NCLEX Urinary Elimination Practice Exam Quiz
What is the normal urine output for an adult?
A) 500-1,000 mL/day
B) 1,000-2,000 mL/day
C) 2,000-3,000 mL/day
D) 3,000-4,000 mL/day
A patient with a history of urinary retention should be taught to:
A) Drink 1 liter of water before bedtime
B) Void every 8 hours
C) Perform intermittent self-catheterization
D) Avoid fluids after 6 PM
Which of the following medications is most likely to cause urinary retention?
A) Morphine
B) Furosemide
C) Metoprolol
D) Docusate
The nurse is caring for a patient who has just had a cystoscopy. Which of the following is the most appropriate intervention to reduce post-procedure complications?
A) Encourage the patient to drink plenty of fluids
B) Monitor the urine for a deep red color
C) Administer antibiotics as ordered
D) Teach the patient to avoid sitting for prolonged periods
A nurse is assessing a patient who has a Foley catheter in place. The nurse notes that the urine is cloudy with a foul odor. What should the nurse do next?
A) Irrigate the catheter with sterile saline
B) Notify the physician of a possible urinary tract infection
C) Change the catheter immediately
D) Increase fluid intake for the patient
Which of the following is a risk factor for urinary incontinence?
A) Increased fiber intake
B) Pregnancy
C) Decreased caffeine intake
D) Use of diuretics
A 75-year-old patient is experiencing nocturia. The nurse should:
A) Recommend reducing fluid intake after 4 PM
B) Teach pelvic floor exercises
C) Ask the patient to void once an hour
D) Increase caffeine intake to prevent nocturia
The nurse is assessing a client with urinary retention. Which of the following is a common sign of this condition?
A) Urgency
B) Painful urination
C) Inability to void despite a full bladder
D) Dysuria
Which of the following is a common cause of stress incontinence in women?
A) Obesity
B) Neurological disorders
C) Pregnancy and childbirth
D) Renal failure
The nurse is caring for a client with a nephrostomy tube. Which of the following is a priority assessment?
A) Drainage color and amount
B) Intake and output
C) Daily weights
D) Skin integrity around the stoma
A patient is undergoing bladder training. The nurse should encourage the patient to:
A) Void every 2 hours during the day
B) Drink excessive fluids to stimulate bladder function
C) Limit fluid intake to decrease bladder capacity
D) Avoid scheduling bathroom breaks to avoid urinary urgency
A patient reports a sudden inability to urinate. The nurse suspects urinary retention. What is the priority intervention?
A) Encourage fluid intake
B) Insert a urinary catheter
C) Provide a warm bath
D) Offer cranberry juice
Which of the following is an expected finding in a patient with a catheterized urinary system?
A) Constant small amounts of clear urine
B) A large volume of concentrated urine
C) Pale yellow, clear urine
D) Urine with a fruity odor
A patient with a history of frequent urinary tract infections (UTIs) is admitted for a kidney stone. What is the nurse’s priority intervention?
A) Administer antibiotics
B) Increase fluid intake
C) Perform a urinalysis
D) Provide pain management
A nurse is preparing to collect a urine specimen from a patient with a Foley catheter. The nurse should:
A) Collect the specimen from the catheter bag
B) Use a sterile syringe to withdraw urine from the catheter port
C) Have the patient void into a clean container
D) Clean the catheter before obtaining the specimen
Which condition is characterized by the involuntary loss of urine during activities such as coughing or sneezing?
A) Urge incontinence
B) Overflow incontinence
C) Stress incontinence
D) Functional incontinence
The nurse is assessing a patient with a urinary retention issue. Which symptom should the nurse expect?
A) Frequent small amounts of urine voided
B) Difficulty initiating urination
C) Urine with a foul odor
D) Abdominal pain with urination
Which of the following is a normal age-related change in urinary elimination?
A) Increased bladder capacity
B) Increased frequency of nocturia
C) Decreased urinary frequency
D) Increase in bladder tone
A nurse is teaching a patient about urinary incontinence. What is the most important instruction to provide?
A) Drink plenty of fluids to increase bladder capacity
B) Perform Kegel exercises regularly to strengthen pelvic muscles
C) Avoid fluids after 6 PM to reduce nighttime urination
D) Limit dietary fiber intake to prevent constipation
Which of the following is a complication of prolonged urinary retention?
A) Urinary tract infection
B) Bladder cancer
C) Acute renal failure
D) Urinary incontinence
The nurse is caring for a patient with a catheter. Which of the following interventions is most important to prevent catheter-associated urinary tract infection (CAUTI)?
A) Use a sterile technique for catheter insertion
B) Empty the catheter bag every 4 hours
C) Keep the drainage bag above the level of the bladder
D) Cleanse the urethral meatus with soap and water daily
Which of the following is an indication for the use of a suprapubic catheter?
A) Chronic urinary retention
B) Severe urethral trauma
C) Acute urinary tract infection
D) Bladder cancer
A nurse is caring for a patient with an indwelling catheter. Which of the following interventions should be included in the care plan?
A) Increase the patient’s fluid intake to 3 liters a day
B) Secure the catheter to prevent tension on the tubing
C) Perform catheter care twice a week
D) Remove the catheter as soon as possible
The nurse should monitor for which of the following complications in a patient with a long-term catheter?
A) Hypertension
B) Urinary tract infection
C) Renal failure
D) Bladder perforation
Which of the following is an appropriate action for a nurse caring for a patient with urinary incontinence?
A) Recommend a low-fiber diet to prevent constipation
B) Encourage the patient to limit fluid intake to reduce frequency
C) Teach the patient to void every 2-3 hours during the day
D) Recommend using adult diapers to manage incontinence
What should the nurse advise a patient to do if they have difficulty starting urination?
A) Increase fluid intake significantly
B) Relax and try to initiate urination without force
C) Use a warm compress on the abdomen
D) Change position frequently while attempting to urinate
A nurse is caring for a patient with urinary retention. What is the first action the nurse should take?
A) Encourage the patient to drink more fluids
B) Perform a bladder scan to assess for retention
C) Insert a Foley catheter to relieve the retention
D) Administer a diuretic as ordered
A nurse is caring for a client with a urinary catheter. Which of the following should be avoided to reduce the risk of infection?
A) Position the catheter bag below the bladder level
B) Clamp the catheter tubing to prevent backflow
C) Keep the catheter tubing coiled in the bed
D) Empty the catheter bag when it is half full
Which of the following is a sign of bladder distention?
A) Decreased urine output
B) Firmness and fullness in the lower abdomen
C) Pain in the lower back
D) Urgency to void
What is the best method to prevent the spread of urinary tract infections in hospitalized patients?
A) Frequent changing of Foley catheters
B) Good hand hygiene and sterile technique during catheter insertion
C) Restricting fluids to reduce the risk of infection
D) Frequent administration of prophylactic antibiotics
31. A patient is diagnosed with a bladder infection. Which of the following is the most important nursing intervention?
A) Encourage the patient to drink plenty of fluids
B) Teach the patient to perform Kegel exercises
C) Administer diuretics as ordered
D) Restrict fluid intake to reduce bladder workload
32. The nurse is caring for a patient with overflow incontinence. What is the most likely cause of this condition?
A) Bladder infection
B) Spinal cord injury
C) Bladder outlet obstruction
D) Pelvic floor weakness
33. A 60-year-old male patient with benign prostatic hyperplasia (BPH) is complaining of difficulty urinating. What is the priority action?
A) Teach the patient Kegel exercises
B) Administer prescribed alpha-blockers
C) Perform a bladder scan
D) Encourage increased fluid intake
34. A nurse is caring for a patient with a urinary diversion. What is the priority teaching topic for this patient?
A) How to irrigate the stoma
B) Importance of proper skin care around the stoma
C) When to change the diversion bag
D) Diet restrictions for urinary diversion patients
35. The nurse is caring for a patient with a nephrostomy tube. Which of the following is the priority action?
A) Keep the nephrostomy tube above the level of the bladder
B) Flush the nephrostomy tube with saline every 4 hours
C) Check the nephrostomy tube for kinks and blockages
D) Restrict fluid intake to prevent overhydration
36. A patient with a history of chronic kidney disease is at risk for which of the following urinary elimination problems?
A) Urinary retention
B) Urinary incontinence
C) Polyuria
D) Anuria
37. What is the most appropriate nursing intervention for a patient experiencing urinary frequency and urgency but unable to void?
A) Encourage the patient to drink cranberry juice
B) Insert a catheter to relieve bladder distention
C) Perform a bladder scan to check for retention
D) Teach the patient pelvic muscle exercises
38. A nurse is caring for a patient with acute urinary retention. What is the most likely immediate intervention?
A) Administer pain medication
B) Insert a Foley catheter
C) Restrict oral fluid intake
D) Encourage the patient to ambulate
39. Which of the following should be included in the teaching plan for a patient with a newly placed urostomy?
A) Avoid drinking fluids to prevent leaks
B) Empty the pouch every 4 to 6 hours
C) Use a cotton swab to clean around the stoma
D) Apply a fresh dressing over the stoma after every voiding
40. A nurse is caring for a patient with a history of kidney stones. Which of the following dietary recommendations should be made?
A) Restrict calcium intake
B) Encourage a high-protein diet
C) Increase fluid intake to 3 liters per day
D) Limit citrus fruit intake
41. A patient with a chronic urinary tract infection is being treated with antibiotics. Which of the following should the nurse monitor for during therapy?
A) Elevated white blood cell count
B) Decreased urine output
C) Abdominal pain and bloating
D) Diarrhea or signs of Clostridium difficile infection
42. What is the first action the nurse should take when a patient with a urinary catheter reports pain?
A) Check the catheter for kinks
B) Increase the patient’s fluid intake
C) Administer prescribed analgesics
D) Change the catheter immediately
43. The nurse is teaching a patient how to care for a suprapubic catheter. Which of the following should be included in the teaching plan?
A) Change the catheter weekly
B) Clean the insertion site with antiseptic wipes
C) Keep the catheter clamped at all times
D) Perform regular bladder irrigation
44. A nurse is assessing a patient with a catheter. What is the most important aspect of catheter care?
A) Prevent infection by maintaining a closed system
B) Limit the patient’s fluid intake to reduce the volume of urine
C) Ensure the catheter is replaced every 24 hours
D) Use sterile gloves when handling the catheter bag
45. A nurse is caring for a patient who has urinary retention and is unable to void. What should the nurse do next?
A) Encourage the patient to drink a large amount of fluid
B) Perform a bladder scan to determine the urine volume
C) Insert an indwelling catheter immediately
D) Increase the patient’s mobility to stimulate urination
46. Which of the following findings is most concerning for a patient with a urinary catheter?
A) Cloudy urine with a foul odor
B) Clear yellow urine
C) Decreased urine output
D) Urine with a pinkish tinge
47. The nurse is caring for a patient with an indwelling urinary catheter. The urine is dark amber in color. The nurse should:
A) Notify the healthcare provider immediately
B) Increase the patient’s fluid intake
C) Change the catheter bag
D) Document the finding as normal
48. The nurse is caring for a patient with incontinence. Which of the following strategies should be included in the care plan?
A) Restrict fluid intake to reduce urinary output
B) Use an incontinence pad with absorbent gel
C) Limit physical activity to avoid leaks
D) Encourage regular voiding intervals every 2 to 3 hours
49. A nurse is caring for a post-operative patient who had a prostatectomy. The patient has difficulty voiding. What is the most appropriate action?
A) Increase the patient’s fluid intake
B) Encourage the patient to void every 2 hours
C) Insert a catheter to relieve retention
D) Administer a diuretic to promote urination
50. Which of the following is a common cause of functional incontinence in older adults?
A) Diabetes mellitus
B) Cognitive impairment
C) Spinal cord injury
D) Bladder cancer
51. The nurse is caring for a patient with a urinary tract infection (UTI). Which of the following interventions should the nurse prioritize?
A) Teach the patient to perform Kegel exercises
B) Ensure the patient has adequate fluid intake
C) Recommend the patient use a urinary catheter for convenience
D) Encourage the patient to limit fluid intake to prevent urgency
52. A nurse is caring for a patient with a nephrostomy tube. The nurse should assess for which of the following complications?
A) Urinary tract infection
B) Renal stone formation
C) Decreased urine output
D) Pulmonary embolism
53. Which of the following actions is appropriate for a nurse caring for a patient who has just had a urinary diversion surgery?
A) Encourage the patient to avoid drinking fluids
B) Teach the patient how to care for the stoma site
C) Monitor for symptoms of urinary retention
D) Avoid emptying the diversion bag regularly to prevent leaks
54. The nurse is preparing to teach a patient with benign prostatic hyperplasia (BPH) about medications. Which medication is commonly prescribed for BPH?
A) Diuretics
B) Alpha-blockers
C) Anticholinergics
D) Antidepressants
55. A patient with chronic kidney disease is experiencing anuria. Which of the following is the most important assessment?
A) Check for dehydration
B) Monitor for signs of hyperkalemia
C) Restrict fluid intake
D) Monitor blood glucose levels
56. A nurse is caring for a patient with a Foley catheter who is at risk for urinary tract infection (UTI). Which of the following actions should the nurse take?
A) Perform routine catheter irrigation every shift
B) Keep the catheter bag above the level of the bladder
C) Cleanse the perineal area with soap and water daily
D) Clamp the catheter every 2 hours to prevent urine flow
57. A nurse is educating a patient about managing urinary incontinence. Which statement by the patient indicates the need for further teaching?
A) “I will try to void regularly to prevent accidents.”
B) “I will avoid drinking liquids in the evening.”
C) “I will use absorbent pads to manage incontinence.”
D) “I will practice pelvic floor exercises to strengthen my bladder.”
58. A nurse is caring for a post-operative patient who has had a cystectomy. Which of the following is the priority nursing intervention?
A) Monitor the urine for signs of infection
B) Encourage deep breathing exercises to prevent pneumonia
C) Assess the stoma site for proper healing and signs of infection
D) Administer prescribed analgesics for pain control
59. A patient with kidney stones is experiencing excruciating pain. Which of the following is the most appropriate nursing intervention?
A) Apply warm compresses to the abdomen
B) Administer prescribed pain medication
C) Encourage the patient to drink fluids to help pass the stones
D) Limit oral fluid intake to reduce the workload on the kidneys
60. The nurse is caring for a patient with a spinal cord injury. The patient is at risk for which urinary elimination complication?
A) Urinary retention
B) Stress incontinence
C) Urinary tract infection
D) Urinary urgency
61. A nurse is caring for a patient with a Foley catheter. The nurse notes that the patient’s urine is cloudy with a foul odor. What is the most appropriate action?
A) Flush the catheter with saline
B) Increase the patient’s fluid intake
C) Notify the healthcare provider of a potential UTI
D) Change the catheter immediately
62. A nurse is educating a patient with a nephrostomy tube about care. Which of the following should be included in the teaching plan?
A) Avoid irrigating the tube unless ordered
B) Use soap and water to clean the insertion site daily
C) Maintain strict bed rest for the first 24 hours
D) Apply a fresh dressing over the insertion site every 12 hours
63. Which of the following is a common complication of prolonged urinary retention?
A) Urinary tract infection
B) Urinary incontinence
C) Kidney stones
D) Renal failure
64. A nurse is caring for a patient who is receiving a diuretic for hypertension. Which of the following should the nurse monitor for?
A) Increased potassium levels
B) Decreased urine output
C) Increased blood pressure
D) Dehydration and electrolyte imbalances
65. A nurse is teaching a patient how to prevent urinary tract infections. Which statement by the patient indicates understanding of the teaching?
A) “I will void before and after sexual intercourse.”
B) “I will avoid drinking cranberry juice.”
C) “I will use a hot tub instead of a shower.”
D) “I will wear tight-fitting clothing to prevent infection.”
66. A nurse is assessing a post-operative patient who has had a prostatectomy. The nurse notices a small amount of bright red blood in the urinary drainage bag. What should the nurse do first?
A) Notify the healthcare provider immediately
B) Encourage the patient to drink more fluids
C) Assess the patient’s vital signs and urinary output
D) Change the urinary drainage bag
67. A nurse is caring for a patient with urinary retention. The patient has not urinated in 12 hours. What is the priority action?
A) Encourage the patient to drink fluids
B) Perform a bladder scan to assess for retention
C) Insert a Foley catheter to relieve retention
D) Encourage the patient to walk around to stimulate urination
68. A nurse is caring for a patient with a history of frequent UTIs. Which of the following would be most appropriate to include in the care plan?
A) Encourage the patient to limit fluid intake to reduce urine volume
B) Suggest that the patient wipe from back to front after using the toilet
C) Educate the patient about the importance of urinating after intercourse
D) Advise the patient to avoid voiding regularly to allow the bladder to fill
69. A nurse is caring for a patient with an indwelling urinary catheter. What is the most important nursing intervention to prevent infection?
A) Empty the catheter bag every 8 hours
B) Clean the perineal area with soap and water daily
C) Keep the catheter bag below the level of the bladder
D) Change the catheter every 24 hours
70. The nurse is caring for a patient with bladder cancer. Which of the following is the priority action?
A) Monitor for signs of hematuria
B) Encourage the patient to perform bladder training
C) Administer prescribed analgesics
D) Teach the patient about the need for radiation therapy
71. The nurse is caring for a patient with acute kidney injury (AKI). Which of the following findings would be most concerning?
A) Blood pressure of 150/90 mmHg
B) Decreased urine output
C) Respiratory rate of 18 breaths per minute
D) Serum potassium level of 4.5 mEq/L
72. A nurse is caring for a patient with a history of frequent urinary tract infections (UTIs). Which of the following should be included in the patient’s teaching plan?
A) Wipe from back to front after urinating
B) Void immediately after sexual intercourse
C) Wear tight-fitting underwear to prevent infection
D) Drink coffee and tea to increase fluid intake
73. The nurse is caring for a patient with a Foley catheter. Which of the following is the most important intervention to prevent a urinary tract infection (UTI)?
A) Change the catheter every 48 hours
B) Ensure the catheter is secured to the thigh to prevent tension
C) Clean the catheter insertion site with alcohol
D) Ensure the catheter bag is kept above the level of the bladder
74. A patient is experiencing urgency, frequency, and dysuria. The nurse suspects a urinary tract infection (UTI). Which of the following diagnostic tests will confirm the diagnosis?
A) Urine culture and sensitivity
B) Bladder scan
C) Serum creatinine
D) Urinalysis for glucose
75. The nurse is caring for a patient who has a nephrostomy tube. What is the most important assessment the nurse should perform?
A) Monitor the patient’s blood pressure
B) Check the urine for color and clarity
C) Monitor the insertion site for infection or leakage
D) Ensure the patient is voiding normally
76. A nurse is preparing to administer a diuretic to a patient with heart failure. Which of the following assessments is the priority before administration?
A) Serum potassium levels
B) Respiratory rate
C) Blood glucose levels
D) Weight
77. The nurse is teaching a patient about urinary incontinence. Which statement by the patient indicates understanding of the teaching?
A) “I will increase my fluid intake to help with urinary retention.”
B) “I will limit my fluid intake in the evening to prevent accidents.”
C) “I will do Kegel exercises to strengthen my pelvic floor muscles.”
D) “I will avoid caffeine and alcohol to decrease urgency.”
78. A nurse is caring for a patient with a bladder infection. Which of the following should the nurse recommend to help relieve discomfort?
A) Apply warm compresses to the abdomen
B) Restrict fluid intake to avoid frequent urination
C) Increase fluid intake to flush out bacteria
D) Limit rest and increase physical activity
79. A nurse is caring for a patient who has undergone a nephrectomy. Which of the following is the priority intervention post-operatively?
A) Monitor for signs of infection
B) Administer prescribed pain medications
C) Assess urine output from the remaining kidney
D) Encourage deep breathing exercises
80. A nurse is caring for a patient with urinary retention. Which of the following actions would be most effective to relieve retention?
A) Increase fluid intake
B) Administer a diuretic
C) Perform intermittent catheterization
D) Apply a warm compress to the abdomen
81. A patient who has had a total cystectomy with an ileal conduit for bladder cancer is being discharged. Which of the following statements by the patient indicates a need for further teaching?
A) “I will change the ostomy bag every 3 to 4 days.”
B) “I will avoid eating foods that cause gas.”
C) “I will monitor the stoma for any redness or irritation.”
D) “I will increase my fluid intake to prevent dehydration.”
82. A nurse is caring for a patient with renal failure. Which of the following findings would suggest that the patient is developing uremic syndrome?
A) Elevated serum potassium levels
B) Dry, flaky skin
C) Decreased urinary output
D) Lethargy and confusion
83. The nurse is preparing to administer an intravenous pyelogram (IVP) to a patient. What is the most important nursing consideration before this procedure?
A) Ensure the patient is NPO for at least 12 hours
B) Assess for allergies to iodine or shellfish
C) Ensure the patient has voided prior to the procedure
D) Obtain a signed consent form for the procedure
84. The nurse is caring for a patient with a urinary tract infection (UTI). The healthcare provider has prescribed an antibiotic. What should the nurse do to promote the effectiveness of the medication?
A) Encourage the patient to take the full course of the prescribed antibiotics
B) Advise the patient to drink large amounts of caffeine
C) Recommend the patient limit fluid intake to prevent irritation
D) Teach the patient to stop the medication if symptoms resolve
85. A nurse is assessing a post-operative patient who has undergone a prostatectomy. The nurse notes that the patient’s urinary drainage is bright red. What is the nurse’s priority action?
A) Notify the healthcare provider
B) Apply a warm compress to the abdomen
C) Encourage the patient to drink fluids
D) Administer prescribed pain medications
86. The nurse is teaching a patient with incontinence about lifestyle changes. Which of the following statements by the patient indicates understanding of the teaching?
A) “I will wear absorbent pads to prevent leakage.”
B) “I will limit fluid intake to decrease the frequency of accidents.”
C) “I will exercise to increase my bladder control.”
D) “I will hold my urine as long as possible to prevent leakage.”
87. A nurse is caring for a patient who has undergone a lithotripsy procedure to treat kidney stones. Which of the following interventions is most important in the post-operative care of this patient?
A) Administer pain medication as prescribed
B) Increase fluid intake to facilitate stone passage
C) Encourage early ambulation
D) Monitor for signs of infection
88. A nurse is assessing a patient who is being treated for a urinary tract infection (UTI). Which of the following findings indicates that the patient’s condition is improving?
A) The patient’s urine becomes cloudy
B) The patient reports decreased frequency and urgency of urination
C) The patient has a temperature of 101°F (38.3°C)
D) The patient experiences increased pain with urination
89. The nurse is caring for a patient with a Foley catheter. Which of the following is the priority assessment to prevent a urinary tract infection (UTI)?
A) Ensure the catheter is properly secured
B) Assess for leakage around the catheter
C) Clean the catheter insertion site with antiseptic solution
D) Keep the catheter bag below the level of the bladder
90. A nurse is educating a patient who has chronic kidney disease about dietary restrictions. Which of the following should the nurse emphasize?
A) Limit protein intake
B) Increase sodium intake
C) Avoid high potassium foods
D) Drink at least 2 liters of fluid per day
91. A nurse is caring for a patient who has a catheter in place. Which of the following is the priority action to prevent a urinary tract infection (UTI)?
A) Empty the drainage bag when it is half full
B) Clean the catheter insertion site with hydrogen peroxide
C) Keep the catheter and drainage bag above the level of the bladder
D) Secure the catheter to the patient’s thigh to prevent tension
92. A patient presents with difficulty urinating and a sensation of bladder fullness. Which of the following assessments should the nurse perform first?
A) Check for abdominal distention
B) Ask the patient about recent fluid intake
C) Perform a bladder scan to measure post-void residual urine
D) Palpate the patient’s bladder for tenderness
93. The nurse is teaching a patient who has a history of recurrent urinary tract infections (UTIs). Which statement by the patient indicates the need for further teaching?
A) “I will wipe from front to back after urinating.”
B) “I will drink plenty of fluids throughout the day.”
C) “I will use a scented vaginal spray to prevent odors.”
D) “I will urinate immediately after sexual intercourse.”
94. A nurse is caring for a patient with benign prostatic hyperplasia (BPH). Which of the following should the nurse include in the teaching plan?
A) Limit fluid intake to reduce urinary retention
B) Urinate immediately when the urge occurs to prevent overflow incontinence
C) Perform pelvic floor exercises to strengthen bladder muscles
D) Use a bedside commode at night to reduce the risk of falls
95. A nurse is caring for a patient with kidney stones. Which of the following interventions is most important to reduce the risk of further stone formation?
A) Encourage increased fluid intake
B) Limit calcium-rich foods in the diet
C) Administer diuretics as prescribed
D) Restrict sodium intake
96. A patient has just undergone a transurethral resection of the prostate (TURP). The nurse observes that the patient’s catheter drainage is bright red with clots. What is the priority action?
A) Irrigate the catheter with normal saline
B) Monitor vital signs and assess for signs of hemorrhage
C) Apply pressure to the lower abdomen to stop bleeding
D) Change the catheter to prevent clot formation
97. The nurse is educating a patient with a newly placed nephrostomy tube. Which statement by the patient indicates the need for further teaching?
A) “I will keep the nephrostomy tube clean and dry.”
B) “I will avoid lifting heavy objects to prevent dislodging the tube.”
C) “I can change the dressing around the tube once a week.”
D) “I will report any pain or redness at the insertion site immediately.”
98. The nurse is caring for a patient with a urinary diversion (ileal conduit). Which of the following actions should the nurse perform to prevent infection at the stoma site?
A) Cleanse the stoma site with an antiseptic solution
B) Apply a sterile dressing to the stoma
C) Ensure the ostomy bag fits snugly around the stoma to prevent leakage
D) Teach the patient to irrigate the stoma daily to promote drainage
99. A nurse is caring for a patient with an indwelling urinary catheter. Which of the following actions would help prevent the risk of catheter-associated urinary tract infections (CAUTIs)?
A) Place the catheter drainage bag on the bed to keep it below the bladder
B) Remove the catheter as soon as it is no longer needed
C) Use sterile technique for all catheter-related procedures
D) Clean the catheter with alcohol and water every shift
100. The nurse is caring for a patient with acute urinary retention. Which of the following is the priority nursing intervention?
A) Encourage the patient to drink large amounts of fluids
B) Perform a bladder scan to assess for residual urine
C) Provide pain relief medications as prescribed
D) Insert an indwelling catheter to relieve the retention
101. The nurse is assessing a patient with suspected bladder cancer. Which of the following would be most indicative of the condition?
A) Dark, smoky, or bright red urine
B) Urinary retention with no history of kidney disease
C) Decreased urine output and high blood pressure
D) Severe, persistent back pain radiating to the abdomen
102. A patient is being treated for acute cystitis. Which of the following is the most important nursing action?
A) Encourage the patient to rest in bed until symptoms subside
B) Administer pain medications and antibiotics as prescribed
C) Limit fluid intake to prevent bladder irritation
D) Perform a bladder scan to measure post-void residual urine
103. The nurse is caring for a patient who is experiencing overflow incontinence. Which of the following interventions should the nurse recommend?
A) Perform bladder training to increase bladder capacity
B) Use intermittent catheterization to relieve urinary retention
C) Encourage pelvic floor exercises to improve muscle tone
D) Restrict fluid intake to reduce the urge to urinate
104. A nurse is caring for a patient with pyelonephritis. Which of the following symptoms is the nurse most likely to observe in the patient?
A) Fever, chills, and flank pain
B) Painful urination and cloudy urine
C) Decreased urine output and high blood pressure
D) Nausea, vomiting, and dizziness
105. The nurse is caring for a patient with polycystic kidney disease. Which of the following interventions is most important in managing the patient’s care?
A) Monitor kidney function and blood pressure regularly
B) Limit fluid intake to prevent kidney overload
C) Encourage the patient to avoid strenuous physical activity
D) Perform daily weight checks and report any significant changes
106. A nurse is caring for a patient with a history of urinary retention. Which of the following interventions is most appropriate?
A) Encourage the patient to void every 2 hours while awake
B) Administer diuretics as prescribed
C) Restrict fluid intake to prevent bladder distention
D) Teach the patient to perform pelvic floor exercises daily
107. A nurse is educating a patient with nephrotic syndrome. Which of the following statements indicates the patient understands the teaching?
A) “I will drink a large amount of fluids each day to flush out my kidneys.”
B) “I will avoid taking any over-the-counter medications without consulting my doctor.”
C) “I should increase my protein intake to help restore kidney function.”
D) “I will restrict my salt intake to reduce swelling.”
108. A nurse is caring for a patient with a newly diagnosed urinary tract infection (UTI). Which of the following is the most appropriate nursing intervention?
A) Administer pain medication to relieve dysuria
B) Encourage the patient to limit fluid intake to avoid further irritation
C) Teach the patient to perform clean intermittent catheterization
D) Assess the patient for a history of kidney stones
109. A nurse is caring for a patient after a renal biopsy. Which of the following should the nurse include in the post-procedure care?
A) Encourage the patient to ambulate immediately after the procedure
B) Monitor the patient for signs of bleeding, such as hypotension and pallor
C) Keep the patient NPO for 12 hours after the procedure
D) Apply a heating pad to the biopsy site for comfort
110. A patient presents with oliguria and edema. The nurse suspects acute glomerulonephritis. Which of the following findings would most likely confirm the diagnosis?
A) Elevated serum creatinine and blood urea nitrogen (BUN) levels
B) Decreased white blood cell count and negative urine culture
C) Presence of hematuria and proteinuria in the urine
D) Positive urine culture for E. coli
111. The nurse is caring for a patient who has just undergone a nephrectomy. Which of the following is a priority for post-operative care?
A) Maintain a high-protein diet to support healing
B) Assess urine output every hour for signs of renal function recovery
C) Encourage early ambulation to prevent deep vein thrombosis
D) Administer pain medication to manage post-surgical discomfort
112. A nurse is teaching a patient with urinary incontinence about lifestyle modifications. Which of the following statements indicates a need for further teaching?
A) “I will avoid caffeine and alcohol to reduce bladder irritation.”
B) “I will limit my fluid intake to prevent frequent urination.”
C) “I will perform Kegel exercises to strengthen my pelvic muscles.”
D) “I will use absorbent pads to manage incontinence episodes.”
113. A nurse is caring for a patient with a urinary tract infection (UTI). Which of the following nursing interventions is most appropriate to reduce the patient’s risk of dehydration?
A) Offer fluids in small amounts throughout the day
B) Limit fluids to reduce bladder irritation
C) Teach the patient to avoid caffeine and alcohol
D) Encourage increased salt intake to help balance electrolytes
114. The nurse is caring for a patient with a history of kidney stones. The nurse should monitor the patient for which of the following complications?
A) Urinary tract infection
B) Hypertension
C) Hyperkalemia
D) Dehydration
115. A nurse is caring for a patient who has just been diagnosed with a UTI. The patient is prescribed antibiotics. Which of the following statements by the patient indicates that teaching has been effective?
A) “I will stop taking the antibiotics once I feel better.”
B) “I should finish the entire course of antibiotics, even if I feel better.”
C) “I will drink less fluid to help my body absorb the medication.”
D) “I can continue taking over-the-counter medications to treat the symptoms.”
116. A nurse is caring for a patient with a chronic indwelling urinary catheter. Which of the following is most important to prevent infection?
A) Empty the catheter bag when it is half full
B) Ensure that the catheter tubing is free from kinks
C) Maintain sterile technique when handling the catheter
D) Clean the catheter insertion site with alcohol daily
117. A nurse is caring for a patient with an ileal conduit urinary diversion. Which of the following should the nurse include in the care plan?
A) Monitor the stoma for signs of infection or irritation
B) Encourage the patient to avoid drinking fluids to prevent leakage
C) Change the appliance every 2 weeks to reduce skin irritation
D) Teach the patient to irrigate the stoma every 3 days
118. A nurse is assessing a patient with bladder cancer. Which of the following findings would be most concerning?
A) Painful urination
B) Hematuria with clots
C) Urgency and frequency of urination
D) Dysuria and fever
119. A nurse is caring for a patient with a newly placed suprapubic catheter. Which of the following actions is most important in preventing complications?
A) Maintain the catheter in a dependent position to promote drainage
B) Ensure the catheter is secured to the patient’s abdomen to avoid tension
C) Clean the insertion site with an antiseptic solution daily
D) Encourage the patient to drink large amounts of fluid to flush the catheter
120. A patient with end-stage renal disease (ESRD) is scheduled for hemodialysis. Which of the following assessments is most important for the nurse to perform prior to the procedure?
A) Assess the patient’s blood pressure and pulse
B) Verify the type of dialysis access device
C) Check the patient’s blood glucose level
D) Determine the patient’s weight to assess fluid status
121. A nurse is caring for a patient with a spinal cord injury who has a neurogenic bladder. Which of the following interventions is most appropriate for managing this condition?
A) Encourage the patient to void every 2 hours while awake
B) Perform intermittent catheterization every 4-6 hours
C) Administer diuretics as prescribed
D) Restrict fluid intake to prevent bladder overdistention
122. A patient who is on diuretic therapy is at risk for which of the following electrolyte imbalances?
A) Hyperkalemia
B) Hypercalcemia
C) Hyponatremia
D) Hypokalemia
123. A nurse is caring for a patient with a urinary tract infection (UTI). Which of the following interventions should the nurse implement to prevent further infection?
A) Encourage the patient to use public restrooms
B) Advise the patient to avoid drinking fluids to prevent bladder irritation
C) Instruct the patient to wipe from front to back after using the toilet
D) Recommend the patient to wear tight-fitting clothing to prevent leakage
124. A nurse is caring for a patient with a history of urinary incontinence. The patient asks about lifestyle changes that can improve symptoms. Which of the following should the nurse recommend?
A) Drink fewer fluids to avoid frequent urination
B) Avoid caffeine, alcohol, and spicy foods
C) Limit physical activity to reduce stress on the bladder
D) Wear absorbent pads regularly without changing them frequently
125. A nurse is caring for a patient who is post-operative following a cystectomy and has an ileal conduit. Which of the following is a priority for post-operative care?
A) Monitor the stoma for signs of infection or irritation
B) Teach the patient to irrigate the ileal conduit daily
C) Encourage fluid intake to flush the conduit
D) Restrict the patient’s physical activity for 24 hours
126. A nurse is teaching a patient with nephrotic syndrome about the importance of diet. Which of the following instructions is appropriate?
A) “Increase your protein intake to replace the lost proteins.”
B) “Avoid foods that are high in sodium to reduce fluid retention.”
C) “Drink large amounts of fluid to flush out your kidneys.”
D) “Increase your intake of potassium-rich foods to prevent hypokalemia.”
127. A nurse is caring for a patient with an indwelling urinary catheter. Which of the following actions is most important to prevent catheter-associated urinary tract infections (CAUTI)?
A) Clean the catheter insertion site with soap and water daily
B) Clamp the catheter when the bag is full to prevent backflow
C) Keep the drainage bag above the level of the bladder
D) Maintain a closed drainage system
128. A nurse is caring for a patient with chronic kidney disease (CKD). The patient asks how to prevent further kidney damage. Which of the following is the most appropriate response?
A) “Avoid any physical activity to decrease kidney stress.”
B) “Limit your fluid intake to reduce kidney workload.”
C) “Control blood pressure and blood glucose levels to prevent further damage.”
D) “Increase your intake of high-protein foods to support kidney function.”
129. A patient with a history of renal calculi (kidney stones) asks the nurse about preventing further stones from forming. Which of the following instructions should the nurse provide?
A) “Increase your intake of calcium-rich foods.”
B) “Drink at least 2-3 liters of fluid per day to dilute urine.”
C) “Limit your intake of citrus fruits, such as oranges and lemons.”
D) “Avoid high-protein foods to prevent stone formation.”
130. A nurse is caring for a patient who has undergone a renal transplant. Which of the following interventions is most important during the immediate post-operative period?
A) Monitor for signs of acute rejection, such as fever and oliguria
B) Encourage the patient to increase their fluid intake to flush the kidney
C) Administer immunosuppressive therapy as prescribed to prevent rejection
D) Teach the patient about signs of infection and the need for frequent urinalysis
131. A nurse is caring for a patient with polycystic kidney disease. Which of the following symptoms is most characteristic of this condition?
A) Hematuria
B) Hypotension
C) Fever
D) Hyperkalemia
132. A nurse is caring for a patient with acute glomerulonephritis. Which of the following signs should the nurse monitor for as a complication of this condition?
A) Hypokalemia
B) Periorbital edema
C) Hypotension
D) Hypercalcemia
133. A nurse is caring for a patient with a urinary retention. The nurse instructs the patient to perform which of the following actions to aid in emptying the bladder?
A) Lean forward while voiding
B) Use the Valsalva maneuver to increase bladder pressure
C) Drink 1-2 cups of coffee before attempting to void
D) Apply heat to the abdomen to relax the bladder
134. A nurse is caring for a patient who is scheduled for a urodynamics test. The nurse should instruct the patient to:
A) Drink a large amount of fluid before the test to fill the bladder
B) Void immediately before the test to empty the bladder
C) Take pain medication 30 minutes before the procedure
D) Restrict fluid intake for 6 hours prior to the test
135. A nurse is caring for a patient with benign prostatic hyperplasia (BPH). Which of the following interventions is most appropriate for relieving symptoms of urinary retention?
A) Encourage the patient to perform Kegel exercises
B) Administer alpha-blockers as prescribed
C) Restrict fluid intake to prevent bladder distention
D) Perform intermittent catheterization every 4 hours
136. A nurse is caring for a patient with a suprapubic catheter. Which of the following actions is most important in preventing complications?
A) Keep the catheter drainage bag above the level of the bladder
B) Keep the catheter in a dependent position to ensure proper drainage
C) Use a sterile dressing to cover the catheter insertion site
D) Avoid irrigating the catheter unless absolutely necessary
137. A nurse is educating a patient about preventing urinary tract infections (UTIs). Which of the following statements by the patient indicates that further teaching is needed?
A) “I should drink plenty of fluids to flush out the bacteria.”
B) “I should wipe from front to back after using the toilet.”
C) “I should take a bath instead of a shower to avoid irritating the urethra.”
D) “I should urinate as soon as I feel the urge to prevent bacteria from growing.”
138. A nurse is caring for a patient after a nephrectomy. The patient reports a decrease in urine output. Which of the following is the priority action by the nurse?
A) Assess for signs of infection
B) Increase fluid intake to promote kidney function
C) Monitor for signs of hemorrhage or shock
D) Notify the healthcare provider of the decrease in urine output
139. A nurse is caring for a patient who has undergone a cystoscopy. Which of the following is the priority post-procedure intervention?
A) Monitor for hematuria
B) Assess the patient for signs of infection
C) Encourage the patient to ambulate to prevent urinary stasis
D) Teach the patient how to perform bladder training exercises
140. A nurse is caring for a patient who has a urinary catheter in place. The nurse observes that the catheter drainage bag is full. Which of the following actions should the nurse take?
A) Empty the drainage bag immediately
B) Clamp the catheter for 30 minutes before emptying the bag
C) Disconnect the catheter from the drainage bag to allow for drainage
D) Raise the catheter bag above the level of the bladder to allow for drainage
141. A nurse is caring for a patient who has a nephrostomy tube. Which of the following interventions should the nurse prioritize?
A) Maintain the tube in a dependent position to prevent urine backflow
B) Irrigate the tube every 4 hours with sterile saline
C) Keep the tube disconnected from the drainage bag to promote airflow
D) Place the patient in a supine position to minimize the risk of tube dislodgment
142. A nurse is providing discharge instructions to a patient who is recovering from kidney stones. Which of the following should the nurse include in the teaching?
A) “Limit fluid intake to avoid excessive urination.”
B) “Increase your intake of foods high in calcium to prevent further stones.”
C) “Drink 2-3 liters of fluid per day to help prevent stone formation.”
D) “Avoid foods that are high in oxalates, such as spinach and chocolate.”
143. A nurse is caring for a patient with chronic kidney disease (CKD). Which of the following laboratory values is most indicative of worsening kidney function?
A) Elevated creatinine levels
B) Elevated sodium levels
C) Low hemoglobin levels
D) Elevated platelet count
144. A nurse is caring for a patient with a urinary retention issue. Which of the following is the priority assessment before initiating a bladder scan?
A) Assess for any pain or discomfort in the lower abdomen
B) Check for recent urinary catheterization
C) Verify the patient’s last voiding time
D) Ensure the patient has been drinking enough fluids
145. A nurse is caring for a patient who has been prescribed antibiotics for a urinary tract infection (UTI). The patient asks why it is important to take the full course of antibiotics. Which of the following responses is most appropriate?
A) “The infection could come back if you don’t finish the antibiotics.”
B) “You need to finish the antibiotics so you don’t develop a resistance.”
C) “The antibiotics will help prevent kidney damage if you finish them all.”
D) “Stopping the antibiotics early could cause dizziness or nausea.”
146. A nurse is caring for a patient who has a history of benign prostatic hyperplasia (BPH). The patient asks about how to manage symptoms. Which of the following should the nurse recommend?
A) “Limit your fluid intake to reduce frequent urination.”
B) “Try using a bedpan instead of walking to the bathroom to reduce effort.”
C) “Consider using alpha blockers to reduce urinary retention.”
D) “Increase your dietary fiber intake to prevent constipation.”
147. A nurse is teaching a patient about urinary incontinence. Which of the following lifestyle modifications should the nurse recommend?
A) “Limit fluid intake to reduce the need to urinate.”
B) “Avoid caffeine and alcohol, which can irritate the bladder.”
C) “Drink as much water as possible to flush out toxins from your body.”
D) “Wear absorbent pads throughout the day to prevent embarrassment.”
148. A nurse is caring for a patient with acute glomerulonephritis. Which of the following findings would indicate the need for further investigation?
A) Frothy urine
B) Hypertension
C) Hematuria
D) Periorbital edema
149. A nurse is caring for a patient who has undergone a kidney transplant. Which of the following is a priority action in the immediate post-operative period?
A) Monitor urine output and notify the provider if there is a decrease
B) Administer immunosuppressive therapy as prescribed
C) Encourage the patient to consume high-protein foods to support kidney function
D) Teach the patient to perform daily blood glucose monitoring
150. A nurse is caring for a patient with urinary tract obstruction. The nurse understands that the primary concern for this patient is:
A) Risk for urinary tract infection
B) Risk for fluid imbalance
C) Risk for kidney damage
D) Risk for constipation
151. A nurse is caring for a patient with renal calculi. Which of the following is an appropriate dietary recommendation to help prevent further stone formation?
A) Increase intake of calcium-rich foods
B) Decrease intake of fluid to prevent overhydration
C) Increase intake of citrus fruits, such as oranges
D) Limit consumption of spinach and other high-oxalate foods
152. A nurse is providing discharge teaching to a patient with a new ileal conduit. Which of the following should the nurse include in the teaching?
A) “The stoma should be cleaned with alcohol to prevent infection.”
B) “You may experience a decrease in urine output for the first few days.”
C) “The pouch should be emptied when it is one-half full to prevent leakage.”
D) “You should avoid using deodorizing products in the urinary pouch.”
153. A nurse is caring for a patient with end-stage renal disease (ESRD) who is undergoing hemodialysis. Which of the following assessments is the priority during the dialysis session?
A) Monitor for signs of hypotension
B) Assess for signs of infection at the access site
C) Check the patient’s hemoglobin levels
D) Monitor for signs of hyperkalemia
154. A nurse is educating a patient with a history of urinary retention. Which of the following should the nurse include in the teaching plan?
A) “Use a bedpan regularly to prevent bladder overdistension.”
B) “Perform Kegel exercises to strengthen the pelvic floor muscles.”
C) “Limit fluid intake to reduce the need for frequent urination.”
D) “Administer diuretics as prescribed to relieve retention.”
155. A nurse is caring for a patient with a history of recurrent UTIs. The nurse should recommend which of the following lifestyle changes?
A) “Wear cotton underwear to reduce moisture buildup.”
B) “Use a heating pad to reduce bladder irritation.”
C) “Limit fluid intake in the evening to reduce nighttime urination.”
D) “Take frequent bubble baths to relax the bladder.”
Questions and Answers for Study Guide
Question:
Discuss the pathophysiology, clinical manifestations, and nursing interventions for a patient with acute urinary retention.
Answer:
Pathophysiology:
Acute urinary retention (AUR) is a sudden and painful inability to void urine, which can occur due to a blockage in the urinary tract, impaired bladder muscle function, or a neurologic condition affecting the bladder’s ability to contract. Common causes include benign prostatic hyperplasia (BPH) in men, urethral obstruction, bladder calculi, and certain medications such as anticholinergics and opioids. When urine accumulates in the bladder, the pressure increases, which can lead to damage of the renal system over time.
Clinical Manifestations:
Patients with AUR typically present with severe lower abdominal pain or discomfort, a palpable, distended bladder, and an inability to void despite a strong urge. They may also experience nausea, vomiting, and sweating. In some cases, the patient may have a history of urinary tract infections or difficulty initiating urination.
Nursing Interventions:
- Assessment: The nurse should assess the patient’s pain level, bladder distention, and any contributing factors such as recent surgery or medication use.
- Relieving the Retention: Inserting a catheter is a common intervention to relieve the obstruction and reduce bladder distension, allowing urine to flow freely. Catheterization can also be diagnostic to assess urine output and confirm retention.
- Monitoring and Education: Once the patient is relieved of retention, monitoring urinary output is essential to ensure the bladder is emptying properly. The nurse should educate the patient on lifestyle modifications such as avoiding bladder irritants (e.g., caffeine), drinking adequate fluids, and scheduling regular voiding times to prevent recurrence.
- Pain Management: The nurse should provide pain relief, often using non-pharmacologic measures, and monitor for signs of infection, particularly if catheterization was required.
Question:
Describe the role of nursing interventions in the prevention of urinary tract infections (UTIs) in hospitalized patients with urinary catheters.
Answer:
Prevention of UTIs in Hospitalized Patients with Urinary Catheters:
Urinary tract infections are a common complication in hospitalized patients with indwelling urinary catheters. Nurses play a crucial role in preventing UTIs by implementing evidence-based interventions to reduce the risk of catheter-associated urinary tract infections (CAUTIs).
Proper Catheter Insertion and Maintenance:
- Aseptic Technique: The use of aseptic technique during catheter insertion is essential to minimize the introduction of bacteria into the urinary tract. Nurses should ensure that sterile gloves and equipment are used and that the catheter is inserted in a clean environment to prevent contamination.
- Secure the Catheter Properly: The catheter should be securely fastened to the patient’s leg to avoid unnecessary traction, which can cause urethral irritation and increase the risk of infection.
Catheter Care and Maintenance:
- Regular Monitoring: Nurses should routinely assess the catheter for signs of infection, including redness or tenderness at the insertion site. Additionally, the nurse should ensure that the catheter and drainage system remain closed and intact to prevent bacteria from entering the urinary tract.
- Hygiene: The perineal area should be cleaned regularly with mild soap and water to reduce bacteria at the catheter insertion site. The nurse should educate patients about the importance of maintaining good personal hygiene.
- Drainage Bag Positioning: The catheter drainage bag should be kept below the level of the bladder at all times to prevent urine from flowing back into the bladder, which can lead to infection.
Timely Removal of the Catheter:
- Indication for Use: Catheters should be used only when medically necessary, and the nurse should advocate for early removal once the catheter is no longer needed. Studies have shown that the longer a catheter is in place, the higher the risk of developing a CAUTI.
- Alternative Methods: When possible, the nurse should promote the use of alternative methods to manage urinary incontinence, such as intermittent catheterization or external catheters, as they carry a lower risk of infection.
Patient Education: Nurses should educate patients and families about the signs and symptoms of a UTI, such as fever, cloudy urine, or a strong odor, and encourage them to report these symptoms promptly. Providing information on maintaining hydration and proper hygiene also helps in reducing the likelihood of infection.
By implementing these preventive strategies, nurses can significantly reduce the incidence of CAUTIs in hospitalized patients and improve patient outcomes.
Question:
Explain the role of nurses in managing patients with chronic kidney disease (CKD) and their urinary elimination needs.
Answer:
Management of Patients with Chronic Kidney Disease (CKD) and Urinary Elimination Needs:
Chronic kidney disease (CKD) is a progressive condition in which the kidneys lose their ability to filter waste and maintain fluid balance. As CKD advances, it can significantly affect urinary elimination, with patients experiencing reduced urine output, fluid retention, and electrolyte imbalances. Nurses play a vital role in managing the symptoms of CKD and addressing the urinary elimination needs of these patients.
Assessment and Monitoring:
- Urinary Output Monitoring: In patients with CKD, urine output should be closely monitored to assess kidney function. Oliguria (low urine output) or anuria (absence of urine output) may be indicators of worsening kidney function. Nurses should regularly measure intake and output and report significant changes to the healthcare provider.
- Urine Characteristics: Nurses should assess the color, clarity, and odor of the urine, as changes may indicate an infection or the need for further intervention. For example, dark or cola-colored urine may suggest hematuria, while cloudy urine could indicate a urinary tract infection (UTI).
- Electrolyte Monitoring: CKD affects the kidney’s ability to regulate electrolytes such as potassium, sodium, and calcium. Nurses should assess laboratory values (e.g., serum creatinine, blood urea nitrogen, potassium levels) and notify the healthcare provider if abnormalities are detected.
Managing Fluid Balance:
- Fluid Restrictions: Many CKD patients require fluid restriction, particularly those in stages 4 and 5 of the disease. Nurses should educate patients on how to manage their fluid intake to prevent fluid overload. This may involve limiting beverages, providing small sips of water, and offering ice chips to help with thirst.
- Edema Management: Patients with CKD may develop peripheral or pulmonary edema due to fluid retention. Nurses should monitor for signs of edema, assess weight gain, and elevate the legs to reduce swelling. Diuretics may be prescribed to promote fluid excretion, and the nurse should monitor for their effectiveness.
Patient Education:
- Dietary Changes: Nurses should educate patients on the importance of a kidney-friendly diet. This typically includes restrictions on protein, potassium, and phosphorus intake to reduce kidney workload and prevent complications like hyperkalemia.
- Medication Adherence: Patients with CKD often require medications to manage symptoms such as hypertension or fluid retention. Nurses should educate patients about the importance of adhering to prescribed medications and attending regular follow-up visits to monitor kidney function.
- Dialysis Education: For patients with advanced CKD, dialysis may be required. Nurses play an essential role in educating patients about the different types of dialysis, including hemodialysis and peritoneal dialysis, and helping them manage the psychological and emotional impact of needing dialysis.
Collaboration and Referral: Nurses collaborate with nephrologists, dietitians, and social workers to provide comprehensive care for CKD patients. Timely referral to a nephrologist for potential dialysis consideration and managing complications is critical to improving outcomes for these patients.
By providing individualized care and education, nurses can help CKD patients manage their urinary elimination needs, promote optimal fluid balance, and improve quality of life.
Question:
Discuss the nursing interventions for a patient with a diagnosis of benign prostatic hyperplasia (BPH) and the impact it has on urinary elimination.
Answer:
Pathophysiology of Benign Prostatic Hyperplasia (BPH):
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which typically occurs in aging men. As the prostate enlarges, it compresses the urethra, which can obstruct urine flow. This obstruction leads to various urinary elimination issues, including difficulty initiating urination, weak urinary stream, frequency, urgency, nocturia, and incomplete bladder emptying. If left untreated, BPH can lead to acute urinary retention, urinary tract infections (UTIs), and kidney damage due to prolonged obstruction.
Nursing Interventions:
- Assessment: The nurse should assess the patient for symptoms of BPH, including changes in urinary patterns (e.g., frequency, urgency, and nocturia). Monitoring the patient’s voiding pattern, including any episodes of incomplete emptying or dribbling, is essential for evaluating the effectiveness of treatment.
- Medications: The nurse should administer medications as prescribed, which may include alpha-blockers (e.g., tamsulosin) to relax the prostate muscles and improve urine flow or 5-alpha reductase inhibitors (e.g., finasteride) to shrink the prostate. The nurse should monitor for side effects such as dizziness, hypotension, or sexual dysfunction.
- Catheterization: If the patient experiences acute urinary retention, the nurse may need to insert a catheter to relieve the bladder and prevent complications like bladder rupture or kidney damage. The nurse should ensure proper technique and follow infection control measures.
- Fluid Management: Nurses should educate the patient on fluid management, including avoiding excessive fluid intake before bedtime to reduce nocturia. Caffeine and alcohol, which can irritate the bladder, should also be limited.
- Post-operative Care (if surgery is performed): In cases where surgical intervention is necessary (e.g., transurethral resection of the prostate), the nurse will monitor the patient’s urinary output, ensure proper catheter care, and educate the patient on postoperative care to prevent complications such as bleeding, infection, or clot retention.
Patient Education:
- The nurse should educate the patient about BPH and its effects on urinary elimination, offering information on lifestyle changes (e.g., avoiding bladder irritants) and managing symptoms with medications or surgery.
- Patients should be instructed to practice double voiding, where they urinate, wait a few minutes, and then try again to ensure the bladder is fully emptied.
Question:
Explain the nursing care required for a patient undergoing dialysis in relation to urinary elimination and fluid balance.
Answer:
Dialysis and Its Impact on Urinary Elimination:
Dialysis is a life-saving procedure used for patients with end-stage renal disease (ESRD) when the kidneys can no longer effectively filter waste and regulate fluid balance. There are two types of dialysis: hemodialysis and peritoneal dialysis. Both methods help maintain fluid balance, electrolytes, and waste removal, but they can significantly impact urinary elimination, especially since many patients with ESRD have reduced or absent urine output.
Nursing Interventions for Dialysis Patients:
- Monitoring Fluid Balance:
Nurses must closely monitor fluid intake and output for dialysis patients. Because these patients often have little to no urine output, fluid retention is a significant concern. Nurses should weigh patients daily to track fluid retention and assess for signs of edema, especially in the legs and lungs. - Dialysis Access Site Care:
The nurse should inspect the dialysis access site (fistula or graft) for signs of infection, bleeding, or clotting. Any complications related to the access site can affect the patient’s treatment and urinary elimination. - Pre-Dialysis Assessment:
Before dialysis, the nurse must assess the patient for signs of fluid overload, such as shortness of breath, swelling, and elevated blood pressure. They should also ensure the patient is compliant with dietary and fluid restrictions to prevent complications during dialysis. - Post-Dialysis Care:
Post-dialysis, nurses should monitor the patient for hypotension, electrolyte imbalances, and signs of fluid depletion. If the patient experiences significant fluid shifts during dialysis, they may need extra monitoring to avoid complications like dizziness or fainting.
Patient Education:
- Nurses must educate patients about managing fluid intake between dialysis sessions. This includes avoiding high-sodium foods, restricting fluids, and monitoring signs of fluid retention.
- Patients should be informed about the importance of adhering to their prescribed diet, which often includes low-potassium and low-phosphorus foods to help prevent electrolyte imbalances.
- The nurse should also educate the patient on the dialysis process, what to expect during treatment, and the signs of complications (e.g., access site infection, cramping, or dizziness).
Question:
What are the common causes and nursing management strategies for a patient experiencing urinary incontinence?
Answer:
Causes of Urinary Incontinence:
Urinary incontinence (UI) refers to the involuntary loss of urine and can affect people of all ages. The most common causes include:
- Stress Incontinence: Often due to weakened pelvic floor muscles, which can result from childbirth, aging, or obesity. It typically occurs with physical activities like coughing, sneezing, or laughing.
- Urge Incontinence: Characterized by a sudden, intense urge to urinate followed by involuntary leakage. This is often related to bladder overactivity, which can be caused by neurological conditions such as stroke, dementia, or multiple sclerosis.
- Overflow Incontinence: Occurs when the bladder is unable to empty completely, leading to leakage due to bladder distension. This can be caused by conditions such as benign prostatic hyperplasia (BPH) in men or nerve damage.
- Functional Incontinence: Due to physical or cognitive limitations that prevent a person from reaching the bathroom in time, such as in patients with severe arthritis or dementia.
Nursing Management Strategies:
- Assessment and Diagnosis:
The nurse should conduct a thorough assessment, including a detailed history of the patient’s incontinence episodes, frequency, and triggers. A physical exam to assess for pelvic floor weakness, bladder distension, or neurological deficits may also be necessary. - Bladder Training and Scheduled Voiding:
For patients with urge or functional incontinence, bladder training can be an effective intervention. This involves scheduled voiding to gradually increase the interval between urination. This technique helps retrain the bladder to hold urine for longer periods. - Pelvic Floor Muscle Exercises (Kegel Exercises):
For stress incontinence, the nurse can teach patients Kegel exercises to strengthen the pelvic floor muscles. These exercises help improve the muscle tone of the pelvic region, reducing the occurrence of incontinence. - Medications:
Depending on the type of incontinence, medications may be prescribed. For urge incontinence, anticholinergic drugs (e.g., oxybutynin) may be used to reduce bladder spasms. For stress incontinence, topical estrogen or alpha-agonists may be recommended. - Behavioral Interventions:
Nurses should advise patients to reduce bladder irritants, such as caffeine, alcohol, and spicy foods, and ensure they maintain a healthy weight, which can reduce the strain on pelvic muscles. - Incontinence Products and Devices:
For patients who require additional support, the nurse should introduce products such as absorbent pads, adult diapers, or external catheters to manage leakage. Nurses should ensure that the patient is comfortable with these products and that they are used appropriately to maintain dignity.
Patient Education:
- Nurses should educate patients about the different types of incontinence and the available treatments, including lifestyle modifications, pelvic exercises, and medications. Patients should be encouraged to practice good hygiene and maintain skin integrity, particularly if they are using absorbent products, to prevent skin breakdown.