Prep U Chapter 55

Which type of incontinence refers to the involuntary loss of urine due to extrinsic medical factors, particularly medications? Overflow Iatrogenic Urge Reflex

Iatrogenic

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report? "Have you had a fever and chills?" "How much fluid are you drinking?" "Do you get up at night to urinate?" "When did you last urinate?"

"When did you last urinate?"

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective? Cipro Septra Bactrim Macrodantin

Cipro

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence? Bladder irritation related to urinary tract infections Obstruction due to fecal impaction or enlarged prostate Decreased pelvic muscle tone due to multiple pregnancies Increased urine production due to metabolic conditions

Decreased pelvic muscle tone due to multiple pregnancies

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder? Incontinence Frequency Hematuria Dysuria

Hematuria

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? Detects calculi, cysts, or tumors If risk for chronic pyelonephritis is likely Shows damage to the kidneys Reveals causative microorganisms

Detects calculi, cysts, or tumors

The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which factor as contributing to UTIs in older adults? Low incidence of chronic illness Immunocompromise Sporadic use of antimicrobial agents Active lifestyle

Immunocompromise

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to: Uninhibited detrusor contractions. Loss of motor control of the detrusor muscle. A stricture or tumor in the bladder. Compromised ligament and pelvic floor support of the urethra.

Loss of motor control of the detrusor muscle.

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action? Maintain skin and stomal integrity. Suggest a visit to a local ostomy group. Determine the client's ability to manage stoma care. Show pictures and drawings of placement of the stoma

Maintain skin and stomal integrity.

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply. For those patients who are incontinent, insert indwelling catheters. Encourage patients to wear briefs. Perform hand hygiene prior to patient care. Provide careful perineal care. Assist the patients with frequent toileting.

Perform hand hygiene prior to patient care. Provide careful perineal care. Assist the patients with frequent toileting.

The nurse is assessing the client's ileal conduit stoma in the clinic. Which assessment finding would be of greatest concern to the nurse? The stoma is dusky red. Yellow urine is draining from the stoma. The skin surrounding the stoma is red. The urine has an ammonia odor.

The stoma is dusky red.

Which of the following is the most common site of a nosocomial infection? Urinary tract Gastrointestinal tract Respiratory tract Skin

Urinary tract

Bladder retraining following removal of an indwelling catheter begins with advising the client to avoid urinating for at least 6 hours. performing straight catheterization after 4 hours. encouraging the client to void immediately. instructing the client to follow a 2- to 3-hour timed voiding schedule.

instructing the client to follow a 2- to 3-hour timed voiding schedule.

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? Assessing present voiding patterns Restricting fluid intake to reduce the need to void Establishing a predetermined fluid intake pattern for the client Encouraging the client to increase the time between voidings

Assessing present voiding patterns

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? It's an abnormal finding that will correct itself when the client ambulates. It's an abnormal finding that requires further assessment. It's a normal finding associated with the client's nothing-by-mouth status. It's a normal finding caused by blood loss during surgery.

It's an abnormal finding that requires further assessment.

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program? Smoking habits Medication usage History of allergies Occupational history

Medication usage

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation? Importance of urinating every 4 to 6 hours while awake Suggestion to take tub baths instead of showers Need to wear underwear made from synthetic material Need to urinate after engaging in sexual intercourse

Need to urinate after engaging in sexual intercourse

Which of the following nursing actions is most important in caring for the client following lithotripsy? Notify the physician of hematuria. Monitor the continuous bladder irrigation. Administer allopurinol (Zyloprim). Strain the urine carefully for stone fragments.

Strain the urine carefully for stone fragments.

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections? The urethra The ureters The rectum The bladder

The urethra

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? Stress Overflow Functional Urge

Urge

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? Ureteral stricture Urinary calculi Acute glomerulonephritis Renal cell carcinoma

Urinary calculi

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction? Bladder stones Cystitis Urethral stricture Urinary retention

Urinary retention

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to: assess whether the client is a good candidate for surgery. assess suicidal risk postoperatively. help the client cope with the anxiety associated with changes in body image. evaluate the client's need for mental health intervention.

help the client cope with the anxiety associated with changes in body image.

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? "My urine will be eliminated with my feces." "I will not need to worry about being incontinent of urine." "My urine will be eliminated through a stoma." "A catheter will drain urine directly from my kidney."

"My urine will be eliminated through a stoma."

Which objective symptom of a UTI is most common in older adults, especially those with dementia? Hematuria Incontinence Change in cognitive functioning Back pain

Change in cognitive functioning

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively? History of allergy to iodine and seafood Dietary habits involving cholesterol-laden food Client's manual dexterity and vision Menstrual history

Client's manual dexterity and vision

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client? Fruit juice midmorning Coffee in the morning Milk at lunch Ginger ale at dinner time

Coffee in the morning

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal? Prevent nephron destruction. Determine the stone type. Relieve the pain. Relieve any obstruction.

Relieve the pain.

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis? Risk for fluid volume excess Risk for deficient knowledge: self-catherization Risk for infection Risk for altered urinary elimination

Risk for infection

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site? Urethra Kidney Bladder Ureter

kidney

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest? A low-sodium diet A diet high in fruits and vegetables A diet high in calcium A low-purine diet

A low-purine diet

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor? Client with a history of cigarette smoking Client with a history of untreated gonorrhea Client with a history of a sexually transmitted disease Client with a history of bladder inflammation

Client with a history of cigarette smoking

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention? Secure or patch it with barrier paste. Empty the pouch. Secure or patch it with tape. Change the wafer and pouch.

Change the wafer and pouch.

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? Drink coffee or tea to increase diuresis. Void every 4 to 6 hours. Use tub baths as opposed to showers. Drink liberal amount of fluids.

Drink liberal amount of fluids.

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem? urinary retention urinary tract infection urethral strictures urinary incontinence

urinary tract infection

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? Low oxalate Low purine High protein High sodium

Low purine

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? Stress Reflex Overflow Urge

Stress

Which statement describing urinary incontinence in an older adult client is true? Urinary incontinence is a normal part of aging. Urinary incontinence is a disease. Urinary incontinence isn't a disease. Urinary incontinence in the elderly population can't be treated.

Urinary incontinence isn't a disease.