Nokea
One quick and common way to get a lot of data about urine is by
- A. Dipping litmus paper into the urine to determine pH.
- B. Adding special stains to see if there are white blood cells in the urine.
- C. Testing the urine with a multiple-pad reagent stick.
- D. Observing the urine for color and clarity.
Correct Answer: C
Rationale: A multiple-pad reagent stick (dipstick) provides rapid data on urine pH, glucose, protein, blood, and other parameters.
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Your patient has a glomerular filtration rate (GFR) of 45 mL/min over a 3-month period. What does this tell you about her kidney function?
- A. She has chronic kidney disease.
- B. She is in renal failure.
- C. She has a kidney infection.
- D. Nothing; only BUN and creatinine levels can give information about kidney function.
Correct Answer: A
Rationale: A GFR of 45 mL/min over 3 months indicates chronic kidney disease (stage 3), as it reflects persistently reduced kidney function.
You will need to push back the foreskin before catheterizing uncircumcised males. After you catheterize the patient, you should
- A. Pull the foreskin back over the glans.
- B. Leave the foreskin retracted.
- C. Lubricate the foreskin with petroleum jelly and then replace it.
- D. Elevate the penis on a folded towel to prevent swelling of the foreskin or glans.
Correct Answer: A
Rationale: Replacing the foreskin over the glans after catheterization prevents paraphimosis, a condition where the retracted foreskin causes swelling.
You are caring for a patient who sustained a spinal cord injury 14 years ago. Two days ago, the health-care provider inserted an indwelling urinary catheter, size 18 Fr, which is to remain in place for several weeks to allow pressure ulcers to heal. The patient has had catheters off and on for many years. You note that urine is leaking around the catheter insertion site and that the patient's meatus is getting red and irritated. Which of the following actions represents the nursing interventions most likely to resolve this situation?
- A. Request medication to calm bladder spasms, which are probably the cause of the leakage.
- B. Obtain an order to remove the current catheter and replace it with a size 22 Fr catheter.
- C. Obtain an order to replace the current catheter with a size 14 Fr catheter.
- D. Obtain an order to remove the current catheter and replace it with a condom catheter.
Correct Answer: C
Rationale: A smaller catheter (14 Fr) may reduce irritation and leakage, as a larger catheter can cause pressure and inflammation at the meatus.
Functional incontinence
- A. Incontinence related to inability to get to the bathroom
- B. The brain does not receive a message that the bladder is full
- C. Incontinence related to bladder spasms and contractions
- D. The bladder does not empty because of an obstruction
- E. Incontinence related to weak pelvic floor muscles
- F. Loss of urine with no warning
Correct Answer: A
Rationale: Functional incontinence results from physical or cognitive inability to reach the bathroom in time.
You are delegating the task of monitoring the output of an elderly male patient at risk for oliguria. He has an indwelling catheter in place. Which is the most appropriate direction for you to give to an unlicensed assistant?
- A. Tell me if his urine output decreases.
- B. Keep an eye on his output for me.
- C. Check his output halfway through the shift and let me know the total.
- D. Check his output after 2 hours. If it is not above 60 mL, let me know immediately.
Correct Answer: D
Rationale: Specific instructions to check output every 2 hours and report if it falls below 60 mL ensure timely detection of oliguria, which requires immediate attention.