Urinary System

Every question here, with the answer

1. A nurse is teaching a patient about how the kidneys help maintain the body’s internal balance. Which functions should the nurse attribute to the kidneys? Select all that apply.

   1. Filtering waste and excess substances from the blood to form urine
   2. Storing urine prior to regulated expulsion from the body
   3. Regulating fluid and electrolyte balance
   4. Transporting urine from each kidney to the urinary bladder
   5. Aiding in the activation of vitamin D for calcium and phosphorus metabolism

   Answer: Filtering waste and excess substances from the blood to form urine, Regulating fluid and electrolyte balance, Aiding in the activation of vitamin D for calcium and phosphorus metabolism

   The kidneys filter blood to form urine, help regulate fluid and electrolyte balance, and aid in vitamin D activation. Storing urine is the bladder’s role, and transporting urine from the kidney to the bladder is the ureter’s role.

2. A patient reports feeling the need to void as the bladder fills. Which explanation by the nurse best describes the normal physiologic trigger for this sensation?

   1. Stretch receptors in the bladder wall send signals to the central nervous system.
   2. The external urethral sphincter contracts to initiate urine expulsion.
   3. The renal pelvis signals the ureter to begin urine transport.
   4. The glomerular membrane releases proteins and blood cells into the filtrate.

   Answer: Stretch receptors in the bladder wall send signals to the central nervous system.

   As the bladder fills, stretch receptors in its wall signal the central nervous system that voiding is needed. The renal pelvis directs urine into the ureter, the glomerular membrane retains larger molecules, and external sphincter relaxation—not contraction—allows urine release.

3. A patient asks why useful substances in the initial filtrate are not normally lost in the urine. Which process should the nurse explain?

   1. Glomerular filtration forces water, electrolytes, and small molecules out of the blood.
   2. Peristaltic contractions move urine in one direction toward the bladder.
   3. Tubular secretion moves excess ions, drugs, and metabolic by-products into the renal tubules.
   4. Tubular reabsorption returns water, glucose, ions, and other needed molecules to the bloodstream.

   Answer: Tubular reabsorption returns water, glucose, ions, and other needed molecules to the bloodstream.

   Tubular reabsorption selectively reclaims substances the body needs from the filtrate back into the bloodstream. Filtration creates the initial filtrate, secretion adds substances for elimination, and ureteral peristalsis transports urine rather than reclaiming substances.

4. A nurse is reviewing the normal voiding stage with a patient who wants to understand how urine leaves the bladder. Which events occur during the voiding stage? Select all that apply.

   1. The detrusor muscle contracts more forcefully.
   2. The parasympathetic nervous system becomes more active.
   3. The bladder remains in a relatively inactive state while urine accumulates.
   4. The internal urethral sphincter relaxes involuntarily.
   5. The external urethral sphincter is voluntarily relaxed.

   Answer: The detrusor muscle contracts more forcefully., The parasympathetic nervous system becomes more active., The internal urethral sphincter relaxes involuntarily., The external urethral sphincter is voluntarily relaxed.

   During voiding, parasympathetic activity increases, the detrusor contracts more forcefully, the internal sphincter relaxes involuntarily, and the person voluntarily relaxes the external sphincter. A relatively inactive bladder that is accumulating urine describes the resting stage, not voiding.

5. A nurse is explaining how the bladder’s anatomy helps prevent urine from moving backward toward the kidneys. Which structure should the nurse identify?

   1. The external urethral sphincter
   2. The renal cortex
   3. The renal artery
   4. The trigone

   Answer: The trigone

   The trigone acts as a physiological valve that helps prevent reflux of urine into the ureters. The renal cortex and renal artery are kidney structures, and the external urethral sphincter regulates urine flow rather than preventing reflux into the ureters.

6. An older adult asks which urinary changes can occur with aging. Which changes should the nurse include? Select all that apply.

   1. Weakened pelvic floor muscles that can contribute to urinary incontinence
   2. Increased bladder capacity with greater tolerance for larger fluid volumes
   3. In males, an enlarged prostate that can make it difficult to initiate and maintain a steady urine stream
   4. Nocturnal urination that can disrupt sleep patterns
   5. A slowed micturition reflex that can delay initiating urination

   Answer: Weakened pelvic floor muscles that can contribute to urinary incontinence, In males, an enlarged prostate that can make it difficult to initiate and maintain a steady urine stream, Nocturnal urination that can disrupt sleep patterns, A slowed micturition reflex that can delay initiating urination

   Aging is associated with decreased bladder capacity, weakened pelvic floor muscles, nocturia, a slower micturition reflex, and in males, possible benign prostatic hyperplasia affecting the urine stream. Increased bladder capacity and greater tolerance for larger fluid volumes are the opposite of the age-related change described.