineal area. It
is recommended that eight glasses of water be drunk to flush out the urinary system. Avoid harsh
soaps, bubble bath, powders, and sprays in the perineal area, because they can have an irritating effect
on the urethra, encouraging inflammation and a bacterial infection. Practice frequent voiding (q2-3
hours) to flush bacteria out other the urethra and prevent organisms from ascending into the bladder.

5.) Urinary incontinence is not a normal part of aging. An intervention used by nurses to assist clients
to regain or maintain continence with individuals suffering from this problem would not include:

a.) Bladder training

b.) Habit training
c.) Prompted voiding
d.) Fluid restriction

RATIONALE
Fluids would be encouraged, to allow the kidneys to be flushed and urine to be formed. Bladder
training requires that the client postpone voiding, resist or inhinbit the sensation of urgency, and void
according to a timetable, rather than according to an urge. Habit training is also referred to timed or
scheduled voiding. There is no attempt to motivate the client to delay voiding if the urge occurs.
Prompted voiding supplements habit training by encouraging the client to try to use the toilet abd
reminding the client when to void.

6.) Urinary catheterization is carried out for clients only when absolutely necessary. Which of the
following candidates/situations would not warrant the need for this procedure?

a.) A client having abdominal surgery

b.) A client who is completely paralyzed
c.) A client in need of decompression of the bladder
d.) To collect a random urine specimen for evaluation

RATIONALE
Collection of a random urine specimen is not routinely obtained by use of the process of
catheterization. The other candidates/situations are appropriate uses of this technique.

7.) The goal of nursing care of the client with an indwelling catheter and continuous drainage is largely
directed at preventing infection of the urinary tract and encouraging urinary flow through the drainage
system. Which of the following interventions encouraged by nurses working with these clients would
not be appropriate in meeting this goal?

a.) Having the client drink up to 3000mL per day

b.) Encouraging the client to eat foods that increase the acid in the urine
c.) Routine hygienic care
d.) Changing indwelling catheters every 72 hours.

RATIONALE
Retention catheters are removed after their purpose is achieved; routine changing of the catheter or
drainage system is not recommended. Large amounts of fluid ensure a large urine output, which keeps
the bladder flushed out and decreases the likelihood of urinary stasis and subsequent infection. Eating
foods that increase the acid in urine helps to reduce the risk of urinary tract infections and stone
formation. Hygiene care related to catheters is set by hospital policy.
8.) A urinary diversion is the surgical rerouting of urine from the kidneys to a site other than the
bladder. Which type of client would this type of procedure be performed on?

a.) An abdominal trauma victim

b.) A renal failure client
c.) A client with kidney stones
d.) An individual suffering from a urinary tract infection

RATIONALE
The abdominal trauma victim is the only appropriate answer here. The remaining problems can
be treated with less traumatic care measures.

9.) A practice guideline for nurses to use in preventing catheter-associated urinary infection includes
which of the instructions listed below?

a.) Maintain clean technique when inserting the catheter into the client.
b.) Disconnect the catheter and drainage tubing once a shift to rinse the unit in cleaning the
device.
c.) Since you are wearing gloves, it is not necessary to wash your hands.
d.) Prevent contamination of the catheter with feces in the incontinent client.

RATIONALE
Keeping the perineal area free of feces eliminates the possible spread of any bacteria that may
colonize in the feces and travel up the catheter to the bladder.
Sterile or aseptic technique is used when inserting Foley catheters into clients to prevent the spread of
infection with the process. Catheter tubing should not be disconnected once put into use. Connections
are usually taped to help secure their seal. Wearing gloves with this procedure is part of the practice of
Universal Precautions utilized when health care workers come in contact with most tubes and body
fluids.

10.) You are counseling a young mother who complains of having stress incontinence continuing for
three months after her pregnancy. It has been recommended that she practice pelvic muscle exercises to
strengthen her bladder muscles. What action would the nurse recommend to this client in order to
perform this activity correctly?

a.) Stopping urination midstream

b.) Standing tall and stretching out her arms and touching her toes
c.) Emptying her bladder completely
d.) Moving her bowels

RATIONALE
Stopping the flow of urination midstream focuses on the muscle used to control this activity. The
remaining answers do not affect this muscle in the same manner.