Nurs 200 - Exam 2 - Chapter 43: Urinary Elimination

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4. The first voided urine of the day is usually ____ concentrated than other urine excreted during the day.

More

Less

Equally

p. 1488

Explanation

p. 1488

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7. As one ages is there an increase or decrease in the sensation of thirst?

As one ages, there is typically a decrease in the sensation of thirst. This is due to various factors such as a decrease in the body's ability to conserve water, a decrease in the number of thirst receptors in the brain, and a decrease in the body's overall water content. Additionally, older adults may not feel thirsty even when they are dehydrated, which can put them at a higher risk for dehydration. Therefore, it is important for older individuals to be mindful of their fluid intake and drink water regularly, even if they do not feel thirsty.

Explanation

As one ages, there is typically a decrease in the sensation of thirst. This is due to various factors such as a decrease in the body's ability to conserve water, a decrease in the number of thirst receptors in the brain, and a decrease in the body's overall water content. Additionally, older adults may not feel thirsty even when they are dehydrated, which can put them at a higher risk for dehydration. Therefore, it is important for older individuals to be mindful of their fluid intake and drink water regularly, even if they do not feel thirsty.

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8. A nurse can test urine for the presence of glucose, blood, protein, bilirubin, and bacteria.

True

False

p. 1497

Explanation

p. 1497

9. Surgery is the first line of therapy for urinary incontience

True

False

Noninvasive, low-risk vehavioural interventions are the first line of therapy. (p. 1507)

Explanation

Noninvasive, low-risk vehavioural interventions are the first line of therapy. (p. 1507)

10. The involuntary losso fo urine that occurs soon after feeling an urgent need to void is called:

Mixed incontience

Stress incontinence

Over-flow incontience

Urge incontinence

None of the above

Urge incontinence is the correct answer because it refers to the involuntary loss of urine that happens after feeling a strong and sudden urge to urinate. This condition is often caused by an overactive bladder, where the bladder muscles contract too frequently or unexpectedly. It can be triggered by various factors such as certain medications, urinary tract infections, or neurological conditions. Urge incontinence is different from stress incontinence, which is the leakage of urine during physical activities or when pressure is exerted on the bladder. Mixed incontinence refers to a combination of both urge and stress incontinence. Overflow incontinence is the inability to completely empty the bladder, resulting in constant dribbling or frequent leakage.

Explanation

Urge incontinence is the correct answer because it refers to the involuntary loss of urine that happens after feeling a strong and sudden urge to urinate. This condition is often caused by an overactive bladder, where the bladder muscles contract too frequently or unexpectedly. It can be triggered by various factors such as certain medications, urinary tract infections, or neurological conditions. Urge incontinence is different from stress incontinence, which is the leakage of urine during physical activities or when pressure is exerted on the bladder. Mixed incontinence refers to a combination of both urge and stress incontinence. Overflow incontinence is the inability to completely empty the bladder, resulting in constant dribbling or frequent leakage.

11. Patients can be taught to insert and remove intermittent catheterse themselves

True

False

p. 1509

Explanation

p. 1509

12. True or False:
When collecting a urine sample, the first voided urine of the day is not collected because it is considered not to be fresh urine.

The first voided urine of the day is not collected because it is considered not to be fresh urine. This is because overnight, urine can accumulate in the bladder and mix with any remaining urine from the previous day, which may affect the accuracy of certain tests. Therefore, it is recommended to collect a midstream urine sample after discarding the first portion to ensure a more accurate representation of the current urine composition.

Explanation

The first voided urine of the day is not collected because it is considered not to be fresh urine. This is because overnight, urine can accumulate in the bladder and mix with any remaining urine from the previous day, which may affect the accuracy of certain tests. Therefore, it is recommended to collect a midstream urine sample after discarding the first portion to ensure a more accurate representation of the current urine composition.

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13. Obtaining a specimen for routine uralysis requires ____ technique

Medical aseptic technique

Sterile technique

Surgical technique

A routine uralysis does not require a sterile urine specimen (p. 1492)

Explanation

A routine uralysis does not require a sterile urine specimen (p. 1492)

14. According to the textbook, to pee is also known as

Micturation

Urination

Voiding

All of the above

None of the above

p. 1488

Explanation

p. 1488

15. Diuretics are commonly used in the treatment of:

Low blood pressure

High blood pressure

Low blood sugar

High blood sugar

None of the above

p. 1490

Explanation

p. 1490

16. Which of the following does not affect urination in older adults?

Medications

Decreased bladder contractility

Extent of ability in the kidneys

Motility problems

None of the above

p. 1489

Explanation

p. 1489

17. Difficulty during urination is known as____; while scanty or diminshed amount urine is known as _____

Dysuria; Anuria

Anuria; Oliguria

Dysuria; Oliguria

Oliguria; Pyuria

Pyuria; Dysuria

p. 1491

Explanation

p. 1491

18. Diuresis is also known as

Glycosuria

Pyuria

Anuria

Oliguria

Polyuria

p. 1491

Explanation

p. 1491

19. How many nephrons are in each kidney?

1,000

100,000

1 million

1 billion

None of the above

p. 1485

Explanation

p. 1485

20. Some causes of decreased muscles tone does not include which of the following:

Muscle atrophy

Exercise

Trauma

Foley catheter

Immobility

p. 1489

Explanation

p. 1489

21. Overflow incontience is:

Continuous and unpredicaable loss of urine, resulting from surger, physical malformation, or trauma.

The involuntary loss of urine that occurs soon after feeling an urgency to void

Urine loss caused by the inability to reach the toilet

Experiencing emptying of the bladder without the sensation of the need to void

The involunary loss of urine associated with overdistension of the bladder

p. 1507

Explanation

p. 1507

22. What type of catheter is used for continuous drainage through the urethra?

Indwelling urethral catheter

Retention catheter

Foley catheter

All of the above

None of the above

p. 1509

Explanation

p. 1509

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25. True or False:
Most people void during sleeping hours

This statement is false. Most people do not void (urinate) during their sleeping hours. The body typically reduces urine production and increases the production of an antidiuretic hormone called vasopressin at night, which helps in reducing the need to urinate during sleep. However, some individuals may have medical conditions or habits that cause them to wake up and void during the night. Overall, it is not a common occurrence for most people.

Explanation

This statement is false. Most people do not void (urinate) during their sleeping hours. The body typically reduces urine production and increases the production of an antidiuretic hormone called vasopressin at night, which helps in reducing the need to urinate during sleep. However, some individuals may have medical conditions or habits that cause them to wake up and void during the night. Overall, it is not a common occurrence for most people.

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26. Proteinuria is:

An indication of kidney disease

Defined by the presence of proteinin urine

Marked by the presence of sugar in urine

B and C

A and B

p. 1491

Explanation

p. 1491

27. When assessing a patient's urine, check all of the following, but do not note:

Colour of urine

Odour of urine

Sugar in urine

Clarity of urine

Sediment in urine

p. 1492

Explanation

p. 1492

28. The surgical creation of an alternate route for excretion of urine is called

Urinary diversion refers to the surgical procedure that creates an alternative pathway for the excretion of urine. This procedure is typically performed when the normal route for urine excretion is blocked or damaged, such as in cases of bladder cancer or urinary tract obstruction. Urinary diversion can involve rerouting the urine to a stoma, a surgically created opening on the abdominal wall, or creating a new bladder using a segment of the intestine. This allows the urine to bypass the affected organs and be excreted through a different route.

Explanation

Urinary diversion refers to the surgical procedure that creates an alternative pathway for the excretion of urine. This procedure is typically performed when the normal route for urine excretion is blocked or damaged, such as in cases of bladder cancer or urinary tract obstruction. Urinary diversion can involve rerouting the urine to a stoma, a surgically created opening on the abdominal wall, or creating a new bladder using a segment of the intestine. This allows the urine to bypass the affected organs and be excreted through a different route.

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30. The higher the number on the urometer the lower the urine concentration and specific gravity.

True

False

p. 1499

Explanation

p. 1499

31. When higher nerve centers develop early in life, the _____ control of micturation develops.

When higher nerve centers develop early in life, the voluntary control of micturation develops. This means that as the brain and nervous system develop, an individual gains the ability to consciously control the process of urination. This control allows them to hold in urine when necessary and release it at appropriate times. This development of voluntary control is an important milestone in a child's development and is typically achieved during early childhood.

Explanation

When higher nerve centers develop early in life, the voluntary control of micturation develops. This means that as the brain and nervous system develop, an individual gains the ability to consciously control the process of urination. This control allows them to hold in urine when necessary and release it at appropriate times. This development of voluntary control is an important milestone in a child's development and is typically achieved during early childhood.

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34. Weakening of which muscles is a common cause of urinary incontinence.

Weakness in the pelvic floor muscles can lead to urinary incontinence. The pelvic floor muscles play a crucial role in supporting the bladder and controlling the release of urine. When these muscles are weakened, they may not be able to properly hold urine, resulting in leakage or urinary incontinence. Therefore, weakness in the pelvic floor muscles is a common cause of urinary incontinence.

Explanation

Weakness in the pelvic floor muscles can lead to urinary incontinence. The pelvic floor muscles play a crucial role in supporting the bladder and controlling the release of urine. When these muscles are weakened, they may not be able to properly hold urine, resulting in leakage or urinary incontinence. Therefore, weakness in the pelvic floor muscles is a common cause of urinary incontinence.

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35. What is the most common organismal cause of urinary tract infections?

Staphylococcus aureus

Being sexually active

Diabetes mellitus

Escherichia coli

A and C

p. 1504

Explanation

p. 1504

36. A culture and sensitivity (C&S) is considered positive if it shows at least 10,000 organisms per mL of urine.

True

False

A C&S would be considered positive if it showed at least 100,000 organisms per mL

Explanation

A C&S would be considered positive if it showed at least 100,000 organisms per mL

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40. Catheter lumens are graded on a:

Credes (C) scale

French (F) scale

Kegel (K) scale

All of the above

None of the above

The correct answer is French (F) scale. The French scale is used to measure the diameter of catheter lumens. It is a numerical scale that indicates the size of the catheter, with larger numbers representing larger diameters. The Credes scale is not related to catheter lumens, but rather refers to a technique used in urology to assist with bladder emptying. The Kegel scale is also unrelated to catheter lumens, but instead refers to exercises used to strengthen the pelvic floor muscles. Therefore, the correct answer is the French (F) scale.

Explanation

The correct answer is French (F) scale. The French scale is used to measure the diameter of catheter lumens. It is a numerical scale that indicates the size of the catheter, with larger numbers representing larger diameters. The Credes scale is not related to catheter lumens, but rather refers to a technique used in urology to assist with bladder emptying. The Kegel scale is also unrelated to catheter lumens, but instead refers to exercises used to strengthen the pelvic floor muscles. Therefore, the correct answer is the French (F) scale.

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42. With micturation, the pressure within the bladder is _____ to the the pressure with the bladder is filling.

Less than

Greater than

Equal to

p. 1488

Explanation

p. 1488

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45. What type of medication can lighten the colour of urine to pale yellow?

Diuretics are medications that increase the production of urine. They work by causing the kidneys to remove excess water and salt from the body. This increased urine production can dilute the concentration of substances in the urine, resulting in a lighter color. Therefore, diuretics can lighten the color of urine to pale yellow.

Explanation

Diuretics are medications that increase the production of urine. They work by causing the kidneys to remove excess water and salt from the body. This increased urine production can dilute the concentration of substances in the urine, resulting in a lighter color. Therefore, diuretics can lighten the color of urine to pale yellow.

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46. Which of the following is synonymous with a 24-hour output of less than 50 mL of urine?

Renal failure

Kidney shutdown

Anuria

All of the above

None of the above

The correct answer is "All of the above." This means that all of the options listed - renal failure, kidney shutdown, and anuria - are synonymous with a 24-hour output of less than 50 mL of urine. Renal failure refers to the inability of the kidneys to properly filter waste from the blood, resulting in decreased urine output. Kidney shutdown is another way to describe the same condition, where the kidneys cease to function effectively. Anuria specifically refers to the absence of urine production. Therefore, all three terms are interchangeable in this context.

Explanation

The correct answer is "All of the above." This means that all of the options listed - renal failure, kidney shutdown, and anuria - are synonymous with a 24-hour output of less than 50 mL of urine. Renal failure refers to the inability of the kidneys to properly filter waste from the blood, resulting in decreased urine output. Kidney shutdown is another way to describe the same condition, where the kidneys cease to function effectively. Anuria specifically refers to the absence of urine production. Therefore, all three terms are interchangeable in this context.

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48. Normally, the kidneys _____ be palpated, generally requring ______ palpation.

Can't; electronic

Can; light

Can; superficial

Can; deep

Can; electronic

p. 1491

Explanation

p. 1491

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50. If a stoma is dark or purple-blue it suggests:

Anemia

Ischemia

Compromised circulation

A and C

B and C

p. 1517

Explanation

p. 1517

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53. Voiding is largely a(n) voluntary/involuntary reflex?

Voiding is largely an involuntary reflect act but its control can be learned (p. 1488)

Explanation

Voiding is largely an involuntary reflect act but its control can be learned (p. 1488)

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55. The technique that requires a sampe obtained by catheterizing the patient's bladder or by use of an foley catheter is a:

Sterile specimen

Routine uralysis specimen

Clean-catch specimen

Midstream specimen

Catheter specimen

A sterile specimen is obtained by catheterizing the patient's bladder or using a foley catheter. This technique ensures that the sample is free from contamination and is suitable for diagnostic purposes where a high level of accuracy is required. It is commonly used in situations where the patient cannot provide a clean-catch specimen or when there is a need to directly access the bladder.

Explanation

A sterile specimen is obtained by catheterizing the patient's bladder or using a foley catheter. This technique ensures that the sample is free from contamination and is suitable for diagnostic purposes where a high level of accuracy is required. It is commonly used in situations where the patient cannot provide a clean-catch specimen or when there is a need to directly access the bladder.

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57. A _____ _____ is a cutaneous urinary diversion. It involves a surgical resection of the small intestine, with transplantation of the ureters to the isolated segment of small bowel. This separated section of th esmall intestine is then brought to the This diversion requires external appliances to collect the urine.

An ileal conduit is a surgical procedure that involves removing a section of the small intestine and using it as a pathway for urine to exit the body. The ureters, which carry urine from the kidneys to the bladder, are transplanted into this isolated segment of the small bowel. The separated section of the small intestine, known as the ileal conduit, is then brought to the surface of the abdomen. External appliances, such as a bag or pouch, are needed to collect and contain the urine that is diverted through the ileal conduit.

Explanation

An ileal conduit is a surgical procedure that involves removing a section of the small intestine and using it as a pathway for urine to exit the body. The ureters, which carry urine from the kidneys to the bladder, are transplanted into this isolated segment of the small bowel. The separated section of the small intestine, known as the ileal conduit, is then brought to the surface of the abdomen. External appliances, such as a bag or pouch, are needed to collect and contain the urine that is diverted through the ileal conduit.

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58. A continent ___ is a surgical alternative that uses a section of the intestine to create an internal reservoire that holds urine. It uses an external stoma that must b e catheterized at regular intervals to drain the urine that has collected in the reservoir.

p. 1516

Explanation

p. 1516

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59. Which of the following is used as a manual bladder compression technique?

Kegel's maneuver

Crede's maneuver

Gravity's maneuver

All of the above

None of the above

p. 1503

Explanation

p. 1503

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62. Any involuntary loss of urine is known as

Urinary incontinence refers to the involuntary loss of urine, which can occur due to various factors such as weak bladder muscles, overactive bladder muscles, nerve damage, or hormonal changes. It is a common condition that can affect people of all ages, but is more prevalent in older adults. Symptoms of urinary incontinence can range from occasional leakage to a complete inability to control urination. Treatment options include lifestyle changes, pelvic floor exercises, medications, and in some cases, surgery.

Explanation

Urinary incontinence refers to the involuntary loss of urine, which can occur due to various factors such as weak bladder muscles, overactive bladder muscles, nerve damage, or hormonal changes. It is a common condition that can affect people of all ages, but is more prevalent in older adults. Symptoms of urinary incontinence can range from occasional leakage to a complete inability to control urination. Treatment options include lifestyle changes, pelvic floor exercises, medications, and in some cases, surgery.

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64. One should apply lubricant to a catheter before inserting it into a male patient.

True

False

Applying lubricant to the catheter before inserting it in a male patient is no longer recommended. Currently, the recommendation is to gently insert the tip of a syringe prefilled with lubricant into the male urethra before inserting the catheter. (p. 1513 - 1514)

Explanation

Applying lubricant to the catheter before inserting it in a male patient is no longer recommended. Currently, the recommendation is to gently insert the tip of a syringe prefilled with lubricant into the male urethra before inserting the catheter. (p. 1513 - 1514)

65. When micturation is initiated the ______ contracts, the _____ relaxes, and urine enters the posterior urethra. The muscles of the perineum and the _______ relax, the ______ contracts slightly, the _____ lowers, and micturation occurs.

Internal sphincter, detrusor muscle, external sphincter, abdominal muscles, diaphragm

Detrusor muscle, external sphincter, internal sphincter, abdominal muscles, diaphragm

Internal sphincter, detrusor muscle, external sphincter, diaphragm, abdominal muscles

Detrusor muscle, diaphragm, internal sphincter, abdominal muscles, external sphincter

Detrusor muscle, internal sphincter, external sphincter, abdominal muscles, diaphragm

p. 1488

Explanation

p. 1488

66. An indwelling catheter is usually preferred over suprapubic catheters for long-term continous drainage.

True

False

This is false because suprapubic catheters are often preferred over indwelling urethral catheters for long-term urinary drainage, because suprapubic catheteres are associated with decreased risk of contamination with organisms from fecal material, elimination of damage to the urethra, a higher rate of patient satisfaction, and a lower risk of catheter-associated urinary tract infection.

Explanation

This is false because suprapubic catheters are often preferred over indwelling urethral catheters for long-term urinary drainage, because suprapubic catheteres are associated with decreased risk of contamination with organisms from fecal material, elimination of damage to the urethra, a higher rate of patient satisfaction, and a lower risk of catheter-associated urinary tract infection.

67. The presence of sugar in the urine is known as

Glycosuria refers to the presence of sugar in the urine. This condition occurs when the blood sugar levels are abnormally high, causing the kidneys to excrete excess glucose into the urine. Normally, the kidneys reabsorb all the glucose from the filtrate, but when blood sugar levels are too high, the reabsorption capacity of the kidneys is exceeded, leading to the presence of glucose in the urine. Glycosuria can be a sign of uncontrolled diabetes or other conditions affecting glucose metabolism. Regular monitoring of blood sugar levels and appropriate treatment is necessary to manage glycosuria.

Explanation

Glycosuria refers to the presence of sugar in the urine. This condition occurs when the blood sugar levels are abnormally high, causing the kidneys to excrete excess glucose into the urine. Normally, the kidneys reabsorb all the glucose from the filtrate, but when blood sugar levels are too high, the reabsorption capacity of the kidneys is exceeded, leading to the presence of glucose in the urine. Glycosuria can be a sign of uncontrolled diabetes or other conditions affecting glucose metabolism. Regular monitoring of blood sugar levels and appropriate treatment is necessary to manage glycosuria.

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69. _____ is the amount of urine rematining in the bladder immediately after voiding, which can be measured by catheterization or use of portable ultrasound device.

Postvoid residual (PVR) refers to the amount of urine that remains in the bladder immediately after urination. This can be measured using catheterization or a portable ultrasound device. PVR is an important measurement as it helps to assess bladder emptying and can indicate if there is any urinary retention or dysfunction. Monitoring PVR levels can be particularly useful in diagnosing and managing conditions such as urinary incontinence, urinary tract infections, and bladder outlet obstruction.

Explanation

Postvoid residual (PVR) refers to the amount of urine that remains in the bladder immediately after urination. This can be measured using catheterization or a portable ultrasound device. PVR is an important measurement as it helps to assess bladder emptying and can indicate if there is any urinary retention or dysfunction. Monitoring PVR levels can be particularly useful in diagnosing and managing conditions such as urinary incontinence, urinary tract infections, and bladder outlet obstruction.

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72. In a Mitrofanoff procedure the bladder neck is closed and one end of the _____ is brought to the skin surface and is used as a stoma; the other end is tunneled into the bladder.

Appendix

Ileum

Stomach

Large intestine

None of the above

p. 1516

Explanation

p. 1516

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75. _____ is a delay or difficulty in initiating voiding.

Hesitancy is a delay or difficulty in initiating voiding, which refers to the process of starting to urinate. It can be caused by various factors such as an enlarged prostate, urinary tract infections, or nerve damage. Hesitancy can result in a weak or interrupted urine stream and a feeling of incomplete bladder emptying. On the other hand, "hesitency" is not a recognized term and does not have any meaning in relation to the given question.

Explanation

Hesitancy is a delay or difficulty in initiating voiding, which refers to the process of starting to urinate. It can be caused by various factors such as an enlarged prostate, urinary tract infections, or nerve damage. Hesitancy can result in a weak or interrupted urine stream and a feeling of incomplete bladder emptying. On the other hand, "hesitency" is not a recognized term and does not have any meaning in relation to the given question.

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76. Continuous and unpredicaable loss of urine, resulting from surger, physical malformation, or trauma is known as what type of incontience?

Total incontinence refers to the continuous and unpredictable loss of urine that occurs as a result of surgery, physical malformation, or trauma. This type of incontinence is characterized by the inability to control urination completely, leading to the constant leakage of urine. It is different from other types of incontinence, such as stress or urge incontinence, which may involve occasional or intermittent leakage. Total incontinence can significantly impact a person's quality of life and may require medical intervention or management strategies to address the underlying cause and improve symptoms.

Explanation

Total incontinence refers to the continuous and unpredictable loss of urine that occurs as a result of surgery, physical malformation, or trauma. This type of incontinence is characterized by the inability to control urination completely, leading to the constant leakage of urine. It is different from other types of incontinence, such as stress or urge incontinence, which may involve occasional or intermittent leakage. Total incontinence can significantly impact a person's quality of life and may require medical intervention or management strategies to address the underlying cause and improve symptoms.

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81. What are the three types of wastes that are characteristics of urine?

The three types of wastes that are characteristic of urine are organic wastes, inorganic wastes, and liquid wastes. Organic wastes refer to the waste products of metabolism, such as urea and uric acid. Inorganic wastes include electrolytes and other dissolved substances that need to be eliminated from the body. Liquid wastes refer to the water content of urine. Therefore, the correct answer includes all three types of wastes: organic, inorganic, and liquid.

Explanation

The three types of wastes that are characteristic of urine are organic wastes, inorganic wastes, and liquid wastes. Organic wastes refer to the waste products of metabolism, such as urea and uric acid. Inorganic wastes include electrolytes and other dissolved substances that need to be eliminated from the body. Liquid wastes refer to the water content of urine. Therefore, the correct answer includes all three types of wastes: organic, inorganic, and liquid.

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82. When the bladder fills to about ____ to ____ mL (in an adult) a person feels the diesire to void.

When the bladder fills to about 150 to 250 mL (in an adult), a person feels the desire to void. This means that when the volume of urine in the bladder reaches between 150 and 250 mL, the individual experiences the urge to urinate.

Explanation

When the bladder fills to about 150 to 250 mL (in an adult), a person feels the desire to void. This means that when the volume of urine in the bladder reaches between 150 and 250 mL, the individual experiences the urge to urinate.

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