Set 10

Question 1

How many mL of urinary output per day is considered normal?

Answer 1

1500 mL (1.5 L)

Question 2

Alert the provider if urine is less than ___ mL/hr

Answer 2

30

Question 3

Concentration of urine

Answer 3

Urine specific gravity

Question 4

Normal range for urine specific gravity

Answer 4

1.005-1.030

Question 5

Low specific gravity = __________ urine

Answer 5

Dilute

Question 6

High specific gravity = _________ urine

Answer 6

Concentrated

Question 7

Patient education for 24 hour urine collection

Answer 7

Discard the first void of the day; keep container refrigerated

Question 8

Leakage of urine as a result of intra-abdominal pressure (coughing, sneezing, jumping, laughing)

Answer 8

Stress incontinence

Question 9

Who is most at risk for stress incontinence?

Answer 9

Patients who have multiple pelvic surgeries or pregnancies/deliveries due to weakened pelvic floor

Question 10

Type of incontinence characterized by inability to make it to the bathroom when there is an urge to urinate

Answer 10

Urge incontinence

Question 11

Who is most at risk for urinary tract infections?

Answer 11

Females due to shorter urethra

Question 12

S/S of UTI

Answer 12

Abdominal pain, dysuria (painful urination), frequency, urgency burning, malodorous urine

Question 13

Key signs of UTI in older adults

Answer 13

Confusion and abdominal pain (may not present with classical symptoms)

Question 14

Patient education for prevention of UTI

Answer 14

• wipe front to back
• wear cotton underwear
• avoid bubble baths
• empty bladder regularly
• urinate after penetrative vaginal intercourse
• increase fluid intake; cranberry juice

Question 15

Placement of bladder scanner transducer

Answer 15

Approximately 1 in above the pubic symphysis pointed down towards bladder

Question 16

Biggest concern for patients with indwelling (foley) catheter

Answer 16

Risk for catheter-associated UTI (CAUTI)

Question 17

Biggest risk associated with external catheters

Answer 17

Skin breakdown

Question 18

Indwelling catheter care

Answer 18

• use STERILE technique during insertion
• keep bag below bladder
• assess for kinks/loops
• remove as soon as appropriate

Question 19

The nurse should educate constipated patients to increase

Answer 19

Fluids, dietary fiber, activity

Question 20

BRAT diet for diarrhea

Answer 20

Bananas, rices, applesauce, toast

Question 21

Patients with diarrhea are at risk for

Answer 21

Fluid volume deficit (increase fluid intake), impaired skin integrity

Question 22

Surgical openings that divert the normal passage of the bowel

Answer 22

Ostomies

Question 23

Surgical opening created in the ileum of the small intestine

Answer 23

Ileostomy

Question 24

Describe output from an ileostomy

Answer 24

Frequent, liquidy stools

Question 25

Surgical opening created in the colon/large intestine

Answer 25

Colostomy

Question 26

Describe the output of colostomies depending on location

Answer 26

Output is going to be more formed the closer it is to the rectum: - ascending colon — watery - transverse colon — semisolid, pudding-like consistency - sigmoid colon — formed stool

Question 27

When should ostomy bags be changed?

Answer 27

When it is 1/3 full or immediately if it is leaking

Question 28

Characteristics of a normal, healthy stomach

Answer 28

Red/pink in color, moist (indicates good blood supply)

Question 29

Stoma findings that should be reported to the provider

Answer 29

Pale, cool, dusky, blue (indicative of ischemia)

Question 30

Part of ostomy device that sticks to the patient’s skin

Answer 30

Wafer

Question 31

Patient education for cutting/fitting of ostomy wafer

Answer 31

- measure stoma - cut opening less than or equal to 1/8 inch wider in diameter

Question 32

Insertion of rectal suppository

Answer 32

- patient in sims position - insert suppository about 1 inch into rectum (past the internal sphincter)

Question 33

Enema solution should be less than or equal to ___ inches above the patient

Answer 33

18

Question 34

What should the nurse do if patient complains of cramping during instillation of enema?

Answer 34

Lower the bag (slows rate of delivery)

Question 35

The nurse should instruct the patient receiving an enema to resist the urge to toilet for approximately ___ minutes or as prescribed per order

Answer 35

10

Question 36

Testing for the presence of blood in the feces that is not seen

Answer 36

Fecal occult blood test

Question 37

For fecal occult blood testing, blood is present if the card turns __________ after developer is added

Answer 37

Blue (NOTE: no color change in the absence of blood)